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      Cognitive impairment in substance use disorders.

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          Abstract

          Cognitive impairments in substance use disorders have been extensively researched, especially since the advent of cognitive and computational neuroscience and neuroimaging methods in the last 20 years. Conceptually, altered cognitive function can be viewed as a hallmark feature of substance use disorders, with documented alterations in the well-known "executive" domains of attention, inhibition/regulation, working memory, and decision-making. Poor cognitive (sometimes referred to as "top-down") regulation of downstream motivational processes-whether appetitive (reward, incentive salience) or aversive (stress, negative affect)-is recognized as a fundamental impairment in addiction and a potentially important target for intervention. As addressed in this special issue, cognitive impairment is a transdiagnostic domain; thus, advances in the characterization and treatment of cognitive dysfunction in substance use disorders could have benefit across multiple psychiatric disorders. Toward this general goal, we summarize current findings in the abovementioned cognitive domains of substance use disorders, while suggesting a potentially useful expansion to include processes that both precede (precognition) and supersede (social cognition) what is usually thought of as strictly cognition. These additional two areas have received relatively less attention but phenomenologically and otherwise are important features of substance use disorders. The review concludes with suggestions for research and potential therapeutic targeting of both the familiar and this more comprehensive version of cognitive domains related to substance use disorders.

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          Author and article information

          Journal
          CNS Spectr
          CNS spectrums
          Cambridge University Press (CUP)
          1092-8529
          1092-8529
          Feb 2019
          : 24
          : 1
          Affiliations
          [1 ] Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Rockville, Maryland.
          [2 ] Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
          Article
          S1092852918001426 NIHMS1508174
          10.1017/S1092852918001426
          6599555
          30591083
          2fa1c7c6-c313-42af-b17e-c97138624155

          Attention,working memory,theory of mind,substance use disorders,social cognition,precognition,metacognition,inhibition,executive function,decision-making

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