Executive function, also called cognitive control, is used to describe a variety of "top-down" cognitive processes and abilities (e.g., working memory, inhibition, and cognitive flexibility) that help us execute goal-oriented behavior. Deficits in executive functions are present in substance abuse disorders; as well developmental disorders that are associated with increased risk for substance abuse (e.g., conduct disorder and attention deficit hyperactivity disorder). Recent research with children, adolescents and adults has indicated that training can enhance executive functioning skills and neuroscience has identified the brain mechanisms by which these interventions work, giving them added credibility.
The purpose of this workshop was to advance a scientific agenda that utilizes developmental cognitive neuroscience to guide the development of novel interventions to improve or ameliorate deficits in cognitive control functions and to translate this knowledge into strategies for the prevention and treatment of drug abuse across the human lifespan. The workshop had the format of brief scientific presentations followed by group discussion to:
Explain current knowledge of executive and cognitive control.
Highlight methods of assessment across the lifespan.
Identify frameworks and mechanisms for translation to drug abuse interventions.
Brief Discussion of Meeting Outcome:
The workshop participants made recommendations about methods that might be useful to further this research endeavor:
Neuroscience and Individual Differences
The development of interventions studies, as well as the efficacy of their effects, should include neuroscientific evidence to support the evidence that they work.
Additional research is needed that examines developmental trajectories of neurochemical dynamics and how these relate to individual differences in risk-taking behaviors in adolescents. This research might facilitate the development of pharmaceutical interventions that could be combined with behavioral interventions for added effectiveness.
There needs to be a focus on learning-related circuitry in that drug users may differ from controls in learning-related behaviors which would have a direct effect on the effectiveness of the intervention in drug users.
Context and an Ecological Framework
There is a need for ecologically valid assessments and an approach that is NOT isolating components. It is important to start with the assumption that specific cognitive training and emotional components are interactive and consider the developing person holistically.
Implications for Prevention and Intervention
The emphasis should be on prevention versus remediation of skills. It is more cost effective to consider preventive interventions for cognitive control than to pay for the effects of poor cognitive abilities later in development.
The development of the intervention should begin with a theoretical framework at multiple levels of analysis in order to get converging evidence. The pathways and the key ingredients of interventions should be examined to determine whether they can be applied to different settings and/or high-risk groups. Community-based participatory research should also be considered.
A focus on individual difference factors in addition to, and interacting with, age in understanding vulnerability to drug abuse and on factors that might predict the effectiveness of interventions.