title: The impact of cognitive impairment and impulsivity on relapse of alcohol-dependent patients: implications for psychotherapeutic treatment.
abstract: Recent models of the development of addiction propose a transition from a pleasure-driven to a heavily automatized behaviour, marked by a loss of cognitive control. This study investigated the deficits in different components of cognitive functions including behavioural inhibition in response to alcohol-related stimuli in alcohol-dependent patients (ADP) and healthy controls (HC). The aims of the study were to identify which particular cognitive functions are impaired in ADP. Furthermore, we analysed the association between cognitive deficits and relapse rates and the reversibility of cognitive deficits under abstinence in a 6-month follow-up period. Ninety-four recently detoxified ADP and 71 HC completed the cognitive tasks as well as questionnaire measures assessing drinking behaviour and personality traits. Compared with HC, ADP showed poorer performance in response initiation, response inhibition, complex-sustained attention and executive functions. Impairment in response inhibition was a significant predictor for relapse, yet the strongest predictor was the interaction between the number of previous detoxifications and response-inhibition deficits. The results of a moderation analysis showed that patients with many previous detoxifications and large deficits in response inhibition showed the highest relapse risk. These findings indicate that interventions should take into account inhibitory deficits especially in ADP with a high number of previous detoxifications.
authors: Department of General Psychiatry, University Hospital Heidelberg, Germany.
authors: Marta
authors: M
authors: Czapla
authors: Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Germany.
authors: Joe J
authors: JJ
authors: Simon
authors: Department for Addictive Disorders, Psychiatric Centre Nordbaden, Germany.
authors: Barbara
authors: B
authors: Richter
authors: Department for Addictive Disorders, Psychiatric Centre Nordbaden, Germany.
authors: Matthias
authors: M
authors: Kluge
authors: Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Germany.
authors: Hans-Christoph
authors: HC
authors: Friederich
authors: Department of Psychosomatic Medicine and Psychotherapy LWL-University Hospital, Ruhr-University Bochum, Germany.
authors: Stephan
authors: S
authors: Herpertz
authors: Centre for Addictive Disorders, Central Institute of Mental Health, Germany.
authors: Karl
authors: K
authors: Mann
authors: Department of General Psychiatry, University Hospital Heidelberg, Germany.
authors: Sabine C
authors: SC
authors: Herpertz
authors: Department of Psychosomatic Medicine and Psychotherapy LWL-University Hospital, Ruhr-University Bochum, Germany.|Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Germany.
authors: Sabine
authors: S
authors: Loeber
mesh_terms: D064829:Alcohol Abstinence; D000437:Alcoholism / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology; D060825:Cognitive Dysfunction / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007175:Impulsive Behavior / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy; D011930:Reaction Time; D012008:Recurrence
keywords: Cognitive impairment; go/no-go task; incentive salience; relapse; response inhibition