The role of neurocognitive abilities in coping with adolescent relapse to alcohol and drug use

Objective: Neurocognitive abilities are hypothesized to influence coping wi th temptations to relapse to alcohol and drug use. In particular, a moderat or model was proposed whereby neurocognitive abilities moderate the influen ce of coping strategies on treatment outcome. Method: Participants (N = 79) were consecutive admissions to inpatient alcohol and drug treatment center s in the San Diego, California, area, (age range = 14 to 18 years; 41% fema le). Treatment programs were abstinence focused, with an average inpatient stay of 5 weeks. Participants met DSM-III-R lifetime criteria for alcohol a buse or dependence and abuse or dependence of at least one other substance. Follow-up assessments were conducted 1 and 2 years following discharge, in cluding a battery of neuropsychological tests, coping questionnaire, and de tailed assessment of alcohol and other drug involvement. Results: The inter action between general intelligence and coping diversity significantly pred icted alcohol and drug use 1 year later (F = 10.71, 1/72 df, p < .005, R-2 change = .08), even when controlling for current use. Attention-coping and problem solving-coping interactions also significantly predicted outcome, b ut not above the intelligence-coping interaction. Conclusions: Teens with p oor neurocognitive abilities used little or no alcohol and drugs if good co ping skills were evidenced, but used more alcohol and drugs if their coping skills were poor. This association between coping skills and outcome did n or exist for teens with better neurocognitive abilities. Clinically, teens with poorer neurocognitive skills may maximally benefit from coping skills training programs, and neuropsychological evaluations may be particularly h elpful in addressing these individual needs in treatment.