Clinical Limitations of Neuropsychological Testing in Predicting Treatment Outcome among Alcoholics

Abstract

The purpose of the present study was to investigate a number of factors that may influence the relationship between neuropsychological impairment and treatment outcome among alcoholics. Cognitive deficit upon admission to treatment was significantly related to the individual's age but independent of the years of problem drinking and the recency of the last drink prior to assessment. Significant improvement was noted on measures of neuropsychological function over the period from treatment admission to 6-month follow-up assessment. On the average, improvement in functioning occurred across time despite drinking relapses during the intervening period. The individual's age, but not years of problem drinking, was associated with recovery of function; neither of these variables interacted with subsequent drinking status to affect differentially the changes in cognitive functioning. Finally, selected measures of neuropsychological function assessed both at admission and 6-month follow-up were reliably related to follow-up employment status but unrelated to the average amount of alcohol consumed per day and to the number of heavy drinking days during the 3-month period between the 6- and 9-month follow-ups. The results are discussed in terms of the need for determining the utility of neuropsychological measures in predicting everyday functioning among alcoholics and for selecting domains of assessment other than cognitive status to predict treatment outcome.

Executive Functioning Early in Abstinence From Alcohol

“…It is reasonable to infer that these observed cognitive lapses would have affected real-world functioning in persons with chronic alcohol abuse. Cognitive impairment has been related to posttreatment employment success (Donovan et al, 1984;Moriyama et al, 2002); we found a correlation with an indicator of past employment success (on the ASI). Consistency in this finding may reflect the greater cognitive demnds of work environments.…”

Patient predictors of alcohol treatment outcome: A systematic review

“…For those that do, the total percentage of variance accounted for varies widely from a nonsignificant R 2 = .03 in predicting drinks per day (Donovan, Kivlahan, & Walker, 1984) to R 2 = .62 in predicting DDD (Sobell, Sobell, & Gavin, 1995), with a mean R 2 = .30.…”

“…Notes to Table1: Letters represent the following studies: a, Abbott and Gregson (1981); b, Allsop, Saunders, and Phillips (2000); c, Bottlender and Soyka (2005); d, Breslin et al (1997); e, Burtscheidt, Wolwer, Schwarz, Strauss, and Gaebel (2002); f, Cannon, Keefe, and Clark (1997); g, Canton et al (1988); h, Curran and Booth (1999); i, Donovan et al (1984) and Kivlahan, Sher, and Donovan (1989); j, Driessen et al (2001); k, Duckert (1993); l, Eckardt et al (1988); m, Edwards and Taylor (1994); n, Ellis and McClure (1992); o, Glenn and Parsons (1991) and Parsons, Schaeffer, and Glenn (1990); p, Greenfield et al (2000Greenfield et al ( , 2002Greenfield et al ( , 2003; q, Gregson and Taylor (1977); r, Haver (2003) and Haver, Dahlgren, and Willander (2001); s, Heather et al (1993); t, Heather et al (2000) and Heather and Dawe (2005); u, Hernandez-Avila, Burleson, and Kranzler (1998);v, Hodgins, el-Guebaly, Armstrong, and Dufour (1999); w, Hunter et al (2000) and Powell et al (1992); x, Jones and McMahon (1994b); y, Jones and McMahon (1994a); z, Jones and McMahon (1996); A, Kavanagh et al (1996); B, Kranzler, Mulgrew, Modesto-Lowe, and Burleson (1999); C, Langenbucher et al (1996Langenbucher et al ( , 1997; D, Lemke and ...…”

Executive Dysfunction and Clinical Outcome in Chronic Alcoholics

“…Yoshino and Kato's study showed high reliability of alcoholic patients' self-reports on abstinence (Yoshino and Kato, 1996). Occupation outcome was defined as follows according to Donovan et al (1984): full-time employment was used to refer to subjects who worked 40 or more hours a week and continued that work schedule for a 6-month period. Full-time employment was regarded as occupation (ϩ).…”

“…On one hand, some researchers have documented a relationship between cognitive deficits and alcoholspecific behavior, such as amount of alcohol consumed (Abbott and Gregson, 1981;O'Leary et al, 1979;Parsons et al, 1990). On the other hand, other investigators have reported that cognitive impairment relates more closely to alcohol-nonspecific outcome (occupation) than alcoholspecific outcome (drinking) (Alterman et al, 1990;Donovan et al, 1984;Kato, 1996). The purpose of this study was to investigate whether performance on various neuropsychological tests, the BADS in particular, predicts alcoholic's alcohol-specific and/or nonspecific outcome.…”