The role of executive cognitive functions in changing substance use: What we know and what we need to know

Abstract

Background: Executive cognitive functions (ECF) have been linked to skills such as planning, organizing, problem solving, decision-making, initiating and self-regulating behavior, working memory, and motivation; critical activities needed to monitor and change substance use behavior. Purpose: The purpose of this study is to investigate how ECF may impact important variables associated with changing substance use behavior. Methods: This study is a critical review of the extant literature about how ECF may influence substance abuse treatment outcomes and behavior change. Results: A review of the literature found evidence that poorer ECF likely hinders substance use behavior change and is often associated with behavior labeled as denial. However, the relationship between ECF and substance abuse appears to be highly complex. Conclusions: Traditional methods of substance abuse assessment, interpretation of behavior, and intervention may need to be reconsidered in light of new research about executive cognitive dysfunction. Implications for future research are discussed. © 2009 The Society of Behavioral Medicine.