title: Impact of general cognition and executive function deficits on addiction treatment outcomes: Systematic review and discussion of neurocognitive pathways.
abstract: This systematic review aims to examine growing evidence linking cognitive-executive functions with addiction treatment outcomes, and to discuss significant cognitive predictors drawing upon addiction neuroscience theory. We conducted a systematic search to identify studies using measures of general cognition and executive functions in patients with substance use disorders for the purpose of predicting two treatment outcomes: therapeutic adherence and relapse. Forty-six studies were selected, and sample characteristics, timing of assessments, and cognitive measures were analyzed. We observed significant methodological differences across studies, resulting in substantial variability in the relationships between cognitive-executive domains and treatment outcomes. Notwithstanding this variability, we found evidence of associations, of medium effect size, between general cognition and treatment adherence, and between reward-based decision-making and relapse. The link between general cognition and treatment adherence is consistent with emerging evidence linking limited cognitive-executive resources with less ability to benefit from talk therapies. The link between reward-based decision-making and relapse accords with decision neuroscience models of addiction. Findings may inform preclinical and clinical research concerning addiction treatment mechanisms.
authors: Department of Clinical & Experimental Psychology, University of Huelva, Avda. Fuerzas Armadas, 21017 Huelva, Spain.
authors: Sara
authors: S
authors: Domínguez-Salas
authors: Department of Clinical & Experimental Psychology, University of Huelva, Avda. Fuerzas Armadas, 21017 Huelva, Spain.
authors: Carmen
authors: C
authors: Díaz-Batanero
authors: Department of Clinical & Experimental Psychology, University of Huelva, Avda. Fuerzas Armadas, 21017 Huelva, Spain; Red de Trastornos Adictivos, University of Granada, Campus de Cartuja S/N, 18071 Granada, Spain.
authors: Oscar Martin
authors: OM
authors: Lozano-Rojas
authors: Red de Trastornos Adictivos, University of Granada, Campus de Cartuja S/N, 18071 Granada, Spain; School of Psychological Sciences & Monash Institute of Cognitive and Clinical Neurosciences, Monash University, 18 Innovation Walk, 3800 Melbourne, Australia. Electronic address: antonio.verdejo@monash.edu.
authors: Antonio
authors: A
authors: Verdejo-García
mesh_terms: D016739:Behavior, Addictive; D003071:Cognition; D003072:Cognition Disorders; D056344:Executive Function; D006801:Humans; D016896:Treatment Outcome
keywords: Decision-making; Executive functions; Relapse; Substance use disorders; Therapeutic adherence