Does Reflective Thinking Improve the Ability to Plan in Light and Heavy Drinkers? A Clinical-Experimental Model of...

BACKGROUND This study was conducted to verify the ability to plan using a short experiment based on the metacognitive model of executive functions proposed by Borkowski and Burke. The research questions were: (1) Are there differences among patients in metacognitive level and executive capacity as measured by visual planning tasks? (2) Does visual planning ability in alcohol-dependent individuals change after metacognitive activation? MATERIAL AND METHODS One hundred twenty-two alcohol-dependent men were examined as part of a neuropsychological clinical trial using a visual planning task (Porteus Maze Test). RESULTS Multivariate mixed-model MANCOVA revealed a significant interaction effect between activation (specific knowledge) and visual planning (P<0.05) in the analyzed group. Patients who confirmed - likely more impulsively - that knowledge about their skills was helpful were characterized by higher alcohol use disorder severity (heavy drinkers) compared with patients who responded less definitively but improved their visual planning on the second trial (light drinkers). Pairwise comparisons showed that patients with planning difficulties made more errors in visual planning before metacognitive activation, but their performance significantly improved afterward (P<0.05). Metacognitive activation type did not result in a significant difference (P>0.05). CONCLUSIONS Patients who responded with more reflection to the question regarding specific knowledge improved their visual planning in the second trial (light drinkers) compared with patients who gave less reflective responses (heavy drinkers). The effect of metacognitive activation was substantial among patients with difficulties in visual planning (light and heavy drinkers), but not among patients with intact planning abilities.