Department of Clinical Psychology, Universidad de Granada, Spain.
Drug Alcohol Depend. 2012 Apr 1;122(1-2):142-8. doi: 10.1016/j.drugalcdep.2011.09.025. Epub 2011 Oct 21.
We aimed to explore the association between baseline executive functioning and treatment outcome in Therapeutic Communities (TCs).
We used a longitudinal descriptive design: a baseline neuropsychological assessment was performed within the first 30 days of treatment in TCs. Once participants finished or abandoned treatment, the information about time of stay in treatment was computed for each individual. The study was conducted across six TCs located in the region of Andalusia (Spain): Cartaya, Almonte, Mijas, Los Palacios, La Línea, and Tarifa. Participants were 131 patients with cocaine dependence who initiated and finished treatment in TCs between January 2009 and December 2010 (2 years). Cognitive assessment was composed of general measures of executive functioning: Letter Number Sequencing (working memory) and Similarities (reasoning), and executive tasks sensitive to ventromedial prefrontal cortex dysfunction, including the Delis-Kaplan Stroop test (inhibition/cognitive switching), the Revised-Strategy Application Test (strategy application/multitasking), and the Iowa Gambling Task (decision-making). The outcome measure was retention, defined as time in TC treatment (number of days).
Poor executive functioning significantly predicted shorter treatment retention in cocaine dependent individuals on TC residential treatment (14% of explained variance). Reduced performance on the R-SAT, a multitasking test taxing the ability to develop and apply the best strategy to organize multiple sub-routine tasks in order to achieve a long-term goal, was the most powerful predictor of treatment retention.
Self-regulation deficits predict the capacity to remain in residential treatment among cocaine dependents.
我们旨在探讨治疗性社区（TC）中基线执行功能与治疗结果之间的关系。
我们采用了纵向描述性设计：在 TC 治疗的头 30 天内进行基线神经心理评估。一旦参与者完成或放弃治疗，就会为每个个体计算治疗时间的信息。该研究在位于安达卢西亚（西班牙）的六个 TC 中进行：卡塔亚、阿尔蒙特、米哈斯、洛斯帕拉西奥斯、拉林哈和塔里法。参与者是 131 名可卡因依赖患者，他们在 2009 年 1 月至 2010 年 12 月期间在 TC 中开始并完成了治疗（2 年）。认知评估包括执行功能的一般测量：字母数字排序（工作记忆）和相似性（推理），以及对腹内侧前额叶皮层功能障碍敏感的执行任务，包括德利斯-卡普兰斯特鲁普测试（抑制/认知转换）、修订策略应用测试（策略应用/多任务处理）和爱荷华赌博任务（决策）。结果衡量标准是保留率，定义为 TC 治疗时间（天数）。
在接受 TC 住院治疗的可卡因依赖个体中，执行功能较差显著预测治疗保留时间较短（解释方差的 14%）。在 R-SAT 上表现不佳，这是一项多任务测试，测试了开发和应用最佳策略以组织多个子例行任务以实现长期目标的能力，是治疗保留的最强预测因素。
自我调节缺陷预测可卡因依赖者在住院治疗中的保留能力。
