Electrophysiological predictors and indicators of contingency management treatment response: Rationale and design for the ways of rewarding abstinence project (WRAP)

Contemporary Clinical Trials Communications

卷:23

Naomi N. Gancz¹  Steven D. Forman²  Michael Walsh Dickey³  Sarah E. Forster⁴  Greg J. Siegle⁴  Stuart R. Steinhauer⁴ 

[1] Building 30, Pittsburgh, PA, 15224, United States.;

[2] Corresponding author. VA Pittsburgh Healthcare System VISN 4 MIRECC, University Drive C;

[3] University of Pittsburgh, Department of Psychiatry, United States;

[4] VISN 4 Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, United States;

关键词: Prognostic factors;    Measurement-based care;    Minimization;    Contingency management;    Cocaine use disorder;    Electroencephalography;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Electrophysiological measures can predict and reflect substance use treatment response. Veterans are disproportionately affected by disorders of addiction; cocaine use disorder (CUD) being particularly problematic due to high relapse rates and the absence of approved pharmacotherapies. Prize-based Contingency Management (PBCM) is an evidence-based behavioral intervention for CUD, involving incentives for cocaine abstinence but treatment response is variable. Measurement-based adaptation of PBCM has promise to improve effectiveness but remains to be usefully developed. Methods: This trial aims to determine if individuals with distinct neurocognitive profiles differentially benefit from one of two existing versions of PBCM. CUD patients will be randomized into treatment-as-usual or 12-weeks of PBCM using either monetary or tangible prize incentives. Prior to randomization, EEG will be used to assess response to monetary versus tangible reward; EEG and cognitive-behavioral measures of working memory, cognitive control, and episodic future thinking will also be acquired. Substance use and treatment engagement will be monitored throughout the treatment interval and assessments will be repeated at post-treatment. Discussion: Results of this trial may elucidate individual differences contributing to PBCM treatment response and reveal predictors of differential benefits from existing treatment variants. The design also affords the opportunity to evaluate treatment-related changes in neurocognitive functioning over the course of PBCM. Our model posits that PBCM scaffolds future-oriented goal representation and self-control to support abstinence. Individuals with poorer functioning may be less responsive to abstract monetary reward and will therefore achieve better outcomes with respect to abstinence and treatment engagement when tangible incentives are utilized.

【 授权许可】

Unknown