Cognitive training and remediation interventions for substance use disorders: a Delphi consensus study.
Journal: Addiction (Abingdon, England)
Volume: 118
Issue: 5
Year of Publication: 2023
Affiliated Institutions:
School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia.
Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran.
Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.
Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, NSW, Australia.
Mind, Brain and Behavior Research Center, Universidad de Granada, Granada, Spain.
McLean Hospital and Harvard Medical School, Belmont, MA, USA.
Department of Psychology, University of Sheffield, Sheffield, UK.
Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, UT, USA.
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.
Mental Health Department, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Turning Point Drug and Alcohol Centre and Monash Addiction Research Centre (MARC), Monash University, Melbourne, VIC, Australia.
School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Addiction Development and Psychopathology (ADAPT) Laboratory, Department of Psychology, Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands.
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Addiction, Development, and Psychopathology (ADAPT) Laboratory, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands.
Research Centre for Brain and Behaviour, School of Psychology, Faculty of Health, Liverpool John Moores University, UK.
School of Psychology, University of Tasmania, TAS, Hobart, Australia.
Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles, Bruxelles, Belgium.
Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, the Netherlands.
School of Human and Behavioural Sciences, Bangor University, Bangor, UK.
Department of Psychiatry and Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, CA, USA.
Department of Psychiatry, University of Cambridge, Cambridge, UK.
Department of Psychiatry and Psychological Sciences, University of Missouri, Columbia, MO, USA.
HEI-Lab, Lusófona University, Lisbon, Portugal.
No affiliation/independent researcher, London, UK.
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands.
Department of Psychiatry, University of California San Diego, CA, USA.
Department of Psychology, University of Liverpool, UK.
Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands.
Salus Klinik Lindow, Lindlow, Germany.
Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
School of Psychological Sciences, Macquarie University, NSW, Australia.
School of Psychology, Aston University, Birmingham, UK.
Cognition and Philosophy Laboratory, Monash Centre for Consciousness and Contemplative Studies, Monash University, Melbourne, VIC, Australia.
Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia.
Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Clinics of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria.
Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA.
School of Psychology, Deakin University, Melbourne, VIC, Australia.
SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
Center for Health Behaviors Research, Fralin Biomedical Research Institute at Virginial Tech, VA, USA.
Department for Clinical Psychology and Psychotherapy, University of Bern, Switzerland.
Department of Behavioral Science, University of Kentucky, Lexington, KY, USA.
Behavioral Pharmacology Research Unit, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Department of Psychology and Center on Alcohol, Substance Use and Addictions, University of New Mexico, NM, USA.
Department of Psychology, University of Houston, Houston, TX, USA.
Department of Psychology, University of Kansas, Lawrence, KS, USA.
Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA.
Abstract summary
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.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.Survey with 67 items covering four key areas of intervention development: targets, intervention approaches, active ingredients and modes of delivery.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.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.
Authors & Co-authors:
Verdejo-Garcia Antonio A
Rezapour Tara T
Giddens Emily E
Khojasteh Zonoozi Arash A
Rafei Parnian P
Berry Jamie J
Caracuel Alfonso A
Copersino Marc L ML
Field Matt M
Garland Eric L EL
Lorenzetti Valentina V
Malloy-Diniz Leandro L
Manning Victoria V
Marceau Ely M EM
Pennington David L DL
Strickland Justin C JC
Wiers Reinout R
Fairhead Rahia R
Anderson Alexandra A
Bell Morris M
Boendermaker Wouter J WJ
Brooks Samantha S
Bruno Raimondo R
Campanella Salvatore S
Cousijn Janna J
Cox W Miles WM
Dean Andrew C AC
Ersche Karen D KD
Franken Ingmar I
Froeliger Brett B
Gamito Pedro P
Gladwin Thomas E TE
Goncalves Priscila D PD
Houben Katrijn K
Jacobus Joanna J
Jones Andrew A
Kaag Anne M AM
Lindenmeyer Johannes J
McGrath Elly E
Nardo Talia T
Oliveira Jorge J
Pennington Charlotte R CR
Perrykkad Kelsey K
Piercy Hugh H
Rupp Claudia I CI
Schulte Mieke H J MHJ
Squeglia Lindsay M LM
Staiger Petra P
Stein Dan J DJ
Stein Jeff J
Stein Maria M
Stoops William W WW
Sweeney Mary M
Witkiewitz Katie K
Woods Steven P SP
Yi Richard R
Zhao Min M
Ekhtiari Hamed H
Study Outcome
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