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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

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.
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