Piloting of an intervention to reduce problematic alcohol use in early phase psychosis
Bibliographic record
Abstract
Substance misuse significantly impacts recovery during early phase psychosis (EPP). However, effective psychotherapeutic interventions for substance misuse in EPP patients are limited. Cognitive remediation offers a novel approach by targeting mechanisms underlying substance use, including cognitive control and emotional regulation. This pilot study aimed to explore the feasibility of using a modified Cognitive Enhancement Therapy (CET) intervention in young adults with EPP, examining its effects on problematic alcohol use. This intervention, which focuses on remediation of neurocognitive and social cognitive deficits, was adapted with a reduced timeframe (6 months) and delivered via a virtual platform with the intent to improve retention. Participants who received CET saw improvements in verbal learning and memory, along with reductions in negative psychotic symptoms. Although the small sample size precluded statistical analyses, a notable reduction (50%) in alcohol use, or cessation, was seen in 6 out of 7 participants with 3 individuals notably reaching abstinence by the trial end. Overall alcohol use was reduced by 35%. Additionally, 3 participants with co-occurring cannabis use had significant reduction in cannabis risk scores (60%) over the course of the trial. Feedback from the participants suggests CET’s focus on emotional regulation, social confidence, and functional recovery contributed to their reduction in alcohol dependence. These promising outcomes highlight the need for further research to explore the potential benefits of cognitive remediation treatments for addressing substance misuse in EPP. This study was registered at clinicaltrials.gov under #NCT05365347. • A modified Cognitive Enhancement Therapy (CET) approach, with a shortened time frame and virtual delivery, is feasible and thus cost effective for services. • The results of the current trial add to the evidence that CET is an effective intervention to reduce problematic alcohol use in patients with a psychotic spectrum disorder. • Psychosocial approaches focusing on improving functional outcomes, emotional regulation, social cognition, and confidence can help individuals with EPP reduce problematic alcohol use.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".