Impact of general cognition and executive function deficits on addiction treatment outcomes: Systematic review and discussion of neurocognitive pathways

Sara Domínguez-Salas, Carmen Díaz-Batanero, Oscar Martin Lozano-Rojas, Antonio Verdejo-Garcia

Research output: Contribution to journalReview ArticleResearchpeer-review

104 Citations (Scopus)


This systematic review aims to examine growing evidence linking cognitive-executive functions with addiction treatment outcomes, and to discuss significant cognitive predictors drawing upon addiction neuroscience theory. We conducted a systematic search to identify studies using measures of general cognition and executive functions in patients with substance use disorders for the purpose of predicting two treatment outcomes: therapeutic adherence and relapse. Forty-six studies were selected, and sample characteristics, timing of assessments, and cognitive measures were analyzed. We observed significant methodological differences across studies, resulting in substantial variability in the relationships between cognitive-executive domains and treatment outcomes. Notwithstanding this variability, we found evidence of associations, of medium effect size, between general cognition and treatment adherence, and between reward-based decision-making and relapse. The link between general cognition and treatment adherence is consistent with emerging evidence linking limited cognitive-executive resources with less ability to benefit from talk therapies. The link between reward-based decision-making and relapse accords with decision neuroscience models of addiction. Findings may inform preclinical and clinical research concerning addiction treatment mechanisms.

Original languageEnglish
Pages (from-to)772-801
Number of pages30
JournalNeuroscience and Biobehavioral Reviews
Publication statusPublished - 1 Dec 2016


  • Decision-making
  • Executive functions
  • Relapse
  • Substance use disorders
  • Therapeutic adherence

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