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ABSTRACT: Background
Decision-making processes have been posited to affect treatment outcome in addicted patients.Objective
The present multi-site study assessed whether two measures of decision-making predicted relapse and subsequent use in stimulant-dependent patients.Methods
A total of 160 methamphetamine- or cocaine-dependent patients participating in a multi-site clinical trial evaluating a modified 12-step facilitation intervention for stimulant-dependent patients (STAGE-12) were assessed. Decision-making processes of risk and delay (Iowa Gambling Task [IGT]) and response reversal (Wisconsin Card Sorting Task [WCST]) were obtained shortly after treatment admission followed by assessment of stimulant use over the next six months. The relationships of the IGT and WCST (Perseverative Errors) with relapse (yes/no) and days of stimulant use during the 6-month period following post-randomization were evaluated.Results
Performance on the IGT and WCST did not significantly predict relapse status or time to relapse. Unexpectedly, worse performance on the IGT was associated with a fewer number of stimulant use days (p = 0.001). In contrast, worse performance on the WCST (more perseverative errors) was associated with a greater number of stimulant use days (p = 0.0003). The predictive effects of perseverative errors on subsequent use were confined to methamphetamine-dependent and Minority participants.Conclusions
Decision-making processes, as measured in the current study, do not uniformly predict relapse or subsequent use. A decrease in the salience attribution of non-drug reinforcers may explain the positive relationship between IGT performance and post-relapse use. More comprehensive and global measures of impulsiveness may better assess relapse risk and use.
SUBMITTER: Adinoff B
PROVIDER: S-EPMC4817850 | biostudies-literature | 2016
REPOSITORIES: biostudies-literature
Adinoff Bryon B Carmody Thomas J TJ Walker Robrina R Donovan Dennis M DM Brigham Gregory S GS Winhusen Theresa M TM
The American journal of drug and alcohol abuse 20160108 1
<h4>Background</h4>Decision-making processes have been posited to affect treatment outcome in addicted patients.<h4>Objective</h4>The present multi-site study assessed whether two measures of decision-making predicted relapse and subsequent use in stimulant-dependent patients.<h4>Methods</h4>A total of 160 methamphetamine- or cocaine-dependent patients participating in a multi-site clinical trial evaluating a modified 12-step facilitation intervention for stimulant-dependent patients (STAGE-12) ...[more]