This small grant application, developed in response to PA-14-037 (Women & Sex/Gender Differences in Drug and Alcohol Abuse/Dependence), integrates the team?s expertise in neurobehavioral assessment and investigation of sex differences with a growing literature regarding the potential efficacy of cognitive retraining in facilitating recovery among persons with substance use disorders (SUDs). As a pilot project, we ask whether cognitive training specifically focused on remediating compromise in top-down control processes underlying selective attention has differential benefits for treatment-seeking men vs. women. We recognize that although neurocognitive improvement during training is desired, of practical import is whether gains are achieved during training transfer to other tasks and settings. Therefore, we propose to examine transfer of training gains to tasks/domains varying in their similarity to training demands. Furthermore, given noted sex differences in emotional processing and the purported role of emotional factors in women?s substance use, we include training that engages emotional processing via the use of affective stimuli (faces and words) as an experimental variable; we posit that both men and women will benefit, but that women may benefit to a greater degree. To interrogate individual differences and inform further treatment development, we will examine associations between/among pre-intervention measures including demographic and substance use histories, family history of SUDs, interpersonal problems, neurocognitive performance and training-related improvements as well as psychosocial adaptation and substance use after discharge; These analyses are enabled by the overlap between the proposed work and the on-going R01 (AA022456, PI Nixon). In the current proposal, we focus on treatment-seekers with alcohol use disorders (AUD) who may or may not meet criteria for other substance use disorders (SUD). To address our objectives/aims, we propose that equal numbers of treatment- seeking men and women (Ss) be randomly assigned to one of two active training interventions (neutral or affective stimuli). Ss will complete baseline and post-intervention testing and will be contacted on a monthly basis for ~ 3 months following discharge to assess substance use and psychosocial adaptation. To control for abstinence-related recovery, a third group of Ss who meet identical selection criteria will complete pre- and post-intervention testing but will not engage in the intervention. The data will inform questions of neurocognitive recovery and sex differences and guide development of more comprehensive initiatives. The feasibility of the work is enhanced by concurrent work addressing parallel questions in the PI?s laboratory.
This pilot project addresses two understudied questions related to the neurocognitive deficits often observed in treatment-seeking alcoholics. The first is whether cognitive training, shown to impact performance in other populations, improves performance and outcomes in alcoholics and whether men and women differ in their response to this training. The second is whether directed training using affective materials (e.g., emotional faces) is differentially effective compared to that using traditional (i.e., neutral) stimuli and whether the benefit differs for men and women.
