Cognitive insight, medication adherence and methamphetamine cessation in people enrolled in a pharmacotherapy trial for methamphetamine use

Publication Name

Journal of Substance Abuse Treatment


Background: The current study examined correlates of cognitive insight in people enrolled in a methamphetamine pharmacotherapy trial; whether cognitive insight at the start of the trial predicted medication adherence and reductions in methamphetamine use during the trial; and, whether insight would remain stable over the trial or improve with reductions in methamphetamine use. Methods: A subset of people enrolled in a 12-week randomised placebo-controlled pharmacotherapy trial for methamphetamine dependence completed the Beck Cognitive Insight Scale, comprising subscales for Self-Reflection and Self-Certainty, at baseline (n = 152) and at week 12 (n = 79). Medication adherence was expressed as the percentage of non-missed doses measured using eCAP™ technology. Methamphetamine use days were assessed using the Timeline Followback. Results: At baseline, greater Self-Reflection was correlated with more severe methamphetamine withdrawal, and hostility, whereas Self-Certainty was correlated with less education and longer duration of methamphetamine use. No relationship was found between BCIS subscales at baseline and medication adherence (Self-Reflection b[SE] = −0.73 [0.43] p =.09; Self-Certainty b[SE] = −0.31 [0.48] p =.52,). Neither BCIS subscale was predictive of reduced methamphetamine use at 12 weeks (Self-Reflection b[SE] = 0.001 [0.01] p =.95 Self-Certainty b[SE] = −0.003 [0.01], p =.74). Self-Reflection decreased over the trial (t = 3.42, p =.001) but this was unrelated to change in methamphetamine use (Self-Reflection, b[SE] = −1.68 [1.16] p =.15) Change in methamphetamine use was found to be a significant predictor of Self-Certainty at 12 weeks (b [SE] = −2.71 [1.16] p =.02). Conclusions: We found no evidence that cognitive insight predicted medication adherence or methamphetamine reduction in people engaged in this trial. Ongoing or increased methamphetamine use predicted increased Self-Certainty at 12 weeks.

Open Access Status

This publication is not available as open access



Article Number


Funding Number

APP 1145634

Funding Sponsor

Brain and Behavior Research Foundation



Link to publisher version (DOI)