Cognitive and metacognitive factors among alcohol-dependent patients during a residential rehabilitation program: a pilot study

Abstract

PurposeThe aims of this pilot study were to examine cognitive factors (brooding and craving) together with positive/negative metacognitive beliefs about alcohol during a residential program for alcohol addiction and to explore relationships with psychological variables at discharge, with the scope of identifying predictive factors of psychological outcome and patients at greatest risk of relapse.MethodsThirty patients underwent a brief semistructured interview on admission to a 28-day rehabilitation program for alcohol addiction, and completed at admission and discharge the following five self-report questionnaires: 1) brooding (Brooding subscale of Ruminative Response Scale [B-RRS]), 2) craving (Penn Alcohol Craving Scale [PACS]), 3) positive beliefs about alcohol use (Positive Alcohol Metacognitions Scale [PAMS]), 4) negative beliefs about alcohol use (Negative Alcohol Metacognitions Scale [NAMS]), and 5) the psychophysical state of health (Cognitive Behavioral Assessment – Outcome Evaluation [CBA-OE]).ResultsSignificant changes were found between admission and discharge in CBA-OE, B-RRS, and PACS. Brooding at admission was a significant predictor of post-treatment psychological variables of “anxiety”, “depression”, and “psychological distress”, whereas craving at admission was a good predictor of “perception of positive change” at discharge.ConclusionOur results confirm the importance of brooding in mood regulation and its role in the development and maintenance of problem drinking. In addition, craving was negatively associated with the perception of positive change in the post-treatment outcomes and was a predictor of this psychological variable, which includes features related to the individual’s resilience and strength. The changes in metacognitive beliefs regarding alcohol use were not statistically significant, but we found a reduction in positive metacognitions and an increase in negative alcohol-related beliefs; future studies are needed to further explore this issue.

<p>Difficulties In Emotion Regulation During Rehabilitation For Alcohol Addiction: Correlations With Metacognitive Beliefs About Alcohol Use And Relapse Risk</p>

“…After the rehabilitation program, all symptoms of distress or psychological discomfort fell within normal values (Figure 4) as observed in our pilot study33 and the difficulties in emotion regulation also decreased, reaching values lower than the median score of the scale. With respect to the other cognitive and metacognitive variables (positive and negative alcohol beliefs and craving), we found a general significant improvement.…”

<p>Cognitive Impairments in Early-Detoxified Alcohol-Dependent Inpatients and Their Associations with Socio-Demographic, Clinical and Psychological Factors: An Exploratory Study</p>

“…First, although several studies in this specific clinical population used similar numbers, the sample size is quite small and only limited quantitative analyses were performed since the main focus was to describe qualitatively the cognitive deficits in patients undergoing treatment for AUD. 12 , 13 , 68 , 79 However, this represents an exploratory study and further research are needed to increase the validity of the results. Second, this study is cross-sectional, with a single neuropsychological assessment of early-detoxified patients; it would be useful to use a longitudinal perspective in order to study cognitive changes over time after detoxification.…”

Mental Imagery Skills in Alcohol-Dependent Subjects and Their Associations With Cognitive Performance: An Exploratory Study During Residential Rehabilitation

“…Thirty-six subjects who completed the 28-days rehabilitation program for alcohol addiction by Department of Physical & Rehabilitation Medicine of ICS Maugeri Spa SB (Institute of Genoa) were included in this pilot study. The subjects admitted to residential rehabilitation held desire to stop drinking and a willingness to undergo an intensive therapeutic program characterized by a short duration and a high intensity of care ( 31 , 32 ). Inclusion criteria to the study were as follows: age >18 years, current diagnosis of alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders , Fifth Edition, (DSM-5) ( 33 ), absence of dementia (evaluated with Mini–Mental State Examination ≥24), understanding of the Italian language (if foreigners subjects) and participation in ≥80% of the proposed rehabilitation sessions.…”

“…The neuropsychological battery and MI Test were administrated at the beginning of residential treatment after 7 days of complete detoxification. Two trained neuropsychologists, not aware of the aims of the study, carried out MIT test and neuropsychological assessment, according to standardized procedures, The residential treatment included: evaluation and treatment of acute withdrawal symptoms, cognitive behavioral therapy, group activities, physiotherapy, and education on alcohol related risk and skills training ( 31 , 35 ).…”