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Cognitive Training and Remediation Interventions for Substance Use Disorders: A Delphi Consensus Study Publisher Pubmed



Verdejogarcia A1 ; Rezapour T2 ; Giddens E1 ; Khojasteh Zonoozi A3 ; Rafei P3 ; Berry J4 ; Caracuel A5 ; Copersino ML6 ; Field M7 ; Garland EL8 ; Lorenzetti V9 ; Malloydiniz L10 ; Manning V11 ; Marceau EM12 Show All Authors
Authors
  1. Verdejogarcia A1
  2. Rezapour T2
  3. Giddens E1
  4. Khojasteh Zonoozi A3
  5. Rafei P3
  6. Berry J4
  7. Caracuel A5
  8. Copersino ML6
  9. Field M7
  10. Garland EL8
  11. Lorenzetti V9
  12. Malloydiniz L10
  13. Manning V11
  14. Marceau EM12
  15. Pennington DL13
  16. Strickland JC14
  17. Wiers R15
  18. Fairhead R1
  19. Anderson A1
  20. Bell M16
  21. Boendermaker WJ17
  22. Brooks S18
  23. Bruno R19
  24. Campanella S20
  25. Cousijn J21
  26. Cox WM22
  27. Dean AC23
  28. Ersche KD24
  29. Franken I21
  30. Froeliger B25
  31. Gamito P26
  32. Gladwin TE27
  33. Goncalves PD28
  34. Houben K29
  35. Jacobus J30
  36. Jones A31
  37. Kaag AM32
  38. Lindenmeyer J33
  39. Mcgrath E34
  40. Nardo T35
  41. Oliveira J26
  42. Pennington CR36
  43. Perrykkad K37
  44. Piercy H38
  45. Rupp CI39
  46. Schulte MHJ32
  47. Squeglia LM40
  48. Staiger P41
  49. Stein DJ42
  50. Stein J43
  51. Stein M44
  52. Stoops WW45
  53. Sweeney M46
  54. Witkiewitz K47
  55. Woods SP48
  56. Yi R49
  57. Zhao M50
  58. Ekhtiari H51
Show Affiliations
Authors Affiliations
  1. 1. School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
  2. 2. Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran
  3. 3. Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, NSW, Australia
  5. 5. Mind, Brain and Behavior Research Center, Universidad de Granada, Granada, Spain
  6. 6. McLean Hospital and Harvard Medical School, Belmont, MA, United States
  7. 7. Department of Psychology, University of Sheffield, Sheffield, United Kingdom
  8. 8. Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, UT, United States
  9. 9. Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioral Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
  10. 10. Mental Health Department, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
  11. 11. Turning Point Drug and Alcohol Centre and Monash Addiction Research Centre (MARC), Monash University, Melbourne, VIC, Australia
  12. 12. School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
  13. 13. Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
  14. 14. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
  15. 15. Addiction Development and Psychopathology (ADAPT) Laboratory, Department of Psychology, Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands
  16. 16. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
  17. 17. Addiction, Development, and Psychopathology (ADAPT) Laboratory, Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
  18. 18. Research Centre for Brain and Behaviour, School of Psychology, Faculty of Health, Liverpool John Moores University, United Kingdom
  19. 19. School of Psychology, University of Tasmania, TAS, Hobart, Australia
  20. 20. Laboratoire de Psychologie Medicale et d’Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Universite Libre de Bruxelles, Bruxelles, Belgium
  21. 21. Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Netherlands
  22. 22. School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
  23. 23. Department of Psychiatry and Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, CA, United States
  24. 24. Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
  25. 25. Department of Psychiatry and Psychological Sciences, University of Missouri, Columbia, MO, United States
  26. 26. HEI-Lab, Lusofona University, Lisbon, Portugal
  27. 27. No affiliation/independent researcher, London, United Kingdom
  28. 28. Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States
  29. 29. Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
  30. 30. Department of Psychiatry, University of California San Diego, CA, United States
  31. 31. Department of Psychology, University of Liverpool, United Kingdom
  32. 32. Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Netherlands
  33. 33. Salus Klinik Lindow, Lindlow, Germany
  34. 34. Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
  35. 35. School of Psychological Sciences, Macquarie University, NSW, Australia
  36. 36. School of Psychology, Aston University, Birmingham, United Kingdom
  37. 37. Cognition and Philosophy Laboratory, Monash Centre for Consciousness and Contemplative Studies, Monash University, Melbourne, VIC, Australia
  38. 38. Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
  39. 39. Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Clinics of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
  40. 40. Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States
  41. 41. School of Psychology, Deakin University, Melbourne, VIC, Australia
  42. 42. SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
  43. 43. Center for Health Behaviors Research, Fralin Biomedical Research Institute at Virginial Tech, VA, United States
  44. 44. Department for Clinical Psychology and Psychotherapy, University of Bern, Switzerland
  45. 45. Department of Behavioral Science, University of Kentucky, Lexington, KY, United States
  46. 46. Behavioral Pharmacology Research Unit, Johns Hopkins School of Medicine, Baltimore, MD, United States
  47. 47. Department of Psychology and Center on Alcohol, Substance Use and Addictions, University of New Mexico, NM, United States
  48. 48. Department of Psychology, University of Houston, Houston, TX, United States
  49. 49. Department of Psychology, University of Kansas, Lawrence, KS, United States
  50. 50. Shanghai Jiaotong University School of Medicine, Shanghai, China
  51. 51. Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States

Source: Addiction Published:2023


Abstract

Aims: Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training and remediation interventions are well suited to fill the gap for managing cognitive deficits in SUD. We aimed to reach consensus on recommendations for developing and applying these interventions. Design, Setting and Participants: We used a Delphi approach with two sequential phases: survey development and iterative surveying of experts. This was an on-line study. During survey development, we engaged a group of 15 experts from a working group of the International Society of Addiction Medicine (Steering Committee). During the surveying process, we engaged a larger pool of experts (n = 54) identified via recommendations from the Steering Committee and a systematic review. Measurements: Survey with 67 items covering four key areas of intervention development: targets, intervention approaches, active ingredients and modes of delivery. Findings: Across two iterative rounds (98% retention rate), the experts reached a consensus on 50 items including: (i) implicit biases, positive affect, arousal, executive functions and social processing as key targets of interventions; (ii) cognitive bias modification, contingency management, emotion regulation training and cognitive remediation as preferred approaches; (iii) practice, feedback, difficulty-titration, bias modification, goal-setting, strategy learning and meta-awareness as active ingredients; and (iv) both addiction treatment work-force and specialized neuropsychologists facilitating delivery, together with novel digital-based delivery modalities. Conclusions: Expert recommendations on cognitive training and remediation for substance use disorders highlight the relevance of targeting implicit biases, reward, emotion regulation and higher-order cognitive skills via well-validated intervention approaches qualified with mechanistic techniques and flexible delivery options. © 2022 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.