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Cognitive and metacognitive factors among alcohol-dependent patients during a residential rehabilitation program: a pilot study

Authors Torselli E, Ottonello M, Franceschina E, Palagi E, Bertolotti G, Fiabane E

Received 28 February 2018

Accepted for publication 1 May 2018

Published 31 July 2018 Volume 2018:14 Pages 1907—1917

DOI https://doi.org/10.2147/NDT.S166669

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Justinn Cochran

Peer reviewer comments 3

Editor who approved publication: Dr Roger Pinder


Elisa Torselli,1 Marcella Ottonello,2 Emilio Franceschina,1 Emanuele Palagi,1 Giorgio Bertolotti,3 Elena Fiabane2,4

1Miller Institute for Behavioral and Cognitive Therapy, Genoa, Italy; 2Department of Physical and Rehabilitation Medicine, ICS Maugeri Spa SB, Institute of Genoa Nervi, Genoa, Italy; 3Psychology Unit, ICS Maugeri SPA SB, IRCCS, Tradate, Italy; 4Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy

Purpose: The aims of this pilot study were to examine cognitive factors (brooding and craving) together with positive/negative metacognitive beliefs about alcohol during a residential program for alcohol addiction and to explore relationships with psychological variables at discharge, with the scope of identifying predictive factors of psychological outcome and patients at greatest risk of relapse.
Methods: Thirty patients underwent a brief semistructured interview on admission to a 28-day rehabilitation program for alcohol addiction, and completed at admission and discharge the following five self-report questionnaires: 1) brooding (Brooding subscale of Ruminative Response Scale [B-RRS]), 2) craving (Penn Alcohol Craving Scale [PACS]), 3) positive beliefs about alcohol use (Positive Alcohol Metacognitions Scale [PAMS]), 4) negative beliefs about alcohol use (Negative Alcohol Metacognitions Scale [NAMS]), and 5) the psychophysical state of health (Cognitive Behavioral Assessment – Outcome Evaluation [CBA-OE]).
Results: Significant changes were found between admission and discharge in CBA-OE, B-RRS, and PACS. Brooding at admission was a significant predictor of post-treatment psychological variables of “anxiety”, “depression”, and “psychological distress”, whereas craving at admission was a good predictor of “perception of positive change” at discharge.
Conclusion: Our results confirm the importance of brooding in mood regulation and its role in the development and maintenance of problem drinking. In addition, craving was negatively associated with the perception of positive change in the post-treatment outcomes and was a predictor of this psychological variable, which includes features related to the individual’s resilience and strength. The changes in metacognitive beliefs regarding alcohol use were not statistically significant, but we found a reduction in positive metacognitions and an increase in negative alcohol-related beliefs; future studies are needed to further explore this issue.

Keywords: alcohol addiction, cognitive factors, metacognition, rehabilitation, craving, brooding

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