A Pilot Study of Adjunctive Group Therapy to Enhance Coping With Cognitive Challenges and Support Cognitive Health After Electroconvulsive Therapy.

Objectives: Concerns about the cognitive adverse effects of electroconvulsive therapy (ECT) are common among recipients of the treatment despite its relatively small adverse effects on cognitive functioning. Interventions aimed at remediating or improving coping with cognitive adverse effects of ECT have not been developed. The Enhancing Cognitive Domains after ECT (ENCODE) program is a new group intervention aimed at teaching self-management strategies to cope with the cognitive challenges and associated anxiety that often accompanies ECT.

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

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.

Clinical utility of a hybrid secondary and relapse prevention program in adults with mild intellectual disability in community residential and day habilitation settings.

Background: Despite evidence that standard substance use disorder (SUD) treatment may be less effective in people with intellectual disability (ID), there is an absence of appropriate clinical tools with which to support them.

Objectives: This study examined the clinical utility of an alcohol and other drug refusal skills intervention designed to be cognitively accessible to adults with ID METHODS: Thirty individuals at high risk for or in recovery from a SUD in developmental disability services (DDS) community residential and day habilitation settings participated in the two-week refusal skills group. Measures included pretest versus posttest improvement in refusal skill competency and baseline performance on a standardized verbal learning test.

First Acute-Course Electroconvulsive Therapy for Moderate-to-Severe Depression Benefits Patients With or Without Accompanying Baseline Cognitive Impairment.

Background: Researchers are increasingly investigating therapeutic response associated with new patient subgroups as a way to improve electroconvulsive therapy (ECT) treatment outcomes and reduce adverse events. This study is the first to examine baseline cognitive impairment status as a predictor of clinical outcome in first acute-course ECT patients.

Methods: Baseline cognitive function at various thresholds and serial depressive symptom severity data from first-time ECT patients were examined using generalized linear mixed-effects models.

Interactive effects of age and recent substance use on striatal shape morphology at substance use disorder treatment entry.

Background: Striatal neuroadaptations are regarded to play an important role in the progression from voluntary to compulsive use of addictive substances and provide a promising target for the identification of neuroimaging biomarkers. Recent advances in surface-based computational analysis enable morphological assessment linking variations in global and local striatal shape to duration and magnitude of substance use with a degree of sensitivity that exceeds standard volumetric analysis.

Methods: This study used a new segmentation methodology coupled with local surface-based indices of surface area and displacement to provide a comprehensive structural characterization of the striatum in 34 patients entering treatment for substance use disorder (SUD) and 49 controls, and to examine the influence of recent substance use on abnormal age-related striatal deformation in SUD patients.

Clinical utility of the 15-item geriatric depression scale (GDS-15) for use with young and middle-aged adults.

Background: The Geriatric Depression Scale, Short Form (GDS-15) is a widely-used depression rating scale for elderly adults. It might be useful for persons across the adult lifespan, but more research is needed to support its clinical utility with young and middle-aged adults.

Methods: We examined the classification accuracy of the GDS-15 in identifying depression cases and non-cases in adults aged 18-54 (n = 199) compared to those aged 55-80 (n = 112), using the standard cutoff score of 5.

Cognitive Mechanisms and Therapeutic Targets of Addiction.

Fundamental to cognitive models of addiction is the gradual strengthening of automatic, urge-related responding that develops in tandem with the diminution of self-control-related processes aimed at inhibiting impulses. Recent conceptualizations of addiction also include a third set of cognitive processes related to self-awareness and superordinate regulation of self-control and other higher brain function. This review describes new human research evidence and theoretical developments related to the multicausal strengthening of urge-related responding and failure of self-control in addiction, and the etiology of disrupted self-awareness and rational decision-making associated with continued substance use.

Default Mode Network Functional Reorganization During Early Abstinence in Polysubstance-Using Emerging Adults Treated for Opioid Dependence.

This study examined default mode network connectivity within the first 30 days of abstinence in emerging adults entering treatment for opioid dependence. There were significant associations between abstinence duration and coupling strength with brain regions within and outside of the network.

Cognitive performance in methadone maintenance patients: effects of time relative to dosing and maintenance dose level.

Given the long-term nature of methadone maintenance treatment, it is important to assess the extent of cognitive side effects. This study investigated cognitive and psychomotor performance in 51 methadone maintenance patients (MMP) as a function of time since last methadone dose and maintenance dose level. MMP maintained on doses ranging from 40 to 200 mg (mean = 97 mg) completed a battery of psychomotor and cognitive measures across 2 sessions, during peak and trough states, in a double-blind crossover design.

Motivations to quit cannabis use in an adult non-treatment sample: are they related to relapse?

Background: The majority of cannabis smokers who quit do so without formal treatment, suggesting that motivations to quit are an important part of cessation process. However, little is known about how motivations relate to successful quitting.

Method: A convenience sample of 385 non-treatment-seeking adult cannabis smokers (58% male, age 16-64years at start of quit attempt) who made a "serious" (self-defined) quit attempt without formal treatment while not in a controlled environment were administered the 176-item Marijuana Quit Questionnaire (MJQQ) to assess their motivations to quit and outcome of the quit attempt.

Effects of cognitive impairment on substance abuse treatment attendance: predictive validation of a brief cognitive screening measure.

Background And Objectives: Neuropsychological impairment among patients with substance use disorders (SUDs) contributes to poorer treatment processes and outcomes. However, neuropsychological assessment is typically not an aspect of patient evaluation in SUD treatment programs because it is prohibitively time and resource consuming. In a previous study, we examined the concurrent validity, classification accuracy, and clinical utility of a brief screening measure, the Montreal Cognitive Assessment (MoCA), in identifying cognitive impairment among SUD patients.

Diagnostic criteria for cannabis withdrawal syndrome.

Objective: Cannabis withdrawal occurs in frequent users who quit, but there are no accepted diagnostic criteria for a cannabis withdrawal syndrome (CWS). This study evaluated diagnostic criteria for CWS proposed in DSM-V and two earlier proposals.

Method: A convenience sample of 384 adult, non-treatment-seeking lifetime cannabis smokers provided retrospective self-report data on their "most difficult" quit attempt without formal treatment, which was used in this secondary analysis.

Sociodemographic characteristics of cannabis smokers and the experience of cannabis withdrawal.

Background: Cannabis withdrawal can be a negative reinforcer for relapse, but little is known about its association with demographic characteristics.

Objectives: Evaluate the association of demographic characteristics with the experience of cannabis withdrawal.

Methods: Retrospective self-report of a "serious" cannabis quit attempt without formal treatment in a convenience sample of 104 non-treatment-seeking, adult cannabis smokers (mean age 35 years, 52% white, 78% male) with no other current substance use disorder (except tobacco) or chronic health problems.

Brain mu-opioid receptor binding predicts treatment outcome in cocaine-abusing outpatients.

Background: Cocaine users not seeking treatment have increased regional brain mu-opioid receptor (mOR) binding that correlates with cocaine craving and tendency to relapse. In cocaine-abusing outpatients in treatment, the relationship of mOR binding and treatment outcome is unknown.

Methods: We determined whether regional brain mOR binding before treatment correlates with outcome and compared it with standard clinical predictors of outcome.

Cannabis withdrawal symptoms in non-treatment-seeking adult cannabis smokers.

Background: Cannabis withdrawal is not recognized in DSM-IV because of doubts about its clinical significance.

Objectives: Assess the phenomenon of cannabis withdrawal and its relationship to relapse in non-treatment-seeking adults.

Subjects: Convenience sample of 469 adult cannabis smokers who had made a quit attempt while not in a controlled environment.

Conducting clinical research with prescription opioid dependence: defining the population.

Most treatment studies of opioid-dependent populations have focused predominantly on heroin users, despite a recent increase in those dependent upon prescription opioids. A key methodological challenge involved in studying the latter group involves defining the population. Specifically, researchers must decide whether to include (1) concurrent heroin users and (2) individuals with pain.

A method to diagnose opioid dependence resulting from heroin versus prescription opioids using the Composite International Diagnostic Interview.

Treatment research with opioid-dependent populations has not traditionally distinguished between those dependent on prescription opioids versus dependent upon heroin. Evidence suggests there is a substantial subpopulation of individuals with opioid dependence resulting largely or exclusively from prescription opioid use. Because this subpopulation may respond to treatment differently from heroin users, a method for discriminating DSM-IV opioid dependence due to prescription opioid use would provide more precision when examining this population.

Rapid cognitive screening of patients with substance use disorders.

To date, there has not been a time-efficient and resource-conscious way to identify cognitive impairment in patients with substance use disorders (SUDs). In this study, we assessed the validity, accuracy, and clinical utility of a brief (10-min) screening instrument, the Montreal Cognitive Assessment (MoCA), in identifying cognitive impairment among patients with SUDs. The Neuropsychological Assessment Battery-Screening Module, a 45-min battery with known sensitivity to the mild to moderate deficits observed in patients with SUDs, was used as the reference criterion for determining agreement, rates of correct and incorrect decision classifications, and criterion-related validity for the MoCA.

Signal-averaged electrocardiogram in physically healthy, recently abstinent chronic cocaine users.

Objectives: : Cocaine use is associated with cardiac arrhythmias. Markers of ventricular late potentials, which may be a precursor to malignant ventricular arrhythmias, can be detected by signal-averaged electrocardiography (SA-ECG) but not by standard ECG.

Methods: : We evaluated SA-ECG parameters in 60 medically screened, physically healthy, recently abstinent cocaine users (53 males, mean [SD] age, 34.

Measurement of self-reported HIV risk behaviors in injection drug users: comparison of standard versus timeline follow-back administration procedures.

This study compares the frequencies of retrospective self-reported HIV high-risk drug use and sexual behaviors in 127 out-of-treatment injection drug users using the HIV Risk Questionnaire (HRQ) across two administration methods: (a) a brief standard quantity-frequency approach covering the past 30 days and (b) a lengthier timeline follow-back (TLFB) procedure for improving recall. The two procedures produced similar frequencies of risk behavior across most items (80%) and good intra- and interclass correlation coefficients. The TLFB, however, resulted in higher frequencies for two risk behavior questions-sharing of any drug injection equipment and having any type of unprotected sex.

EEG and cerebral blood flow velocity abnormalities in chronic cocaine users.

EEG and cerebral blood flow abnormalities have been documented in chronic cocaine abusers. To identify possible relationships between EEG and blood flow changes and their relationship to the intensity of cocaine use, we recorded the resting eyes-closed EEG and anterior (ACA) and middle (MCA) cerebral artery blood flow velocity during systole (V(S)) and diastole (V(D)) by transcranial Doppler (TCD) sonography of 99 (76 male, 23 female; mean [SD] age 34.3 [5.

Reliability and validity of a short form of the Marijuana Craving Questionnaire.

Background: The Marijuana Craving Questionnaire (MCQ) is a valid and reliable, 47-item self-report instrument that assesses marijuana craving along four dimensions: compulsivity, emotionality, expectancy, and purposefulness. For use in research and clinical settings, we constructed a 12-item version of the MCQ by selecting three items from each of the four factors that exhibited the greatest within-factor internal consistency (Cronbach's alpha coefficient).

Methods: Adult marijuana users (n=490), who had made at least one serious attempt to quit marijuana use but were not seeking treatment, completed the MCQ-Short Form (MCQ-SF) in a single session.

Brain mu-opioid receptor binding: relationship to relapse to cocaine use after monitored abstinence.

Rationale: Cocaine users have increased regional brain mu-opioid receptor (mOR) binding which correlates with cocaine craving. The relationship of mOR binding to relapse is unknown.

Objective: To evaluate regional brain mOR binding as a predictor of relapse to cocaine use is the objective of the study.

Longitudinal ECG changes in cocaine users during extended abstinence.

Background: Cocaine lengthens electrocardiographic QTc, QRS and PR intervals through blockade of sodium and potassium channels, but changes during withdrawal have not been well studied.

Methods: We recorded weekly electrocardiograms (ECGs) from 25 physically healthy cocaine users (84.0% men, mean [S.