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Nègre F, Lemercier-Dugarin M, Gomet R, Pelissolo A, Malbos E, Romo L, Zerdazi EH. Study on the efficiency of virtual reality in the treatment of alcohol use disorder: study protocol for a randomized controlled trial : E-Reva. Trials 2024; 25:417. [PMID: 38937776 PMCID: PMC11212355 DOI: 10.1186/s13063-024-08271-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 06/19/2024] [Indexed: 06/29/2024] Open
Abstract
CONTEXT According to the World Health Organization, alcohol is a major global public health problem, leading to a significant increase in illness and death. To treat alcohol use disorders, new therapeutic tools are being promoted, among which virtual reality (VR) shows promise. Previous research has demonstrated the efficacy of VR in reducing alcohol cravings in patients, but there is a lack of data on its effectiveness in maintaining abstinence or reducing consumption in recently abstinent individuals. The E-Reva study aims to compare the efficacy of a treatment strategy combining virtual reality cue exposure therapy (VR-CET) and cognitive behavioral therapy (CBT) with conventional CBT in reducing alcohol consumption and craving in patients with alcohol use disorder (AUD). In addition to this primary objective, the study will compare the effects of VR-CET combined with CBT on anxiety, depression, rumination, and feelings of self-efficacy versus conventional CBT. METHODS This prospective randomized controlled trial will be conducted over 8 months in four addiction departments in France. It includes two parallel groups: i) the VR-CET + CBT group, and ii) the CBT-only group, which serves as a control group. Participants will be recruited by the investigating doctor in the addiction centers. The sample will consist of 156 patients diagnosed with AUD and abstinent for at least 15 days. Both treatment groups will participate in four group CBT sessions followed by four individual sessions: i) the VR-CET group will be exposed to virtual environments associated with alcohol-related stimuli, ii) the CBT-only group will receive traditional CBT sessions. After completion of the 8 sessions, patients will be followed up for 6 months. The primary outcome is the cumulative number of standard drinks consumed at 8 months, assessed using the TLFB method. DISCUSSION Despite the promise of VR-CET to reduce the desire to drink, the effect on alcohol consumption remains uncertain in the existing literature. Our protocol aims to address the limitations of previous research by increasing sample size, targeting consumption reduction, and incorporating neutral environments. E-Reva aims to enrich the literature on the use of VR in the treatment of AUD and open new perspectives for future interventions. TRIAL REGISTRATION ClinicalTrials.gov ID NCT06104176, Registered 2023/11/13 ( https://clinicaltrials.gov/study/NCT06104176?id=NCT06104176&rank=1 ). N° IDRCB: 2022-A02797-36. Protocol version 1.0, 12/05/2023.
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Affiliation(s)
- Fanny Nègre
- Laboratoire CLIPSYD, Université Paris Nanterre, 92000, Nanterre, France.
- DMU IMPACT, APHP, Hôpitaux Universitaires Henri-Mondor, Hôpital Albert-Chenevier, Service d'addictologie, 94010, Créteil, France.
| | | | - Romain Gomet
- DMU IMPACT, APHP, Hôpitaux Universitaires Henri-Mondor, Hôpital Albert-Chenevier, Service d'addictologie, 94010, Créteil, France
| | - Antoine Pelissolo
- DMU IMPACT, AP-HP, Université Paris-Est-Créteil (UPEC), Hôpitaux Universitaires Henri-MondorService de Psychiatrie, 94000, Créteil, France
- Université Paris-Est Créteil, INSERM U995, IMRB, Translational Neuropsychiatry Laboratory, 94010, Créteil, France
| | - Eric Malbos
- Psychiatry Service of Pr Lançon, CHU de Sainte Marguerite, Marseille, France
- Institut Fresnel Aix-Marseille Université, CNRS, Ecole Centrale Marseille, UMR, 72490, Marseille, France
| | - Lucia Romo
- Laboratoire CLIPSYD, Université Paris Nanterre, 92000, Nanterre, France
- APHP, Hôpital Universitaire Raymond Poincaré, 92380, Garches, France
- Université Paris Saclay, INSERM CESP, 1018 UPS, 94807, Villejuif, France
| | - El-Hadi Zerdazi
- DMU IMPACT, APHP, Hôpitaux Universitaires Henri-Mondor, Hôpital Albert-Chenevier, Service d'addictologie, 94010, Créteil, France
- Université Paris-Est Créteil, INSERM U995, IMRB, Translational Neuropsychiatry Laboratory, 94010, Créteil, France
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Bonfils NA, Aubin HJ, Grall-Bronnec M, Caillon J, Perney P, Limosin F, Luquiens A. Development and Psychometric Properties of a New Patient-Reported Outcome Instrument of Health-Related Quality of Life Specific to Patients with Gambling Disorder: The Gambling Quality of Life Scale (GQoLS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10806. [PMID: 36078519 PMCID: PMC9517863 DOI: 10.3390/ijerph191710806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Impairment or distress caused by gambling disorder can be subjectively assessed via quality of life. The aim of this study was to develop a new patient-reported outcome instrument to explore the health-related quality of life (HRQoL) in gambling disorders, the Gambling quality-of-life scale (GQoLS), and to document its psychometric properties. METHODS A previous qualitative study had been conducted using focus groups of problem gamblers to identify areas of HRQoL impacted by gambling. The seven domains identified served as the basis for the hypothetical structure of GQoLS. Draft items were generated from the patient's speeches to illustrate each of these domains. Cognitive debriefing interviews were realized to obtain a final hypothetical GQoLS. A validation study was then carried out to determine the final version of GQoLS and its psychometric properties (structural validity, construct validity, internal consistency). RESULTS The final GQoLS was composed of 21 items, with a total mean score of 38.3 (±13.6). Structural validity found a major dimension and four other minor dimensions. The five dimensions were: "emotion", "lifestyle", "loneliness", "taboo" and "preoccupation". GQoLS was moderately to strongly correlated with PGSI and EQ-5D visual analogic scale. Cronbach's alpha coefficient was 0.92. CONCLUSION GQoLS is the first HRQoL instrument specific to patients with a gambling disorder and developed from the patient's perspective. GQoLS presents good psychometric properties. GQoLS can be used in clinical research to demonstrate the effectiveness of an intervention on outcomes that are relevant from the patient's perspective.
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Affiliation(s)
- Nicolas A. Bonfils
- CESP, UVSQ, INSERM, Université Paris-Saclay, 94804 Villejuif, France
- Department of Psychiatry and Addictology, Assistance Publique-Hopitaux de Paris, Hôpitaux Universitaires Paris Ouest, 92130 Issy-les-Moulineaux, France
- Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 75000 Paris, France
- Inserm, U894, Centre Psychiatrie et Neurosciences, 75013 Paris, France
| | - Henri-Jean Aubin
- CESP, UVSQ, INSERM, Université Paris-Saclay, 94804 Villejuif, France
- Assistance Publique-Hopitaux de Paris, Hôpitaux Universitaires Paris-Sud, 94804 Villejuif, France
- Faculté de Médecine Paris Sud, Université Paris XI, 91405 Orsay, France
| | - Marie Grall-Bronnec
- Addictology and Psychiatry Department, CHU Nantes, 44093 Nantes, France
- Inserm, U1246, Université de Nantes, Université de Tours, 44093 Nantes, France
| | - Julie Caillon
- Addictology and Psychiatry Department, CHU Nantes, 44093 Nantes, France
- Inserm, U1246, Université de Nantes, Université de Tours, 44093 Nantes, France
| | - Pascal Perney
- CESP, UVSQ, INSERM, Université Paris-Saclay, 94804 Villejuif, France
- Department of Addictions, CHU Nîmes, Université de Montpellier, 30000 Nîmes, France
| | - Frédéric Limosin
- Department of Psychiatry and Addictology, Assistance Publique-Hopitaux de Paris, Hôpitaux Universitaires Paris Ouest, 92130 Issy-les-Moulineaux, France
- Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 75000 Paris, France
- Inserm, U894, Centre Psychiatrie et Neurosciences, 75013 Paris, France
| | - Amandine Luquiens
- CESP, UVSQ, INSERM, Université Paris-Saclay, 94804 Villejuif, France
- Assistance Publique-Hopitaux de Paris, Hôpitaux Universitaires Paris-Sud, 94804 Villejuif, France
- Faculté de Médecine Paris Sud, Université Paris XI, 91405 Orsay, France
- Department of Addictions, CHU Nîmes, Université de Montpellier, 30000 Nîmes, France
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von Hammerstein C, Cornil A, Rothen S, Romo L, Khazaal Y, Benyamina A, Billieux J, Luquiens A. Psychometric properties of the transaddiction craving triggers questionnaire in alcohol use disorder. Int J Methods Psychiatr Res 2020; 29:e1815. [PMID: 31884724 PMCID: PMC7051841 DOI: 10.1002/mpr.1815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 08/28/2019] [Accepted: 11/08/2019] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES We aimed to develop the transaddiction craving triggers questionnaire (TCTQ), which assesses the propensity of specific situations and contexts to trigger craving and to test its psychometric properties in alcohol use disorder (AUD). METHODS This study included a sample of 111 AUD outpatients. We performed exploratory factor analysis (EFA) and calculated item-dimension correlations. Internal consistency was measured with Cronbach's alpha coefficient. Construct validity was assessed through Spearman correlations with craving, emotional symptoms, impulsivity, mindfulness, and drinking characteristics. RESULTS The EFA suggested a 3-factor solution: unpleasant affect, pleasant affect, and cues and related thoughts. Cronbach's coefficient alpha ranged from .80 to .95 for the three factors and the total score. Weak positive correlations were identified between the TCTQ and drinking outcomes, and moderate correlation were found between the TCTQ and craving strength, impulsivity, anxiety, depression, and impact of alcohol on quality of life. CONCLUSIONS The 3-factor structure is congruent with the well-established propensity of emotions and cues to trigger craving. Construct validity is supported by close relations between the TCTQ and psychological well-being rather than between the TCTQ and drinking behaviors. Longitudinal validation is warranted to assess sensitivity to change of the TCTQ and to explore its psychometric properties in other addictive disorders.
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Affiliation(s)
- Cora von Hammerstein
- Department of Psychiatry and Addictology, University Paris‐Saclay, University Paris‐Sud, UVSQ, CESP, INSERM U 1178, APHPPaul Brousse HospitalVillejuifFrance
- EA 4430 CLIPSYDUniversity Paris NanterreNanterreFrance
| | - Aurélien Cornil
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research InstituteUniversité catholique de LouvainLouvain‐la‐NeuveBelgium
| | - Stéphane Rothen
- Research Center for Statistics, Geneva School of Economics and ManagementUniversity of GenevaGenevaSwitzerland
| | - Lucia Romo
- EA 4430 CLIPSYDUniversity Paris NanterreNanterreFrance
- Inserm, U894Center for Psychiatry and NeuroscienceParisFrance
| | - Yasser Khazaal
- Addiction Medecine, Department of psychiatryLausanne University HospitalsLausanneSwitzerland
| | - Amine Benyamina
- Department of Psychiatry and Addictology, University Paris‐Saclay, University Paris‐Sud, UVSQ, CESP, INSERM U 1178, APHPPaul Brousse HospitalVillejuifFrance
| | - Joël Billieux
- Addictive and Compulsive Behaviours Lab. Institute for Health and BehaviourUniversity of LuxembourgEsch‐sur‐AlzetteLuxembourg
- Institute of PsychologyUniversity of LausanneLausanneSwitzerland
| | - Amandine Luquiens
- Department of Psychiatry and Addictology, University Paris‐Saclay, University Paris‐Sud, UVSQ, CESP, INSERM U 1178, APHPPaul Brousse HospitalVillejuifFrance
- Universitary Hospital of NîmesParisFrance
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