TY - JOUR
T1 - Cognitive training and remediation interventions for substance use disorders
T2 - a Delphi consensus study
AU - Verdejo-Garcia, Antonio
AU - Rezapour, Tara
AU - Giddens, Emily
AU - Khojasteh Zonoozi, Arash
AU - Rafei, Parnian
AU - Berry, Jamie
AU - Caracuel, Alfonso
AU - Copersino, Marc L.
AU - Field, Matt
AU - Garland, Eric L.
AU - Lorenzetti, Valentina
AU - Malloy-Diniz, Leandro
AU - Manning, Victoria
AU - Marceau, Ely M.
AU - Pennington, David L.
AU - Strickland, Justin C.
AU - Wiers, Reinout
AU - Fairhead, Rahia
AU - Anderson, Alexandra
AU - Bell, Morris
AU - Boendermaker, Wouter J.
AU - Brooks, Samantha
AU - Bruno, Raimondo
AU - Campanella, Salvatore
AU - Cousijn, Janna
AU - Cox, W. Miles
AU - Dean, Andrew C.
AU - Ersche, Karen D.
AU - Franken, Ingmar
AU - Froeliger, Brett
AU - Gamito, Pedro
AU - Gladwin, Thomas E.
AU - Goncalves, Priscila D.
AU - Houben, Katrijn
AU - Jacobus, Joanna
AU - Jones, Andrew
AU - Kaag, Anne M.
AU - Lindenmeyer, Johannes
AU - McGrath, Elly
AU - Nardo, Talia
AU - Oliveira, Jorge
AU - Pennington, Charlotte R.
AU - Perrykkad, Kelsey
AU - Piercy, Hugh
AU - Rupp, Claudia I.
AU - Schulte, Mieke H.J.
AU - Squeglia, Lindsay M.
AU - Staiger, Petra
AU - Stein, Dan J.
AU - Stein, Jeff
AU - Stein, Maria
AU - Stoops, William W.
AU - Sweeney, Mary
AU - Witkiewitz, Katie
AU - Woods, Steven P.
AU - Yi, Richard
AU - Zhao, Min
AU - Ekhtiari, Hamed
N1 - Publisher Copyright:
© 2022 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.
PY - 2023/5
Y1 - 2023/5
N2 - 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.
AB - 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.
KW - Cognitive remediation
KW - Delphi method
KW - cognitive training
KW - interventions
KW - neuroscience
KW - treatment
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U2 - 10.1111/add.16109
DO - 10.1111/add.16109
M3 - Article
C2 - 36508168
AN - SCOPUS:85145333497
SN - 0965-2140
VL - 118
SP - 935
EP - 951
JO - Addiction
JF - Addiction
IS - 5
ER -