title: Disadvantageous Decision-Making as a Predictor of Drop-Out among Cocaine-Dependent Individuals in Long-Term Residential Treatment.
abstract: BACKGROUND
  The treatment of cocaine-dependent individuals (CDI) is substantially challenged by high drop-out rates, raising questions regarding contributing factors. Recently, a number of studies have highlighted the potential of greater focus on the clinical significance of neurocognitive impairments in treatment-seeking cocaine users. In the present study, we hypothesized that disadvantageous decision-making would be one such factor placing CDI at greater risk for treatment drop-out.
  
  
  METHODS
  In order to explore this hypothesis, the present study contrasted baseline performance (at treatment onset) on two validated tasks of decision-making, the Iowa Gambling Task (IGT) and the Cambridge Gamble Task (CGT) in CDI who completed treatment in a residential Therapeutic Community (TC) (N = 66) and those who dropped out of TC prematurely (N = 84).
  
  
  RESULTS
  Compared to treatment completers, CDI who dropped out of TC prematurely did not establish a consistent and advantageous response pattern as the IGT progressed and exhibited a poorer ability to choose the most likely outcome on the CGT. There were no group differences in betting behavior.
  
  
  CONCLUSIONS
  Our findings suggest that neurocognitive rehabilitation of disadvantageous decision-making may have clinical benefits in CDI admitted to long-term residential treatment programs.
authors.affiliation: Department of Orthopedagogics, Ghent University , Ghent , Belgium.
authors.forename: Laura
authors.initials: L
authors.lastname: Stevens
authors.forename: Patricia
authors.initials: P
authors.lastname: Betanzos-Espinosa
authors.forename: Cleo L
authors.initials: CL
authors.lastname: Crunelle
authors.forename: Esperanza
authors.initials: E
authors.lastname: Vergara-Moragues
authors.forename: Herbert
authors.initials: H
authors.lastname: Roeyers
authors.forename: Oscar
authors.initials: O
authors.lastname: Lozano
authors.forename: Geert
authors.initials: G
authors.lastname: Dom
authors.forename: Francisco
authors.initials: F
authors.lastname: Gonzalez-Saiz
authors.forename: Wouter
authors.initials: W
authors.lastname: Vanderplasschen
authors.forename: Antonio
authors.initials: A
authors.lastname: Verdejo-García
authors.forename: Miguel
authors.initials: M
authors.lastname: Pérez-García
keywords: addiction treatment outcomes; cocaine dependence; decision-making; drop-out; treatment retention