Priscila Dib Gonçalves1, Mariella Ometto2, Antoine Bechara3, André Malbergier4, Ricardo Amaral4, Sergio Nicastri5, Paula A Martins6, Livia Beraldo4, Bernardo dos Santos7, Daniel Fuentes8, Arthur G Andrade4, Geraldo F Busatto2, Paulo Jannuzzi Cunha9. 1. Interdisciplinary Group of Studies on Alcohol and Drugs (GREA), Institute of Psychiatry (IPq), School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil; Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), USP, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil; Psychology & Neuropsychology Service, IPq, USP, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil. Electronic address: prisciladib@gmail.com. 2. Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), USP, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil. 3. Department of Psychology, Brain and Creativity Institute, University of Southern California (USC), 3620A McClintock Avenue, 90089-2921 Los Angeles, CA, USA. 4. Interdisciplinary Group of Studies on Alcohol and Drugs (GREA), Institute of Psychiatry (IPq), School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil. 5. Interdisciplinary Group of Studies on Alcohol and Drugs (GREA), Institute of Psychiatry (IPq), School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil; Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), USP, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil. 6. Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil. 7. School of Nursing, University of São Paulo, Rua Dr. Enéias de Carvalho Aguiar, 419, Cerqueira César, 05403-000 São Paulo, SP, Brazil. 8. Psychology & Neuropsychology Service, IPq, USP, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil. 9. Interdisciplinary Group of Studies on Alcohol and Drugs (GREA), Institute of Psychiatry (IPq), School of Medicine, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil; Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, University of São Paulo (USP), Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), USP, Rua Dr. Ovídio Pires de Campos, 785, Cerqueira César, 05403-010 São Paulo, SP, Brazil; Equilibrium Program, Department of Psychiatry, University of São Paulo School of Medicine, Rua Anhanguera, 484, Barra Funda, 01135-000 São Paulo, SP, Brazil.
Abstract
BACKGROUND: In cocaine-dependent individuals, executive function (EF) deficits are associated with poor treatment outcomes. Psychological interventions and pharmacological approaches have produced only modest effect sizes. To date, studies of this topic have been few and limited. The aim of this study was to examine the effects of a new model of intervention, which integrates chess and Motivational Interviewing, Motivational Chess (MC) METHODS: We evaluated 46 cocaine-dependent inpatients (aged 18-45), in two groups-MC (n=26); and active comparison-AC (n=20). Using neuropsychological tests and an impulsivity scale, we assessed the subjects before and after the study period (one month of abstinence monitored by urine toxicology screening). RESULTS: The MC and AC groups did not differ at baseline. In the post-intervention assessment (after one month), both groups showed significant improvements in attention, mental flexibility, inhibitory control, abstraction abilities, and decision-making (p<0.01). In addition, the improvement in working memory was more significant in the MC group than in the AC group (group-by-time interaction, p=01). CONCLUSIONS: One month of abstinence was sufficient to improve various attentional and executive domains in cocaine-dependent subjects. The MC intervention was associated with greater improvements in EFs, especially working memory, suggesting that tailored interventions focusing on complex EFs accelerate the process of cognitive recovery during the initial period of abstinence.
BACKGROUND: In cocaine-dependent individuals, executive function (EF) deficits are associated with poor treatment outcomes. Psychological interventions and pharmacological approaches have produced only modest effect sizes. To date, studies of this topic have been few and limited. The aim of this study was to examine the effects of a new model of intervention, which integrates chess and Motivational Interviewing, Motivational Chess (MC) METHODS: We evaluated 46 cocaine-dependent inpatients (aged 18-45), in two groups-MC (n=26); and active comparison-AC (n=20). Using neuropsychological tests and an impulsivity scale, we assessed the subjects before and after the study period (one month of abstinence monitored by urine toxicology screening). RESULTS: The MC and AC groups did not differ at baseline. In the post-intervention assessment (after one month), both groups showed significant improvements in attention, mental flexibility, inhibitory control, abstraction abilities, and decision-making (p<0.01). In addition, the improvement in working memory was more significant in the MC group than in the AC group (group-by-time interaction, p=01). CONCLUSIONS: One month of abstinence was sufficient to improve various attentional and executive domains in cocaine-dependent subjects. The MC intervention was associated with greater improvements in EFs, especially working memory, suggesting that tailored interventions focusing on complex EFs accelerate the process of cognitive recovery during the initial period of abstinence.
Authors: Craig R Rush; Justin C Strickland; Erika Pike; Christina R Studts; William W Stoops Journal: Drug Alcohol Depend Date: 2019-12-16 Impact factor: 4.492