Division of Substance Abuse, Yale University School of Medicine, West Haven, CT 06516, USA.
Drug Alcohol Depend. 2011 Apr 1;114(2-3):169-76. doi: 10.1016/j.drugalcdep.2010.09.019. Epub 2010 Nov 2.
Coping skills training is an important component of cognitive behavioral therapy (CBT), yet cognitive impairment and related limitations that are often associated with chronic substance use may interfere with an ability to learn, retain, or use new information. Little previous research has examined the cognitive or neuropsychological factors that may affect substance users' ability to learn new coping skills in CBT.
Fifty-two substance dependent individuals randomized to receive a computerized version of cognitive behavioral therapy (CBT4CBT) or treatment as usual (TAU) were administered several cognitive and neuropsychological measures, as well as a coping skills measure prior to and upon completing an 8-week treatment period.
Across treatment conditions, participants who scored above the median on a measure of IQ demonstrated greater improvement in the quality of their coping skills than those below the median on IQ (Group×Time, F(1,49)=4.31, p<.05). Also, IQ had a significant indirect effect on substance use outcomes through an effect on the quality of coping skills acquired, specifically for those who received CBT4CBT.
Individuals with higher IQ at baseline improved the quality of their coping skills more than those with lower IQ, which in turn reduced rates of substance use following treatment. This highlights the impact of substance users' cognitive functioning and abilities on the acquisition of coping skills from CBT, and suggests need for greater awareness and tailoring of coping skills training for those with poorer functioning.
应对技能训练是认知行为疗法(CBT)的重要组成部分,然而,与慢性物质使用相关的认知障碍和相关限制可能会干扰学习、保留或使用新信息的能力。以前很少有研究探讨可能影响物质使用者在 CBT 中学习新应对技能的认知或神经心理学因素。
52 名物质依赖者随机分配接受计算机化认知行为疗法(CBT4CBT)或常规治疗(TAU),在接受 8 周治疗期前后,他们接受了几种认知和神经心理学测试,以及应对技能测试。
在治疗条件下,智商测试得分高于中位数的参与者在应对技能的质量上比智商得分低于中位数的参与者有更大的改善(组间×时间,F(1,49)=4.31,p<.05)。此外,智商通过对获得的应对技能质量的影响对物质使用结果有显著的间接影响,特别是对于接受 CBT4CBT 的参与者。
基线智商较高的个体比智商较低的个体在应对技能的质量上有更大的改善,这反过来又降低了治疗后的物质使用率。这突显了物质使用者的认知功能和能力对 CBT 中应对技能习得的影响,并表明需要对认知功能较差的个体更加重视和调整应对技能训练。