AUTHOR=Stevens Laura , Betanzos-Espinosa Patricia , Crunelle Cleo L., Vergara-Moragues Esperanza , Roeyers Herbert , Lozano Oscar , Dom Geert , Gonzalez-Saiz Fransisco , Vanderplasschen Wouter , Verdejo-García Antonio , Pérez-García Miguel 

TITLE=Disadvantageous Decision-Making as a Predictor of Drop-Out among Cocaine-Dependent Individuals in Long-Term Residential Treatment

JOURNAL=Frontiers in Psychiatry

VOLUME=4

YEAR=2013

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2013.00149

DOI=10.3389/fpsyt.2013.00149

ISSN=1664-0640

ABSTRACT=<p><bold>Background</bold>: The treatment of cocaine-dependent individuals (CDI) is substantially challenged by high drop-out rates, raising questions regarding contributing factors. Recently, a number of studies have highlighted the potential of greater focus on the clinical significance of neurocognitive impairments in treatment-seeking cocaine users. In the present study, we hypothesized that disadvantageous decision-making would be one such factor placing CDI at greater risk for treatment drop-out.</p><p><bold>Methods</bold>: In order to explore this hypothesis, the present study contrasted baseline performance (at treatment onset) on two validated tasks of decision-making, the Iowa Gambling Task (IGT) and the Cambridge Gamble Task (CGT) in CDI who completed treatment in a residential Therapeutic Community (TC) (<italic>N</italic> = 66) and those who dropped out of TC prematurely (<italic>N</italic> = 84).</p><p><bold>Results</bold>: Compared to treatment completers, CDI who dropped out of TC prematurely did not establish a consistent and advantageous response pattern as the IGT progressed and exhibited a poorer ability to choose the most likely outcome on the CGT. There were no group differences in betting behavior.</p><p><bold>Conclusion</bold>: Our findings suggest that neurocognitive rehabilitation of disadvantageous decision-making may have clinical benefits in CDI admitted to long-term residential treatment programs.</p>