Marco Cavicchioli

and 5 more

Objectives: Impulsivity is considered a core feature of substance use disorders (SUDs). However, the efficacy of evidence-based treatments for SUDs on this dimension remains a topic of debate, especially considering therapeutic community (TC) interventions for severe forms of these clinical conditions. Therefore, the current study aims at investigating pre- posttreatment changes in levels of impulsivity and related psychological dimensions during a 6-month Dialectical Behavior Therapy skills training program integrated within a TC (DBT-ST-TC) for individuals with severe SUDs. Methods: Impulsivity were assessed through a self-report measure (UPPS-P) and a neuropsychological battery. There were also evaluated levels of mindfulness (FFMQ, MAAS) emotion dysregulation (DERS) and distress tolerance (DTS). Intention-to-treat analysis controlling for baseline levels was performed. Contrast analyses were also conducted in order to compare results of the DBT-ST-TC group with two control groups (i.e., outpatient treatment-seeking individuals with SUDs; healthy controls [HCs]) Results: Sixty-eight patients with SUDs were admitted to the DBT-ST-TC. The clinical control group included 41 treatment-seeking individuals with SUDs. The HC group was composed of 53 participants. Considering pre- posttreatment changes, DBT-ST-TC patients reported that emotion dysregulation slightly improved as well as positive urgency and sensation seeking. Neuropsychological domain of cognitive disinhibition showed the most robust improvement, especially considering no significant differences between DBT-ST-TC group and HCs at the end of 6-month period of observation. Conclusion: The DBT-ST-TC might be a promising intervention for treating impulsivity among patients with severe SUDs. Future long-term outcomes are needed to corroborate and extent these provisional results.