Cognitive impairment influences drinking outcome by altering therapeutic mechanisms of change

ArticleinPsychology of Addictive Behaviors 20(3):241-53 · October 2006with20 Reads
Impact Factor: 2.75 · DOI: 10.1037/0893-164X.20.3.241 · Source: PubMed

Serious neuropsychological impairments are seen in a minority of addiction treatment clients, and, theoretically, these impairments should undermine behavioral changes targeted by treatment; however, little evidence supports a direct influence of impairment on treatment response. To address this paradox, the authors used structural equation modeling and Project MATCH data (N=1,726) to examine direct, mediated, and moderated paths between cognitive impairment, therapeutic processes, and treatment outcome. Mediated relations were found, wherein impairment led to less treatment compliance, lower self-efficacy, and greater Alcoholics Anonymous Involvement, which, in turn, more proximally predicted drinking. Impairment further moderated the effect of self-efficacy, making it a poor predictor of drinking outcomes in impaired clients, thereby suggesting that impaired and unimpaired clients traverse different pathways to addiction recovery.


Available from: Marsha E Bates, Jan 07, 2014