Understanding the psychological processes that underlie recovery can help improve substance use disorder treatments. This study examined the potential roles of reward processes and executive functioning in the maintenance of abstinence among participants who selected to join an online registry of individuals in recovery from substance use disorder.
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Research indicates that mechanisms spanning both psychosocial and neurocognitive functioning help explain substance use recovery. Likewise, successful recovery most often includes significant growth and self-change, in addition to substance use abstinence. For example, engagement in health behaviors, such as healthy eating, exercise, and adherence to a sleep routine, can play a key role in recovery. Nevertheless, the psychology and neuroscience underlying engagement in health behaviors in substance use recovery is not yet well understood.
One popular theory among psychologists and neuroscientists (e.g., The Competing Neurobehavioral Decision Systems [CNDS] theory) suggests that the relative balance of the brain’s reward system and higher-order-planning (“executive function”) system promote healthy decision-making and engagement in positive behaviors, including substance use recovery. Researchers using a variety of methods, such as brain imaging and computerized psychological testing, find evidence of differences in these dual reward and planning systems among individuals with active substance use disorders. More recent research, however, has sought to determine the relative contributions of these neurobehavioral reward and planning systems to substance use abstinence and recovery.
Using a sample of adults from an online registry of individuals in recovery, this cross-sectional study examined neurobehavioral differences of reward and high-order-planning systems among individuals in recovery. Ultimately, research in this area can help uncover the relative contributions of these reward and executive functioning processes to initiating and sustaining recovery, thereby identifying potentially novel targets for treatments.
This study included 238 adults from an online registry for those in recovery from substance use disorders around the world (International Quit and Recovery Registry). Individuals that were part of this registry could self-refer to participate in this research study. Participants had self-identified primary substance use challenges with alcohol, stimulants, opioids, or other substances (e.g., cannabis, nicotine,). Participants likewise self-reported the duration of abstinence from the self-identified primary substance, which was approximately 8 years, on average.
The research team used behavioral measures to assess the dual systems of reward and high-order-planning, emphasized in relative balance theories from neuroscience. Participants completed assessments of delay discounting, a computerized assessment of impulsivity that has been widely associated with substance use and is thought to index the brain’s reward system. Participants completed self-report measures on their executive function and higher order planning skills thought to index the brain’s executive system. Participants also completed a self-report measure assessing their health-related behaviors (e.g., sleep, diet, exercise). Abstinence duration was determined by a retrospective report combining information from registry members’ initial baseline assessment and the updated research assessment containing delay discounting, executive function, and health behavior measures.
This cross-sectional study, where participants were only assessed at one time point, examined how strongly variation in abstinence duration was associated with differences in delay discounting, executive function, and health behaviors. The research team also determined whether there were any differences in delay discounting, executive function, and health behaviors when participants were grouped by their primary substance use challenge.
Delay discounting, executive function, and health behaviors were similar across the primary categories of substance use types (alcohol, stimulants, opioids, other).
When aggregating all participants in recovery (independent of the substance use type), lower impulsivity (as assessed via delay discounting) and more health behaviors were associated with longer durations of abstinence, indicating a potential role in the maintenance of substance use recovery. Or, another way of stating this is that longer durations of abstinence were associated with lower impulsivity and more healthy behaviors. More healthy behaviors were also associated with higher executive function.
This study of individuals from an online registry focused on substance use recovery examined correlates of successful substance use recovery, operationally defined here as number of current consecutive abstinent days. Using measures from multiple domains, including impulsivity, executive function, and health behaviors, the research team found that longer durations of abstinence were associated with lower impulsivity and more health behaviors, but not executive functioning. In additional analyses, the research team did not find that these behaviors substantially varied based on specific substance use types that individuals were in recovery from. These results thus highlight the potential importance of factors that may possibly influence or are a consequence of successful substance use recovery, independent of the specific type of substance use.
While the role of delay discounting – an index of reward processing and impulsivity – was associated with abstinence duration, executive functioning was not. Particularly given the cross-sectional nature of the study, and measurement strategies that used self-report only without complementary performance measures (e.g., laboratory tests of executive functioning), future research should re-examine these research questions using multi-modal approaches in a longitudinal framework.
This study adds to existing work emphasizing the importance of healthy behaviors in successful substance use recovery, such as healthy eating, exercise, and adherence to a sleep routine. Consistent with broader conceptualizations, this work also highlights substance use recovery as often including significant growth and self-change, in addition to substance use abstinence. While this study by itself cannot determine whether greater abstinence duration naturally leads to lower impulsivity and more health behaviors or vice versa, given its cross-sectional nature, it is likely a reciprocal relationship with both of things influencing each other dynamically over time. The results here support this notion, and it may make good sense clinically to target health behaviors and broader goals to bolster the chances of stable remission and recovery. This study also suggested that individual differences in impulsivity may influence recovery success, thus treatments that help patients decrease impulsivity may have greater success. Despite the clear limitations of the current cross-sectional study design to consider, as more evidence is accumulated, scientists and clinicians can better take advantage of insights from studies like this to help develop and optimize such interventions.
Successful recovery is related to broader processes of self-change and health behaviors, in addition to substance use abstinence. The current study found that reward processing and impulsivity – measured by delay discounting – but not executive functioning, was associated with abstinence duration. Understanding what leads to what, or if each of these different aspects augment each other dynamically in a reciprocal manner over time remains to be clarified. Longitudinal studies that follow participants over many time points and treatment studies that aim to provide direct support on these additional processes of self-change and health behaviors will help in this regard.
Satyal, M. K., Basso, J. C., Wilding, H., Athamneh, L. N., & Bickel, W. K. (2023). Examining neurobehavioral differences that support success in recovery from alcohol and other substance use disorders. Journal of Substance Use and Addiction Treatment, 148, 209007. doi: 10.1016/j.josat.2023.209007
l
Research indicates that mechanisms spanning both psychosocial and neurocognitive functioning help explain substance use recovery. Likewise, successful recovery most often includes significant growth and self-change, in addition to substance use abstinence. For example, engagement in health behaviors, such as healthy eating, exercise, and adherence to a sleep routine, can play a key role in recovery. Nevertheless, the psychology and neuroscience underlying engagement in health behaviors in substance use recovery is not yet well understood.
One popular theory among psychologists and neuroscientists (e.g., The Competing Neurobehavioral Decision Systems [CNDS] theory) suggests that the relative balance of the brain’s reward system and higher-order-planning (“executive function”) system promote healthy decision-making and engagement in positive behaviors, including substance use recovery. Researchers using a variety of methods, such as brain imaging and computerized psychological testing, find evidence of differences in these dual reward and planning systems among individuals with active substance use disorders. More recent research, however, has sought to determine the relative contributions of these neurobehavioral reward and planning systems to substance use abstinence and recovery.
Using a sample of adults from an online registry of individuals in recovery, this cross-sectional study examined neurobehavioral differences of reward and high-order-planning systems among individuals in recovery. Ultimately, research in this area can help uncover the relative contributions of these reward and executive functioning processes to initiating and sustaining recovery, thereby identifying potentially novel targets for treatments.
This study included 238 adults from an online registry for those in recovery from substance use disorders around the world (International Quit and Recovery Registry). Individuals that were part of this registry could self-refer to participate in this research study. Participants had self-identified primary substance use challenges with alcohol, stimulants, opioids, or other substances (e.g., cannabis, nicotine,). Participants likewise self-reported the duration of abstinence from the self-identified primary substance, which was approximately 8 years, on average.
The research team used behavioral measures to assess the dual systems of reward and high-order-planning, emphasized in relative balance theories from neuroscience. Participants completed assessments of delay discounting, a computerized assessment of impulsivity that has been widely associated with substance use and is thought to index the brain’s reward system. Participants completed self-report measures on their executive function and higher order planning skills thought to index the brain’s executive system. Participants also completed a self-report measure assessing their health-related behaviors (e.g., sleep, diet, exercise). Abstinence duration was determined by a retrospective report combining information from registry members’ initial baseline assessment and the updated research assessment containing delay discounting, executive function, and health behavior measures.
This cross-sectional study, where participants were only assessed at one time point, examined how strongly variation in abstinence duration was associated with differences in delay discounting, executive function, and health behaviors. The research team also determined whether there were any differences in delay discounting, executive function, and health behaviors when participants were grouped by their primary substance use challenge.
Delay discounting, executive function, and health behaviors were similar across the primary categories of substance use types (alcohol, stimulants, opioids, other).
When aggregating all participants in recovery (independent of the substance use type), lower impulsivity (as assessed via delay discounting) and more health behaviors were associated with longer durations of abstinence, indicating a potential role in the maintenance of substance use recovery. Or, another way of stating this is that longer durations of abstinence were associated with lower impulsivity and more healthy behaviors. More healthy behaviors were also associated with higher executive function.
This study of individuals from an online registry focused on substance use recovery examined correlates of successful substance use recovery, operationally defined here as number of current consecutive abstinent days. Using measures from multiple domains, including impulsivity, executive function, and health behaviors, the research team found that longer durations of abstinence were associated with lower impulsivity and more health behaviors, but not executive functioning. In additional analyses, the research team did not find that these behaviors substantially varied based on specific substance use types that individuals were in recovery from. These results thus highlight the potential importance of factors that may possibly influence or are a consequence of successful substance use recovery, independent of the specific type of substance use.
While the role of delay discounting – an index of reward processing and impulsivity – was associated with abstinence duration, executive functioning was not. Particularly given the cross-sectional nature of the study, and measurement strategies that used self-report only without complementary performance measures (e.g., laboratory tests of executive functioning), future research should re-examine these research questions using multi-modal approaches in a longitudinal framework.
This study adds to existing work emphasizing the importance of healthy behaviors in successful substance use recovery, such as healthy eating, exercise, and adherence to a sleep routine. Consistent with broader conceptualizations, this work also highlights substance use recovery as often including significant growth and self-change, in addition to substance use abstinence. While this study by itself cannot determine whether greater abstinence duration naturally leads to lower impulsivity and more health behaviors or vice versa, given its cross-sectional nature, it is likely a reciprocal relationship with both of things influencing each other dynamically over time. The results here support this notion, and it may make good sense clinically to target health behaviors and broader goals to bolster the chances of stable remission and recovery. This study also suggested that individual differences in impulsivity may influence recovery success, thus treatments that help patients decrease impulsivity may have greater success. Despite the clear limitations of the current cross-sectional study design to consider, as more evidence is accumulated, scientists and clinicians can better take advantage of insights from studies like this to help develop and optimize such interventions.
Successful recovery is related to broader processes of self-change and health behaviors, in addition to substance use abstinence. The current study found that reward processing and impulsivity – measured by delay discounting – but not executive functioning, was associated with abstinence duration. Understanding what leads to what, or if each of these different aspects augment each other dynamically in a reciprocal manner over time remains to be clarified. Longitudinal studies that follow participants over many time points and treatment studies that aim to provide direct support on these additional processes of self-change and health behaviors will help in this regard.
Satyal, M. K., Basso, J. C., Wilding, H., Athamneh, L. N., & Bickel, W. K. (2023). Examining neurobehavioral differences that support success in recovery from alcohol and other substance use disorders. Journal of Substance Use and Addiction Treatment, 148, 209007. doi: 10.1016/j.josat.2023.209007
l
Research indicates that mechanisms spanning both psychosocial and neurocognitive functioning help explain substance use recovery. Likewise, successful recovery most often includes significant growth and self-change, in addition to substance use abstinence. For example, engagement in health behaviors, such as healthy eating, exercise, and adherence to a sleep routine, can play a key role in recovery. Nevertheless, the psychology and neuroscience underlying engagement in health behaviors in substance use recovery is not yet well understood.
One popular theory among psychologists and neuroscientists (e.g., The Competing Neurobehavioral Decision Systems [CNDS] theory) suggests that the relative balance of the brain’s reward system and higher-order-planning (“executive function”) system promote healthy decision-making and engagement in positive behaviors, including substance use recovery. Researchers using a variety of methods, such as brain imaging and computerized psychological testing, find evidence of differences in these dual reward and planning systems among individuals with active substance use disorders. More recent research, however, has sought to determine the relative contributions of these neurobehavioral reward and planning systems to substance use abstinence and recovery.
Using a sample of adults from an online registry of individuals in recovery, this cross-sectional study examined neurobehavioral differences of reward and high-order-planning systems among individuals in recovery. Ultimately, research in this area can help uncover the relative contributions of these reward and executive functioning processes to initiating and sustaining recovery, thereby identifying potentially novel targets for treatments.
This study included 238 adults from an online registry for those in recovery from substance use disorders around the world (International Quit and Recovery Registry). Individuals that were part of this registry could self-refer to participate in this research study. Participants had self-identified primary substance use challenges with alcohol, stimulants, opioids, or other substances (e.g., cannabis, nicotine,). Participants likewise self-reported the duration of abstinence from the self-identified primary substance, which was approximately 8 years, on average.
The research team used behavioral measures to assess the dual systems of reward and high-order-planning, emphasized in relative balance theories from neuroscience. Participants completed assessments of delay discounting, a computerized assessment of impulsivity that has been widely associated with substance use and is thought to index the brain’s reward system. Participants completed self-report measures on their executive function and higher order planning skills thought to index the brain’s executive system. Participants also completed a self-report measure assessing their health-related behaviors (e.g., sleep, diet, exercise). Abstinence duration was determined by a retrospective report combining information from registry members’ initial baseline assessment and the updated research assessment containing delay discounting, executive function, and health behavior measures.
This cross-sectional study, where participants were only assessed at one time point, examined how strongly variation in abstinence duration was associated with differences in delay discounting, executive function, and health behaviors. The research team also determined whether there were any differences in delay discounting, executive function, and health behaviors when participants were grouped by their primary substance use challenge.
Delay discounting, executive function, and health behaviors were similar across the primary categories of substance use types (alcohol, stimulants, opioids, other).
When aggregating all participants in recovery (independent of the substance use type), lower impulsivity (as assessed via delay discounting) and more health behaviors were associated with longer durations of abstinence, indicating a potential role in the maintenance of substance use recovery. Or, another way of stating this is that longer durations of abstinence were associated with lower impulsivity and more healthy behaviors. More healthy behaviors were also associated with higher executive function.
This study of individuals from an online registry focused on substance use recovery examined correlates of successful substance use recovery, operationally defined here as number of current consecutive abstinent days. Using measures from multiple domains, including impulsivity, executive function, and health behaviors, the research team found that longer durations of abstinence were associated with lower impulsivity and more health behaviors, but not executive functioning. In additional analyses, the research team did not find that these behaviors substantially varied based on specific substance use types that individuals were in recovery from. These results thus highlight the potential importance of factors that may possibly influence or are a consequence of successful substance use recovery, independent of the specific type of substance use.
While the role of delay discounting – an index of reward processing and impulsivity – was associated with abstinence duration, executive functioning was not. Particularly given the cross-sectional nature of the study, and measurement strategies that used self-report only without complementary performance measures (e.g., laboratory tests of executive functioning), future research should re-examine these research questions using multi-modal approaches in a longitudinal framework.
This study adds to existing work emphasizing the importance of healthy behaviors in successful substance use recovery, such as healthy eating, exercise, and adherence to a sleep routine. Consistent with broader conceptualizations, this work also highlights substance use recovery as often including significant growth and self-change, in addition to substance use abstinence. While this study by itself cannot determine whether greater abstinence duration naturally leads to lower impulsivity and more health behaviors or vice versa, given its cross-sectional nature, it is likely a reciprocal relationship with both of things influencing each other dynamically over time. The results here support this notion, and it may make good sense clinically to target health behaviors and broader goals to bolster the chances of stable remission and recovery. This study also suggested that individual differences in impulsivity may influence recovery success, thus treatments that help patients decrease impulsivity may have greater success. Despite the clear limitations of the current cross-sectional study design to consider, as more evidence is accumulated, scientists and clinicians can better take advantage of insights from studies like this to help develop and optimize such interventions.
Successful recovery is related to broader processes of self-change and health behaviors, in addition to substance use abstinence. The current study found that reward processing and impulsivity – measured by delay discounting – but not executive functioning, was associated with abstinence duration. Understanding what leads to what, or if each of these different aspects augment each other dynamically in a reciprocal manner over time remains to be clarified. Longitudinal studies that follow participants over many time points and treatment studies that aim to provide direct support on these additional processes of self-change and health behaviors will help in this regard.
Satyal, M. K., Basso, J. C., Wilding, H., Athamneh, L. N., & Bickel, W. K. (2023). Examining neurobehavioral differences that support success in recovery from alcohol and other substance use disorders. Journal of Substance Use and Addiction Treatment, 148, 209007. doi: 10.1016/j.josat.2023.209007
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