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  • Addiction, Drugs
  • Information from Lay-Language Summaries is Embargoed Until the Conclusion of the Scientific Presentation

    119—Addiction Treatment and Genetics: Translational Studies

    Sunday, November 10, 2013, 8:00 am - 11:30 am

    119.05: Event-related potential measures of incorrect responses predict completion of substance abuse treatment

    Location: 24A

    V. R. STEELE1, B. C. FINK2, J. M. MAURER3, M. R. ARABSHIRANI1, A. SIDZ3, V. D. CALHOUN4, V. P. CLARK1, *K. A. KIEHL5;
    1The Mind Res. Network, Univ. of New Mexico, Albuquerque, NM; 2Univ. of New Mexico, Albuquerque, NM; 3The Mind Res. Network, Albuquerque, NM; 4The Mind Res. Network, Univ. of New Mexico, Yale Univ. Sch. of Med., Albuquerque, NM; 5Mind Res. Network, Albuquerque, NM

    Abstract Body: US nationwide estimates indicate at least two-thirds of prisoners have a history of substance abuse or dependence. Tailoring substance abuse treatment to specific needs of incarcerated individuals could improve effectiveness of treating substance dependence and preventing drug abuse relapse. The purpose of the present study was to test the hypothesis that pre-treatment neural measures of error processing would predict which individuals would or would not complete a 12-week cognitive behavioral substance abuse treatment program. Adult incarcerated participants (N = 89; Females = 55) who volunteered for substance abuse treatment performed a response inhibition (Go/NoGo) task while event-related potentials (ERP) were recorded. The error-related negativity (ERN) and the error positivity (Pe) elicited during false alarm trials were compared between individuals who completed (N = 68; Females = 45) and discontinued (N = 21; Females = 10) treatment. As predicted, both the ERN and Pe, measured with windowed time-domain and principal component analysis, differed between groups. Using logistic regression and pattern classifiers, Pe predicted treatment completion above and beyond other measures (i.e., ERN, age, sex, IQ, impulsivity, and self-reported depression, anxiety, and motivation for change). We conclude individuals who discontinue treatment are deficient in both error-monitoring, as indexed by the ERN, and adjusting response strategy post-error, as indexed by the Pe. However, only the latter predicted treatment outcomes. The Pe has been shown to reflect internal response strategy adjustments which appear to be deficient in individuals who prematurely discontinue treatment. Specialized treatments should be developed to enhance modulation of response strategies which could lead to more favorable, long-term outcomes.

    Lay Language Summary: Event-related potential measures of incorrect responses predict completion of substance abuse treatment
    Our research is the first to use a neuroimaging measure to identify prison inmates who would complete or discontinue treatment for substance use disorders. Using this measure we were able to predict with 83% accuracy the inmates who would discontinue substance abuse treatment.
    These findings are important because substance use is a wide-spread problem among incarcerated populations with nearly two-thirds of inmates in the US meeting diagnostic criteria for a substance use disorder. Even though 40-49% of inmates participate in some form of treatment while incarcerated, the period shortly after release represents a time of significant risk for the return to substance use and accidental overdose death. For example, drug-related causes of death account for 76% of deaths within the first two weeks and 59% of deaths within the first three months following release from custody.
    Because more treatment has been consistently related to lower rates of relapse to substance use, and the stakes are high with an inmate population, it is important to discover improved and novel predictors of treatment completion. The present study tested the hypothesis that pre-treatment neural measures of a response inhibition measured using electroencephalography (EEG) would identify inmates who would complete or discontinue a 12-week cognitive behavioral treatment for substance use disorders.
    We used a response inhibition task to make this identification because response inhibition is a hallmark of flexible and goal-directed behavior when one is in a changing environment. An example of response inhibition is how most people can easily stop what they are doing when there are changes to their internal state, such as feeling tired, anxious or frightened, or when there are changes in the environment, such as not crossing the street when a car is coming. Our brain processes these internal or environmental events very quickly. When we examine these quick processes using neuroimaging techniques, we can obtain insights into how people will behave. We found that inmates who demonstrated problems in neural processing when inhibiting responses and in the neural processing that occurred after they made response inhibition mistakes were the inmates most likely to discontinue treatment.
    Psychological treatments of any kind can be mentally taxing. If future research determines that the problems in neural processing seen in our study are part of the reason why an inmate discontinues treatment then we may be able to have these inmates engage in neurocognitive tasks that improve their neural processing. These tasks may make treatment less mentally taxing for those inmates and may increase the likelihood they will complete substance use treatment and remain substance free after release from prison.