Campbell Family Mental Health Research Institute.
Institute for Mental Health Policy Research.
Psychol Addict Behav. 2018 Dec;32(8):861-872. doi: 10.1037/adb0000415. Epub 2018 Nov 26.
Despite interest in computerized working memory training as a transdiagnostic intervention, little is known about its feasibility and efficacy in addiction treatment settings. This double-blind, randomized controlled trial examined the efficacy of working memory training for improving performance on standardized measures of executive function during inpatient substance use disorder treatment. Secondary outcomes included delay discounting, adherence to cognitive training, and posttreatment relapse. Adults ( = 110) entering inpatient alcohol or drug treatment were randomized to active (adaptive) or control (nonadaptive) training conditions, with up to 25 training sessions spanning inpatient and postdischarge phases. In generalized estimating equation (GEE) analyses, the experimental group showed relatively greater improvements on the primary outcome (digit span performance) based on Time × Treatment interactions in per-protocol ( < .05) and intent-to-treat ( = .07) models. Similar results were observed for one secondary outcome. Lower working memory performance at baseline predicted significantly greater delay discounting; however, no time or treatment effects on discounting were observed. Adherence to cognitive training was generally good during inpatient treatment, but suboptimal overall. These results suggest that implementing cognitive training is feasible in inpatient settings, and that adaptive working memory training can potentially lead to near-transfer effects for select cognitive outcomes. However, further work is necessary to establish training effects on clinical outcomes and to improve adherence in outpatient contexts. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
尽管人们对计算机化工作记忆训练作为一种跨诊断干预措施很感兴趣，但在成瘾治疗环境中，其可行性和疗效知之甚少。这项双盲、随机对照试验研究了工作记忆训练在改善住院物质使用障碍治疗期间执行功能的标准化测量结果方面的效果。次要结果包括延迟折扣、认知训练的依从性和治疗后复发。进入住院酒精或药物治疗的成年人（n=110）被随机分配到主动（适应性）或对照（非适应性）训练条件，最多可进行 25 次训练，横跨住院和出院后阶段。在广义估计方程（GEE）分析中，实验组根据时间×治疗的交互作用，在方案（<0.05）和意向治疗（=0.07）模型中，主要结果（数字跨度表现）显示出相对更大的改善。一个次要结果也观察到了类似的结果。基线时较低的工作记忆表现显著预测了更大的延迟折扣；然而，没有观察到折扣的时间或治疗效果。在住院治疗期间，认知训练的依从性通常较好，但总体上不理想。这些结果表明，在住院环境中实施认知训练是可行的，适应性工作记忆训练可能会对特定认知结果产生近转移效应。然而，需要进一步的工作来建立训练对临床结果的影响，并提高门诊环境中的依从性。（心理信息数据库记录（c）2018 APA，保留所有权利）。
