Five Challenges in Implementing Cognitive Remediation for Patients with Substance Use Disorders in Clinical Settings.

IF 5.4 2区 心理学 Q1 NEUROSCIENCES
Neuropsychology Review Pub Date : 2024-09-01 Epub Date: 2023-10-16 DOI:10.1007/s11065-023-09623-1
Pierre Maurage, Benjamin Rolland, Anne-Lise Pitel, Fabien D'Hondt
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引用次数: 0

Abstract

Many patients with substance use disorders (SUDs) present cognitive deficits, which are associated with clinical outcomes. Neuropsychological remediation might help rehabilitate cognitive functions in these populations, hence improving treatment effectiveness. Nardo and colleagues (Neuropsychology Review, 32, 161-191, 2022) reviewed 32 studies applying cognitive remediation for patients with SUDs. They underlined the heterogeneity and lack of quality of studies in this research field but concluded that cognitive remediation remains a promising tool for addictive disorders. We capitalize on the insights of this review to identify the key barriers that currently hinder the practical implementation of cognitive remediation in clinical settings. We outline five issues to be addressed, namely, (1) the integration of cognitive remediation in clinical practices; (2) the selection criteria and individual factors to consider; (3) the timing to be followed; (4) the priority across trained cognitive functions; and (5) the generalization of the improvements obtained. We finally propose that cognitive remediation should not be limited to classical cognitive functions but should also be extended toward substance-related biases and social cognition, two categories of processes that are also involved in the emergence and persistence of SUDs.

在临床环境中对物质使用障碍患者实施认知补救的五大挑战。
许多物质使用障碍(SUD)患者存在认知缺陷,这与临床结果有关。神经心理修复可能有助于恢复这些人群的认知功能,从而提高治疗效果。Nardo及其同事(《神经心理学评论》,32161-19120122)回顾了32项对SUD患者应用认知补救的研究。他们强调了这一研究领域研究的异质性和缺乏质量,但得出的结论是,认知修复仍然是治疗成瘾性疾病的一种很有前途的工具。我们利用这篇综述的见解来确定目前阻碍认知补救在临床环境中实际实施的关键障碍。我们概述了五个需要解决的问题,即:(1)认知补救在临床实践中的整合;(2) 选择标准和需要考虑的个别因素;(3) 所遵循的时间;(4) 经过训练的认知功能的优先级;以及(5)所获得的改进的推广。我们最后提出,认知补救不应局限于经典的认知功能,还应扩展到与物质相关的偏见和社会认知,这两类过程也与SUD的出现和持续有关。
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来源期刊
Neuropsychology Review
Neuropsychology Review 医学-神经科学
CiteScore
11.00
自引率
1.70%
发文量
36
期刊介绍: Neuropsychology Review is a quarterly, refereed publication devoted to integrative review papers on substantive content areas in neuropsychology, with particular focus on populations with endogenous or acquired conditions affecting brain and function and on translational research providing a mechanistic understanding of clinical problems. Publication of new data is not the purview of the journal. Articles are written by international specialists in the field, discussing such complex issues as distinctive functional features of central nervous system disease and injury; challenges in early diagnosis; the impact of genes and environment on function; risk factors for functional impairment; treatment efficacy of neuropsychological rehabilitation; the role of neuroimaging, neuroelectrophysiology, and other neurometric modalities in explicating function; clinical trial design; neuropsychological function and its substrates characteristic of normal development and aging; and neuropsychological dysfunction and its substrates in neurological, psychiatric, and medical conditions. The journal''s broad perspective is supported by an outstanding, multidisciplinary editorial review board guided by the aim to provide students and professionals, clinicians and researchers with scholarly articles that critically and objectively summarize and synthesize the strengths and weaknesses in the literature and propose novel hypotheses, methods of analysis, and links to other fields.
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