Clinical limitations of neuropsychological testing in predicting treatment outcome among alcoholics

The purpose of the present study was to investigate a number of factors that may influence the relationship between neuropsychological impairment and treatment outcome among alcoholics. Cognitive deficit upon admission to treatment was significantly related to the individual's age but independent of the years of problem drinking and the recency of the last drink prior to assessment. Significant improvement was noted on measures of neuropsychological function over the period from treatment admission to 6-month follow-up assessment. On the average, improvement in functioning occurred across time despite drinking relapses during the intervening period. The individual's age, but not years of problem drinking, was associated with recovery of function; neither of these variables interacted with subsequent drinking status to affect differentially the changes in cognitive functioning. Finally, selected measures of neuropsychological function assessed both at admission and 6-month follow-up were reliably related to follow-up employment status but unrelated to the average amount of alcohol consumed per day and to the number of heavy drinking days during the 3-month period between the 6- and 9-month follow-ups. The results are discussed in terms of the need for determining the utility of neuropsychological measures in predicting everyday functioning among alcoholics and for selecting domains of assessment other than cognitive status to predict treatment outcome.