Relationship of cognitive function and the acquisition of coping skills in computer assisted treatment for substance use disorders

Background: Coping skills training is an important component of cognitive behavioral therapy (CBT), yet cognitive impairment and related limitations that are often associated with chronic substance use may interfere with an ability to learn, retain, or use new information. Little previous research has examined the cognitive or neuropsychological factors that may affect substance users' ability to learn new coping skills in CBT. Methods: Fifty-two substance dependent individuals randomized to receive a computerized version of cognitive behavioral therapy (CBT4CBT) or treatment as usual (TAU) were administered several cognitive and neuropsychological measures, as well as a coping skills measure prior to and upon completing an 8-week treatment period. Results: Across treatment conditions, participants who scored above the median on a measure of IQ demonstrated greater improvement in the quality of their coping skills than those below the median on IQ (Group x Time, F(1,49) = 4.31, p < .05). Also, IQ had a significant indirect effect on substance use outcomes through an effect on the quality of coping skills acquired, specifically for those who received CBT4CBT. Conclusion: Individuals with higher IQ at baseline improved the quality of their coping skills more than those with lower IQ which in turn reduced rates of substance use following treatment. This highlights the impact of substance users' cognitive functioning and abilities on the acquisition of coping skills from CBT, and suggests need for greater awareness and tailoring of coping skills training for those with poorer functioning. (c) 2010 Elsevier Ireland Ltd. All rights reserved.