The impact of cognitive training in substance use disorder: the effect of working memory training on impulse control in methamphetamine users

Sari B.A., Koster E.H., Pourtois G., Derakshan N.

Trait anxiety is associated with impairments in attentional control and processing efficiency (see Berggren & Derakshan, 2013, for a review). Working memory training using the adaptive dual n-back task has shown to improve attentional control in subclinical depression with transfer effects at the behavioral and neural level on a working memory task (Owens, Koster, & Derakshan, 2013). Here, we examined the beneficial effects of working memory training on attentional control in pre-selected high trait anxious individuals who underwent a three week daily training intervention using the adaptive dual n-back task. Pre and post outcome measures of attentional control were assessed using a Flanker task that included a stress induction and an emotional a Antisaccade task (with angry and neutral faces as target). Resting state EEG (theta/beta ratio) was recorded to as a neural marker of trait attentional control. Our results showed that adaptive working memory training improved attentional control with transfer effects on the Flanker task and resting state EEG, but effects of training on the Antisaccade task were less conclusive. Finally, training related gains were associated with lower levels of trait anxiety at post (vs pre) intervention. Our results demonstrate that adaptive working memory training in anxiety can have beneficial effects on attentional control and cognitive performance that may protect against emotional vulnerability in individuals at risk of developing clinical anxiety.

Weybright E.H., Caldwell L.L., Wegner L., Smith E., Jacobs J.J.

Loughead J., Falcone M., Wileyto E.P., Albelda B., Audrain-McGovern J., Cao W., Kurtz M.M., Gur R.C., Lerman C.

Deficits in cognitive function are observed during nicotine withdrawal and present a challenge to successful smoking cessation. This clinical trial evaluated a cognitive exercise training (CT) program to improve smoking cessation rates.Adult treatment-seeking smokers (n=213) were randomized to receive nicotine patch therapy and 12 weeks of either computerized CT or computerized relaxation (control) training. Smoking status was biochemically verified at the end of treatment and 6-month follow-up.Quit rates did not differ by treatment arm at either time-point, nor were there effects on withdrawal symptoms or smoking urges. Reaction time for emotion recognition and verbal interference tasks showed improvement in the CT group. When including only successful quitters, improvements in recognition memory, verbal interference accuracy, and attention switching error rate were also observed in the CT group, while commission errors on the continuous performance task decreased in the control group.Despite modest changes in cognitive performance, these results do not support the efficacy of computerized cognitive training as an adjunctive therapy for smoking cessation.

Ching T.H., Tang C.S., Wu A., Yan E.

Background and aims The addictive nature of compulsive buying implies that mood disturbances, stress, and cognitive biases that underlie compulsive buying might operate in ways similar in both genders. In the current study, we aimed to test hypothetical pathways of mood compensation and irrational cognitions, which may explain compulsive buying tendencies. We also examined potential gender differences in these pathways. Methods Two-hundred and thirty-two male (age: M = 20.30, SD = 1.74) and 373 female Chinese college students (age: M = 19.97, SD = 1.74) in Hong Kong and Macau completed measures assessing compulsive buying, psychological distress, avoidance coping, materialism, and buying-related cognitions. Mediation analyses via a structural equation modeling approach explained by Cheung (2007, 2009) were conducted, with gender as a grouping variable. Results There was a gender difference in the mood compensation pathway; avoidance coping partially mediated the link between psychological distress and compulsive buying severity in females only. On the other hand, the irrational cognitive pathway, in which irrational buying-related cognitions fully mediated the link between materialism and compulsive buying severity, was supported for both genders. There was no gender difference in the extent of mediation within the irrational cognitive pathway, and the mediation effect within the irrational cognitive pathway was larger than that within the mood compensation pathway for both genders. Conclusions Mood compensation processes in compulsive buying might be female specific, and secondary to irrational cognitions, which were gender invariant. Gender-dependent mechanisms and irrational cognitions should be emphasized in compulsive buying treatment.

Anthes E.

Smartphone apps claim to help conditions from addiction to schizophrenia, but few have been thoroughly tested.

McKetin R., Dawe S., Burns R.A., Hides L., Kavanagh D.J., Teesson M., McD. Young R., Voce A., Saunders J.B.

Methamphetamine use can produce symptoms almost indistinguishable from schizophrenia. Distinguishing between the two conditions has been hampered by the lack of a validated symptom profile for methamphetamine-induced psychiatric symptoms. We use data from a longitudinal cohort study to examine the profile of psychiatric symptoms that are acutely exacerbated by methamphetamine use.164 methamphetamine users, who did not meet DSM-IV criteria for a lifetime primary psychotic disorder, were followed monthly for one year to assess the relationship between days of methamphetamine use and symptom severity on the 24-item Brief Psychiatric Rating Scale. Exacerbation of psychiatric symptoms with methamphetamine use was quantified using random coefficient models. The dimensions of symptom exacerbation were examined using principal axis factoring and a latent profile analysis.Symptoms exacerbated by methamphetamine loaded on three factors: positive psychotic symptoms (suspiciousness, unusual thought content, hallucinations, bizarre behavior); affective symptoms (depression, suicidality, guilt, hostility, somatic concern, self-neglect); and psychomotor symptoms (tension, excitement, distractibility, motor hyperactivity). Methamphetamine use did not significantly increase negative symptoms. Vulnerability to positive psychotic and affective symptom exacerbation was shared by 28% of participants, and this vulnerability aligned with a past year DSM-IV diagnosis of substance-induced psychosis (38% vs. 22%, χ(2)(df1)=3.66, p=0.056).Methamphetamine use produced a symptom profile comprised of positive psychotic and affective symptoms, which aligned with a diagnosis of substance-induced psychosis, with no evidence of a negative syndrome.

Sanchis-Segura C., Becker J.B.

Among mammals, every cell has a biological sex, and the sex of an individual pervades its body and brain. In this review, we describe the processes through which mammals become phenotypically male or female by organizational and activational influences of genes and hormones throughout development. We emphasized that the molecular and cellular changes triggered by sex chromosomes and steroid hormones may generate sex differences in overt physiological functions and behavior, but they may alternatively promote end-point convergences between males and females. Clinical and pre-clinical evidences suggest that sex and gender differences modulate drug consumption as well as of the transition towards drug-promoted pathological states such as dependence and addiction. Additionally, sex differences in drug pharmacokinetics and pharmacodynamics will also influence dependence and addiction as well as side effects of drugs. These effects will further interact with socially gendered factors to result in sex differences in the access to, engagement in and efficacy of any therapeutic attempt. Finally, we maintain that 'sex sameness' is as important as 'sex differences' when building a complete understanding of biology for both males and females and provide a framework with which to classify and guide investigation into the mechanisms mediating sex differences and sex sameness.

Fattore L., Melis M.

Sex differences in inhibition and self-regulation at a behavioral level have been widely described. From an evolutionary point of view, the different selection pressures placed on male and female hominids led them to differ in their behavioral strategies that allowed our species to survive during natural selection processes. These differences reflect changes in neural and structural plasticity that might be the core of sex differences, and of the susceptibility towards one psychiatric condition rather than another. The goal of the present review is to summarize current evidence for such a dichotomy in impulsive and compulsive behavior with a focus on drug addiction. Sex-dependent differences in drug abuse and dependence will be examined in the context of pathophysiological regulation of impulse and motivation by neuromodulators (i.e. gonadal hormones) and neurotransmitters (i.e. dopamine). Advances in the understanding of the sex differences in the capability to control impulses and motivational states is key for the determination of efficacious biologically based intervention and prevention strategies for several neuropsychiatric disorders where loss of impulse control and compulsivity are the core symptoms.

Carroll M.E., Smethells J.R.

The purpose of this review is to discuss recent findings related to sex differences in behavioral dyscontrol that lead to drug addiction, and clinical implications for humans are discussed. This review includes research conducted in animals and humans that reveals fundamental aspects of behavioral dyscontrol. The importance of sex differences in aspects of behavioral dyscontrol, such as impulsivity and compulsivity, are discussed as major determinants of drug addiction. Behavioral dyscontrol during adolescence is also an important consideration, as this is the time of onset for drug addiction. These vulnerability factors additively increase drug abuse vulnerability, and they are integral aspects of addiction that covary and interact with sex differences. Sex differences in treatments for drug addiction are also reviewed in terms of their ability to modify the behavioral dyscontrol that underlies addictive behavior. Customized treatments to reduce behavioral dyscontrol are discussed, such as: 1) using natural consequences such as nondrug rewards (e.g., exercise) to maintain abstinence, or using punishment as a consequence for drug use, 2) targeting factors that underlie behavioral dyscontrol, such as impulsivity or anxiety, by repurposing medications to relieve these underlying conditions, and 3) combining two or more novel behavioral or pharmacological treatments to produce additive reductions in drug seeking. Recent published work has indicated that factors contributing to behavioral dyscontrol are an important target for advancing our knowledge on the etiology of drug abuse, intervening with the drug addiction process and developing novel treatments.

Brooks S.J., Burch K.H., Maiorana S.A., Cocolas E., Schioth H.B., Nilsson E.K., Kamaloodien K., Stein D.J.

Protracted methamphetamine (MA) use is associated with decreased control over drug craving and altered brain volume in the frontostriatal network. However, the nature of volumetric changes following a course of psychological intervention for MA use is not yet known.66 males (41 MA patients, 25 healthy controls, HC) between the ages of 18-50 were recruited, the MA patients from new admissions to an in-patient drug rehabilitation centre and the HC via public advertisement, both in Cape Town, South Africa. 17 MA patients received 4 weeks of treatment as usual (TAU), and 24 MA patients completed TAU plus daily 30-minute cognitive training (CT) using an N-back working memory task. Magnetic resonance imaging (MRI) at baseline and 4-week follow-up was acquired and voxel-based morphometry (VBM) was used for analysis.TAU was associated with larger bilateral striatum (caudate/putamen) volume, whereas CT was associated with more widespread increases of the bilateral basal ganglia (incorporating the amygdala and hippocampus) and reduced bilateral cerebellum volume coinciding with improvements in impulsivity scores.While psychological intervention is associated with larger volume in mesolimbic reward regions, the utilisation of additional working memory training as an adjunct to treatment may further normalize frontostriatal structure and function.

Brooks S.J.

Anorexia Nervosa (AN) is a debilitating, sometimes fatal eating disorder (ED) whereby restraint of appetite and emotion is concomitant with an inflexible, attention-to-detail perfectionist cognitive style and obsessive-compulsive behaviour. Intriguingly, people with AN are less likely to engage in substance use, whereas those who suffer from an ED with a bingeing component are more vulnerable to substance use disorder (SUD). This insight into a beneficial consequence of appetite control in those with AN, which is shrouded by the many other unhealthy, excessive and deficit symptoms, may provide some clues as to how the brain could be trained to exert better, sustained control over appetitive and impulsive processes. Structural and functional brain imaging studies implicate the executive control network (ECN) and the salience network (SN) in the neuropathology of AN and SUD. Additionally, excessive employment of working memory (WM), alongside more prominent cognitive deficits may be utilised to cope with the experience of negative emotions and may account for aberrant brain function. WM enables mental rehearsal of cognitive strategies while regulating, restricting or avoiding neural responses associated with the SN. Therefore, high versus low WM capacity may be one of the factors that unites common cognitive and behavioural symptoms in those suffering from AN and SUD respectively. Furthermore, emerging evidence suggests that by evoking neural plasticity in the ECN and SN with WM training, improvements in neurocognitive function and cognitive control can be achieved. Thus, considering the neurocognitive processes of excessive appetite control and how it links to WM in AN may aid the application of adjunctive treatment for SUD.

Motter J.N., Pimontel M.A., Rindskopf D., Devanand D.P., Doraiswamy P.M., Sneed J.R.

Depression is common, frequently resistant to antidepressant treatment, and associated with impairments in cognition and everyday functioning. Computerized cognitive training (CCT) paradigms offer potential to improve cognition, mood and everyday functioning, but their effectiveness is not well established. The goal of this article was to conduct a systematic review and meta-analysis to determine the efficacy of CCT in depressive disorders.A search was conducted to identify high quality randomized controlled CCT trials per PRISMA guidelines using PsycINFO and MEDLINE with the keywords "Cognitive training" or "Cognitive remediation" or "Cognitive rehabilitation" and "Depression". 9 randomized trials for depressed adults met inclusion criteria. Effect sizes (Hedge's g) were calculated for key outcome measures of mood symptom severity, daily functioning, and cognition. A 3-level Bayesian hierarchical linear model was used to estimate effect sizes for each domain and study. Publication bias was assessed using Classic Fail Safe N's and homogeneity was evaluated using Q and I(2) indexes.Significant small-moderate effects for Symptom Severity (0.43) and Daily Functioning (0.72), and moderate-large effects for Attention (0.67), Working Memory (0.72), and Global Functioning (1.05) were found. No significant effects were found for Executive Functioning or Verbal Memory. Moderator variable analysis revealed decreased effect of CCT with age. Gender and concurrent medication treatment did not affect the results.Small sample size, short duration, pseudo-specificity, and high heterogeneity for Verbal Memory measures.CCT is associated with improvement in depressive symptoms and everyday functioning, though produces inconsistent effects on cognition.

Danielsson H., Zottarel V., Palmqvist L., Lanfranchi S.

Working memory training has been increasingly popular in the last year. Previous studies has shown that children with intellectual disabilities have low working memory capacity and therefore have a great potential for improvement by this type of intervention. The aim of this study was to investigate the effect of working memory and cognitive training for children with intellectual disabilities. The effects reported in previous studies have varied and therefore meta-analysis of articles in the major databases was conducted. Inclusion criteria included to have a pretest-posttest design with a training group and a control group and to have measures of working memory or short-term memory. Ten studies with 28 comparisons were included. The results reveal a significant overall pretest-posttest small effect size for of working memory training for children with intellectual disabilities compared to controls. A mixed working memory approach, considering both verbal and visuo-spatial components and working mainly on strategies, was the only significantly effective training type with a medium effect size. The most commonly reported training type with 60 percent of the included comparisons, visuo-spatial working memory training, had a non-significant effect size that was close to zero. We conclude that even if there is an overall effect of working memory training, a mixed working memory approach appears to cause this effect. Given the few studies included and the different characteristics of the included studies, interpretations should be done with caution. However, different types of interventions appear to have different effects. Even if the results were promising, more studies are needed to better understand how to design an effective working memory intervention for this group and to understand if, and how, these short-term effects remains over time and transfer to everyday activities.

Re A.M., Capodieci A., Cornoldi C.

The development of early intervention strategies for children with symptoms of Attention Deficit Hyperactivity Disorder (ADHD) is important because it provides an opportunity to prevent severe problems in the future. The main purpose of this investigation was to determine the efficacy of a group training for the control of attention, working memory and impulsive behaviors, involving five-year-old children with ADHD symptoms. Twenty-six children with ADHD symptoms and 26 with typical development were randomly divided in two conditions. 13 children in each group were assigned to the training condition and the other to the business as usual condition (normal class activity). Children who participated in the intervention showed an improvement in the tasks measuring their control of attention, impulsive behavior and working memory. Moreover, children with typical development who attended the training also improved their competencies. The results confirm the importance of an early intervention for preschool-age children with ADHD symptoms.

Li X., Xiao Y., Zhao Q., Leung A.W., Cheung E.F., Chan R.C.

We conducted an activation likelihood estimation (ALE) meta-analysis to quantitatively review the existing working memory (WM) training studies that investigated neural activation changes both in healthy individuals and patients with schizophrenia. ALE analysis of studies in healthy individuals indicates a widespread distribution of activation changes with WM training in the frontal and parietal regions, especially the dorsolateral prefrontal cortex, the medial frontal cortex and the precuneus, as well as subcortical regions such as the insula and the striatum. WM training is also accompanied by activation changes in patients with schizophrenia, mainly in the dorsolateral prefrontal cortex, the precuneus and the fusiform gyrus. Our results demonstrate that WM training is accompanied by changes in neural activation patterns in healthy individuals, which may provide the basis for understanding neuroplastic changes in patients with schizophrenia.

Chen J., Tian Y., Li Y., Zhu R., Jia L., Fu F., Tang S., Wang X., Wang D.M., Zhang X.Y.

Khan R., Turner A., Berk M., Walder K., Rossell S., Guerin A.A., Kim J.H.

Methamphetamine use disorder is a pressing global health issue, often accompanied by significant cognitive deficits that impair daily functioning and quality of life and complicate treatment. Emerging evidence highlights the potential role of genetic factors in methamphetamine use disorder, particularly in association with cognitive function. This review examines the key genetic and cognitive dimensions and their interplay in methamphetamine use disorder. There is converging evidence from several studies that genetic polymorphisms in BDNF, FAAH, SLC18A1, and SLC18A2 are associated with protection against or susceptibility to the disorder. In addition, people with methamphetamine use disorder consistently displayed impairments in cognitive flexibility and inhibitory control compared with people without the disorder. These cognitive domains were associated with reactivity to methamphetamine cues that were positively correlated with total years of methamphetamine use history. Emerging research also suggests that inhibitory control is negatively correlated with lower blood FAAH mRNA levels, while cognitive flexibility positively correlates with higher blood SLC18A2 mRNA levels, highlighting how genetic and cognitive dimensions interact in methamphetamine use disorder. We also include some future directions, emphasizing potential personalized therapeutic strategies that integrate genetic and cognitive insights. By drawing attention to the interplay between genes and cognition, we hope to advance our understanding of methamphetamine use disorder and inform the development of targeted interventions.

Milligan K., Osminin I., Ingram V., Daari L.

Gillespie K.M., Dymond A.H., Li X., Schweitzer D., Branjerdporn G., Khan S., Hii Q., Keller S., Bartlett S.E.

Introduction: The one unifying and distinguishing feature of all neuropsychiatric illnesses is the co-occurrence of cognitive dysfunction. Cognitive training (CT) was developed to enhance neural connectivity and cognition and improve day-to-day functioning. However, the benefits of CT are still debated. This current systematic review aimed to examine the efficacy of CT and to identify diagnostic and CT characteristics associated with superior outcomes across a range of psychiatric disorders. Method: Studies investigating CT in psychiatric illnesses were extracted from Embase, PubMed, CINAHL, PsycINFO, and PsycARTICLES up to 17 August 2023. Inclusion criteria were randomised control trials (RCT) and English language. The primary search strategy included terms relating to cognitive training, cognitive remediation, cognitive enhancement, or cognitive rehabilitation and randomised control trials, clinical trials, or experiments. Risk of bias was assessed using RevMan Web version 8.1.1. Narrative synthesis was used to analyse findings. Due to the heterogeneity of participant demographics, diagnoses, and interventions, meta-analyses were considered inappropriate. Results: Fifteen studies, including a total of 1075 participants, were identified. Approximately 67% of studies reported significant improvements in at least one trained domain of cognitive function after CT, and 47% observed improvements in psychiatric symptoms or function. Cognitive transfer effects were not observed. Sample sizes for studies were generally small, and most CT durations were 6 weeks or less. Conclusions: Findings suggest that CT can improve cognitive function in trained domains, though little evidence of cognitive transfer effects was observed. Due to the lack of standardisation in CT format and delivery, and inadequate measures of psychiatric symptoms or daily function, there is insufficient evidence to conclude whether or not this technique may benefit cognitive impairment in psychiatric disorders, or lead to subsequent improvement in disease symptomatology. Further studies of longer duration and using consistent methodologies must be conducted to identify the benefits of CT in psychiatric disorders.

Brasser M., Frühholz S., Schneeberger A.R., Trevor C., Ruschetti G.G., Held F.E., Häner M., Studer-Luethi B.

Ninety percent of people with depression also report suffering from additional cognitive disorders. However, despite the high prevalence, the effectiveness of cognitive training methods for mental illnesses has not yet been extensively researched. In our study, ninety-six adult patients with depressive symptoms were randomly assigned to one of two intervention groups or a passive control group. Ultimately, 48 patients successfully completed the training and assessments. The first intervention group completed computer-based cognitive training (three times a week for 20 min). The second intervention group practiced different memory strategies three times a week, in addition to completing the same computer-based cognitive training as the first intervention group. All groups demonstrated several improvements in cognitive performance and experienced benefits in everyday life over time. However, we found neither a significant group effect nor a significant time × group interaction effect for any of the measures. Despite this, on a descriptive level, the intervention groups showed improvements across all five cognitive test performance outcomes (especially attention and working memory) and displayed better scores in the post intervention assessment of the self-reported personal variables (well-being, emotional regulation and depressive symptoms). Approximately 50% of the subjects in each group did not complete the training or the post intervention assessment and were excluded. We worked closely with healthcare professionals, therapists and doctors and were thus able to gather not only research results but also valuable experience in dealing with patients with depressive symptoms who are undergoing cognitive training. Our findings and experiences may have implications for optimizing the reintegration of people with depressive symptoms.

Rezapour T., Rafei P., Baldacchino A., Conrod P.J., Dom G., Fishbein D.H., Kazemi A., Hendriks V., Newton N., Riggs N.R., Squeglia L.M., Teesson M., Vassileva J., Verdejo-Garcia A., Ekhtiari H.

Neuroscience has contributed to uncover the mechanisms underpinning substance use disorders (SUD). The next frontier is to leverage these mechanisms as active targets to create more effective interventions for SUD treatment and prevention. Recent large-scale cohort studies from early childhood are generating multiple levels of neuroscience-based information with the potential to inform the development and refinement of future preventive strategies. However, there are still no available well-recognized frameworks to guide the integration of these multi-level datasets into prevention interventions. The Research Domain Criteria (RDoC) provides a neuroscience-based multi-system framework that is well suited to facilitate translation of neurobiological mechanisms into behavioral domains amenable to preventative interventions. We propose a novel RDoC-based framework for prevention science and adapted the framework for the existing preventive interventions. From a systematic review of randomized controlled trials using a person-centered drug/alcohol preventive approach for adolescents, we identified 22 unique preventive interventions. By teasing apart these 22 interventions into the RDoC domains, we proposed distinct neurocognitive trajectories which have been recognized as precursors or risk factors for SUDs, to be targeted, engaged and modified for effective addiction prevention.

Floyd L.J.

Wang Y., Bian W., Wei J., Hu S.

To assess whether working memory training will relieve anxiety in participants.The PubMed, PsycINFO, Web of Science, and ProQuest databases were searched up to January 25, 2022. We included random controlled trials with low to moderate risk of bias in comparing working memory training with control condition as the only intervention in treating anxiety (PROSPERO ID: CRD42022300404). The language was restricted to English. Data extraction was independently carried out by two authors, following the PRISMA guideline for systematic reviews.Of the 477 records identified, 19 studies (n = 1051) were included in the meta-analysis. The results showed that the post-training anxiety was reduced with a small but significant value (Hedge's g = -0.392, p = .009) by working memory training. Subgroup analyses confirmed that the moderating effect of anxiety type, anxiety measurement and training environment were significant.These results should be considered with caution for the heterogeneity of training paradigms, participant population and types of anxiety assessed between studies. Further research is required to support these results.Working memory training is a promising intervention to relieve anxiety symptoms.

Nestor L.J., Ghahremani D.G., London E.D.

Methamphetamine misuse, a surging cause of morbidity and mortality worldwide, identifies Methamphetamine Use Disorder (MUD) as a critical public health problem. Treatment for MUD typically is sought during early abstinence when patients are experiencing cognitive difficulties that may hamper their engagement in treatment and recovery. Cognitive difficulties, particularly those that involve executive functions, likely reflect disruptions in neural functioning involving multiple brain areas and circuits. To extend knowledge in this area, we compared individuals with MUD (MUD group, n = 30) in early abstinence (3–11 days abstinent) with a healthy control group (HC, n = 33) on brain activation and network connectivity and topology, using functional magnetic resonance imaging (fMRI) during performance on an N-back working memory task. The N-back task involves the maintenance and manipulation of information in short-term memory and engages multiple neural processes related to executive functioning. The task was administered at two working-memory difficulty loads (1-back and 2-back). Compared with the HC group, the MUD group had worse task performance but no differences in task-related brain activation. Network-based statistics analyses, however, revealed that the MUD group exhibited less functional network connectivity at both difficulty loads of the N-back task than the HC group. Additional graph theory analyses showed that path lengths were longer, and clustering was lower across these networks, which also exhibited disrupted small-world properties in the MUD group. These results suggest a decoupling in network dynamics that may underlie deficits in cognition during early abstinence in MUD patients.

Yates J.R.

The cognitive model of addiction proposes that individuals with a substance use disorder (SUD) experience dysfunctional thought patterns (cognitive distortions), which can interfere with abstinence. This chapter will focus on two major cognitive processes affected by drug use: attention and memory. Long-term drug use negatively impacts attentional and memory processes. Attention and memory are also important determinants of addiction. Individuals with a SUD show heightened attention to drug-paired stimuli (attentional bias; see the previous chapter). These stimuli can trigger memories associated with drug use, leading to intense drug cravings and relapse. As such, this chapter discusses the various methods for measuring relapse-like behavior in animals, such as reinstatement, incubation of drug craving, renewal, and resurgence. The neuromechanisms of learning and memory are discussed and are linked to SUDs. Finally, some cognitive-based treatments for SUDs are covered, with a large focus on cognitive-behavioral therapy.

Xin Y., Zhong X., Zhang X., Chen Y., Xin W., Liu C., Fu H., Feng C., Zuo G.

Previous studies have shown that males with substance use disorder (SUD) in their first mandatory detoxification experience high rates of depression. It is unknown whether this high depression incidence contributes to impaired inhibition. In this work, two studies were undertaken to examine the role of depression in cognitive inhibition in heroin and methamphetamine withdrawal. We used the Beck Depression Inventory (BDI) and the self-control scale (SCS) to explore the relationship between depression and impulse inhibition in patients participating in mandatory drug treatment for the first time (Study 1). The results showed that depression negatively predicted impulse inhibition. The Stroop color–word interference task was used to explore the role of patients’ depression in their inhibitory abilities (Study 2). The results showed that the high-depression group had weaker inhibition performances in the Stroop color–word interference task compared to the low-depression group. This study shows that cognitive inhibition is weaker in people with high-depression addiction than in those with low depression. This result suggests that attention should be paid to the role of depressive comorbidity when conducting working memory training treatment for substance addiction.

Robledo-Castro C., Castillo-Ossa L.F., Corchado J.M.

This article presents a systematic review of studies on cognitive training programs based on artificial cognitive systems and digital technologies and their effect on executive functions. The aim has been to identify which populations have been studied, the characteristics of the implemented programs, the types of implemented cognitive systems and digital technologies, the evaluated executive functions, and the key findings of these studies. The review has been carried out following the PRISMA protocol; five databases have been selected from which 1889 records were extracted. The articles were filtered following established criteria, to give a final selection of 264 articles that have been used for the purposes of this study in the analysis phase. The findings showed that the most studied populations were school-age children and the elderly. The most studied executive functions were working memory and attentional processes, followed by inhibitory control and processing speed. Many programs were commercial, customizable, gamified, and based on classic tasks. Some more recent initiatives have begun to incorporate user-machine interfaces, robotics, and virtual reality, although studies on their effects remain scarce. The studies recognize multiple benefits of computerized neuropsychological stimulation and rehabilitation programs for executive functions in different age groups, but there is a lack of studies in specific population sectors and with more rigorous research designs.

Rudner T., Hume D.J., Larmuth K., Atterbury E., Rauch H.G., Kroff J.

AbstractIntroductionAbstaining from unwanted behaviors requires a sufficient balance between the executive and impulsive cognitive systems. Working memory (WM) is a vital component of both systems, identified in a wide range of research as the central and dominant component of executive function. WM potentially modulates the desires, tendencies, and behaviors specific to and seen in individuals with substance use disorder (SUD) and obesogenic eating (OE). Compared to healthy populations, research has shown individuals with SUD, as well as those who display OE, to have some degree of executive dysfunction, and both conditions have far-reaching health care implications. Additionally, these deficits are associated with impulsive behavior. Research has proposed that impulsive and so-called reward-driven responses could be altered through cognitive therapy and that both SUD and OE could benefit from working memory training (WMT).MethodIn this narrative review, we systematically align extant empirical reasoning and evidence with these assumptions. Our main aim is to ascertain and summarize the value of WMT for the treatment of both SUD and food reward consummatory behaviors. As a means to include detailed narrative accounts of all papers of potential value, our thresholds for meaningful improvements in both WM and unwanted behaviors are broad.ResultsThe results from the eleven qualifying studies are as follows: Nine of ten studies show a significant positive training effect of WMT on one or more components of WM capacity; three of six eligible papers (two on alcohol and one on opioid addiction) deliver notable improvements in SUD in response to WMT. One of two suitable studies showed WMT to be a moderately efficacious form of therapy for OE. Conversely, WMT appears to have negligible therapeutic benefit for cognitive function deficits or psychopathology unrelated to WM, suggesting that WMT has unique treatment efficacy for impulsive human behaviors.ConclusionIn conclusion, more rigorous and uniform studies on WMT and impulsive harmful behaviors are required to give proof of the benefits of this potential useful treatment.

Finn P.R., Nemes L., Bailey A., Gunn R.L., Wiemers E.A., Redick T.S.

There is considerable debate about whether working memory (WM) training specifically results in far-transfer improvements in executive cognitive function (ECF) rather than improvements on tasks similar to the training tasks. There has also been recent interest in whether WM training can improve ECF in clinical populations with clear deficits in ECFs. The current study examined the effects of WM training compared with non-WM adaptive visual search (VS) control training (15 sessions over 4 weeks) on various measures of ECF, including delay discounting (DD) rate, inhibition on flanker, color and spatial Stroop tasks, and drinking in a community-recruited sample with alcohol use disorder (AUD, 41 men, 41 women, mean age = 21.7 years), who were not in treatment or seeking treatment, and non-AUD healthy controls (37 men, 52 women, mean age = 22.3 years). Both WM and VS training were associated with improvements on all ECF measures at 4 weeks and 1-month follow-up. WM and VS training were associated with reductions in both DD rates and interference on Stroop and flanker tasks in all participants, as well as reductions in drinking in AUD participants that remained apparent 1-month post-training. The results suggest that nonspecific effects of demanding cognitive training, as opposed to specific WM training effects, could enhance ECF, and that such enhancements are retained at least 1-month post-training.

Zou A.R., Muñoz Lopez D.E., Johnson S.L., Collins A.G.

Impulsivity is defined as a trait-like tendency to engage in rash actions that are poorly thought out or expressed in an untimely manner. Previous research has found that impulsivity relates to deficits in decision making, in particular when it necessitates executive control or reward outcomes. Reinforcement learning (RL) relies on the ability to integrate reward or punishment outcomes to make good decisions, and has recently been shown to often recruit executive function; as such, it is unsurprising that impulsivity has been studied in the context of RL. However, how impulsivity relates to the mechanisms of RL remains unclear. We aimed to investigate the relationship between impulsivity and learning in a reward-driven learning task with probabilistic feedback and reversal known to recruit executive function. Based on prior literature in clinical populations, we predicted that higher impulsivity would be associated with poorer performance on the task, driven by more frequent switching following unrewarded outcomes. Our results did not support this prediction, but more advanced, trial-history dependent analyses revealed specific effects of impulsivity on switching behavior following consecutive unrewarded trials. Computational modeling captured group-level behavior, but not impulsivity results. Our results support previous findings highlighting the importance of sensitivity to negative outcomes in understanding how impulsivity relates to learning, but indicate that this may stem from more complex strategies than usually considered in computational models of learning. This should be an important target for future research.