Cognitive training and remediation interventions for substance use disorders: A Delphi consensus study

Antonio Verdejo-Garcia; Tara Rezapour; Emily Giddens; Arash Khojasteh Zonoozi; Parnian Rafei; Jamie Berry; Alfonso Caracuel; Marc L Copersino; Matt Field; Eric L Garland; Valentina Lorenzetti; Leandro Malloy-Diniz; Victoria Manning; Ely M Marceau; David L Pennington; Justin C Strickland; Reinout Wiers; Rahia Fairhead; Alexandra Anderson; Morris Bell; Wouter J Boendermaker; Samantha Brooks; Raimondo Bruno; Salvatore Campanella; Janna Cousijn; Miles Cox; Andrew C Dean; Karen D Ersche; Ingmar Franken; Brett Froeliger; Pedro Gamito; Thomas E Gladwin; Priscila D Goncalves; Katrijn Houben; Joanna Jacobus; Andrew Jones; Anne M Kaag; Johannes Lindenmeyer; Elly McGrath; Talia Nardo; Jorge Oliveira; Charlotte R Pennington; Kelsey Perrykkad; Hugh Piercy; Claudia I Rupp; Mieke H J Schulte; Lindsay M Squeglia; Petra Staiger; Dan J Stein; Jeff Stein

doi:10.1111/add.16109

Cognitive training and remediation interventions for substance use disorders: A Delphi consensus study

Antonio Verdejo-Garcia^*, Tara Rezapour, Emily Giddens, Arash Khojasteh Zonoozi, Parnian Rafei, Jamie Berry, Alfonso Caracuel, Marc L Copersino, Matt Field, Eric L Garland, Valentina Lorenzetti, Leandro Malloy-Diniz, Victoria Manning, Ely M Marceau, David L Pennington, Justin C Strickland, Reinout Wiers, Rahia Fairhead, Alexandra Anderson, Morris BellWouter J Boendermaker, Samantha Brooks, Raimondo Bruno, Salvatore Campanella, Janna Cousijn, Miles Cox, Andrew C Dean, Karen D Ersche, Ingmar Franken, Brett Froeliger, Pedro Gamito, Thomas E Gladwin, Priscila D Goncalves, Katrijn Houben, Joanna Jacobus, Andrew Jones, Anne M Kaag, Johannes Lindenmeyer, Elly McGrath, Talia Nardo, Jorge Oliveira, Charlotte R Pennington, Kelsey Perrykkad, Hugh Piercy, Claudia I Rupp, Mieke H J Schulte, Lindsay M Squeglia, Petra Staiger, Dan J Stein, Jeff Stein

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND AND AIMS: Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training and remediation interventions are well suited to fill the gap for managing cognitive deficits in SUD. We aimed to reach consensus on recommendations for developing and applying these interventions.

DESIGN: Delphi approach with two sequential phases: survey development and iterative surveying of experts.

SETTING: Online study.

PARTICIPANTS: During survey development, we engaged a group of 15 experts from a working group of the International Society of Addiction Medicine (Steering Committee). During the surveying process, we engaged a larger pool of experts (n=54) identified via recommendations from the Steering Committee and a systematic review.

MEASUREMENTS: Survey with 67 items covering four key areas of intervention development: targets, intervention approaches, active ingredients, and modes of delivery.

FINDINGS: Across two iterative rounds (98% retention rate), the experts reached a consensus on 50 items including: (i) implicit biases, positive affect, arousal, executive functions, and social processing as key targets of interventions; (ii) cognitive bias modification, contingency management, emotion regulation training, and cognitive remediation as preferred approaches; (iii) practice, feedback, difficulty-titration, bias-modification, goal setting, strategy learning, and meta-awareness as active ingredients; and (iv) both addiction treatment workforce and specialized neuropsychologists facilitating delivery, together with novel digital-based delivery modalities.

CONCLUSIONS: Expert recommendations on cognitive training and remediation for substance use disorders highlight the relevance of targeting implicit biases, reward, emotion regulation, and higher-order cognitive skills via well-validated intervention approaches qualified with mechanistic techniques and flexible delivery options.

Original language	English
Number of pages	17
Journal	Addiction
DOIs	https://doi.org/10.1111/add.16109
Publication status	E-pub ahead of print - 12 Dec 2022

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10.1111/add.16109Licence: CC BY-NC

Cite this

Verdejo-Garcia, A., Rezapour, T., Giddens, E., Khojasteh Zonoozi, A., Rafei, P., Berry, J., Caracuel, A., Copersino, M. L., Field, M., Garland, E. L., Lorenzetti, V., Malloy-Diniz, L., Manning, V., Marceau, E. M., Pennington, D. L., Strickland, J. C., Wiers, R., Fairhead, R., Anderson, A., ... Stein, J. (2022). Cognitive training and remediation interventions for substance use disorders: A Delphi consensus study. Addiction. https://doi.org/10.1111/add.16109

@article{c6e5ca268b864e8a8bc023aba4f47ff3,

title = "Cognitive training and remediation interventions for substance use disorders: A Delphi consensus study",

abstract = "BACKGROUND AND AIMS: Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training and remediation interventions are well suited to fill the gap for managing cognitive deficits in SUD. We aimed to reach consensus on recommendations for developing and applying these interventions.DESIGN: Delphi approach with two sequential phases: survey development and iterative surveying of experts.SETTING: Online study.PARTICIPANTS: During survey development, we engaged a group of 15 experts from a working group of the International Society of Addiction Medicine (Steering Committee). During the surveying process, we engaged a larger pool of experts (n=54) identified via recommendations from the Steering Committee and a systematic review.MEASUREMENTS: Survey with 67 items covering four key areas of intervention development: targets, intervention approaches, active ingredients, and modes of delivery.FINDINGS: Across two iterative rounds (98% retention rate), the experts reached a consensus on 50 items including: (i) implicit biases, positive affect, arousal, executive functions, and social processing as key targets of interventions; (ii) cognitive bias modification, contingency management, emotion regulation training, and cognitive remediation as preferred approaches; (iii) practice, feedback, difficulty-titration, bias-modification, goal setting, strategy learning, and meta-awareness as active ingredients; and (iv) both addiction treatment workforce and specialized neuropsychologists facilitating delivery, together with novel digital-based delivery modalities.CONCLUSIONS: Expert recommendations on cognitive training and remediation for substance use disorders highlight the relevance of targeting implicit biases, reward, emotion regulation, and higher-order cognitive skills via well-validated intervention approaches qualified with mechanistic techniques and flexible delivery options.",

author = "Antonio Verdejo-Garcia and Tara Rezapour and Emily Giddens and {Khojasteh Zonoozi}, Arash and Parnian Rafei and Jamie Berry and Alfonso Caracuel and Copersino, {Marc L} and Matt Field and Garland, {Eric L} and Valentina Lorenzetti and Leandro Malloy-Diniz and Victoria Manning and Marceau, {Ely M} and Pennington, {David L} and Strickland, {Justin C} and Reinout Wiers and Rahia Fairhead and Alexandra Anderson and Morris Bell and Boendermaker, {Wouter J} and Samantha Brooks and Raimondo Bruno and Salvatore Campanella and Janna Cousijn and Miles Cox and Dean, {Andrew C} and Ersche, {Karen D} and Ingmar Franken and Brett Froeliger and Pedro Gamito and Gladwin, {Thomas E} and Goncalves, {Priscila D} and Katrijn Houben and Joanna Jacobus and Andrew Jones and Kaag, {Anne M} and Johannes Lindenmeyer and Elly McGrath and Talia Nardo and Jorge Oliveira and Pennington, {Charlotte R} and Kelsey Perrykkad and Hugh Piercy and Rupp, {Claudia I} and Schulte, {Mieke H J} and Squeglia, {Lindsay M} and Petra Staiger and Stein, {Dan J} and Jeff Stein",

year = "2022",

month = dec,

day = "12",

doi = "10.1111/add.16109",

language = "English",

journal = "Addiction",

issn = "0965-2140",

publisher = "Wiley",

}

Verdejo-Garcia, A, Rezapour, T, Giddens, E, Khojasteh Zonoozi, A, Rafei, P, Berry, J, Caracuel, A, Copersino, ML, Field, M, Garland, EL, Lorenzetti, V, Malloy-Diniz, L, Manning, V, Marceau, EM, Pennington, DL, Strickland, JC, Wiers, R, Fairhead, R, Anderson, A, Bell, M, Boendermaker, WJ, Brooks, S, Bruno, R, Campanella, S, Cousijn, J, Cox, M, Dean, AC, Ersche, KD, Franken, I, Froeliger, B, Gamito, P, Gladwin, TE, Goncalves, PD, Houben, K, Jacobus, J, Jones, A, Kaag, AM, Lindenmeyer, J, McGrath, E, Nardo, T, Oliveira, J, Pennington, CR, Perrykkad, K, Piercy, H, Rupp, CI, Schulte, MHJ, Squeglia, LM, Staiger, P, Stein, DJ & Stein, J 2022, 'Cognitive training and remediation interventions for substance use disorders: A Delphi consensus study', Addiction. https://doi.org/10.1111/add.16109

TY - JOUR

T1 - Cognitive training and remediation interventions for substance use disorders

T2 - A Delphi consensus study

AU - Verdejo-Garcia, Antonio

AU - Rezapour, Tara

AU - Giddens, Emily

AU - Khojasteh Zonoozi, Arash

AU - Rafei, Parnian

AU - Berry, Jamie

AU - Caracuel, Alfonso

AU - Copersino, Marc L

AU - Field, Matt

AU - Garland, Eric L

AU - Lorenzetti, Valentina

AU - Malloy-Diniz, Leandro

AU - Manning, Victoria

AU - Marceau, Ely M

AU - Pennington, David L

AU - Strickland, Justin C

AU - Wiers, Reinout

AU - Fairhead, Rahia

AU - Anderson, Alexandra

AU - Bell, Morris

AU - Boendermaker, Wouter J

AU - Brooks, Samantha

AU - Bruno, Raimondo

AU - Campanella, Salvatore

AU - Cousijn, Janna

AU - Cox, Miles

AU - Dean, Andrew C

AU - Ersche, Karen D

AU - Franken, Ingmar

AU - Froeliger, Brett

AU - Gamito, Pedro

AU - Gladwin, Thomas E

AU - Goncalves, Priscila D

AU - Houben, Katrijn

AU - Jacobus, Joanna

AU - Jones, Andrew

AU - Kaag, Anne M

AU - Lindenmeyer, Johannes

AU - McGrath, Elly

AU - Nardo, Talia

AU - Oliveira, Jorge

AU - Pennington, Charlotte R

AU - Perrykkad, Kelsey

AU - Piercy, Hugh

AU - Rupp, Claudia I

AU - Schulte, Mieke H J

AU - Squeglia, Lindsay M

AU - Staiger, Petra

AU - Stein, Dan J

AU - Stein, Jeff

PY - 2022/12/12

Y1 - 2022/12/12

N2 - BACKGROUND AND AIMS: Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training and remediation interventions are well suited to fill the gap for managing cognitive deficits in SUD. We aimed to reach consensus on recommendations for developing and applying these interventions.DESIGN: Delphi approach with two sequential phases: survey development and iterative surveying of experts.SETTING: Online study.PARTICIPANTS: During survey development, we engaged a group of 15 experts from a working group of the International Society of Addiction Medicine (Steering Committee). During the surveying process, we engaged a larger pool of experts (n=54) identified via recommendations from the Steering Committee and a systematic review.MEASUREMENTS: Survey with 67 items covering four key areas of intervention development: targets, intervention approaches, active ingredients, and modes of delivery.FINDINGS: Across two iterative rounds (98% retention rate), the experts reached a consensus on 50 items including: (i) implicit biases, positive affect, arousal, executive functions, and social processing as key targets of interventions; (ii) cognitive bias modification, contingency management, emotion regulation training, and cognitive remediation as preferred approaches; (iii) practice, feedback, difficulty-titration, bias-modification, goal setting, strategy learning, and meta-awareness as active ingredients; and (iv) both addiction treatment workforce and specialized neuropsychologists facilitating delivery, together with novel digital-based delivery modalities.CONCLUSIONS: Expert recommendations on cognitive training and remediation for substance use disorders highlight the relevance of targeting implicit biases, reward, emotion regulation, and higher-order cognitive skills via well-validated intervention approaches qualified with mechanistic techniques and flexible delivery options.

AB - BACKGROUND AND AIMS: Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training and remediation interventions are well suited to fill the gap for managing cognitive deficits in SUD. We aimed to reach consensus on recommendations for developing and applying these interventions.DESIGN: Delphi approach with two sequential phases: survey development and iterative surveying of experts.SETTING: Online study.PARTICIPANTS: During survey development, we engaged a group of 15 experts from a working group of the International Society of Addiction Medicine (Steering Committee). During the surveying process, we engaged a larger pool of experts (n=54) identified via recommendations from the Steering Committee and a systematic review.MEASUREMENTS: Survey with 67 items covering four key areas of intervention development: targets, intervention approaches, active ingredients, and modes of delivery.FINDINGS: Across two iterative rounds (98% retention rate), the experts reached a consensus on 50 items including: (i) implicit biases, positive affect, arousal, executive functions, and social processing as key targets of interventions; (ii) cognitive bias modification, contingency management, emotion regulation training, and cognitive remediation as preferred approaches; (iii) practice, feedback, difficulty-titration, bias-modification, goal setting, strategy learning, and meta-awareness as active ingredients; and (iv) both addiction treatment workforce and specialized neuropsychologists facilitating delivery, together with novel digital-based delivery modalities.CONCLUSIONS: Expert recommendations on cognitive training and remediation for substance use disorders highlight the relevance of targeting implicit biases, reward, emotion regulation, and higher-order cognitive skills via well-validated intervention approaches qualified with mechanistic techniques and flexible delivery options.

U2 - 10.1111/add.16109

DO - 10.1111/add.16109

M3 - Article

C2 - 36508168

SN - 0965-2140

JO - Addiction

JF - Addiction

ER -