Decision-making deficits are strong predictors of poor clinical outcomes in addiction treatment. However, research on interventions that address decision-making deficits among people with addiction is scarce and has not been analyzed. We aimed to systematically review evidence on neuropsychological interventions for decision-making deficits in addiction to identify promising therapies. Eligibility criteria were (1) participants with a diagnosis of substance use or behavioral addictive disorders, (2) interventions consisting of (neuro) psychological treatments that address decision-making, (3) comparators comprising control (sham) interventions, treatment as usual or no-treatment, (4) outcomes including a decision-making task, and (5) studies including RCTs and non-randomized trials. Search terms included addiction (or alcohol/drug/substance use/gambling) AND treatment (or specific interventions) AND decision-making (or specific tasks). The search yielded 728 hits, and two independent assessors agreed on the final selection of 12 articles. Interventions included Contingency Management (3 studies), Working Memory Training (2 studies) Goal Management Training (2 studies), Cognitive Behavioral Therapy (2 studies), Reality Therapy, Motivational Interview and Monetary Management. The main outcome measures were tasks of delay discounting, risk-taking and reward-based decision-making. Results showed that Goal Management Training improves reward-based decision-making, while Contingency Management combined with Cognitive Behavioral Therapy has beneficial effects on delay discounting. The evidence on Working Memory Training and Cognitive Behavioral Therapy as stand-alone treatments was mixed. Motivational Interview and Monetary Management had no significant effects on decision-making. Bias control across studies was moderate. We conclude that Goal Management Training and Contingency Management combined with Cognitive Behavioral Therapy have potential to modify decision-making in people with addiction. RCTs are needed to establish the efficacy of these interventions.

中文翻译：

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成瘾决策的神经心理学干预：系统评价。

决策缺陷是成瘾治疗临床预后不良的有力预测指标。但是，关于解决成瘾者决策缺陷的干预措施的研究很少，并且尚未进行分析。我们旨在系统地审查关于成瘾决策缺陷的神经心理学干预措施的证据，以找出有前途的疗法。符合条件的标准是（1）具有药物使用或行为成瘾性疾病诊断的参与者，（2）干预措施，包括针对决策的（神经）心理治疗，（3）比较者，包括对照（假）干预，常规治疗或不予治疗，（4）包括一项决策任务的结果以及（5）包括RCT和非随机试验的研究。搜索词包括成瘾（或酒精/毒品/物质使用/赌博），治疗（或特定干预措施）和决策（或特定任务）。搜索产生728次命中，两名独立评估者同意最终选择12篇文章。干预措施包括应急管理（3项研究），工作记忆训练（2项研究），目标管理培训（2项研究），认知行为疗法（2项研究），现实疗法，动机访谈和货币管理。主要成果指标是延误折现，承担风险和基于奖励的决策等任务。结果表明，目标管理培训可改善基于奖励的决策，而权变管理与认知行为疗法相结合可对延迟折扣产生有益的影响。关于工作记忆训练和认知行为疗法作为独立疗法的证据是混合的。动机访谈和货币管理对决策没有重大影响。各项研究的偏倚控制程度中等。我们得出结论，目标管理培训和应变管理与认知行为疗法相结合，具有改变成瘾者决策的潜力。需要RCT来确定这些干预措施的功效。我们得出结论，目标管理培训和应变管理与认知行为疗法相结合，具有改变成瘾者决策的潜力。需要RCT来确定这些干预措施的功效。我们得出结论，目标管理培训和应变管理与认知行为疗法相结合，具有改变成瘾者决策的潜力。需要RCT来确定这些干预措施的功效。