Matching Cognitive Remediation to Cognitive Deficits in Substance-Abusing Inmates

Study Overview
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Brief Summary
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This is a 2 -year NIDA funded grant (Co-PIs: Joseph P. Newman, John Curtin, and Carl Lejuez) that examines whether recent progress in characterizing the cognitive deficits associated with psychopathic and externalizing offenders may be used to develop better therapeutic interventions to treat their substance abuse and other self-control problems. Inmates with externalizing or psychopathy will receive one of two computer-based interventions to remediate the core cognitive skills that have been linked to self-regulation deficits in the two groups. One intervention (ACC) targets the affective cognitive control deficits associated with externalizing offenders whereas the other intervention (ATC) targets the attention to context deficits associated with psychopathic offenders. The specific components of the project include: selection and randomization of inmates; pre- and post-treatment behavioral and brain-related (ERP and Startle) measures to evaluate the impact and specificity of the ACC and ATC treatments; and 6 sessions of behavioral (e.g. computerized) and verbal training in ACC or ATC.

Official Title
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Matching Cognitive Remediation to Cognitive Deficits in Substance-Abusing Inmates

Conditions
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Psychopathy, Personality Disorders

Intervention / Treatment
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* Other: Cognitive Remediation
* Other: Cognitive Remediation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male, ages 18-45 years, elevated scores of psychopathy or externalizing measures Exclusion Criteria: currently taking psychotropic medication, below a 4th grade reading level, history or current learning disability, history of head trauma with lasting effects, current diagnosis of PTSD, Bipolar, or psychosis

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Attention to Context<br> | Other: Cognitive Remediation<br>* Computer training on 3 tasks that targets the attention to context deficits associated with psychopathic offenders. Participants complete 6 training sessions, that include the tasks, feedback and real-world translational examples.<br>|
| Experimental: Affective Cognitive Control<br> | Other: Cognitive Remediation<br>* Computer training on 3 tasks that targets the affective cognitive control deficits associated with externalizing offenders. Participants complete 6 training sessions, that include the tasks, feedback and real-world translational examples.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Psychophysiological change from pre-treatment to post-treatment | We will measure electrophysiology (EEG), startle responses (EMG measured in microvolts), and behavioral responses on six tasks that measure such processes as affective regulation, distress tolerance, cognitive control, selective attention, and attending to context. | 6 weeks after pre-testing | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frequency of Conduct Reports | Assess change in the frequency of institution conduct reports post-treatment. We will compare frequency of these reports pre-treatment and post-treatment. | within 3 months of participation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Incarcerated offenders, emotionally reactive, emotionally stable, psychopathy