A Newly Designed Mobile-Based Computerized Cognitive Addiction Therapy App for the Improvement of Cognition Impairments and Risk Decision Making in Methamphetamine Use Disorder: Randomized Controlled Trial

Abstract

BackgroundCognitive rehabilitation therapy has been found to improve cognitive deficits and impulse control problems in methamphetamine use disorder (MUD). However, there is limited research regarding this therapy’s feasibility when using mobile-based health technologies in supporting recovery from MUD in China.ObjectiveThe main aim of this study was to test whether 4 weeks of a newly designed computerized cognitive addiction therapy (CCAT) app can improve cognitive impairments, eliminate drug-related attention bias, and attenuate risk decision-making behaviors in participants with MUD.MethodsForty MUD participants were assigned randomly to either the CCAT group (n=20), who received 4 weeks of CCAT plus regular detoxification treatment as usual, or the control group (n=20), who only received the regular detoxification treatment as usual, in drug rehabilitation centers in Shanghai. The CCAT was designed by combine methamphetamine use-related picture stimuli with cognitive training with the aim of improving cognitive function and eliminating drug-related attention bias. The CogState Battery, Delay Discounting Task (DDT), Iowa Gambling Task (IGT), and Balloon Analog Risk Task (BART) were administered face-to-face to all participants before and after CCAT interventions.ResultsForty male patients were recruited. The mean age was 32.70 (SD 5.27) years in the CCAT group and mean 35.05 (SD 8.02) years in the control group. Compared to the control group, CCAT improved working memory in the CCAT group (P=.01). Group×time interactions were observed among DDT, IGT, and BART tasks, with rates of discounting delayed rewards, IGT, and BART scores (P<.001) being reduced among those who received CCAT, whereas no changes were found in the control group.ConclusionsThe newly designed CCAT can help to improve cognitive impairment and impulsive control in MUD. Further study is needed to understand the underlying brain mechanisms of the cognitive therapy.Trial RegistrationClinicalTrials.gov NCT03318081; https://clinicaltrials.gov/ct2/show/NCT03318081 (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT03318081)

Methamphetamine‐associated psychosis: Clinical presentation, biological basis, and treatment options

“…Computerized cognitive addiction therapy (CCAT) represents another computer/digital‐based therapy with potential therapeutic benefit for treating methamphetamine addiction (Zhu et al, ). Previous findings demonstrate cognitive function and decision making as predictors of long‐term prognosis in methamphetamine use.…”

“…CCAT methods have been shown to produce cognitive benefits for both schizophrenia and substance use disorders. A pilot RCT of a novel mobile‐based CCAT app for methamphetamine use found that CCAT therapy improved performance on both cognitive function (Chinese version of CogState Battery) and impulse control tasks (e.g., Balloon Analog Risk Task, Delay Discounting Task, Iowa Gambling Task) when compared with treatment as usual controls (d'Amato et al, ; Zhu et al, ).…”

“…Computerized cognitive addiction therapy (CCAT) represents another computer/digital-based therapy with potential therapeutic benefit for treating methamphetamine addiction (Zhu et al, 2018).…”

“…Analog Risk Task, Delay Discounting Task, Iowa Gambling Task) when compared with treatment as usual controls (d' Amato et al, 2011;Zhu et al, 2018).…”

Cognitive Training for the Treatment of Addictions Mediated by Information and Communication Technologies (ICT)

“…Kapitány-Fövény et al [52] presented an interactive application that focuses on the prevention of psychoactive substance use by developing six modules: (1) interactive comics/cartoons, telling recovery stories; (2) quiz game; (3) role play; (4) introduction of psychoactive drugs; (5) information on the somatic and psychological effects of psychoactive substances; (6) list of available treatment units, rehabilitation and self-help groups in Hungary. Zhu et al [53] concluded that computerized cognitive therapy helps cognitive impairment and impulse control of patients with substance use disorder and invited them to continue with this research line for the understanding of the underlying brain mechanisms of cognitive therapy. Finally, Kiluk et al [54], through a review of the literature, found results that show benefits in interventions based on Cognitive Behavioral Therapy developed through technology with chronic alcohol consumers.…”