Specific aspects of cognitive impulsivity are longitudinally associated with lower treatment retention and greater relapse in therapeutic community treatment

Barreno, Enrique Moraleda; Domínguez-Salas, Sara; Batanero, María Carmen Díaz; Lozano, Óscar; Marín, José Andrés Lorca; Verdejo-García, Antonio

doi:10.1016/j.jsat.2018.10.004

Cited by 46 publications

(28 citation statements)

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“…These neurocognitive deficits may influence the patients' ability to attend and retain new information, identify goals or flexibly adapt to new environmental demands (Rupp, 2012). Moreover, cognitive deficits can be associated with increased impulsivity (Bates et al, 2002;Czapla et al, 2016;Moraleda Barreno et al, 2019) that alter decision making (Domínguez-Salas, Díaz-Batanero, Lozano-Rojas, & Verdejo-García, 2016; Moraleda Barreno et al, 2019;Stevens et al, 2015). As a consequence, patients with alcohol-related cognitive impairment (ARCI) present lower self-efficacy (Bates, Pawlak, Tonigan, & Buckman, 2006;Sachdeva et al, 2016), lower motivation and treatment compliance (Bates et al, 2013(Bates et al, , 2006Bernardin et al, 2014), as well as fewer days of abstinence (Florez et al, 2019;Sachdeva et al, 2016), more drinks per drinking day (US SDUs, 1SDU = 14 g) (Bates et al, 2006) and poorer quality of life (Horton, Duffy, & Martin, 2015;Rensen, Egger, Westhoff, Walvoort, & Kessels, 2017).…”

Section: Introductionmentioning

confidence: 99%

A systematic review of treatments for alcohol-related cognitive impairment: lessons from the past and gaps for future interventions

et al. 2020

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Alcohol-related cognitive impairment (ARCI) is highly prevalent among patients with alcohol dependence. Although it negatively influences treatment outcome, this condition is underdiagnosed and undertreated. The aim of this systematic review is to investigate the existing evidence regarding both cognitive and pharmacological interventions for ARCI. We systematically reviewed PubMed, Scopus and Science direct databases up to May 2019 and followed the PRISMA guidelines. The quality of the studies was assessed using the Jadad Scale. Twenty-six studies were eligible for inclusion (14 referring to neuropsychological interventions and 12 to pharmacological treatments). Among neuropsychological interventions, computerised treatments, errorless learning and component method showed positive effects on working memory, memory measures and general cognitive function. On the other hand, thiamine, memantine and methylphenidate improved working memory, long-term memory and general cognitive function. Nevertheless, these studies have several limitations, such as small sample size, lack of replication of the results or low specificity of the interventions. Therefore, no gold-standard intervention can yet be recommended for clinical practice, and further research based on promising strategies (e.g. digital interventions, thiamine) is required.

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Section: Introductionmentioning

confidence: 99%

A systematic review of treatments for alcohol-related cognitive impairment: lessons from the past and gaps for future interventions

et al. 2020

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“…Emerging research has revealed that executive functions, such as inhibitory control, working memory and decision-making, are significantly associated with MUD treatment outcomes 8,9 . Specifically, consumers with deficits in executive functions are at greater risk of dropping out of treatment, relapsing after abstinence-oriented treatment, and struggling to regain quality of life 10,11 . This research, together with recent evidence showing that current treatment interventions for MUD have overall limited efficacy 4 , raises the need to incorporate cognitive remediation interventions for executive dysfunction as an add-on to current treatment approaches 12,13 .…”

Section: Resultsmentioning

confidence: 99%

Development of Goal Management Training⁺ (GMT⁺) for Methamphetamine Use Disorder Through Collaborative Design: A Process Description

Anderson

Robinson

Potter

et al. 2021

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Background Methamphetamine use disorder (MUD) is associated with executive dysfunctions, which are linked with poorer treatment outcomes including earlier drop out and relapse. However, current treatments for MUD do not address executive functions. Goal Management Training (GMT) is an evidence-based cognitive remediation program for executive dysfunction but required modifications to enhance its relevance and application within addiction treatment settings. This study aimed to 1) tailor GMT to the key cognitive deficits and typical treatment duration of MUD; 2) explore consumers (people with MUD) engagement with the revised program; 3) implement a protocol of the program with consumers; and 4) present the manualised standard administration to clinical service providers. Methods We followed the Medical Research Council Complex Interventions Framework and employed an evidence- and person-based intervention development process. We used a four-phased approach and collaborated with neuropsychology experts, design researchers in healthcare, consumers with MUD, and clinical service providers. Each aim was addressed in a separate study phase; including content refinement and review with neuropsychology experts (phase 1), intervention design and collaboration with consumers (phase 2), prototype development and review with consumers (phase 3), and final program modifications and review with clinical stakeholders (phase 4). Results Findings from phase 1 indicated support for targeting four cognitive processes (attention, impulse control, goal setting, and decision-making). Key feedback included the need to help habitualise program strategies and guide consumers in applying them in emotionally salient situations. Findings from phases 2 and 3 indicated consumer support for the program strategies and materials but highlighted the need to further enhance the personal relevance of specific content and journal activities. Findings from phase 4 provided overall clinical support for the revised program but indicated an opportunity to minimise unintended effects. We present the intervention materials for the revised program, Goal Management Training+ (GMT+), in line with TIDieR guidelines. Conclusions GMT+ targets tailored cognitive processes, includes reimagined materials and activities, and is sensitive to the clinical needs of people with MUD. Our intervention development process was important for informing the training components, design and intervention materials, and indicating initial acceptability prior to conducting a clinical trial.

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“…Response inhibition is more reliably impaired than attentional inhibition in those with alcohol use disorder (Wilcox et al 2014). Additionally, it has been shown that response inhibition ability, but not attentional inhibition ability, predicted relapse and drop-out from treatment in patients with alcohol use disorder (Rupp et al 2016;Tilden et al 2018;Barreno et al 2019;van Emmerik-van Oortmerssen et al 2020). Other studies demonstrated that not only relapse, but also treatment response could be predicted using response inhibition ability (Czapla et al 2016).…”

Section: Discussionmentioning

confidence: 99%

Acute alcohol does not impair attentional inhibition as measured with Stroop interference scores but impairs Stroop performance

et al. 2021

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Rationale Inhibition is a core executive function and refers to the ability to deliberately suppress attention, behavior, thoughts, and/or emotions and instead act in a specific manner. While acute alcohol exposure has been shown to impair response inhibition in the stop-signal and Go/NoGo tasks, reported alcohol effects on attentional inhibition in the Stroop task are inconsistent. Notably, studies have operationalized attentional inhibition variably and there has been intra- and inter-individual variability in alcohol exposure. Objective This study aimed to examine the acute effects of alcohol on attentional inhibition, considering previous limitations. Methods In a single-blind, cross-over design, 40 non-dependent participants with a medium-to-high risk drinking behavior performed a Counting Stroop task (CST) under a baseline and an arterial blood alcohol concentration (aBAC) clamp at 80 mg%. Attentional inhibition was assessed as the alteration of reaction times (RT), error rates (ER), and inverse efficiency scores (IES) between incongruent and congruent trials (interference score). Stroop performance was also assessed regardless of trial-type. Results Compared to saline, acute alcohol exposure via an aBAC clamp did not affect CST interference scores but increased RTs and IES in both incongruent and congruent trials. Conclusions Attentional inhibition (Stroop interference score) was not impaired by clamped moderate alcohol exposure. Acute alcohol impaired Stroop performance evidenced by a general increase in response times. Our findings suggest that response and attentional inhibition do not share the same neurocognitive mechanisms and are affected differently by alcohol. Results could also be explained by automated behaviors known to be relatively unaffected by acute alcohol.

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Specific aspects of cognitive impulsivity are longitudinally associated with lower treatment retention and greater relapse in therapeutic community treatment

Cited by 46 publications

References 38 publications

A systematic review of treatments for alcohol-related cognitive impairment: lessons from the past and gaps for future interventions

A systematic review of treatments for alcohol-related cognitive impairment: lessons from the past and gaps for future interventions

Development of Goal Management Training⁺ (GMT⁺) for Methamphetamine Use Disorder Through Collaborative Design: A Process Description

Acute alcohol does not impair attentional inhibition as measured with Stroop interference scores but impairs Stroop performance

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Specific aspects of cognitive impulsivity are longitudinally associated with lower treatment retention and greater relapse in therapeutic community treatment

Cited by 46 publications

References 38 publications

A systematic review of treatments for alcohol-related cognitive impairment: lessons from the past and gaps for future interventions

A systematic review of treatments for alcohol-related cognitive impairment: lessons from the past and gaps for future interventions

Development of Goal Management Training+ (GMT+) for Methamphetamine Use Disorder Through Collaborative Design: A Process Description

Acute alcohol does not impair attentional inhibition as measured with Stroop interference scores but impairs Stroop performance

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Development of Goal Management Training⁺ (GMT⁺) for Methamphetamine Use Disorder Through Collaborative Design: A Process Description