Patterns of Substance Use During Cognitive Enhancement Therapy: An 18-Month Randomized Feasibility Study

Eack, Shaun M.; Hogarty, Susan S.; Bangalore, Srihari S.; Keshavan, Matcheri S.; Cornelius, Jack R.

doi:10.1080/15504263.2016.1145778

Cited by 34 publications

(19 citation statements)

References 48 publications

(51 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since the association between OFC and insula abnormalities and MS appear to be mediated by cognitive deficits, cognitive remediation, aiming to diminish unhealthy lifestyles might be of help. Cognitive remediation has shown improvements in eating behaviour and weight reduction and reductions in substance use , although these associations have not been investigated yet in relation to MS. In addition, in the former study, the association between cognitive remediation and substance use was not specifically investigated in patients with schizophrenia.…”

Section: Discussionmentioning

confidence: 99%

Reward‐related brain structures are smaller in patients with schizophrenia and comorbid metabolic syndrome

Nijs

Schnack

Koevoets

et al. 2018

Acta Psychiatr Scand

View full text Add to dashboard Cite

Reward-related brain structures are smaller in patients with schizophrenia and comorbid metabolic syndrome de Nijs J, Schnack HG, Koevoets MGJC, Kubota M, Kahn RS, van Haren NEM, Cahn W. Reward-related brain structures are smaller in patients with schizophrenia and comorbid metabolic syndrome.Objective: Metabolic syndrome (MS) is highly prevalent in schizophrenia and often a consequence of unhealthy behaviour. Reward-related brain areas might be associated with MS, since they play a major role in regulating health behaviour. This study examined the relationship between MS and brain volumes related to the reward system in schizophrenia. Method: We included patients with schizophrenia, with MS (MS+; n = 23), patients with schizophrenia, without MS (MSÀ; n = 48), and healthy controls (n = 54). Global brain volumes and volumes of (sub)cortical areas, part of the reward circuit, were compared between patients and controls. In case of a significant brain volume difference between patients and controls, the impact of MS in schizophrenia was examined. Results: Patients had smaller total brain (TB; P = 0.001), GM (P = 0.010), larger ventricles (P = 0.026), and smaller reward circuit volume (P < 0.001) than controls. MS+ had smaller TB (P = 0.017), GM (P = 0.008), larger ventricles (P = 0.015), and smaller reward circuit volume (P = 0.002) than MSÀ. MS+ had smaller orbitofrontal cortex (OFC; P = 0.002) and insula volumes (P = 0.005) and smaller OFC (P = 0.008) and insula cortical surface area (P = 0.025) compared to MSÀ. Conclusion: In schizophrenia, structural brain volume reductions in areas of the reward circuitry appear to be related to comorbid MS. Significant outcomes• This present study is the first to report that in schizophrenia comorbid metabolic syndrome is related to smaller total brain and gray matter volumes as well to smaller volumes and cortical surface areas of the orbitofrontal cortex and insula.• Exploratory whole-brain analysis did not reveal other regions related to metabolic syndrome status, suggesting specificity to the reward circuitry. Limitations• Due to the cross-sectional study design, evidence for a causal relationship between reward circuitry and metabolic syndrome cannot be obtained.• The study has limited power, due to the modest sample size.• We did not collect information on physical activity, food intake, and reward functioning, which may be mediating factors in our study.• A comparison group with MS and without schizophrenia is lacking.

show abstract

Section: Discussionmentioning

confidence: 99%

Reward‐related brain structures are smaller in patients with schizophrenia and comorbid metabolic syndrome

Nijs

Schnack

Koevoets

et al. 2018

Acta Psychiatr Scand

View full text Add to dashboard Cite

show abstract

“…Recently, it has become evident that it may also be useful in the fairly common situation where substance use is comorbid with schizophrenia (Sofuoglu et al ). For example, a recent study showed that CET improved the rate of substance abuse in patients with schizophrenia (Eack et al , ). It has also been shown to be effective in improving cognition for veterans with alcohol‐use disorder (Bell et al ).…”

Section: Cognitive Enhancing Agents May Facilitate Behavioral Therapymentioning

confidence: 99%

Addiction, cognitive decline and therapy: seeking ways to escape a vicious cycle

Perry

Lawrence

2016

Genes Brain and Behavior

View full text Add to dashboard Cite

Any type of behavioral change is an effortful process. Thus, the process of behavioral therapy, where clients seek to change maladaptive behavioral patterns, requires high-level cognitive engagement. It is unfortunate, then, that cognitive impairment is a feature of substance use disorders (SUDs), and especially because the domains that tend to be impaired are the very ones involved in the process of therapeutic behavioral change. In this review, we compare the cognitive profile that is frequently observed with chronic SUD with the skills that are required to initiate and sustain behavioral change during rehabilitation. Furthermore, we look to new therapeutic developments that seek to improve cognitive function. We propose that the use of these cognitive enhancing agents as adjuncts to behavioral therapy should help to overcome some of the cognitive barriers imposed by the disorder itself, and hence reduce the chance of relapse.Keywords: Abstinence, addiction, animal models, behavioral therapy, cognition, cognitive enhancement, cognitive impairment, exercise, relapse, substance use disorder, therapy Received 31 May 2016, revised 14 August 2016, accepted for publication 25 August 2016Substance use disorder (SUD) is a maladaptive pattern of drug use involving impaired control over drug-taking activities, social impairment, risky use and pharmacological indicators such as tolerance and withdrawal (American Psychiatric Association & DSM-5 Task Force 2013). Leaving aside the final point, these diagnostic criteria are clearly indicative of maladaptive cognition and behavior arising from suboptimal decision-making, poor executive function and inappropriate prioritization of goals. Drug seeking and drug taking has replaced normal social, work and leisure activities. Thus, the aim of addiction therapy is to inhibit and replace the maladaptive behaviors with others that will allow the individual to lead a more fulfilling lifestyle. A problem that arises with SUD is that the very cognitive impairments that define the disorder are to domains that need to be engaged in order to initiate and maintain the behavioral changes necessary for recovery. This creates a vicious cycle, which is no doubt a major contributory factor behind the poor retention rates and high incidence of relapse that are hallmarks of the disorder.Addiction or SUD is frequently conceptualized as a disorder of the brain and mind that is brought about by exposure to drugs of abuse -psychostimulants, opiates, barbiturates, alcohol, nicotine and cannabis -in combination with genetic and environmental influences (Leshner 1997). This description is somewhat contentious, partly because of the stigma implied, but perhaps more importantly because it may disempower those who are seeking to change their drug-taking patterns. If maladaptive drug seeking is seen as the result of a disordered mind, and not the free will of the subject, then perhaps that person will be less engaged or motivated to change those behavioral patterns (Kellogg & Tatarsky 2012). This, however, ...

show abstract

“…A recent study delivered 12 two-hour group sessions of clinician-guided CRT and computerized CT (Lumosity) (156) over 4 weeks to a sample of female residents completing residential rehabilitation and found significant improvements in EF, response inhibition, selfcontrol, and quality of life relative to treatment as usual (TAU) (157). Similar research has reported comparable improvements in cognitive functioning following CRT (150,151) and CET (148), and improved cognitive functioning has been associated with reduced substance use at 3-and 6-month follow-ups (148,150). Importantly, CET and CRT also demonstrate preliminary efficacy for SUD patients with cognitive impairments (e.g., schizophrenia, past head injury) (148,157).…”

Section: Cognitive Remediationmentioning

confidence: 96%

“…In SUD, general cognitive remediation approaches such as cognitive enhancement therapy (CET) and cognitive remediation therapy (CRT) aim to reduce substance use (148)(149)(150) and craving (151) by targeting EF and self-regulation. Cognitive remediation has been shown to improve cognition in domains of working memory (WM), verbal memory, verbal learning, attention, and processing speed (151)(152)(153)(154).…”

Section: Cognitive Remediationmentioning

confidence: 99%

A Roadmap for Integrating Neuroscience Into Addiction Treatment: A Consensus of the Neuroscience Interest Group of the International Society of Addiction Medicine

et al. 2019

View full text Add to dashboard Cite

Although there is general consensus that altered brain structure and function underpins addictive disorders, clinicians working in addiction treatment rarely incorporate neuroscienceinformed approaches into their practice. We recently launched the Neuroscience Interest Group within the International Society of Addiction Medicine (ISAM-NIG) to promote initiatives to bridge this gap. This article summarizes the ISAM-NIG key priorities and strategies to achieve implementation of addiction neuroscience knowledge and tools for the assessment and treatment of substance use disorders. We cover two assessment areas: cognitive assessment and neuroimaging, and two interventional areas: cognitive training/remediation and neuromodulation, where we identify key challenges and proposed solutions. We reason

show abstract

Patterns of Substance Use During Cognitive Enhancement Therapy: An 18-Month Randomized Feasibility Study

Cited by 34 publications

References 48 publications

Reward‐related brain structures are smaller in patients with schizophrenia and comorbid metabolic syndrome

Reward‐related brain structures are smaller in patients with schizophrenia and comorbid metabolic syndrome

Addiction, cognitive decline and therapy: seeking ways to escape a vicious cycle

A Roadmap for Integrating Neuroscience Into Addiction Treatment: A Consensus of the Neuroscience Interest Group of the International Society of Addiction Medicine

Contact Info

Product

Resources

About