Abstract
Introduction: Impulsivity has been consistently associated with poorer addiction treatment outcomes. However, impulsivity is a multifaceted construct and current evidence have failed to unravel which specific aspects explain this relationship. There is also limited research examining long-term outcomes. We aimed to examine the longitudinal association between baseline performance on a comprehensive battery of impulsivity measures and retention and relapse at the end of treatment. Methods: The sample comprised 68 participants with miscellaneous diagnoses of substance use disorders and polysubstance use patterns, enrolled in public residential therapeutic communities in Andalusia (Spain). At baseline, we applied measures of selective attention (Stroop), response inhibition (Affective Go/No Go), delay discounting (Monetary Choice Questionnaire; MCQ), and decision-making (Iowa Gambling Task; IGT). At the end of treatment (mean = 148.36 days, range = 22–289 days), we collected outcome measures of retention (coded by the clinical team as completion or dropout based on statewide practice guidelines) and relapse (defined as at least two separate alcohol/drug use episodes based on urine analyses). Results: Cox regression models showed that poorer decision-making in the IGT was associated with premature treatment dropout, whereas elevated commission errors in the Affective Go/No Go were associated with higher relapse rates. Selective attention and delay discounting were unrelated to outcomes. Conclusion: Long-term based decision-making skills are important to commit to the complex and intensive treatment programs of therapeutic communities. The ability to withhold behavioural responses under positive affect is relevant to prevent relapse. Both skills should be assessed and potentially trained during therapeutic community treatment.
| Original language | English |
|---|---|
| Pages (from-to) | 33-38 |
| Number of pages | 6 |
| Journal | Journal of Substance Abuse Treatment |
| Volume | 96 |
| DOIs | |
| Publication status | Published - 1 Jan 2019 |
Keywords
- Cognitive impulsivity
- Dropout
- Relapse
- Substance use disorders
- Therapeutic community
- Treatment adherence
Cite this
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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; Díaz-Batanero, Carmen; Lozano, Óscar M.; Marín, José Andrés Lorca; Verdejo-García, Antonio.
In: Journal of Substance Abuse Treatment, Vol. 96, 01.01.2019, p. 33-38.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Specific aspects of cognitive impulsivity are longitudinally associated with lower treatment retention and greater relapse in therapeutic community treatment
AU - Barreno, Enrique Moraleda
AU - Domínguez-Salas, Sara
AU - Díaz-Batanero, Carmen
AU - Lozano, Óscar M.
AU - Marín, José Andrés Lorca
AU - Verdejo-García, Antonio
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Introduction: Impulsivity has been consistently associated with poorer addiction treatment outcomes. However, impulsivity is a multifaceted construct and current evidence have failed to unravel which specific aspects explain this relationship. There is also limited research examining long-term outcomes. We aimed to examine the longitudinal association between baseline performance on a comprehensive battery of impulsivity measures and retention and relapse at the end of treatment. Methods: The sample comprised 68 participants with miscellaneous diagnoses of substance use disorders and polysubstance use patterns, enrolled in public residential therapeutic communities in Andalusia (Spain). At baseline, we applied measures of selective attention (Stroop), response inhibition (Affective Go/No Go), delay discounting (Monetary Choice Questionnaire; MCQ), and decision-making (Iowa Gambling Task; IGT). At the end of treatment (mean = 148.36 days, range = 22–289 days), we collected outcome measures of retention (coded by the clinical team as completion or dropout based on statewide practice guidelines) and relapse (defined as at least two separate alcohol/drug use episodes based on urine analyses). Results: Cox regression models showed that poorer decision-making in the IGT was associated with premature treatment dropout, whereas elevated commission errors in the Affective Go/No Go were associated with higher relapse rates. Selective attention and delay discounting were unrelated to outcomes. Conclusion: Long-term based decision-making skills are important to commit to the complex and intensive treatment programs of therapeutic communities. The ability to withhold behavioural responses under positive affect is relevant to prevent relapse. Both skills should be assessed and potentially trained during therapeutic community treatment.
AB - Introduction: Impulsivity has been consistently associated with poorer addiction treatment outcomes. However, impulsivity is a multifaceted construct and current evidence have failed to unravel which specific aspects explain this relationship. There is also limited research examining long-term outcomes. We aimed to examine the longitudinal association between baseline performance on a comprehensive battery of impulsivity measures and retention and relapse at the end of treatment. Methods: The sample comprised 68 participants with miscellaneous diagnoses of substance use disorders and polysubstance use patterns, enrolled in public residential therapeutic communities in Andalusia (Spain). At baseline, we applied measures of selective attention (Stroop), response inhibition (Affective Go/No Go), delay discounting (Monetary Choice Questionnaire; MCQ), and decision-making (Iowa Gambling Task; IGT). At the end of treatment (mean = 148.36 days, range = 22–289 days), we collected outcome measures of retention (coded by the clinical team as completion or dropout based on statewide practice guidelines) and relapse (defined as at least two separate alcohol/drug use episodes based on urine analyses). Results: Cox regression models showed that poorer decision-making in the IGT was associated with premature treatment dropout, whereas elevated commission errors in the Affective Go/No Go were associated with higher relapse rates. Selective attention and delay discounting were unrelated to outcomes. Conclusion: Long-term based decision-making skills are important to commit to the complex and intensive treatment programs of therapeutic communities. The ability to withhold behavioural responses under positive affect is relevant to prevent relapse. Both skills should be assessed and potentially trained during therapeutic community treatment.
KW - Cognitive impulsivity
KW - Dropout
KW - Relapse
KW - Substance use disorders
KW - Therapeutic community
KW - Treatment adherence
UR - http://www.scopus.com/inward/record.url?scp=85055312240&partnerID=8YFLogxK
U2 - 10.1016/j.jsat.2018.10.004
DO - 10.1016/j.jsat.2018.10.004
M3 - Article
VL - 96
SP - 33
EP - 38
JO - Journal of Substance Abuse Treatment
JF - Journal of Substance Abuse Treatment
SN - 0740-5472
ER -