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Testing for rehab success on cocaine users hailed as a success

13 February 2012

An article in the health section of the Irish Independent describes recent research by Department of Psychology Professor Dermot Barnes-Holmes and colleagues that has led to the development of a test that can establish the likely success or failure of rehab treatment for cocaine addicts. Read the full text below or see the original article here.

An Irish-designed psychological test, invented and developed by the Department of Psychology at NUI Maynooth, can successfully predict whether a person addicted to cocaine will attend treatment and how successful the treatment will be. The collaborative study was directed by a team of international psychologists including NUI Maynooth Professor of Psychology Dermot Barnes-Holmes and published in this month’s The American Journal of Drug and Alcohol Abuse.

The success of the psychological test, known as the Implicit Relational Assessment Procedure (IRAP), will have significant implications for substance addiction treatment, in particular our understanding and treatment of cocaine abuse. In a unique collaboration, Prof. Dermot Barnes-Holmes has co-authored the study with an international team including psychologists from the New York State Psychiatric Institute at Columbia University in New York.

The study was conducted at the prestigious research centre of the New York State Psychiatric Institute and involved a group of 25 cocaine-dependant participants who were enrolled in a six month outpatient programme. The participants were given questionnaires before treatment began which asked them to record their thoughts about cocaine craving and the consequences of cocaine use. They were also asked to complete two implicit tests, the IRAP and a Drug Stroop Protocol, which measured the reaction times of the participants.

The study tested the relationship between the treatment outcome and the implicit and standard questionnaire assessments. The regular questionnaire failed to predict how well the participants would do in the treatment programme. The IRAP test, which measured reaction times to questions about cocaine, correctly predicted which of the group was likely to turn up for treatment and if they did, whether their system would be free of the drug.

The study showed that the stronger the participants’ implicit beliefs about the positive effects of cocaine use were prior to treatment, the poorer the treatment outcome and the greater the link between substance abuse and negative consequences, the more successful the outcome of the treatment.

The IRAP test identified participants’ implicit cognitions i.e. thoughts, feelings and beliefs that they might wish to conceal or of which they are not consciously aware. An ordinary questionnaire will not reflect these hidden thoughts because invariably people aren’t fully aware of their own implicit cognitions. However, when they undergo an IRAP test they are required to confirm or refute statements under time pressure and respond more rapidly to the statements that reflect their hidden beliefs. The Drug Stroop tasks measured the response times of participants toward cocaine related and neutral words.

Discussing the study, Professor Dermot Barnes-Holmes said: “Our system has far-reaching implications for the treatment of drug addiction. Participants’ beliefs about their substance abuse and the negative or positive consequences that follow appear to have an impact on the success of their treatment – and these beliefs aren’t currently being identified through standard drug abuse treatment. The study highlights that Irish researchers can export their solutions into the best research centres in North America, rather than always thinking of importing American solutions into Ireland.”

NUI Maynooth President, Professor Philip Nolan commented: “I’m pleased to see Irish researchers developing a system which has achieved incredible results in a highly regarded American research centre. NUI Maynooth’s Department of Psychology is among the strongest in the world as evidenced by Dermot’s role on this study and this collaborative international project has made an extremely important contribution to the field of substance abuse.”

The study was approved by the Institutional Review Board of the New York State Psychiatric Institute. The group was made up of 25 men and three women with an average age of 37, who had been using cocaine for approximately 15 years.

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