title: Cognition, commitment language, and behavioral change among cocaine-dependent patients.
abstract: Patients' cognitive abilities and verbal expressions of commitment to behavioral change predict different aspects of substance abuse treatment outcome, but these 2 traits have never been examined conjointly. The authors therefore investigated patients' cognitive abilities and verbal expressions of commitment to behavioral change as predictors of retention and drug use outcomes in an outpatient cognitive behavioral treatment (CBT) of adult cocaine-dependent patients. A neuropsychological battery was administered at baseline. Two independent raters used recordings of CBT sessions to code commitment language strength across the temporal segments (e.g., beginning, middle, and end) of 1 session per patient. Better cognitive abilities predicted treatment retention (p < .01) but not drug use, whereas mean commitment strength across the session segments predicted reduced drug use (p = .01). Results indicate that although commitment to behavioral changes such as abstinence may occur independently of patients' cognitive abilities, engagement in the behavioral intervention process appears to depend on cognitive abilities. Future clinical studies should further investigate the relations between cognition and commitment to change and their differential contributions to treatment processes and outcome.
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA. ea2017@columbia.edu
authors.forename: Efrat
authors.initials: E
authors.lastname: Aharonovich
authors.forename: Paul C
authors.initials: PC
authors.lastname: Amrhein
authors.forename: Adam
authors.initials: A
authors.lastname: Bisaga
authors.forename: Edward V
authors.initials: EV
authors.lastname: Nunes
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Hasin
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D003071:Cognition; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D009042:Motivation; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014705:Verbal Behavior