The impact of cognitive training in substance use disorder: the effect of working memory training on impulse control in methamphetamine users

Abstract

ObjectivesImpulsivity is a vulnerability trait for poor self-regulation in substance use disorder (SUD). Working memory (WM) training improves impulsivity and self-regulation in psychiatric disorders. Here we test WM training in methamphetamine use disorder (MUD).MethodsThere are 15 MUD patients receiving inpatient treatment as usual (TAU) and 20 who additionally completed WM cognitive training (CT) and 25 healthy controls (HC). MANCOVA repeated measures analyses examined changes in impulsivity and self-regulation at baseline and after 4 weeks.ResultsPost hoc t tests confirmed that at baseline, feelings of self-control were significantly lower in the MUD (t = 2.001, p = 0.05) and depression was higher (t = 4.980, p = 0.001), as was BIS total impulsivity (t = 5.370, p = 0.001) compared to the HC group. Total self-regulation score was higher in HC than MUD patients (t = 5.370, p = 0.001). CT had a 35% learning rate (R 2 = 0.3523, p < 0.05). Compared to follow-up TAU, follow-up CT group had higher self-reported mood scores (t = 2.784, p = 0.01) and higher compared to CT baseline (t = 2.386, p = 0.036). Feelings of self-control were higher in CT than TAU at follow-up (t = 2.736, p = 0.012) and also compared to CT baseline (t = 3.390, p = 0.006), lack of planning significantly improved in CT between baseline and follow-up (t = 2.219, p = 0.048), as did total impulsivity scores (t = 2.085, p = 0.048). Measures of self-regulation were improved in the CT group compared to TAU at follow-up, in total score (t = 2.442, p = 0.038), receiving score (t = 2.314, p = 0.029) and searching score (t = 2.362, p = 0.027). Implementing self-regulation was higher in the CT group compared to TAU (t = 2.373, p = 0.026).ConclusionsWM training may improve control of impulsivity and self-regulation in people with MUD.

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 (Preprint)

“…These researches have already indicated the underlining relationship between cognitive training and impulsive control enhancement, either measure by cognitive tasks or self-report measures [32,34]. In this study，our results not only revealed the similar trend, but also in cognitive tasks such as DDT and IGT.…”

“…Previous studies have proved that computerized cognitive related training showed promising treatment effect and even brain plasticity in substance use disorder patients, such as stimulants, cocaine, methamphetamine, alcohol and nicotine [32,33]. However, these researches either only used cognitive training such as working memory training or cognitive bias modification training.…”

The neurobiology of impulsivity and substance use disorders: implications for treatment

“…This includes targeting underlying processes involved in impulsivity and SUDs (i.e., working memory (WM) and attention) to validate behavioral measures of impulsivity . For instance, WM training can improve SUD outcomes . The second approach, behavioral measures are easy to administer in both species, thus requiring a modest amount of training, which may allow the ability to determine the efficacy of individualized treatments targeting impulsivity and SUD .…”

“…Three studies have been conducted investigating behavioral treatments for impulsivity and stimulant use. Black and Rosen conducted an RCT of the Advisor‐Teller monetary manager (ATM) intervention compared with a control condition in cocaine users. ATM addresses money management problems in substance abuse and provides help from therapists with planning and monitoring budgets .…”

“…They found that in individuals with high impulsivity had reduced abstinence rates in the low magnitude condition, but not in the high‐magnitude condition, signifying that high magnitude CM might be more effective in impulsive cocaine users . Finally, Brooks et al . investigated the effects of WM cognitive training (CT) compared with treatment as usual in methamphetamine users and healthy controls.…”