Matching Treatments to Cognitive Deficits in Offenders With Substance Use Disorders
The Mind Research Network
Summary
The goal of this clinical trial is to investigate the effect of two types of cognitive remediation training on real-world behavioral outcomes including substance use, institutional adjustment, and recidivism following release from prison. Each training type is designed to target one of two subtypes of antisocial criminal offenders, who are characterized by either: 1) Attention to context-based deficits, or 2) Affective cognitive control-based deficits. The main questions it aims to answer are: Does matching deficit type with targeted cognitive training improve outcomes (relative to mismatched training)? What are the functional brain mechanisms that underlie treatment change? Participants will: Be assigned to cognitive training that either does or does not match their deficit type. Complete six one-hour sessions of cognitive skills training. Complete pre and post-training behavioral tasks assessing self-regulation deficits. Complete structural MRI scans and functional MRI scans assessing cognitive control. Complete post-treatment follow-up assessments evaluating self-regulation, adjustment, and stressful life events, substance use and recidivism.
Description
Prior research has identified two subtypes of antisocial offenders, typified by distinct dysfunctional cognitive emotion interactions undermining self-regulation. One subtype is characterized by an attention-based abnormality, which impairs adaptive processing of contextual information, tangential to one's primary focus. This abnormality is typified by offenders with high levels of callous/unemotional traits. A second subtype is characterized by hyper-reactions to personally relevant cues, interfering with executive functions that are otherwise needed to regulate behavior. This abnormality is…
Eligibility
- Age range
- 18–55 years
- Sex
- Male
- Healthy volunteers
- No
Inclusion Criteria: * Currently incarcerated * No uncorrectable auditory or visual deficits * Able to speak and/or understand English * 5th grade reading level or higher * IQ score = 80 or above * Lifetime history of substance use disorder based on DSM criteria * No history of dementia or other cognitive disability * No indication of current psychotic disorder * No major medical illness or CNS disease * Scores from the Psychopathy Checklist-Revised (PCL-R) meet criteria for one of the designated treatment groups Exclusion Criteria: \-
Interventions
- BehavioralAttention to Context (ATC) training
ATC training focuses on learning to attend to and integrate contextual cues present in the environment. Three tasks, Reversal Learning, Divided Visual Field, and Affective Gaze, require ATC functioning and provide individuals with practice noticing changes in contextual information, such as rule changes and using emotion information to modulate behavior.
- BehavioralAffective Cognitive Control (ACC) training
ACC training focuses on providing individuals with practice inhibiting behavior, particularly within motivational or affective contexts. Three tasks, Shapes, Numbers, and Lottery, tap ACC functioning and place demands on the basic employment of cognitive control, such as task switching, as well as on the concurrent engagement of cognitive control and affective processing.
Location
- Mind Research Network/Lovelace Biomedical Research InstituteAlbuquerque, New Mexico