Cognitive remediation improves executive functions, self-regulation and quality of life in residents of a substance use disorder therapeutic community

•Cognitive remediation (CR) was trialled for females with substance use disorder.•CR improved inhibition and inventory-based assessment of executive functions.•Decreased impulsivity and increased self-control were observed in the CR group.•Improvements in quality of life were also reported after CR.

BackgroundExecutive dysfunction is common in substance use disorder (SUD) populations and hinders treatment. We previously found that 50% of residents in SUD therapeutic communities had been hospitalized for head injuries; this was a significant determinant of cognitive impairment. The current study aimed to establish whether cognitive remediation improves executive functions (EFs) and self-regulation in an ecologically valid sample of female residents attending SUD therapeutic community treatment, including those with past head injuries and psychiatric comorbidities.MethodsControlled sequential groups design with residents (N = 33, all female) receiving treatment as usual (TAU). The intervention group (n = 16) completed four weeks of cognitive remediation (CR) and the control, TAU only (n = 17). Outcome measures assessed pre- and post-intervention included both performance- and inventory-based measures of EFs, and self-reported self-regulation and quality of life.ResultsCR relative to TAU significantly improved performance-based assessment of inhibition (Color-Word Interference Test; F = 4.29, p = 0.047), inventory-based assessment of EFs (Behavior Rating Inventory of Executive Function - Adult Version: Global Executive Composite; F = 6.38, p = 0.017), impulsivity (Barratt Impulsiveness Scale; F = 4.61, p = 0.040), self-control (Brief Self-Control Scale; F = 5.53, p = 0.026), and quality of life (Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form; F = 7.68, p = 0.010).ConclusionsFindings suggest that CR improves EFs in a heterogeneous sample of female residents in therapeutic community SUD treatment. Future research may explore the possibility of tailoring CR interventions for various SUD subgroups.