Frontiers in Psychiatry (Nov 2013)

Disadvantageous decision-making as a predictor of drop-out among cocaine-dependent individuals in long-term residential treatment.

  • Laura eStevens,
  • Patricia eBetanzos-Espinosa,
  • Cleo L. Crunelle,
  • Cleo L. Crunelle,
  • Esperanza eVergara-Moragues,
  • Esperanza eVergara-Moragues,
  • Herbert eRoeyers,
  • Oscar eLozano,
  • Oscar eLozano,
  • Geert eDom,
  • Geert eDom,
  • Fransisco eGonzalez-Saiz,
  • Fransisco eGonzalez-Saiz,
  • Fransisco eGonzalez-Saiz,
  • Wouter eVanderplasschen,
  • Antonio eVerdejo-García,
  • Antonio eVerdejo-García,
  • Antonio eVerdejo-García,
  • Antonio eVerdejo-García,
  • Miguel ePérez-García,
  • Miguel ePérez-García

DOI
https://doi.org/10.3389/fpsyt.2013.00149
Journal volume & issue
Vol. 4

Abstract

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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.

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