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动机性访谈结合国际象棋可加速可卡因依赖患者执行功能的改善:一项为期一个月的前瞻性研究。

Motivational interviewing combined with chess accelerates improvement in executive functions in cocaine dependent patients: a one-month prospective study.

作者信息

Gonçalves Priscila Dib, Ometto Mariella, Bechara Antoine, Malbergier André, Amaral Ricardo, Nicastri Sergio, Martins Paula A, Beraldo Livia, dos Santos Bernardo, Fuentes Daniel, Andrade Arthur G, Busatto Geraldo F, Cunha Paulo Jannuzzi

机构信息

Interdisciplinary Group of Studies on Alcohol and Drugs (GREA), Institute of Psychiatry (IPq), School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil; Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), USP, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil; Psychology & Neuropsychology Service, IPq, USP, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil.

Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), USP, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil.

出版信息

Drug Alcohol Depend. 2014 Aug 1;141:79-84. doi: 10.1016/j.drugalcdep.2014.05.006. Epub 2014 May 24.

Abstract

BACKGROUND

In cocaine-dependent individuals, executive function (EF) deficits are associated with poor treatment outcomes. Psychological interventions and pharmacological approaches have produced only modest effect sizes. To date, studies of this topic have been few and limited. The aim of this study was to examine the effects of a new model of intervention, which integrates chess and Motivational Interviewing, Motivational Chess (MC) METHODS: We evaluated 46 cocaine-dependent inpatients (aged 18-45), in two groups-MC (n=26); and active comparison-AC (n=20). Using neuropsychological tests and an impulsivity scale, we assessed the subjects before and after the study period (one month of abstinence monitored by urine toxicology screening).

RESULTS

The MC and AC groups did not differ at baseline. In the post-intervention assessment (after one month), both groups showed significant improvements in attention, mental flexibility, inhibitory control, abstraction abilities, and decision-making (p<0.01). In addition, the improvement in working memory was more significant in the MC group than in the AC group (group-by-time interaction, p=01).

CONCLUSIONS

One month of abstinence was sufficient to improve various attentional and executive domains in cocaine-dependent subjects. The MC intervention was associated with greater improvements in EFs, especially working memory, suggesting that tailored interventions focusing on complex EFs accelerate the process of cognitive recovery during the initial period of abstinence.

摘要

背景

在可卡因依赖个体中,执行功能(EF)缺陷与治疗效果不佳相关。心理干预和药物治疗方法仅产生了中等程度的效应量。迄今为止,关于该主题的研究很少且有限。本研究的目的是检验一种新的干预模式——动机性国际象棋(MC)的效果,该模式整合了国际象棋和动机性访谈。

方法

我们评估了46名年龄在18 - 45岁的可卡因依赖住院患者,分为两组——MC组(n = 26);和积极对照组——AC组(n = 20)。使用神经心理学测试和冲动性量表,在研究期(通过尿液毒理学筛查监测一个月的戒断情况)前后对受试者进行评估。

结果

MC组和AC组在基线时无差异。在干预后评估(一个月后),两组在注意力、心理灵活性、抑制控制、抽象能力和决策方面均有显著改善(p < 0.01)。此外,MC组工作记忆的改善比AC组更显著(组间时间交互作用,p = 0.01)。

结论

一个月的戒断足以改善可卡因依赖受试者的各种注意力和执行领域。MC干预与执行功能的更大改善相关,尤其是工作记忆,这表明针对复杂执行功能的定制干预可加速戒断初期的认知恢复过程。

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