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Screening Tools for Cognitive Impairment in Adults with Substance Use Disorders: A Systematic Review. J Int Neuropsychol Soc 2022; 28:756-779. [PMID: 34433502 DOI: 10.1017/s135561772100103x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Cognitive impairment is common in individuals with substance use disorders (SUDs), yet no evidence-based guidelines exist regarding the most appropriate screening measure for use in this population. This systematic review aimed to (1) describe different cognitive screening measures used in adults with SUDs, (2) identify substance use populations and contexts these tools are utilised in, (3) review diagnostic accuracy of these screening measures versus an accepted objective reference standard, and (4) evaluate methodology of included studies for risk of bias. METHODS Online databases (PsycINFO, MEDLINE, Embase, and CINAHL) were searched for relevant studies according to pre-determined criteria, and risk of bias and applicability was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). At each review phase, dual screening, extraction, and quality ratings were performed. RESULTS Fourteen studies met inclusion, identifying 10 unique cognitive screening tools. The Montreal Cognitive Assessment (MoCA) was the most common, and two novel screening tools (Brief Evaluation of Alcohol-Related Neuropsychological Impairments [BEARNI] and Brief Executive Function Assessment Tool [BEAT]) were specifically developed for use within SUD populations. Twelve studies reported on classification accuracy and relevant psychometric parameters (e.g., sensitivity and specificity). While several tools yielded acceptable to outstanding classification accuracy, there was poor adherence to the Standards for Reporting Diagnostic Accuracy Studies (STARD) across all studies, with high or unclear risk of methodological bias. CONCLUSIONS While some screening tools exhibit promise for use within SUD populations, further evaluation with stronger methodological design and reporting is required. Clinical recommendations and future directions for research are discussed.
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Dark Side or Bright Side: The Impact of Alcohol Drinking on the Trust of Chinese Rural Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105924. [PMID: 35627461 PMCID: PMC9141662 DOI: 10.3390/ijerph19105924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/06/2022] [Accepted: 04/09/2022] [Indexed: 11/17/2022]
Abstract
Existing studies have explored the causal effect of social capital on harmful drinking, while the effect of drinking habits on trust is scant. In China, drinking rituals and drinking culture are considered important ways of promoting social interaction and trust, especially in rural areas where traditional culture is stronger. Based on a field survey in rural China in 2019, this paper explores the relationship between drinking habits and trust. First, we found a negative relationship between drinking habits and trust, indicating that those people who drink alcohol are more likely to have a lower trust. Second, we found significant heterogeneity in the effect of alcohol consumption on social trust across various groups. Specifically, the negative effects of alcohol consumption on trust were stronger for the females than for males; drinking alcohol did not reduce the level of trust among the Chinese Communist Party (CCP) in rural China; compared with the Han nationality, we found that the effect of drinking on trust was not significant for the ethnic minority. Third, we observed that the negative effects of alcohol consumption on trust had thresholds across age and income. Among people under 51, the risk of trust from drinking was greater than for those over 51; the negative effect of drinking on residents’ trust was more obvious in low-income families, but not significant in the group with an annual household income of more than CNY 40,000. Our empirical study provides a deeper understanding of drinking culture in rural China from a dialectical perspective.
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Moon TJ, Mathias CW, Mullen J, Karns-Wright TE, Hill-Kapturczak N, Roache JD, Dougherty DM. Social Support and the Rehabilitation of Alcohol-Impaired Drivers: Drinking Motives as Moderators. HEALTH COMMUNICATION 2021; 36:540-550. [PMID: 32091242 PMCID: PMC7483183 DOI: 10.1080/10410236.2020.1731914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Alcohol-impaired driving is a common and costly public health problem associated with alcohol misuse. This investigation aims to understand the role of social support and drinking motives in motivating alcohol-impaired drivers to reduce alcohol use. One hundred nineteen participants with a history of driving-while-intoxicated arrest were recruited from either a correctional treatment facility (n = 59) or the community (n = 60) and asked about their motivation to change alcohol use. Motivation to change was tested in relationships with two types of social support (i.e. Abstinence-Specific Social Support and General Social Support) and drinking motives (Coping, Enhancement, and Social Motives). The results showed: (1) only Abstinence-Specific Social Support was positively associated with motivation to change; (2) Coping and Social Motives had a negative association with motivation to change; (3) the impact of Abstinence-Specific Social Support on motivation to change was greater among those with a stronger Enhancement Motives. In other words, those who drink primarily for pleasure showed a greater increase in motivation to change when more Abstinence-Specific Social Support is available, compared to those with lower Enhancement Motives. The findings of this investigation contribute to our knowledge of the roles of communication in the rehabilitation of alcohol-impaired drivers.
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Affiliation(s)
- Tae-Joon Moon
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | - Charles W. Mathias
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | - Jillian Mullen
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | - Tara E. Karns-Wright
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | | | - John D. Roache
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | - Donald M. Dougherty
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
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4
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Francis MW. Transitions of Women's Substance Use Recovery Networks and 12-Month Sobriety Outcomes. SOCIAL NETWORKS 2020; 63:1-10. [PMID: 32675917 PMCID: PMC7365593 DOI: 10.1016/j.socnet.2020.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Little is known about how the structure and composition of women's personal social networks (PSNs) combine to support recovery from substance use disorders, how PSNs change during early recovery, or how known covariates such as trauma, co-occurring mental health disorders, or treatment modality impact this relationship. This study used latent profile and transition analyses with 6 recovery-specific PSN indicators in a sample of women in early recovery (N=377) to identify three PSN typologies in relation to abstinence outcomes over 12 months, and track transitions between the typologies at 0-6 and 6-12 months. Women in the Highly Connected type (14.3%) had tightly-knit networks, more sober alters, and fewer treatment-related alters. Women in the Treatment-Related type (49.3%) had looser-knit networks with more sober and sobriety-supporting alters and alters they know from treatment. Women in the At-Risk type (36.3%) had more isolates, few sobriety-supporting alters, and more alters with whom they used. Women in the Treatment-Related Sobriety Support type were significantly more likely to maintain sobriety by 12 months (B=-0.81; OR=2.09, 95% CI [1.23-3.56]) than women in the At Risk type. Higher mean Trauma Symptom Checklist scores were positively related to membership in the At Risk type. The majority of women who transitioned did so by 6 months, with 41.6% transitioning then. Women in the At Risk group had the highest probability of transition (P=0.55). Being in residential treatment (versus outpatient) predicted lower odds of transitioning (B= -0.81, p=.06). This study provides a framework for conducting longitudinal latent variable analysis with social network data, and offers a clinically-useful starting point for research on individualized, targeted, and stage-based interventions for women in recovery.
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Affiliation(s)
- Meredith W Francis
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, USA
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5
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Martelli C, Petillion A, Brunet-Lecomte M, Miranda Marcos R, Chanraud S, Amirouche A, Letierce A, Kostogianni N, Lemaitre H, Aubin HJ, Blecha L, Reynaud M, Martinot JL, Benyamina A. Neuropsychological Impairment in Detoxified Alcohol-Dependent Subjects with Preserved Psychosocial Functioning. Front Psychiatry 2017; 8:193. [PMID: 29033861 PMCID: PMC5626858 DOI: 10.3389/fpsyt.2017.00193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 09/19/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic alcoholism and its related cognitive impairments are associated with increased social, relational, and professional deficits which have a variable overall impact on social integration. These impairments are known to have varying severities and have rarely been studied among healthy alcohol-dependent subjects with preserved psychosocial functioning. Thus, the objective of this study is to describe neuropsychological performance in this particular population. METHOD Twenty-nine socially adjusted alcohol-dependent men, hospitalized for a first or second withdrawal and abstinent for 3 weeks minimum, were compared to 29 healthy non-alcoholic controls. All subjects underwent clinical and psychiatric examination, neuropsychological tests of memory (M), working memory (WM), and executive functions (EF). Comparisons were performed using Student's t-tests or Mann-Whitney U tests. RESULTS No group differences were found on the Self-Reported Social Adjustment Scale (SAS-SR) or in the Mini-Mental State Examination. Compared to controls, patients had greater episodic, spatial, and WM deficits as well as slightly altered executive functions. In contrast, their executive functions (spontaneous flexibility, criteria generation, rule maintenance, and inhibitory control) were relatively preserved. CONCLUSION Our sample of socially and professionally integrated alcoholic patients shows fewer cognitive deficits than described in previous studies. Our results suggest that early on, alcohol-dependent subjects develop compensatory adaptation processes to preserve social function and adaptation. Minor cognitive impairments should be screened early in the disease to integrate cognitive interventions into the health-care plan to thus eventually prevent further socio-professional marginalization.
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Affiliation(s)
- Catherine Martelli
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France.,INSERM U1018, Centre de recherche en Epidémiologie et Santé des Populations, Villejuif, France.,Université Paris-Sud, Le Kremlin Bicêtre, France
| | - Amélie Petillion
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France
| | - Marine Brunet-Lecomte
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France
| | - Rubén Miranda Marcos
- INSERM, U1000 "Neuroimaging & Psychiatry", IFR49, Orsay, France.,CEA, "Neuroimaging & Psychiatry" U1000 Unit, Hospital Department Frédéric Joliot, Orsay, France
| | - Sandra Chanraud
- Bordeaux University, INCIA, UMR 5287, Talence, France.,CNRS, INCIA, UMR 5287, Talence, France
| | - Ammar Amirouche
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France.,INSERM U1018, Centre de recherche en Epidémiologie et Santé des Populations, Villejuif, France.,Université Paris-Sud, Le Kremlin Bicêtre, France
| | - Alexia Letierce
- AP-HP, Bicêtre Hospital, Clinical Research Unit, Le Kremlin Bicêtre, France
| | - Nikoleta Kostogianni
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France
| | - Hervé Lemaitre
- INSERM, U1000 "Neuroimaging & Psychiatry", IFR49, Orsay, France.,Bordeaux University, INCIA, UMR 5287, Talence, France.,CNRS, INCIA, UMR 5287, Talence, France
| | - Henri-Jean Aubin
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université Paris Descartes, UMR U797, Paris, France
| | - Lisa Blecha
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France.,INSERM U1018, Centre de recherche en Epidémiologie et Santé des Populations, Villejuif, France.,Université Paris-Sud, Le Kremlin Bicêtre, France
| | - Michel Reynaud
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France.,INSERM U1018, Centre de recherche en Epidémiologie et Santé des Populations, Villejuif, France.,Université Paris-Sud, Le Kremlin Bicêtre, France
| | - Jean-Luc Martinot
- INSERM, U1000 "Neuroimaging & Psychiatry", IFR49, Orsay, France.,CEA, "Neuroimaging & Psychiatry" U1000 Unit, Hospital Department Frédéric Joliot, Orsay, France.,Bordeaux University, INCIA, UMR 5287, Talence, France.,CNRS, INCIA, UMR 5287, Talence, France
| | - Amine Benyamina
- AP-HP, Paul Brousse Hospital, Department of Psychiatry and Addictology, Villejuif, France.,INSERM U1018, Centre de recherche en Epidémiologie et Santé des Populations, Villejuif, France.,Université Paris-Sud, Le Kremlin Bicêtre, France
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Manning V, Teo HC, Guo S, Wong KE, Li TK. Neurocognitive Functioning and Treatment Outcome Following Detoxification Among Asian Alcohol-Dependent Inpatients. Subst Use Misuse 2016; 51:193-205. [PMID: 26771240 DOI: 10.3109/10826084.2015.1092985] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The prevalence of alcohol use disorders in Asia is increasing and relapse among treated populations remains the norm, not the exception. The extent to which cognitive impairment influences clinical outcome remains unclear, with research dominated by studies of Caucasian populations. OBJECTIVES This study examines behavioral and self-reported cognitive functioning in detoxified alcohol-dependent (AD) patients in Singapore and its association with outcome. METHODS The cognitive performance of 30 recently-detoxified AD inpatients and 30 demographically-matched controls was compared using visuospatial memory, working memory, set-shifting, planning and reflection impulsivity tests of the CANTAB®, and self-reported dysexecutive symptoms and everyday cognitive difficulties. Patients' alcohol use and self-reported cognitive functioning were reassessed 3-months post-discharge. RESULTS Compared to matched controls, AD inpatients exhibited significantly poorer fluid intelligence, visuospatial memory, working memory, set-shifting flexibility and planning/organization, but not reflection impulsivity. In support of Western studies, a significant proportion (three-quarters) were "clinically impaired" on subtests. Significant reductions were observed in alcohol units, frequency and dependency scores at follow-up, though improvements in self-reported cognitive functioning were limited to abstainers. Baseline cognitive performance did not differentiate those who had abstained from alcohol and relapsed at follow-up. CONCLUSIONS/IMPORTANCE Memory and executive functioning impairments were evident among Asian AD patients alongside self-reported cognitive difficulties, thus cognitively demanding psychological interventions may have limited impact during early detoxification. Future studies can build on these findings, with larger samples and measurement of moderating and mediating factors to extend our understanding of how cognitive impairment influences outcome.
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Affiliation(s)
- Victoria Manning
- a Institute of Mental Health, National Addictions Management Service , Singapore , Singapore.,b Turning Point, Eastern Health , Melbourne , Australia.,c Eastern Health Clinical School , Monash University , Melbourne , Australia
| | - Hui Chin Teo
- a Institute of Mental Health, National Addictions Management Service , Singapore , Singapore
| | - Song Guo
- a Institute of Mental Health, National Addictions Management Service , Singapore , Singapore
| | - Kim Eng Wong
- a Institute of Mental Health, National Addictions Management Service , Singapore , Singapore
| | - Ting-Kai Li
- d Department of Psychiatry , Duke University , Durham , North Carolina , USA
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7
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Worley MJ, Tate SR, Granholm E, Brown SA. Mediated and moderated effects of neurocognitive impairment on outcomes of treatment for substance dependence and major depression. J Consult Clin Psychol 2014; 82:418-28. [PMID: 24588403 DOI: 10.1037/a0036033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Neurocognitive impairment has not consistently predicted substance use treatment outcomes but has been linked to proximal mediators of outcome. These indirect effects have not been examined in adults with substance dependence and co-occurring psychiatric disorders. We examined mediators and moderators of the effects of neurocognitive impairment on substance use among adults in treatment for alcohol or drug dependence and major depression (MDD). METHOD Participants were veterans (N = 197, mean age = 49.3 years, 90% male, 75% Caucasian) in a trial of 2 group interventions for alcohol/drug dependence and MDD. Measures examined here included intake neurocognitive assessments and percent days drinking (PDD), percent days using drugs (PDDRG), self-efficacy, 12-step affiliation, and depressive symptoms measured every 3 months from intake to the 18-month follow-up. RESULTS Greater intake neurocognitive impairment predicted lower self-efficacy, lower 12-step affiliation, and greater depression severity, and these time-varying variables mediated the effects of impairment on future PDD and PDDRG. The prospective effects of 12-step affiliation on future PDD were greater for those with greater neurocognitive impairment. Impairment also interacted with depression to moderate the effects of 12-step affiliation and self-efficacy on PDD. Adults with greater impairment and currently severe depression had the strongest associations between 12-step affiliation/self-efficacy and future drinking. CONCLUSIONS Greater neurocognitive impairment may lead to poorer outcomes from group therapy for alcohol/drug dependence and MDD due to compromised change in therapeutic processes. Distal factors such as neurocognitive impairment can interact with dynamic risk factors to modulate the association between therapeutic processes and future drinking outcomes.
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Affiliation(s)
- Matthew J Worley
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology
| | | | | | - Sandra A Brown
- Department of Psychology, University of California-San Diego
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8
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Hill TK, Colistra AL. Addiction-Related Cognitive Impairment in Substance Use Disorder Treatment: Behavioral Suggestions for Addictions Treatment Practitioners. ALCOHOLISM TREATMENT QUARTERLY 2014. [DOI: 10.1080/07347324.2013.831688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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9
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Bates ME, Buckman JF, Voelbel GT, Eddie D, Freeman J. The mean and the individual: integrating variable-centered and person-centered analyses of cognitive recovery in patients with substance use disorders. Front Psychiatry 2013; 4:177. [PMID: 24399976 PMCID: PMC3870950 DOI: 10.3389/fpsyt.2013.00177] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Accepted: 12/09/2013] [Indexed: 11/13/2022] Open
Abstract
Neuropsychological and cognitive deficits are observed in the majority of persons with alcohol and drug use disorders and may interfere with treatment processes and outcomes. Although, on average, the brain and cognition improve with abstinence or markedly reduced substance use, better understanding of the heterogeneity in the time-course and extent of cognitive recovery at the individual level is useful to promote bench-to-bedside translation and inform clinical decision making. This study integrated a variable-centered and a person-centered approach to characterize diversity in cognitive recovery in 197 patients in treatment for a substance use disorder. We assessed executive function, verbal ability, memory, and complex information processing speed at treatment entry, and then 6, 26, and 52 weeks later. Structural equation modeling was used to define underlying ability constructs and determine the mean level of cognitive changes in the sample while minimizing measurement error and practice effects on specific tests. Individual-level empirical growth plots of latent factor scores were used to explore prototypical trajectories of cognitive change. At the level of the mean, small to medium effect size gains in cognitive abilities were observed over 1 year. At the level of the individual, the mean trajectory of change was also the modal individual recovery trajectory shown by about half the sample. Other prototypical cognitive change trajectories observed in all four cognitive domains included Delayed Gain, Loss of Gain, and Continuous Gain. Together these trajectories encompassed between 86 and 94% of individual growth plots across the four latent abilities. Further research is needed to replicate and predict trajectory membership. Replication of the present findings would have useful implications for targeted treatment planning and the new cognitive interventions being developed to enhance treatment outcomes.
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Affiliation(s)
- Marsha E. Bates
- Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | | | - Gerald T. Voelbel
- NYU Steinhardt School of Culture, Education, and Human Development, New York, NY, USA
| | - David Eddie
- Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Jason Freeman
- Rutgers, The State University of New Jersey, Piscataway, NJ, USA
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10
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Levola J, Kaskela T, Holopainen A, Sabariego C, Tourunen J, Cieza A, Pitkänen T. Psychosocial difficulties in alcohol dependence: a systematic review of activity limitations and participation restrictions. Disabil Rehabil 2013; 36:1227-39. [DOI: 10.3109/09638288.2013.837104] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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11
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Bates ME, Buckman JF, Nguyen TT. A role for cognitive rehabilitation in increasing the effectiveness of treatment for alcohol use disorders. Neuropsychol Rev 2013; 23:27-47. [PMID: 23412885 PMCID: PMC3610413 DOI: 10.1007/s11065-013-9228-3] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 01/31/2013] [Indexed: 12/14/2022]
Abstract
Neurocognitive impairments are prevalent in persons seeking treatment for alcohol use disorders (AUDs). These impairments and their physical, social, psychological and occupational consequences vary in severity across persons, much like those resulting from traumatic brain injury; however, due to their slower course of onset, alcohol-related cognitive impairments are often overlooked both within and outside of the treatment setting. Evidence suggests that cognitive impairments can impede treatment goals through their effects on treatment processes. Although some recovery of alcohol-related cognitive impairments often occurs after cessation of drinking (time-dependent recovery), the rate and extent of recovery is variable across cognitive domains and individuals. Following a long hiatus in scientific interest, a new generation of research aims to facilitate treatment process and improve AUD treatment outcomes by directly promoting cognitive recovery (experience-dependent recovery). This review updates knowledge about the nature and course of cognitive and brain impairments associated with AUD, including cognitive effects of adolescent AUD. We summarize current evidence for indirect and moderating relationships of cognitive impairment to treatment outcome, and discuss how advances in conceptual frameworks of brain-behavior relationships are fueling the development of novel AUD interventions that include techniques for cognitive remediation. Emerging evidence suggests that such interventions can be effective in promoting cognitive recovery in persons with AUD and other substance use disorders, and potentially increasing the efficacy of AUD treatments. Finally, translational approaches based on cognitive science, neurophysiology, and neuroscience research are considered as promising future directions for effective treatment development that includes cognitive rehabilitation.
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Affiliation(s)
- Marsha E Bates
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, 607 Allison Road, Piscataway, NJ 08854-8001, USA.
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12
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Granholm E, Tate SR, Link PC, Lydecker KP, Cummins KM, McQuaid J, Shriver C, Brown SA. Neuropsychological Functioning and Outcomes of Treatment for Co-occurring Depression and Substance Use Disorders. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2011; 37:240-9. [DOI: 10.3109/00952990.2011.570829] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Eric Granholm
- VA San Diego Healthcare System,
San Diego, CA, USA
- Department of Psychology, University of California,
San Diego, CA, USA
| | - Susan R. Tate
- VA San Diego Healthcare System,
San Diego, CA, USA
- Department of Psychology, University of California,
San Diego, CA, USA
| | | | - Katherine P. Lydecker
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University,
San Diego, CA, USA
| | - Kevin M. Cummins
- Department of Psychology, University of California,
San Diego, CA, USA
| | - John McQuaid
- San Francisco VA Medical Center and University of California,
San Diego, CA, USA
| | - Chris Shriver
- Department of Psychiatry, University of California,
San Diego, CA, USA
| | - Sandra A. Brown
- Department of Psychology, University of California,
San Diego, CA, USA
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13
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Moos RH, Schutte KK, Brennan PL, Moos BS. Personal, family and social functioning among older couples concordant and discordant for high-risk alcohol consumption. Addiction 2011; 106:324-34. [PMID: 20883458 PMCID: PMC3017234 DOI: 10.1111/j.1360-0443.2010.03115.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS This study compares the personal, family and social functioning of older husbands and wives concordant or discordant for high-risk alcohol consumption and identifies predictors of changes in concordance and high-risk consumption. DESIGN, PARTICIPANTS, MEASUREMENTS Three groups of couples were identified at baseline and followed 10 years later: (i) concordant couples in which husbands and wives engaged in low-risk alcohol consumption (n = 54); (ii) concordant couples in which husbands and wives engaged in high-risk alcohol consumption (n = 38); and (iii) discordant couples in which one partner engaged in high-risk alcohol consumption and the other partner did not (n = 75). At each follow-up, husbands and wives completed an inventory that assessed their personal, family and social functioning. FINDINGS Compared to the low-risk concordant group, husbands and wives in the high-risk concordant group were more likely to rely on tension-reduction coping, reported more friend approval of drinking, and were less involved in religious activities; however, they did not differ in the quality of the spousal relationship. The frequency of alcohol consumption declined among husbands in discordant couples, but not among husbands in concordant couples. Predictors of high-risk drinking included tension-reduction coping, friend approval of drinking and, for husbands, their wives' level of drinking. CONCLUSIONS High-risk and discordant alcohol consumption do not seem to be linked to decrements in family functioning among older couples in long-term stable marriages. The predictors of heavy alcohol consumption among older husbands and wives identify points of intervention that may help to reduce their high-risk drinking.
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Affiliation(s)
- Rudolf H Moos
- Center for Health Care Evaluation, Department of Veterans Affairs and Stanford University, Palo Alto, CA 94025, USA.
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14
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Friendship networks of inner-city adults: a latent class analysis and multi-level regression of supporter types and the association of supporter latent class membership with supporter and recipient drug use. Drug Alcohol Depend 2010; 107:134-40. [PMID: 19939586 PMCID: PMC2822006 DOI: 10.1016/j.drugalcdep.2009.09.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Revised: 09/03/2009] [Accepted: 09/27/2009] [Indexed: 11/24/2022]
Abstract
BACKGROUND Social support is a multi-dimensional construct that is important to drug use cessation. The present study identified types of supportive friends among the social network members in a community-based sample and examined the relationship of supporter-type classes with supporter, recipient, and supporter-recipient relationship characteristics. We hypothesized that the most supportive network members and their support recipients would be less likely to be current heroin/cocaine users. METHODS Participants (n=1453) were recruited from low-income neighborhoods with a high prevalence of drug use. Participants identified their friends via a network inventory, and all nominated friends were included in a latent class analysis and grouped based on their probability of providing seven types of support. These latent classes were included as the dependent variable in a multi-level regression of supporter drug use, recipient drug use, and other characteristics. RESULTS The best-fitting latent class model identified five support patterns: friends who provided Little/No Support, Low/Moderate Support, High Support, Socialization Support, and Financial Support. In bivariate models, friends in the High, Low/Moderate, and Financial Support were less likely to use heroin or cocaine and had less conflict with and were more trusted by the support recipient than friends in the Low/No Support class. Individuals with supporters in those same support classes compared to the Low/No Support class were less likely to use heroin or cocaine, or to be homeless or female. Multivariable models suggested similar trends. CONCLUSIONS Those with current heroin/cocaine use were less likely to provide or receive comprehensive support from friends.
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Buckman JF, Bates ME, Morgenstern J. Social support and cognitive impairment in clients receiving treatment for alcohol- and drug-use disorders: a replication study. J Stud Alcohol Drugs 2008; 69:738-46. [PMID: 18781249 PMCID: PMC2575395 DOI: 10.15288/jsad.2008.69.738] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2008] [Revised: 04/07/2008] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The influence that social network members exert on the drinking behaviors of alcohol-dependent individuals may represent a behavioral change process that is sensitive to co-occurring cognitive impairment and operates outside treatment to promote or impede outcomes. This study was aimed at extending earlier research support for this hypothesis by assessing impairment in memory as well as executive functions in a more heterogeneous population with alcohol- and/or drug-use disorders. METHOD Latent class analysis was used as a person-centered approach to characterize the nature and extent of social support for abstinence from alcohol and drug use in 122 men and women entering treatment for substance-use disorders. Substance use, executive dysfunction, and memory impairments were compared across latent classes at four points during the first year after treatment entry. The interrelationship of impairment and social support on treatment outcomes was also examined. RESULTS Three independent social support classes--(1) Frequent Positive Support, (2) Limited Positive Support, and (3) Negative Support--were identified. The Frequent Positive Support class demonstrated the most frequent substance use and greatest executive impairment at treatment entry but-by the end of treatment-showed pronounced improvements in both. In addition, less recovery of executive function by the end of treatment predicted better 12-month substance-use outcomes in the Frequent Positive Support class, whereas it predicted poorer outcomes in the Negative Support class. CONCLUSIONS The results offer further evidence for the heightened importance of informal social network processes in the treatment outcomes of persons with severe and ongoing deficits in executive functioning.
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Affiliation(s)
| | - Marsha E. Bates
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, 607 Allison Road, Piscataway, New Jersey 08854
| | - Jon Morgenstern
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, 607 Allison Road, Piscataway, New Jersey 08854
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