Cognitive training and remediation interventions for substance use disorders: a Delphi consensus study

Abstract

Aims: Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training and remediation interventions are well suited to fill the gap for managing cognitive deficits in SUD. We aimed to reach consensus on recommendations for developing and applying these interventions. Design, Setting and Participants: We used a Delphi approach with two sequential phases: survey development and iterative surveying of experts. This was an on-line study. During survey development, we engaged a group of 15 experts from a working group of the International Society of Addiction Medicine (Steering Committee). During

Cognitive training interventions for substance use disorders: what they really offer?

“…It remains uncertain which changes can be expected from which CT protocol. Moreover, while certain cognitive impairments, like those in executive functions are often considered core to compulsive substance use, it is difficult to see how cognitive training and remediation could serve as treatments for SUD in and of themselves as is sometimes stated ( 1 ). Given the multifaceted and complex nature of addiction, it is still unclear how CT can affect various aspects of drug addiction, including its biological, psychological, and sociocultural determinants, and overcome their impacts in real-life settings.…”

“…The treatment burden associated with this issue is substantial, and any efficient approach that can aid in its management is valuable. Neuropsychological interventions, including cognitive training (CT), are increasingly being recognized as effective methods for addressing cognitive impairments associated with substance use disorders (SUD) ( 1 ).…”

A Comparative Event-Related Potentials Study between Alcohol Use Disorder, Gambling Disorder and Healthy Control Subjects through a Contextual Go/NoGo Task

“…Such a view has been conceptualized by Goldstein and Volkow [9,10] in the Impaired Response Inhibition and Salience Attribution (I-RISA) model, a model substantiated by many empirical behavioral studies, disclosing by means of numerous brain imaging studies specific impairments in six large-scale brain networks [11], and supporting behavioral as well as substance-related addictions [12]. As an add-on tool to psychotherapy, social support, and medication, such findings led to the consideration of these mechanisms as key targets to be rehabilitated in GD and AUD patients in order to promote abstinence and well-being [13].…”

The potential utility of evoked potentials in the treatment of mental illnesses

“…Among these techniques, electroencephalography (EEG) indexed spontaneous brain electrical activity, and included event-related potentials (ERPs), referring to epochs of EEG activity that are time-locked to the processing of stimuli (Rugg and Coles, 1995 ). Once mental diseases were also envisaged as resulting from brain alterations (Price et al ., 2000 ), a neurocognitive approach emerged, promoting that: (i) significant cognitive disturbances are observed in psychiatric diseases (Green, 2006 ); (ii) these cognitive disturbances, indexed by dysfunctional neural networks, may trigger/subtend the onset and/or maintenance of clinical symptoms, thereby defining valid therapeutic targets (Verdejo-Garcia et al ., 2023 ); and (iii) rehabilitating these cognitive functions (through neuropsychological training programs and/or neuromodulation tools) disclosed encouraging results by promoting reduction of clinical symptoms as well as enhancement of patients’ quality of life (Lesniak et al ., 2014 ). In this view, ERPs, considered a useful tool to probe the information processing stream in the brain, can help pinpoint the specific neurocognitive functions that should be targeted in each patient through specific and individualized cognitive remediation procedures (Campanella, 2016 ).…”