Spontaneous flexibility, attentional set shifting and cognitive control in men with alcohol dependence

Purpose:
The aim of the study was to assess spontaneous flexibility, attentional set shifting and cognitive control in alcohol- dependent men in the process of therapy in alcohol addiction treatment units, and to recognise the use of production strategies in visual-spatial mode in this clinical group.

Methods:
A total of 72 men participated in the study, 43 were alcohol-dependent (ADS) and 29 were controls (CTR). The Ruff Figural Fluency Test (RFFT), the Color Trails Test part 2 (CTT-2) and the Montreal Cognitive Assessment (MoCA) were administered.

Results:
The findings showed that alcohol dependence significantly impacted performance CTT-2 and RFFT, beyond and above age and education. The ADS group performed significantly worse than controls in CTT-2 and all indices of RFFT. A significant interaction effect was observed between group and task type for perseverations, with ADS patients producing fewer perseverations for the first part of RFFT compared to other parts of the test. They also used fewer production strategies than controls.

Conclusions:
Our findings highlight that alcohol dependence specifically contributes to explaining the results in terms of reactive flexibility in the aspect of attentional set shifting, as well as spontaneous flexibility in tasks requiring the generation of unique designs in limited time. The alcohol-dependent group demonstrated poor cognitive control, as evidenced by significantly higher number of perseverations. Furthermore, an analysis of the production strategies employed by alcohol-dependent men provided important information about their control and planning capacities. These findings support the recommendation to work with cognitive stimulation in therapeutic work with this population.