Neurocognitive predictors of treatment outcome in a sample of abstinent alcohol and amphetamine users attending a residential substance dependence treatment facility

Stuart Andrews

The chronic and prolonged use of alcohol and illicit substances has been associated with serious neurocognitive impairment. The aim of this study was to examine whether this impairment impacts upon treatment outcomes in contemporary substance dependence treatment programs. Specifically, the study examined whether level of neurocognitive functioning was associated with outcomes in an intensive 17 week residential substance dependent treatment program. After withdrawal and detoxification, 33 alcohol dependent and 27 amphetamine dependent participants completed a psychometric battery assessing three domains of executive functioning (i.e. cognitive flexibility, verbal fluency & working memory) as well as memory and learning, attention and speed of information processing. Treatment outcomes pre and post treatment were also collated (viz. perceived self-efficacy to abstain from substance use; the use of coping behaviours to prevent relapse; emotional regulation skills; and treatment completion). A series of hierarchical multiple regressions were computed to assess whether psychometric test performance could predict treatment outcome. The results indicate that treatment outcome was associated with performance in each executive functioning domain. Also, treatment completers demonstrated significantly better performance iri the memory and learning and working memory domains than treatment non-completers. Poorer performance on the tests of attention was also associated with poorer treatment outcomes. Contrary to expectations, no between-group differences were found between the alcohol and amphetamine dependent groups on any of the neurocognitive domains. More generally, this study found that following a protracted period of abstinence, neurocognitive functioning was associated with treatment efficacy in a substance dependence program. These findings demonstrate the utility of understanding the role of neurocognitive functioning in responses to substance dependence treatment. Keywords: Substance dependence; Amphetamine dependence; Alcohol dependence; Neurocognitive functioning; Executive functioning; Treatment outcome; Abstinence

Neurocognitive predictors of treatment outcome in a sample of abstinent alcohol and amphetamine users attending a residential substance dependence treatment facility

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