Neuropsychological predictors of the attainment of treatment objectives in substance abuse patients.

This study examined the contribution of neuropsychological functioning to the attainment of treatment objectives in substance abuse patients. Subjects were 85 patients enrolled in comprehensive, inpatient and outpatient substance abuse treatment at a VA Medical Center. Most subjects were diagnosed with Alcohol Dependence or Abuse, and nearly half were seeking treatment for Cocaine Dependence or Abuse. After acute detoxification, but before beginning individualized treatment, subjects were administered a neuropsychological screening battery to assess cognitive functioning and affective status. They then attended a variety of daily group therapies. Each therapy group had its own set of specific treatment objectives; on each treatment day, group therapists rated each patient's attainment of the specific objectives for their group. Groups included Assertiveness Training (Levels I and II), Stress Management (Levels I and II), Social Skills Training, Job Skills, Relapse Prevention (Levels I and II), Leisure Planning, Leisure Skills, Occupational Therapy, and 12-Step Study. Stepwise multiple regression indicated that the best predictors of overall objective attainment were better attention (WMS-R Digits Backwards) and less depressive symptomatology (Beck Depression Inventory). These results suggest that attention and mood have a modest yet significant impact on the success of treatment interventions for substance abuse patients. Thus, evaluation of cognitive as well as affective factors in substance abuse patients might be helpful in designing and implementing specialized interventions to maximize the likelihood of treatment success.