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Sklenarik SM, Potenza MN, Astur RS. Avoidance biases for vaping stimuli among college students with electronic-cigarette use. Addict Behav 2024; 151:107934. [PMID: 38101120 DOI: 10.1016/j.addbeh.2023.107934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/06/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023]
Abstract
Previous research has suggested that individuals who smoke demonstrate a behavioral tendency to approach rather than avoid smoking-related stimuli (i.e., approach bias). This study assessed whether 149 undergraduates with varying levels of e-cigarette use demonstrated an approach bias for vaping-related stimuli on an Approach-Avoidance Task (AAT). In contrast to our hypotheses, participants with e-cigarette use demonstrated a significant avoidance bias to vaping-related stimuli, and this effect appeared to be primarily driven by female e-cigarette users. Further, we found that more severe e-cigarette use was associated with numerous adverse outcomes, including reduced quality of life and increased vaping cravings, depressive symptoms, perceived stress, and cannabis use severity. Overall, our findings elucidate various negative impacts of e-cigarette use and suggest a potential role for sex differences in approach-avoidance tendencies toward vaping-related stimuli among young adults.
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Affiliation(s)
- Skyler M Sklenarik
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA; Child Study Center, Yale University School of Medicine, New Haven, CT 06520, USA; Department of Neuroscience, Yale University, New Haven, CT 06510, USA; The Connecticut Council on Problem Gambling, Wethersfield, CT 06109, USA; The Connecticut Mental Health Center, New Haven, CT 06519, USA; Wu Tsai Institute, Yale University, New Haven, CT 06510, USA.
| | - Robert S Astur
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA.
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2
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Machulska A, Woud ML, Brailovskaia J, Margraf J, Klucken T. Nicotine-related interpretation biases in cigarette smoking individuals. Sci Rep 2024; 14:4796. [PMID: 38413636 PMCID: PMC10899185 DOI: 10.1038/s41598-024-55256-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/21/2024] [Indexed: 02/29/2024] Open
Abstract
Addictive behaviors are characterized by information processing biases, including substance-related interpretation biases. In the field of cigarette smoking, such biases have not been investigated yet. The present study thus adopted an open-ended scenario approach to measure smoking-related interpretation biases. Individuals who smoke, those who ceased smoking, and those without a smoking history (total sample N = 177) were instructed to generate spontaneous continuations for ambiguous, open-ended scenarios that described either a smoking-related or neutral context. Overall, people who smoke generated more smoking-related continuations in response to smoking-relevant situations than non-smoking individuals or people who had stopped smoking, providing evidence for a smoking-related interpretation bias. When differentiating for situation type within smoking-relevant scenarios, smoking individuals produced more smoking-related continuations for positive/social and habit/addictive situations compared to negative/affective ones. Additionally, the tendency to interpret habit/addictive situations in a smoking-related manner was positively associated with cigarette consumption and levels of nicotine dependence. Exploratory analyses indicated that other substance-related continuations were correlated with their respective behavioral counterparts (e.g., the level of self-reported alcohol or caffeine consumption). The present study is the first to demonstrate smoking-related interpretation biases in relation to current cigarette smoking. Future studies should investigate the causal role of such biases in the initiation and/or maintainance of nicotine addiction and the merit of Interpretation-Bias-Modification training to support smoking cessation.
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Affiliation(s)
- Alla Machulska
- Department of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Siegen, Siegen, Germany.
| | - Marcella L Woud
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Psychology, Georg-August-University, Göttingen, Germany
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-University Bochum, Bochum, Germany
| | - Julia Brailovskaia
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-University Bochum, Bochum, Germany
- DZPG (German Center for Mental Health), Partner Site Bochum/Marburg, Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-University Bochum, Bochum, Germany
- DZPG (German Center for Mental Health), Partner Site Bochum/Marburg, Bochum, Germany
| | - Tim Klucken
- Department of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Siegen, Siegen, Germany
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3
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Wittekind CE, Schiebel T, Kühn S. Reliability of and associations between cognitive bias measures and response inhibition in smoking. J Behav Ther Exp Psychiatry 2023; 81:101853. [PMID: 36947971 DOI: 10.1016/j.jbtep.2023.101853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 02/06/2023] [Accepted: 03/10/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND AND OBJECTIVE Theoretical models propose that different cognitive biases are caused by a common underlying mechanism (incentive salience/"wanting") and should, therefore, be interrelated. Additionally, stronger impulsive processes should be related to weaker inhibitory abilities. However, these assumptions have hardly been empirically tested and key psychometric information have hardly been reported in samples of smokers. To extent previous research, the present study aimed (1) to estimate the reliability (split-half) of different cognitive bias measures and (2) to investigate associations between attention, approach and associative biases, response inhibition, and smoking-related variables. METHODS Eighty current, non-deprived smokers completed the following tasks in random order: Approach-Avoidance Task (AAT), Stimulus-Response Compatibility Task (SRCT), Implicit-Association Tests (IAT, approach-avoid, valence), Dotprobe Task, Go-/NoGo Task (GNGT). Additionally, different smoking-related variables were assessed. Split-half reliabilities of the different cognitive (bias) measures and correlations between them were calculated. RESULTS Split-half reliabilities of the AAT, the SRCT, and the Dotprobe Task were unacceptable whereas both IATs and the GNGT showed good to excellent reliability. Smoking-approach associations were significantly related to nicotine dependence; however, none of the cognitive bias measures correlated with response inhibition or smoking-related variables. LIMITATIONS Pictorial stimuli were the same across paradigms and might not have been relevant to all participants. CONCLUSIONS This is the first study to investigate the association between different cognitive biases, response inhibition, and smoking-related variables. Although findings are at odds with theoretical assumptions, their interpretation is clearly restricted by the low reliability of the cognitive bias measures.
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Affiliation(s)
- Charlotte E Wittekind
- LMU Munich, Department of Psychology, Clinical Psychology and Psychotherapy, Germany; University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Germany.
| | - Tanja Schiebel
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Germany
| | - Simone Kühn
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Germany; Max Planck Institute for Human Development, Lise Meitner Group for Environmental Neuroscience, Berlin, Germany; Max Planck-UCL Center for Computational Psychiatry and Ageing Research, Berlin, Germany
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4
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Song Y, Pi Y, Tan X, Xia X, Liu Y, Zhang J. Approach-avoidance behavior and motor-specific modulation towards smoking-related cues in smokers. Addiction 2023; 118:1895-1907. [PMID: 37400937 DOI: 10.1111/add.16285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 05/26/2023] [Indexed: 07/05/2023]
Abstract
AIMS By performing three transcranial magnetic stimulation (TMS) experiments, we measured the motor-specific modulatory mechanisms in the primary motor cortex (M1) at both the intercortical and intracortical levels when smokers actively approach or avoid smoking-related cues. DESIGN, SETTING AND PARTICIPANTS For all experiments, the design was group (smokers versus non-smokers) × action (approach versus avoidance) × image type (neutral versus smoking-related). The study was conducted at the Shanghai University of Sport, CHN, TMS Laboratory. For experiment 1, 30 non-smokers and 30 smokers; for experiment 2, 16 non-smokers and 16 smokers; for experiment 3, 16 non-smokers and 16 smokers. MEASUREMENTS For all experiments, the reaction times were measured using the smoking stimulus-response compatibility task. While performing the task, single-pulse TMS was applied to the M1 in experiment 1 to measure the excitability of the corticospinal pathways, and paired-pulse TMS was applied to the M1 in experiments 2 and 3 to measure the activity of intracortical facilitation (ICF) and short-interval intracortical inhibition (SICI) circuits, respectively. FINDINGS Smokers had faster responses when approaching smoking-related cues (F1,58 = 36.660, P < 0.001, η p 2 = 0.387), accompanied by higher excitability of the corticospinal pathways (F1,58 = 10.980, P = 0.002, η p 2 = 0.159) and ICF circuits (F1,30 = 22.187, P < 0.001, η p 2 = 0.425), while stronger SICI effects were observed when they avoided these cues (F1,30 = 10.672, P = 0.003, η p 2 = 0.262). CONCLUSIONS Smokers appear to have shorter reaction times, higher motor-evoked potentials and stronger intracortical facilitation effects when performing approach responses to smoking-related cues and longer reaction times, a lower primary motor cortex descending pathway excitability and a stronger short-interval intracortical inhibition effect when avoiding them.
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Affiliation(s)
- Yuyu Song
- Center for Exercise and Brain Science, School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Yanling Pi
- Shanghai Punan Hospital, Shanghai, China
| | - Xiaoying Tan
- School of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Xue Xia
- Center for Exercise and Brain Science, School of Psychology, Shanghai University of Sport, Shanghai, China
- School of Social Development and Health Management, University of Health and Rehabilitation Sciences, Qingdao, China
| | - Yu Liu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Jian Zhang
- Center for Exercise and Brain Science, School of Psychology, Shanghai University of Sport, Shanghai, China
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5
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Ascone L, Wirtz J, Mellentin AI, Kugler D, Bremer T, Schadow F, Hoppe S, Jebens C, Kühn S. Transferring the approach avoidance task into virtual reality: a study in patients with alcohol use disorder versus healthy controls. VIRTUAL REALITY 2023; 27:2711-2722. [PMID: 37614715 PMCID: PMC10442255 DOI: 10.1007/s10055-023-00835-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/02/2023] [Indexed: 08/25/2023]
Abstract
Study aims were to (I) transfer the measurement of the approach bias (Apb) related to alcoholic stimuli via the Approach Avoidance Task (AAT) into Virtual Reality (VR), (II) check whether measuring Apb in VR leads to similar or different results compared to the classical PC-based version, (III) check the validity of VR versus PC-based bias scores in terms of relatedness to clinical variables. Different 'grasping-conditions' were tested and contrasted in VR concerning (Ia) feasibility (performance): (1) never grasp, (2) always grasp, (3) grasp when PULLing stimuli towards oneself. (Ib) Differences in the bias scores between patients with alcohol use disorder (AUD) and healthy controls (HC) were examined for each grasping-condition. (II) PC-based bias scores were computed and contrasted for AUD versus HC. (III) Correlations of the different VR- versus PC-based bias scores with AUD symptom severity and impulsivity were checked to evaluate validity. (Ia) Grasping-condition 1, followed by 3, showed acceptable (> 50%) and good (> 80%) rates of correct performances allowing for robust median estimation. (Ib) Significant differences in the resulting bias scores emerged between AUD and HC only for grasping-condition 1 (p = 0.034) and 3 at trend-level (p = 0.093). For grasping-condition 1 the Apb Median for AUD was different from zero at a non-significant trend-level (p = 0.064). (II) The PC-based bias scores did not discriminate between AUD versus HC groups. (III) Grasping-condition 1 and 3 VR-based bias scores correlated significantly with impulsivity. In sum, transferring the AAT into VR is feasible, valid, and best implemented without an additional grasping-component when using the VR-controller. This way of Apb assessment represents a viable, perhaps even superior, alternative to PC-based assessments. Trial registration The trial was pre-registered at AsPredicted #76854: 'Transferring the approach avoidance task into virtual reality', 10/13/2021; prior to any analyses being undertaken.
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Affiliation(s)
- Leonie Ascone
- Neuronal Plasticity Working Group, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Janina Wirtz
- Neuronal Plasticity Working Group, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Angelina Isabella Mellentin
- Unit for Clinical Alcohol Research, Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, J. B. Winsløwvej 18, 5000 Odense C, Denmark
- Brain Research-Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
- Center for Digital Psychiatry (CEDIP), Heden 11, 5000 Odense C, Region of Southern Denmark Denmark
| | - Dimitrij Kugler
- Neuronal Plasticity Working Group, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Thomas Bremer
- University of Applied Sciences, Treskowallee 8, 10318 Berlin, Germany
| | - Friedrich Schadow
- University of Applied Sciences, Treskowallee 8, 10318 Berlin, Germany
| | - Stine Hoppe
- Department of Clinical Psychology and Psychotherapy, Christian-Albrechts-University Kiel, Christian-Albrechts-Platz 4, 24118 Kiel, Germany
| | - Charlotte Jebens
- Department of Clinical Psychology and Psychotherapy, Christian-Albrechts-University Kiel, Christian-Albrechts-Platz 4, 24118 Kiel, Germany
| | - Simone Kühn
- Neuronal Plasticity Working Group, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Lentzeallee 94, 14195 Berlin, Germany
- Max Planck-UCL Center for Computational Psychiatry and Ageing Research, Max Planck Institute for Human Development, Lentzeallee 94, 14195 Berlin, Germany
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6
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Zech HG, Gable P, van Dijk WW, van Dillen LF. Test-retest reliability of a smartphone-based approach-avoidance task: Effects of retest period, stimulus type, and demographics. Behav Res Methods 2023; 55:2652-2668. [PMID: 35915356 PMCID: PMC9342838 DOI: 10.3758/s13428-022-01920-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2022] [Indexed: 11/25/2022]
Abstract
The approach-avoidance task (AAT) is an implicit task that measures people's behavioral tendencies to approach or avoid stimuli in the environment. In recent years, it has been used successfully to help explain a variety of health problems (e.g., addictions and phobias). Unfortunately, more recent AAT studies have failed to replicate earlier promising findings. One explanation for these replication failures could be that the AAT does not reliably measure approach-avoidance tendencies. Here, we first review existing literature on the reliability of various versions of the AAT. Next, we examine the AAT's reliability in a large and diverse sample (N = 1077; 248 of whom completed all sessions). Using a smartphone-based, mobile AAT, we measured participants' approach-avoidance tendencies eight times over a period of seven months (one measurement per month) in two distinct stimulus sets (happy/sad expressions and disgusting/neutral stimuli). The mobile AAT's split-half reliability was adequate for face stimuli (r = .85), but low for disgust stimuli (r = .72). Its test-retest reliability based on a single measurement was poor for either stimulus set (all ICC1s < .3). Its test-retest reliability based on the average of all eight measurements was moderately good for face stimuli (ICCk = .73), but low for disgust stimuli (ICCk = .5). Results suggest that single-measurement AATs could be influenced by unexplained temporal fluctuations of approach-avoidance tendencies. These fluctuations could be examined in future studies. Until then, this work suggests that future research using the AAT should rely on multiple rather than single measurements.
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Affiliation(s)
- Hilmar G Zech
- Leiden University, Leiden, The Netherlands.
- Technical University Dresden, Dresden, Germany.
| | | | - Wilco W van Dijk
- Leiden University, Leiden, The Netherlands
- Knowledge Centre Psychology and Economic Behaviour, Leiden, The Netherlands
| | - Lotte F van Dillen
- Leiden University, Leiden, The Netherlands
- Knowledge Centre Psychology and Economic Behaviour, Leiden, The Netherlands
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7
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Wiers RW, Pan T, van Dessel P, Rinck M, Lindenmeyer J. Approach-Bias Retraining and Other Training Interventions as Add-On in the Treatment of AUD Patients. Curr Top Behav Neurosci 2023. [PMID: 37221351 DOI: 10.1007/7854_2023_421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
In the past two decades, a variety of cognitive training interventions have been developed to help people overcome their addictive behaviors. Conceptually, it is important to distinguish between programs in which reactions to addiction-relevant cues are trained (varieties of cognitive bias modification, CBM) and programs in which general abilities are trained such as working memory or mindfulness. CBM was first developed to study the hypothesized causal role in mental disorders: by directly manipulating the bias, it was investigated to what extent this influenced disorder-relevant behavior. In these proof-of-principle studies, the bias was temporarily modified in volunteers, either temporarily increased or decreased, with corresponding effects on behavior (e.g., beer consumption), in case the bias was successfully manipulated. In subsequent clinical randomized controlled trials (RCTs), training (away from the substance vs. sham training) was added to clinical treatment. These studies have demonstrated that CBM, as added to treatment, reduces relapse with a small effect of about 10% (similar effect size as for medication, with the strongest evidence for approach-bias modification). This has not been found for general ability training (e.g., working memory training), although effects on other psychological functions have been found (e.g., impulsivity). Mindfulness also has been found to help people overcome addictions, and different from CBM, also as stand-alone intervention. Research on (neuro-)cognitive mechanisms underlying approach-bias modification has pointed to a new perspective in which automatic inferences rather than associations are influenced by training, which has led to the development of a new variety of training: ABC training.
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Affiliation(s)
- Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Ting Pan
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Pieter van Dessel
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Mike Rinck
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Ruhr University Bochum, Bochum, Germany
| | - Johannes Lindenmeyer
- Salus Klinik, Lindow, Germany
- Medizinische Hochschule Brandenburg Theodor Fontane, Brandenburg, Germany
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8
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Dampuré J, Agudelo-Orjuela P, van der Meij M, Belin D, Barber HA. Electrophysiological signature of the interplay between habits and inhibition in response to smoking-related cues in individuals with a smoking habit: An event-related potential study. Eur J Neurosci 2023; 57:1335-1352. [PMID: 36829295 PMCID: PMC10946726 DOI: 10.1111/ejn.15942] [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: 07/28/2022] [Revised: 01/24/2023] [Accepted: 02/17/2023] [Indexed: 02/26/2023]
Abstract
The rigid, stimulus-bound nature of drug seeking that characterizes substance use disorder (SUD) has been related to a dysregulation of motivational and early attentional reflexive and inhibitory reflective systems. However, the mechanisms by which these systems are engaged by drug-paired conditioned stimuli (CSs) when they promote the enactment of seeking habits in individuals with a SUD have not been elucidated. The present study aimed behaviourally and electrophysiologically to characterize the nature of the interaction between the reflexive and reflective systems recruited by CSs in individuals with a smoking habit. We measured the behavioural performance and associated event-related potentials (ERPs) of 20 individuals with a smoking habit and 20 controls, who never smoked regularly, in a modified Go/NoGo task during which smoking-related CSs, appetitive and neutral pictures, presented either in first or third-person visual perspective were displayed 250 ms before the Go/NoGo cue. We show that smoking-related cues selectively influence early incentive motivation-related attention bias (N2 after picture onset), motor readiness and behavioural inhibition (Go-P3, NoGo-P3 and Pc) of individuals with a smoking habit only when presented from a first-person visual perspective. These data together identify the neural signature of the aberrant engagement of the reflexive and reflective systems during the recruitment of an incentive habit by CSs presented as if they had been response-produced, that is, as conditioned reinforcers.
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Affiliation(s)
- Julien Dampuré
- Facultad de Psicología, Universidad de La Sabana, Chía, Colombia
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna (ULL), Tenerife, Spain
- Faculté de Psychologie, Université Catholique de l'Ouest, 79500, Niort, France
| | - Paola Agudelo-Orjuela
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna (ULL), Tenerife, Spain
- Universidad Externado de Colombia, Bogotá, Colombia
| | - Maartje van der Meij
- Departamento de Psicología Cognitiva, Universidad de La Laguna (ULL), Tenerife, Spain
| | - David Belin
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Horacio A Barber
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna (ULL), Tenerife, Spain
- Departamento de Psicología Cognitiva, Universidad de La Laguna (ULL), Tenerife, Spain
- Basque Center on Cognition, Brain and Language (BCBL), Donostia-San Sebastián, Spain
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9
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Beckenstrom AC, Coloma PM, Dawson GR, Finlayson AK, Malik A, Post A, Steiner MA, Potenza MN. Use of experimental medicine approaches for the development of novel psychiatric treatments based on orexin receptor modulation. Neurosci Biobehav Rev 2023; 147:105107. [PMID: 36828161 PMCID: PMC10165155 DOI: 10.1016/j.neubiorev.2023.105107] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/08/2023] [Accepted: 02/18/2023] [Indexed: 02/25/2023]
Abstract
Despite progress in understanding the pathological mechanisms underlying psychiatric disorders, translation from animal models into clinical use remains a significant bottleneck. Preclinical studies have implicated the orexin neuropeptide system as a potential target for psychiatric disorders through its role in regulating emotional, cognitive, and behavioral processes. Clinical studies are investigating orexin modulation in addiction and mood disorders. Here we review performance-outcome measures (POMs) arising from experimental medicine research methods which may show promise as markers of efficacy of orexin receptor modulators in humans. POMs provide objective measures of brain function, complementing patient-reported or clinician-observed symptom evaluation, and aid the translation from preclinical to clinical research. Significant challenges include the development, validation, and operationalization of these measures. We suggest that collaborative networks comprising clinical practitioners, academics, individuals working in the pharmaceutical industry, drug regulators, patients, patient advocacy groups, and other relevant stakeholders may provide infrastructure to facilitate validation of experimental medicine approaches in translational research and in the implementation of these approaches in real-world clinical practice.
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Affiliation(s)
- Amy C Beckenstrom
- P1vital Ltd, Manor House, Howbery Business Park, Wallingford OX10 8BA, UK.
| | - Preciosa M Coloma
- Idorsia Pharmaceuticals Ltd, Hegenheimermattweg 91, Allschwil 4123, Switzerland
| | - Gerard R Dawson
- P1vital Ltd, Manor House, Howbery Business Park, Wallingford OX10 8BA, UK
| | - Ailidh K Finlayson
- P1vital Ltd, Manor House, Howbery Business Park, Wallingford OX10 8BA, UK; Department of Psychology, University of Bath, Claverton Down, Bath BA2 7AY, UK
| | - Asad Malik
- P1vital Ltd, Manor House, Howbery Business Park, Wallingford OX10 8BA, UK
| | - Anke Post
- Corlieve Therapeutics, Swiss Innovation Park, Hegenheimermattweg 167A, 4123 Allschwil, Switzerland
| | | | - Marc N Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center, Yale School of Medicine, 1 Church Street, Room 726, New Haven, CT 06510, USA; Connecticut Mental Health Center, 34 Park Street, New Haven, CT 06519, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; The Wu Tsai Institute, Yale University, 100 College St, New Haven, CT 06510, USA
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10
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van Alebeek H, Kahveci S, Rinck M, Blechert J. Touchscreen-based approach-avoidance responses to appetitive and threatening stimuli. J Behav Ther Exp Psychiatry 2023; 78:101806. [PMID: 36435548 DOI: 10.1016/j.jbtep.2022.101806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 09/07/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Individuals are thought to be biased towards approaching positive stimuli and avoiding negative stimuli. Yet, it is unclear whether this general pattern applies to all stimulus classes or whether biases are more specific. We expected significant approach biases towards two types of positive stimuli, appetitive foods and butterflies; and avoidance biases away from two types of negative stimuli, spoiled foods and spiders. METHODS A touchscreen-based Approach-Avoidance Task (AAT), using hand gestures toward or away from stimuli assessed biases. Questionnaires and image ratings assessed individual differences in stimulus evaluations. RESULTS Approach biases for butterflies and appetitive foods were found, the latter being strongest towards individually liked foods. There was no avoidance bias for spoiled foods. An avoidance bias for spiders was found in individuals with elevated spider fear. LIMITATIONS Incomplete counterbalancing precluded direct comparison between both positive and negative stimuli. CONCLUSIONS Behavioural biases in the touchscreen AAT generally co-vary with individuals' affective evaluation of the stimuli. Approach biases were elicited by positive stimuli independently of whether they were regularly (foods) or rarely (butterflies) approached in everyday life. This may hint towards a tendency to approach positive stimuli regardless of the specific category, whereas avoidance biases may be more stimulus specific.
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Affiliation(s)
- Hannah van Alebeek
- Department of Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria; Center for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Salzburg, Austria.
| | - Sercan Kahveci
- Department of Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria; Center for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Salzburg, Austria
| | - Mike Rinck
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Jens Blechert
- Department of Psychology, Paris-Lodron-University of Salzburg, Salzburg, Austria; Center for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Salzburg, Austria
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11
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TÜRKOĞLU S, AMADO S, GÖNÜL AS, EKER Ç. Comparison of Alcohol Attentional Bias and Alcohol Craving Among Alcohol Abusers and Non-Abusers. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2022. [DOI: 10.18863/pgy.1095312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The aim of this research is to investigate implicit cognitive process underlying alcohol craving and relationship between alcohol attentional bias and alcohol craving by using visual probe task. Current study examined whether alcohol abusers show attentional bias toward alcohol related task compared with non- abusers and causal relationship between alcohol attentional bias and alcohol craving. Firstly, participants were divided two groups (non abusers- abusers) and they were completed alcohol craving scale to determinate their alcohol craving level. Then, participants alcohol attentional bias was investigated using the visual probe task. In this task, images (alcohol-related and neutral) were presented for 500 ms on a computer screen. After that, probe (*, asterisk) was presented. Participants were asked to decide the place of the probe place by using keyboard keys within 1500 ms. Participants reaction time and number of correct and incorrect answers during the test. According to results, alcohol abuser group’s reaction times were faster than non-abuser when probe was associated with alcohol picture but not in neutral trials. These results suggested that, alcohol abusers showed significantly greater attentional bias to alcohol related pictures than non- abusers. From this point, investigation of alcohol attentional bias might be important component of alcohol dependence in terms of the alcohol relapse risk and determination of the alcohol craving.
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Affiliation(s)
- Sevgül TÜRKOĞLU
- EGE ÜNİVERSİTESİ, MADDE BAĞIMLILIĞI, TOKSİKOLOJİ VE İLAÇ BİLİMLERİ ENSTİTÜSÜ
| | - Sonia AMADO
- EGE ÜNİVERSİTESİ, EDEBİYAT FAKÜLTESİ, PSİKOLOJİ BÖLÜMÜ, PSİKOLOJİ PR
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Schmidt LD, Wegmann E, Bischof A, Klein L, Zhou C, Rozgonjuk D, Kannen C, Borgwardt S, Brand M, Montag C, Rumpf HJ. Implicit Cognitions, Use Expectancies and Gratification in Social-Networks-Use Disorder and Tobacco Use Disorder. SUCHT 2022. [DOI: 10.1024/0939-5911/a000782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Abstract: Aims: The problematic use of social networks is discussed as a further specific type of Internet-use disorders. Our project aims to clarify whether social-networks-use disorder (SNUD) is marked by characteristics of addictive behaviors by tracking behavior and investigating the relevance of 1) implicit cognitions, 2) the experiences of gratification and compensation and 3) use expectancies in SNUD compared to tobacco-use disorder. Methodology: Four groups will be examined: individuals with 1) SNUD without tobacco use, 2) risky use patterns with regard to social networks without tobacco use, 3) tobacco use disorder and 4) healthy controls. All participants first complete a laboratory examination including the Implicit Association Test (IAT) and the Approach-Avoidance task (AAT). We will use smartphone-based data tracking for 14 days following laboratory testing to record smoking and social-networks-use patterns. During this period, we further measure use expectancies and the experience of gratification and compensation by means of a smartphone-based experience sampling method (ESM). Conclusions: This is the first study to examine relevant characteristics of addictive behaviors in individuals with SNUD compared to individuals with tobacco use, using a combination of experimental psychological methods and smartphone-based measurements. We expect that this investigative approach will contribute to a deeper understanding of the processes involved in SNUD.
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Affiliation(s)
| | - Elisa Wegmann
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Anja Bischof
- Department of Psychiatry and Psychotherapy, University of Lübeck, Germany
| | - Lena Klein
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | - Chang Zhou
- Department of Molecular Psychology, University of Ulm, Germany
| | - Dmitri Rozgonjuk
- Department of Molecular Psychology, University of Ulm, Germany
- Institute of Mathematics and Statistics, University of Tartu, Estonia
| | | | - Stefan Borgwardt
- Department of Psychiatry and Psychotherapy, University of Lübeck, Germany
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany
| | | | - Hans-Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, University of Lübeck, Germany
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Solzbacher J, Czeszumski A, Walter S, König P. Evidence for the embodiment of the automatic approach bias. Front Psychol 2022; 13:797122. [PMID: 36160565 PMCID: PMC9505509 DOI: 10.3389/fpsyg.2022.797122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 07/07/2022] [Indexed: 11/24/2022] Open
Abstract
Tendencies of approach and avoidance seem to be a universal characteristic of humans. Specifically, individuals are faster in avoiding than in approaching negative stimuli and they are faster in approaching than in avoiding positive stimuli. The existence of this automatic approach-avoidance bias has been demonstrated in many studies. Furthermore, this bias is thought to play a key role in psychiatric disorders like drug addiction and phobias. However, its mechanisms are far from clear. Theories of embodied cognition postulate that the nature of gestures plays a key role in this process. To shed light on the role of the involved gesture we employed a 2 × 2 factorial design with two types of stimuli. Participants had either to approach positive and avoid negative stimuli (congruent conditions) or to avoid positive stimuli and approach negative stimuli (incongruent conditions). Further, they responded either with a joystick or a button press on a response pad. Participants reacted faster in congruent conditions, i.e., avoiding negative stimuli and approaching positive stimuli, than in incongruent conditions. This replicates the known approach and avoidance bias. However, direct analysis of the button press condition revealed no reaction time advantage for congruent trials compared to incongruent trials. In contrast, in the joystick condition participants were significantly faster performing congruent reactions than incongruent reactions. This interaction, a significant reaction time advantage, when the response is enacted by moving a joystick towards or away from the body provides evidence that approach-avoidance tendencies have a crucial bodily component.
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Affiliation(s)
- Johannes Solzbacher
- Institute of Cognitive Science, Osnabrück University, Osnabrück, Germany
- *Correspondence: Johannes Solzbacher,
| | - Artur Czeszumski
- Institute of Cognitive Science, Osnabrück University, Osnabrück, Germany
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Sven Walter
- Institute of Cognitive Science, Osnabrück University, Osnabrück, Germany
| | - Peter König
- Institute of Cognitive Science, Osnabrück University, Osnabrück, Germany
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Smits JAJ, Rinck M, Rosenfield D, Beevers CG, Brown RA, Conroy Busch HE, Dutcher CD, Perrone A, Zvolensky MJ, Garey L. Approach bias retraining to augment smoking cessation: A pilot randomized controlled trial. Drug Alcohol Depend 2022; 238:109579. [PMID: 35917763 PMCID: PMC10041775 DOI: 10.1016/j.drugalcdep.2022.109579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/11/2022] [Accepted: 07/17/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Approach tendency to smoking-related cues has been associated with greater cravings, nicotine dependence, and the likelihood of relapse. In this pilot randomized clinical trial, we examined the efficacy of approach bias retraining (ABR; i.e., increasing avoidance tendency) for enhancing standard smoking cessation treatment (ST). METHODS Adult smokers (N = 96) motivated to quit were randomly assigned to 7 weekly in-person treatment sessions consisting of either (1) cognitive-behavioral therapy for smoking cessation (ST) and ABR (ST+ABR) or ST and sham retraining (ST+Sham). All participants also received optional nicotine replacement therapy for up to 8 weeks following the scheduled quit date (week 6). We measured avoidance tendency from weeks 1-7. Point prevalence abstinence (PPA) and prolonged abstinence (PA) were measured up to 3 months following the quit attempt (week 18 follow-up). RESULTS Consistent with our hypothesis, participants in ST+ABR evidenced higher abstinence rates than those in ST+Sham at the final follow-up (b=0.71, 95 % CI: [0.14, 1.27], t[1721]=2.46, p = 0.014, OR=2.03, 95 % CI: [1.15, 3.57]). Specifically, PPA and PA rates were 50 % and 66 % in ST+ABR compared to 31 % and 47 % in ST+Sham. As expected, participants assigned to the ST+ABR condition also showed a greater training-compatible increase in avoidance tendency scores relative to those assigned to the ST+Sham condition (b=248.06, 95 % CI: [148.51, 347,62], t[84]=4.96, p < .001). CONCLUSIONS The current pilot randomized clinical trial provides initial evidence for the efficacy of integrating standard smoking cessation with ABR. These findings encourage the testing of the long-term efficacy and mechanisms of action of this integrated intervention.
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Affiliation(s)
- Jasper A J Smits
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA.
| | - Mike Rinck
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - David Rosenfield
- Department of Psychology, Southern Methodist University, Dallas, USA
| | - Christopher G Beevers
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Richard A Brown
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | | | - Christina D Dutcher
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Alex Perrone
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | | | - Lorra Garey
- Department of Psychology, University of Houston, Houston, USA
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Wirtz J, Moritz S, Gehlenborg J, Ascone L, Kühn S. Is less more? Dismantling imaginal retraining and examining the effects of psychoeducation and embodied cognition on craving and alcohol consumption in problem drinkers. A randomized controlled trial. Addict Behav 2022; 135:107429. [DOI: 10.1016/j.addbeh.2022.107429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 05/25/2022] [Accepted: 07/12/2022] [Indexed: 11/01/2022]
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Cognitive Biases and Addictive Disorders: A Bibliometric Review. PSYCHIATRY INTERNATIONAL 2022. [DOI: 10.3390/psychiatryint3020011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Since the early 2000s, there have been extensive investigations into cognitive biases in addictive disorders. The advances in the field have led to the discovery that cognitive bias exists in substance disorders and could in turn be modified. To date, there have been primary studies and meta-analysis demonstrating the existence of these biases and the effectiveness of cognitive bias modification (i.e., whereby such biases are retrained). There remains a lack of understanding of how the field has progressed and the research gaps, in light of the evidences provided by these primary studies. Objectives: A bibliometric analysis of the publications to date was performed to provide a map of the work that has been done so far. This would help researchers to better understand the development of cognitive bias research, the direction of the research, and the recent trends. Methods: For the purposes of this bibliometric research, Web of Science (WOS) was used in the identification of relevant articles. To identify the relevant articles, the following search strategy was implemented, that of ((((((TS = (“cognitive bias”)) OR TS = (“attention bias”)) OR TS = (“approach bias”)) OR TS = (“avoidance bias)) OR TS = (“interpretative bias”))). Bibliometric data analysis was conducted based on the identified articles. Results: A total of 161 citations were eventually included. These citations were published between 1994 and 2022. The average number of citations per documents was 26.73. Of these 161 citations, 122 were articles, 2 were editorials, 3 were corrections to the original manuscript, 5 were reviews, and 29 were meeting abstracts. The analysis of the trend of topics has shown that researchers were focused on understanding and gaining insights into cognitive biases and potentially examining the association between cognitive biases and cravings and aggression in the early days. Over the years, there has been an evolution into examining specific unconscious biases, namely, that of attention and approach biases. In the most recent years, the investigations have been more focused on examining bias modification/retraining. Conclusions: From our knowledge, this is the first bibliometric analysis that has been undertaken to explore all the publications related to cognitive bias in the field of addiction. The insights gained from this article could inform future research.
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Wittekind CE, Takano K, Sckopke P, Winkler MH, Werner GG, Ehring T, Rüther T. Efficacy of approach bias modification as an add-on to smoking cessation treatment: study protocol for a randomized-controlled double-blind trial. Trials 2022; 23:223. [PMID: 35313949 PMCID: PMC8935694 DOI: 10.1186/s13063-022-06155-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 03/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background Although effective treatments for smoking cessation are available, long-term abstinence is the exception rather than the norm. Accordingly, there is a need for novel interventions that potentially improve clinical outcome. Although implicit information processing biases, for example approach biases for smoking-related stimuli, are ascribed a dominant role in the maintenance of tobacco dependence, these biases are hardly targeted in current treatment. Past research has shown that so-called Approach Bias Modification (AppBM) trainings, aiming to modify this bias, lead to improved long-term abstinence in abstinent alcoholic inpatients when delivered as an add-on to treatment-as-usual. Findings on the efficacy of AppBM in smoking have been inconsistent. The present large-scale clinical trial pursues two goals. First, it aims to investigate the efficacy of AppBM as an add-on to treatment-as-usual in a representative sample of adult smokers. Second, possible mechanisms of change are investigated. Methods The study is a randomized-controlled, double-blind, parallel-group superiority trial. We aim at a final sample of at least 336 adult smokers. Participants are allocated with a 1:1:1 allocation ratio to one of the following conditions: (1) treatment-as-usual + AppBM, (2) treatment-as-usual + Sham, (3) treatment-as-usual only. During the add-on training, participants are presented smoking-related and positive pictures and are instructed to respond by either pushing or pulling a joystick, depending on the tilt of the pictures (5○ to the left/right). During AppBM, all smoking-related pictures are tilted in the direction that is associated with pushing, thereby aiming to train an avoidance bias for smoking. All positive pictures are tilted in the direction associated with pulling. During Sham, the contingency is 50/50. Participants are assessed before and after the intervention and at a 6-month follow-up. The primary outcome is prolonged abstinence, and secondary outcomes include smoking-related variables and psychological distress. Additionally, the motivational significance of smoking-related stimuli (i.e., approach bias, valence) is assessed with different experimental tasks (Approach-Avoidance Task; Single Target Implicit Association Test) and psychophysiological measures. Discussion This is the first large-scale clinical trial investigating the efficacy of AppBM as an add-on in smokers including a TAU only condition. Additionally, it is the first study to systematically investigate potential mechanisms mediating the effects of treatment on clinical outcome. Trial registration German Clinical Trials Register, DRKS00019221, 11/11/2019 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06155-6.
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Machulska A, Rinck M, Klucken T, Kleinke K, Wunder JC, Remeniuk O, Margraf J. "Push it!" or "Hold it!"? A comparison of nicotine-avoidance training and nicotine-inhibition training in smokers motivated to quit. Psychopharmacology (Berl) 2022; 239:105-121. [PMID: 35013762 PMCID: PMC8748000 DOI: 10.1007/s00213-021-06058-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/28/2021] [Indexed: 12/20/2022]
Abstract
RATIONALE Recently, experimental paradigms have been developed to strengthen automatic avoidance or inhibitory responses for smoking cues. However, these procedures have not yet been directly compared regarding their effectiveness and mechanisms of action. OBJECTIVE This study compared the effects of avoidance vs. inhibitory training as an add-on to a brief smoking cessation intervention. The standard Approach-Avoidance-Task (AAT) was adapted for both training types and control conditions. METHODS One hundred twenty-four smokers attended behavioral counseling for smoking cessation and were thereafter randomized to one of four training conditions: avoidance-AAT, sham-avoidance-AAT, inhibition-AAT, sham-inhibition-AAT. During a 2-week training period including five training sessions, smokers in the avoidance-AAT trained to implicitly avoid all smoking-related cues, while smokers in the inhibition-AAT trained to implicitly inhibit behavioral response to smoking cues. During sham training, no such contingencies appeared. Self-report and behavioral data were assessed before and after training. Cigarette smoking and nicotine dependence were also assessed at 4- and 12-week follow-ups. RESULTS At posttest, avoidance training was more effective in reducing daily smoking than inhibition training. However, this difference was no longer evident in follow-up assessments. All training conditions improved other smoking- and health-related outcomes. Neither training changed smoking-related approach biases or associations, but approach biases for smoking-unrelated pictures increased and Stroop interference decreased in all conditions. Smoking devaluation was also comparable in all groups. CONCLUSIONS Avoidance training might be slightly more effective in reducing smoking than inhibitory training. Overall, however, all four training types yielded equivalent therapy and training effects. Hence, a clear preference for one type of training remains premature.
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Affiliation(s)
- Alla Machulska
- Department of Clinical Psychology, Institute of Psychology, University of Siegen, Adolf-Reichwein-Str. 2a, D-57068, Siegen, Germany.
| | - Mike Rinck
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Tim Klucken
- Department of Clinical Psychology, Institute of Psychology, University of Siegen, Adolf-Reichwein-Str. 2a, D–57068 Siegen, Germany
| | - Kristian Kleinke
- Department of Clinical Psychology, Institute of Psychology, University of Siegen, Adolf-Reichwein-Str. 2a, D–57068 Siegen, Germany
| | - Jana-Carina Wunder
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Olga Remeniuk
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr-Universität Bochum, Bochum, Germany
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Hong T, He C, Gu ZK, Xie JJ, Lu Q, Li YQ, Xu XJ, Shen Y, Wang YQ, Zheng H. Psychometric investigation of the Chinese version of the Habit, Reward and Fear Scale (HRFS). Brain Behav 2021; 11:e2364. [PMID: 34554655 PMCID: PMC8613424 DOI: 10.1002/brb3.2364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/14/2021] [Accepted: 08/31/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Tobacco use is one of the most important risk factors for health, and China is the largest producer and consumer of tobacco in the world. Monitoring and controlling the tobacco epidemic is an important issue. However, the motivation underlying smoking behavior is complex and specific to the individual. The Habit, Reward and Fear Scale (HRFS) is a feasible tool to evaluate this complex motivation. OBJECTIVES To validate the psychometric properties of the HRFS Chinese version (HRFS-C) and to assess the relationship between motivation and smoking behavior. METHOD We recruited 967 participants through social media and assessed their smoking behavior with three instruments: the Fagerstrom Test for Nicotine Dependence-Chinese version (FTND-C), the Questionnaire on Smoking Urges-Brief Scale-Chinese version (QSU-brief-C), and the HRFS-C. Ultimately, we retained 700 valid data points. Cronbach's α and split-half tests were used to evaluate the reliability. Confirmatory factor analysis, Pearson's r and an analysis of variance (ANOVA) were used to evaluate the validity. In addition, linear regression was used to explore the relationship among the three instruments. The HRFS-C showed good homogeneity (α = 0.965), concurrent validity, and discriminant validity. A significant linear relationship was observed among the FTND-C, QSU-brief-C, and HRFS-C (p < .001). CONCLUSION The motivation measured by the HRFS-C can significantly predict nicotine dependence and craving in the smoking population. The HRFS-C can be used to carry out targeted interventions for addicted patients (e.g., motivational enhancement therapy).
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Affiliation(s)
- Tu Hong
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China.,College of Psychology, Nanjing Normal University, Nanjing, China
| | - Chuan He
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China
| | - Zhong-Ke Gu
- Department of Sport and Health Sciences, Nanjing Sport Institute, Nanjing, China
| | - Jun-Jie Xie
- College of Psychology, Nanjing Normal University, Nanjing, China
| | - Qian Lu
- Department of Rehabilitation Medicine, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, China
| | - Yong-Qiang Li
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xing-Jun Xu
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ying Shen
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yun-Qiang Wang
- College of Psychology, Nanjing Normal University, Nanjing, China
| | - Hui Zheng
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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A Pilot Study on Approach Bias Modification in Smoking Cessation: Activating Personalized Alternative Activities for Smoking in the Context of Increased Craving. Int J Behav Med 2021; 29:480-493. [PMID: 34697780 PMCID: PMC9338119 DOI: 10.1007/s12529-021-10033-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 11/21/2022]
Abstract
Background The act of smoking has been associated with the automatic activation of approach biases towards smoking-related stimuli. However, previous research has produced mixed findings when smokers are trained to avoid such smoking-related stimuli through the application of Approach Bias Modification (ApBM). As such, this study aimed to test an improved ApBM (ApBM +), where smokers were trained to approach personalized alternative activities for smoking in the context of increased craving, in addition to training smoking-avoidance responses. Methods Sixty-seven daily smokers motivated to quit (M age = 29.27, 58.2% female) were randomly assigned to seven sessions of either ApBM + (n = 26), standard-ApBM (n = 19), or sham-ApBM (n = 22), after a brief motivational smoking intervention. Primary outcomes of approach biases for smoking and for alternative activities and secondary outcomes of smoking-related behaviors were assessed at pre-test, post-test, and 1-month follow-up. Results Overall, no group differences by condition were demonstrated in changing approach biases or smoking-related behaviors at post-test and 1-month follow-up. A trend level indication for differences in changes of smoking-approach biases between sham-ApBM and ApBM + for relatively heavy smokers was found at post-test. This was primarily driven by a significant increase in smoking-approach biases within the sham-ApBM condition and a trend decrease in smoking-approach biases within the ApBM + condition. Conclusions Our findings did not provide support for the current ApBM + concerning improved effects across the whole sample. Diverging training effects on approach biases for smoking in relatively heavy smokers warrants further research, for which we provide some suggestions. Supplementary Information The online version contains supplementary material available at 10.1007/s12529-021-10033-x.
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The predictive value of evaluative bias, attentional bias, approach bias, and self-regulatory control in soft drink consumption. Appetite 2021; 168:105771. [PMID: 34688729 DOI: 10.1016/j.appet.2021.105771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 10/06/2021] [Accepted: 10/19/2021] [Indexed: 11/23/2022]
Abstract
Global consumption of soft drinks has increased rapidly over the past 50 years, making this a major public health problem. Guided by dual-process models, the present study aimed to provide a comprehensive investigation of the roles of cognitive biases (evaluative, attentional, and approach biases) and self-regulatory control in soft drink consumption and choice. Participants were 128 undergraduate students (17-25 years). They completed computer-based measures of the three biases (Implicit Association Task, Dot Probe Task, and Approach Avoidance Task) and self-regulatory control (Go/no-go Task). Soft drink consumption and choice were measured using a taste test and a take home beverage choice task, respectively. Evaluative bias for soft drink cues was positively associated with the amount of soft drink consumed. Self-regulatory control was negatively correlated with amount of soft drink consumed, but only for men. There was no interaction between cognitive biases and self-regulatory control in predicting soft drink consumption or choice. Nonetheless, the results support the application of dual-process models to soft drink consumption in that automatic (evaluative bias) and controlled processes (self-regulatory control) each predicted amount of soft drink consumed, albeit independently and only for certain individuals. Future research should extend these findings to habitual soft drink consumers and to individuals who actively wish to limit their soft drink intake.
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Gehlenborg J, Göritz AS, Moritz S, Lüdtke T, Kühn S. Imaginal Retraining Reduces Craving for Tobacco in 1-Year Controlled Follow-Up Study. Eur Addict Res 2021; 28:68-79. [PMID: 34569480 DOI: 10.1159/000518678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/23/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Imaginal retraining is a self-help technique that adapts the principles of approach bias modification to the imagination. Imaginal retraining has been shown to reduce craving and addictive behaviours in 3 randomized controlled trials (RCTs) on problematic alcohol consumption, overweight, and tobacco use. To date, there have been no studies evaluating the long-term efficacy of the intervention. The aim of the present study was to generate first hypotheses on the long-term efficacy of imaginal retraining in smokers in a controlled 1-year follow-up study. MATERIALS AND METHODS We recontacted the 345 participants who had taken part in an RCT on imaginal retraining for smokers 1 year later. The survey was carried out online and assessed craving for tobacco (primary outcome), smoking behaviour, well-being, and subjective appraisal. Individuals who applied the technique at least once during the previous year were categorized as the training group, whereas participants who never performed the training were categorized as the no-training group. Data were analysed using linear mixed models (LMMs). The study was preregistered as DRKS00021044. RESULTS The completion rate was 45.5%. Less than 40% used the intervention at least once in the previous 12 months. LMM analyses showed a significant reduction in craving for tobacco for the training compared to the no-training group after 1 year. No significant group differences emerged in smoking behaviour, depressive symptoms, or quality of life. Subjective appraisal of the intervention was favorable, similar to the initial study. CONCLUSION The present study provides preliminary support for the long-term efficacy of imaginal retraining on craving for tobacco but not on smoking behaviour, highlighting the importance of multimodal treatment concepts in smoking cessation that target a variety of maintaining factors. Future studies need to investigate the long-term efficacy of the intervention in prospective RCTs that test alternative ways of conveying the technique to improve adherence.
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Affiliation(s)
- Josefine Gehlenborg
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Anja S Göritz
- Department of Occupational and Consumer Psychology, University of Freiburg, Freiburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Thies Lüdtke
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
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Wirtz J, Ascone L, Gehlenborg J, Moritz S, Kühn S. A dismantling study on imaginal retraining in overweight or obese women. Transl Psychiatry 2021; 11:481. [PMID: 34535631 PMCID: PMC8448732 DOI: 10.1038/s41398-021-01595-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/20/2021] [Accepted: 08/25/2021] [Indexed: 11/09/2022] Open
Abstract
Imaginal retraining is a variant of approach bias modification and transfers the method into one's own mind. As the technique contains multiple elements, this pilot study aimed to dismantle which of its components is most efficient in reducing craving for high-calorie food. A total of 113 women were randomly allocated to one out of six conditions containing a short intervention to mentally manipulate a picture displaying high-calorie foods. Four of the interventions involved different combinations of elements of the imaginal retraining technique, while the remaining two conditions comprised thought suppression or merely observing a picture. Participants rated their level of craving, as well as three pictures containing healthy and unhealthy foods regarding their pleasantness before and after the interventions took place. Within-group changes were assessed with paired t-tests (in case of non-normal data Wilcoxon paired t-tests) and between-group differences with one-way ANOVAs (non-parametric Kruskal-Wallis tests). A trend level reduction in craving was found in the imaginal retraining condition with and without a movement. A post hoc analysis of both conditions joint together showed a statistically significant reduction in craving. In addition, positive picture appraisal for unhealthy foods was significantly reduced in both imaginal retraining conditions (with and without movement) with medium to large effect sizes. This study demonstrated that imaginal retraining with an arm movement can reduce craving and picture appraisal for high-calorie foods significantly in a one-time application. It is a promising technique to reduce appraisal for unhealthy high-calorie foods. Future studies should repeat the experiment in situations of high craving and allow for a personalized selection of stimuli.
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Affiliation(s)
- Janina Wirtz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
| | - Leonie Ascone
- grid.13648.380000 0001 2180 3484Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Josefine Gehlenborg
- grid.13648.380000 0001 2180 3484Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Steffen Moritz
- grid.13648.380000 0001 2180 3484Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany. .,Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany.
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24
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Shi Z, Langleben DD, O'Brien CP, Childress AR, Wiers CE. Multivariate pattern analysis links drug use severity to distributed cortical hypoactivity during emotional inhibitory control in opioid use disorder. Neuroimage Clin 2021; 32:102806. [PMID: 34525436 PMCID: PMC8436158 DOI: 10.1016/j.nicl.2021.102806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 11/22/2022]
Abstract
Opioid use disorder (OUD) is characterized by emotional and cognitive impairements that are associated with poor treatment outcomes. The present study investigated the neural mechanism underlying emotion evaluation and inhibitory control using an affective go/no-go (AGN) task and its association with drug use severity and craving in patients with OUD. Twenty-six recently detoxified patients with OUD underwent functional magnetic resonance imaging (fMRI) while performing the AGN task that required response to frequently presented appetitive stimuli ("go") and inhibition of response to infrequently presented aversive stimuli ("no-go"). The fMRI session was immediately followed by an injection of extended-release opioid antagonist naltrexone (XR-NTX). Participants' opioid craving was assessed immediately before fMRI and 10 ± 2 days after XR-NTX injection. Multivariate pattern analysis (MVPA) showed that drug use severity was associated with distributed brain hypoactivity in response to aversive no-go stimuli, with particularly large negative contributions from the cognitive control and dorsal attention brain networks. While drug use severity and its associated MVPA brain response pattern were both correlated with opioid craving at baseline, only the brain response pattern predicted craving during XR-NTX treatment. Our findings point to widespread functional hypoactivity in the brain networks underlying emotional inhibitory control in OUD. Such a distributed pattern is consistent with the multifaceted nature of OUD, which affects multiple brain networks. It also highlights the utility of the multivariate approach in uncovering large-scale cortical substrates associated with clinical severity in complex psychiatric disorders and in predicting treatment response.
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Affiliation(s)
- Zhenhao Shi
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA.
| | - Daniel D Langleben
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA
| | - Charles P O'Brien
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA
| | - Anna Rose Childress
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA
| | - Corinde E Wiers
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St Ste 500, Philadelphia, PA 19104, USA
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25
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Tzavella L, Lawrence NS, Button KS, Hart EA, Holmes NM, Houghton K, Badkar N, Macey E, Braggins AJ, Murray FC, Chambers CD, Adams RC. Effects of go/no-go training on food-related action tendencies, liking and choice. ROYAL SOCIETY OPEN SCIENCE 2021; 8:210666. [PMID: 34457346 PMCID: PMC8385366 DOI: 10.1098/rsos.210666] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/03/2021] [Indexed: 05/16/2023]
Abstract
Inhibitory control training effects on behaviour (e.g. 'healthier' food choices) can be driven by changes in affective evaluations of trained stimuli, and theoretical models indicate that changes in action tendencies may be a complementary mechanism. In this preregistered study, we investigated the effects of food-specific go/no-go training on action tendencies, liking and impulsive choices in healthy participants. In the training task, energy-dense foods were assigned to one of three conditions: 100% inhibition (no-go), 0% inhibition (go) or 50% inhibition (control). Automatic action tendencies and liking were measured pre- and post-training for each condition. We found that training did not lead to changes in approach bias towards trained foods (go and no-go relative to control), but we warrant caution in interpreting this finding as there are important limitations to consider for the employed approach-avoidance task. There was only anecdotal evidence for an effect on food liking, but there was evidence for contingency learning during training, and participants were on average less likely to choose a no-go food compared to a control food after training. We discuss these findings from both a methodological and theoretical standpoint and propose that the mechanisms of action behind training effects be investigated further.
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Affiliation(s)
- Loukia Tzavella
- Brain Research Imaging Centre, Cardiff University, Cardiff CF24 4HQ, UK
| | | | | | | | | | | | - Nina Badkar
- School of Psychology, University of Exeter, Exeter EX4 4QG, UK
| | - Ellie Macey
- School of Psychology, University of Exeter, Exeter EX4 4QG, UK
| | | | | | | | - Rachel C. Adams
- Brain Research Imaging Centre, Cardiff University, Cardiff CF24 4HQ, UK
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26
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Machulska A, Eiler TJ, Kleinke K, Grünewald A, Brück R, Jahn K, Niehaves B, Klucken T. Approach bias retraining through virtual reality in smokers willing to quit smoking: A randomized-controlled study. Behav Res Ther 2021; 141:103858. [PMID: 33862407 DOI: 10.1016/j.brat.2021.103858] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/25/2021] [Accepted: 03/25/2021] [Indexed: 11/26/2022]
Abstract
Automatic approach biases toward smoking-related cues have been implicated in the development and maintenance of addictive behaviors. Studies aiming at modifying such biases have shown promise in changing maladaptive approach tendencies for smoking cues and reducing smoking behavior. However, training effects tend to be small and partly inconsistent. The present randomized-controlled trial incorporated virtual reality (VR) technology into Approach Bias Modification (ABM) to improve efficacy. One-hundred-eight smokers attended behavioral counseling for smoking cessation and were thereafter randomized to receive VR-ABM or VR-control training. During VR-ABM, participants trained to implicitly avoid smoking-related objects and to approach alternative objects, while no such contingency existed in the VR-control condition. Trainings were administered in six sessions within a two-week period. Assessments were conducted at baseline, post-intervention (three weeks after baseline), and at follow-up (seven weeks after baseline). VR-ABM did not change approach biases, nor other cognitive biases, but it was superior in reducing daily smoking. However, this effect was limited to the two-week training period. Both groups improved in other smoking- and health-related variables across time. Future work should continue to investigate working mechanisms of ABM, in particular crucial training ingredients. VR could prove valuable for public health as the potential of VR-based treatments is large and not fully explored.
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Affiliation(s)
- Alla Machulska
- Department of Clinical Psychology, University of Siegen, Siegen, Germany.
| | - Tanja Joan Eiler
- Medical Informatics and Micro Systems Engineering, University of Siegen, Siegen, Germany; Life Science Faculty, University of Siegen, Siegen, Germany.
| | - Kristian Kleinke
- Department of Clinical Psychology, University of Siegen, Siegen, Germany.
| | - Armin Grünewald
- Medical Informatics and Micro Systems Engineering, University of Siegen, Siegen, Germany; Life Science Faculty, University of Siegen, Siegen, Germany.
| | - Rainer Brück
- Life Science Faculty, University of Siegen, Siegen, Germany.
| | - Katharina Jahn
- Department of Business Informatics, University of Siegen, Siegen, Germany.
| | - Björn Niehaves
- Department of Business Informatics, University of Siegen, Siegen, Germany.
| | - Tim Klucken
- Department of Clinical Psychology, University of Siegen, Siegen, Germany.
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27
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Czeszumski A, Albers F, Walter S, König P. Let Me Make You Happy, and I'll Tell You How You Look Around: Using an Approach-Avoidance Task as an Embodied Emotion Prime in a Free-Viewing Task. Front Psychol 2021; 12:604393. [PMID: 33790829 PMCID: PMC8005526 DOI: 10.3389/fpsyg.2021.604393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/18/2021] [Indexed: 11/29/2022] Open
Abstract
The embodied approach of human cognition suggests that concepts are deeply dependent upon and constrained by an agent's physical body's characteristics, such as performed body movements. In this study, we attempted to broaden previous research on emotional priming, investigating the interaction of emotions and visual exploration. We used the joystick-based approach-avoidance task to influence the emotional states of participants, and subsequently, we presented pictures of news web pages on a computer screen and measured participant's eye movements. As a result, the number of fixations on images increased, the total dwell time increased, and the average saccade length from outside of the images toward the images decreased after the bodily congruent priming phase. The combination of these effects suggests increased attention to web pages' image content after the participants performed bodily congruent actions in the priming phase. Thus, congruent bodily interaction with images in the priming phase fosters visual interaction in the subsequent exploration phase.
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Affiliation(s)
- Artur Czeszumski
- Institute of Cognitive Science, Universität Osnabrück, Osnabrück, Germany
| | - Friederike Albers
- Institute of Cognitive Science, Universität Osnabrück, Osnabrück, Germany
| | - Sven Walter
- Institute of Cognitive Science, Universität Osnabrück, Osnabrück, Germany
| | - Peter König
- Institute of Cognitive Science, Universität Osnabrück, Osnabrück, Germany.,Institut für Neurophysiologie und Pathophysiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
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28
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Moritz S, Gehlenborg J, Wirtz J, Ascone L, Kühn S. A dismantling study on imaginal retraining in smokers. Transl Psychiatry 2021; 11:92. [PMID: 33531467 PMCID: PMC7854587 DOI: 10.1038/s41398-020-01191-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 02/06/2023] Open
Abstract
Imaginal retraining is a noncomputerized variant of cognitive bias modification, an intervention aimed at reducing craving in substance use disorders and behavioral addictions. We conducted a dismantling study to elucidate which of its multiple components are effective and hence essential ingredients of the training and which are ineffective (and hence perhaps dispensable) in reducing craving. We randomized 187 smokers to one out of six conditions that instructed participants to perform a brief intervention. In four of these, participants were instructed to perform isolated components of the imaginal retraining protocol, and in the two other conditions participants either suppressed or simply observed (control condition) the image of a cigarette. Before and after the intervention, participants were asked to rate their level of craving and how pleasant they found three smoking-related images. We examined within-group changes by means of paired t-tests separately across conditions (trial registration: DRKS00021044). Mental distancing from cigarettes (without a corresponding actual physical movement; non-motor retraining) led to a significant decline in craving (paired t-test), which remained significant when compared to the control condition. The effects of other components of the retraining were less consistent. The present study shows that a single therapeutic "dose" of distinct components involved in imaginal retraining can reduce craving for cigarettes. Future trials should investigate the effectiveness of components of imaginal retraining not yet tested (e.g., mood induction) and whether combinations and repetition of single components strengthen or dilute efficacy.
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Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Josefine Gehlenborg
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Janina Wirtz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Leonie Ascone
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany.
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29
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Garfield JBB, Piercy H, Arunogiri S, Lubman DI, Campbell SC, Sanfilippo PG, Gavin J, Hopwood M, Kotler E, George S, Okedara G, Piccoli LR, Manning V. Protocol for the methamphetamine approach-avoidance training (MAAT) trial, a randomised controlled trial of personalised approach bias modification for methamphetamine use disorder. Trials 2021; 22:21. [PMID: 33407781 PMCID: PMC7788914 DOI: 10.1186/s13063-020-04927-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 11/21/2020] [Indexed: 01/23/2023] Open
Abstract
Background Globally, methamphetamine use has increased in prevalence in recent years. In Australia, there has been a dramatic increase in numbers of people seeking treatment, including residential rehabilitation, for methamphetamine use disorder (MUD). While residential rehabilitation is more effective for MUD than withdrawal treatment (i.e. “detoxification”) alone, relapse rates remain high, with approximately half of rehabilitation clients using methamphetamine within 3 months of rehabilitation. “Approach bias modification” (ABM) is a computerised cognitive training approach that aims to dampen automatically triggered impulses to approach drugs and drug-related stimuli. ABM has been demonstrated to reduce alcohol relapse rates, but no randomised controlled trials of ABM for MUD have yet been conducted. We aim to test whether a novel “personalised” form of ABM, delivered during rehabilitation, reduces post-treatment methamphetamine use, relative to a sham-training control condition. Secondary outcomes will include dependence symptoms, cravings, and approach bias. Methods We aim to recruit 100 participants attending residential rehabilitation for MUD at 3 sites in the Melbourne metropolitan area. Participants will complete baseline measures of methamphetamine use, craving, dependence severity, and approach bias before being randomised to receiving 6 sessions of ABM or “sham” training. In the active condition, ABM will be personalised for each participant, using those methamphetamine images that they rate as most relevant to their recent methods of methamphetamine use as “avoidance” images and using positive images representing their goals or healthy sources of pleasure as “approach” images. Approach bias and craving will be re-assessed following completion of training, and methamphetamine use, dependence, and craving will be assessed 4 weeks and 3 months following discharge from residential treatment. Discussion This study is the first randomised controlled trial of ABM for MUD and also the first ABM study to test using a personalised set of both approach and avoid images for ABM training. If effective, the low cost and easy implementation of ABM means it could be widely implemented as a standard part of MUD treatment. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12620000072910. Registered on 30 January 2020 (prospectively registered): https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378804&isReview=true
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Affiliation(s)
- Joshua B B Garfield
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia. .,Turning Point, Eastern Health, 110 Church Street, Richmond, Melbourne, Victoria, 3121, Australia.
| | - Hugh Piercy
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, 110 Church Street, Richmond, Melbourne, Victoria, 3121, Australia
| | - Shalini Arunogiri
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, 110 Church Street, Richmond, Melbourne, Victoria, 3121, Australia
| | - Dan I Lubman
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, 110 Church Street, Richmond, Melbourne, Victoria, 3121, Australia
| | - Samuel C Campbell
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, 110 Church Street, Richmond, Melbourne, Victoria, 3121, Australia
| | - Paul G Sanfilippo
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, 110 Church Street, Richmond, Melbourne, Victoria, 3121, Australia
| | - Jeff Gavin
- Association of Participating Service Users (APSU), Self Help Addiction Resource Centre (SHARC), 140 Grange Road, Carnegie, Melbourne, Victoria, 3163, Australia
| | - Malcolm Hopwood
- Department of Psychiatry, University of Melbourne, Melbourne, Australia.,Albert Road Clinic, Ramsay Health, 31-33 Albert Road, Melbourne, Victoria, 3004, Australia
| | - Eli Kotler
- Malvern Private Hospital, 5 Wilton Vale Crescent, Malvern East, Melbourne, Victoria, 3145, Australia.,Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Australia
| | - Suzanne George
- Malvern Private Hospital, 5 Wilton Vale Crescent, Malvern East, Melbourne, Victoria, 3145, Australia
| | - Goke Okedara
- Albert Road Clinic, Ramsay Health, 31-33 Albert Road, Melbourne, Victoria, 3004, Australia
| | - Lara R Piccoli
- School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.,Turning Point, Eastern Health, 110 Church Street, Richmond, Melbourne, Victoria, 3121, Australia
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30
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Ramirez V, Wiers CE, Wang GJ, Volkow ND. Personality traits in substance use disorders and obesity when compared to healthy controls. Addiction 2020; 115:2130-2139. [PMID: 32350970 DOI: 10.1111/add.15062] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/23/2019] [Accepted: 03/13/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Although personality traits are implicated in substance use disorders (SUDs) and obesity, differences and similarities between them have not been assessed. Our main aim was to compare personality traits between people with different SUDs, obese people and healthy controls. DESIGN This was a secondary analysis of personality scores obtained from participants in neuroimaging studies from Brookhaven National Laboratory and the Laboratory of Neuroimaging, National Institutes of Health. SETTING United States. PARTICIPANTS/CASES Individuals with obesity (OB) n = 41, alcohol use disorder (AUD) n = 39, marijuana use disorder (MUD) n = 24, cocaine use disorder (CUD) n = 100, and healthy controls (HC) n = 117 (237 males and 84 females). MEASUREMENTS The Multidimensional Personality Questionnaire, which characterizes positive emotionality (PEM), negative emotionality (NEM) and constraint (CON) traits. Adjusted covariates included cigarette smoking status, age, gender and body mass index (BMI). FINDINGS Multivariate analysis of covariance showed a main group effect (i.e. OB, AUD, MUD, CUD and HC) only on NEM (P < 0.0001, η2 = 0.17) and CON (P = 0.005, η2 = 0.12). Specifically, NEM was higher in AUD (P < 0.0001, d = 10.4), CUD (P < 0.0001, d = 8.2) and MUD (P = 0.001, d = 9.2), but not in OB (P > 0.05, d = 2.8) relative to HC. CUD showed lower CON (P = 0.015, d = 5.4) and PEM (P = 0.018, d = 4.8) than HC; however, these differences were not significant in the other groups. NEM and CON were negatively correlated for groups combined (r = -0.26, P < 0.0001), and separately for OB (r = -0.49, P = 0.001) and CUD (r = -0.22, P = 0.03). Cigarette smoking status did not influence group differences in NEM, PEM or CON. CONCLUSIONS Compared with healthy controls, people with substance use disorders appear to show higher negative emotionality, and people with cocaine use disorders appear to show lower positive emotionality and constraint traits. Similar findings were not found among people with obesity.
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Affiliation(s)
- Veronica Ramirez
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Corinde E Wiers
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Gene-Jack Wang
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Nora D Volkow
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA.,National Institute on Drug Abuse, Bethesda, MD, USA
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31
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Kahveci S, van Bockstaele B, Blechert J, Wiers RW. Pulling for pleasure? Erotic approach-bias associated with porn use, not problems. LEARNING AND MOTIVATION 2020. [DOI: 10.1016/j.lmot.2020.101656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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32
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Rudaizky D, Rinck M, Becker E, MacLeod C. Are avoidance biases in social anxiety due to biases in stimulus coding or in post-coding behavioral tendencies? Behav Res Ther 2020; 132:103656. [PMID: 32559674 DOI: 10.1016/j.brat.2020.103656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/16/2020] [Accepted: 05/27/2020] [Indexed: 10/24/2022]
Abstract
On the Approach-Avoidance Task (AAT) high socially anxious (HSA) individuals exhibit increased behavioral avoidance of faces displaying emotional expressions. Two accounts could explain these findings: 1) HSA individuals have a heightened readiness to code faces in terms of emotionality, and all individuals behaviorally avoid faces coded as emotional (pre-behavior coding bias hypothesis), or 2) everyone is equally ready to code faces in terms of emotionality, but when faces are coded as emotional HSA have a heightened tendency to behaviorally avoid such stimuli (post coding behavioral bias hypothesis). To test these hypotheses, we created the Stimulus-Coding AAT. Participants categorized emotional and non-emotional faces in terms of either gender or emotional expression, before making a standard AAT response. Time to make each type of categorization, and to execute AAT responses following categorization, was assessed in 32 HSA and 32 LSA participants. Groups did not differ in their relative speed to categorize face stimuli on the two dimensions. When participants coded faces in terms of their emotionality, HSA relative to LSA participants demonstrated increased behavioral avoidance of emotional faces. We conclude that these findings are inconsistent with the pre-behavior coding bias hypothesis and support the post-coding behavioral bias hypothesis.
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Affiliation(s)
- Daniel Rudaizky
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Australia.
| | - Mike Rinck
- Behavioural Science Institute, Radboud University, Netherlands; Ruhr-University Bochum, Germany.
| | - Eni Becker
- Behavioural Science Institute, Radboud University, Netherlands.
| | - Colin MacLeod
- Centre for the Advancement of Research on Emotion, School of Psychological Science, University of Western Australia, Australia.
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33
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Fricke K, Vogel S. How interindividual differences shape approach-avoidance behavior: Relating self-report and diagnostic measures of interindividual differences to behavioral measurements of approach and avoidance. Neurosci Biobehav Rev 2020; 111:30-56. [PMID: 31954150 DOI: 10.1016/j.neubiorev.2020.01.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/03/2020] [Accepted: 01/06/2020] [Indexed: 02/03/2023]
Abstract
Responding to stimuli in ambiguous environments is partially governed by approach-avoidance tendencies. Imbalances in these approach-avoidance behaviors are implicated in many mental disorders including anxiety disorders, phobias and substance use disorders. While factors biasing human behavior in approach-avoidance conflicts have been researched in numerous experiments, a much-needed comprehensive overview integrating those findings is missing. Here, we systematically searched the existing literature on individual differences in task-based approach-avoidance behavior and aggregated the current evidence for the effect of self-reported approach/avoidance traits, anxiety and anxiety disorders, specific phobias, depression, aggression, anger and psychopathy, substance use and related disorders, eating disorders and habits, trauma, acute stress and, finally, hormone levels (mainly testosterone, oxytocin). We highlight consistent findings, underrepresented research areas and unexpected results, and detail the amount of controversy between studies. We discuss potential reasons for ambiguous results in some research areas, offer practical advice for future studies and highlight potential variables such as task-related researcher decisions that may influence how interindividual differences and disorders drive automatic approach-avoidance biases in behavioral experiments.
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Affiliation(s)
- Kim Fricke
- Department of Psychology, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany.
| | - Susanne Vogel
- Department of Psychology, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany
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34
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Loijen A, Vrijsen JN, Egger JI, Becker ES, Rinck M. Biased approach-avoidance tendencies in psychopathology: A systematic review of their assessment and modification. Clin Psychol Rev 2020; 77:101825. [DOI: 10.1016/j.cpr.2020.101825] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 01/18/2023]
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35
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Promoting smoking abstinence in smokers willing to quit smoking through virtual reality-approach bias retraining: a study protocol for a randomized controlled trial. Trials 2020; 21:227. [PMID: 32102685 PMCID: PMC7045706 DOI: 10.1186/s13063-020-4098-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 01/21/2020] [Indexed: 12/13/2022] Open
Abstract
Background Automatic processes to approach smoking-related cues have been repeatedly linked to smoking status, intensity of smoking, and cigarette craving. Moreover, recent findings suggest that targeting those tendencies directly by means of approach bias modification (ABM) has merit in changing maladaptive approach tendencies for drug cues and reducing drug consumption. However, training effects tend to be small. Embedding the training into virtual reality (VR) technology could be a promising way to improve training efficacy. The present protocol describes a randomized controlled trial that aims to assess the efficacy of a newly developed VR-ABM as a means of reducing smoking-related approach biases or nicotine consumption in smokers seeking abstinence. Methods One hundred daily smokers who are motivated to quit smoking will be recruited into the randomized controlled trial. All participants will attend a brief smoking cessation intervention (TAU) and will be randomly assigned either to the experimental (VR-avoidance training) or the placebo-control group (VR-placebo training). During the VR-avoidance training, participants are implicitly instructed to make an avoidance movement in response to smoking-related objects (e.g., cigarettes) and an approach movement in response to alternative objects (e.g., healthy food). During the VR-placebo training, no such contingency between arm movement and item content exists. Trainings are administered in six sessions within two weeks. Training effects on automatic approach tendencies and smoking behavior are measured immediately after training and at a 7-week follow-up. Discussion Embedding the training into virtual reality (VR) technology could be a promising new way to improve ecological validity, realism, and immersion and thereby increase ABM training effects. The results of this study can inform future research in the optimization and advancement of treatment for addiction. Trial registration Registered with Current Controlled Trials: study ID ISRCTN16006023. Registered on 28 March 2019.
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Rougier M, Muller D, Courset R, Smeding A, Devos T, Batailler C. Toward the use of approach/avoidance tendencies as attitude measures: Individual‐ and group‐level variability of the ingroup bias. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2020. [DOI: 10.1002/ejsp.2653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Marine Rougier
- LIP/PC2S Univ. Grenoble Alpes Grenoble France
- IPSY Université Catholique de Louvain Louvain-la-Neuve Belgique
| | - Dominique Muller
- LIP/PC2S Univ. Grenoble Alpes Grenoble France
- Institut Universitaire de France Paris France
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Kemps E, Tiggemann M, Cibich M, Cabala A. Cognitive bias modification for energy drink cues. PLoS One 2019; 14:e0226387. [PMID: 31841542 PMCID: PMC6913920 DOI: 10.1371/journal.pone.0226387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/25/2019] [Indexed: 11/18/2022] Open
Abstract
Energy drink consumption is increasing worldwide, especially among young adults, and has been associated with physical and mental health problems. In two experiments, we tested the prediction that energy drink consumption is in part driven by biased cognitive processing (attentional and approach biases), with a view to modifying these to reduce consumption. Young adults (18-25 years) who regularly consume energy drinks completed the dot probe (Exp.1; N = 116) or approach-avoidance task (Exp.2; N = 110) to measure attentional and approach bias for energy drink cues, respectively. They then underwent a cognitive bias modification protocol where they were trained to direct their attention away from pictures of energy drink cans (Exp.1), or to push a joystick away from themselves in response to these pictures (Exp.2). Following a post-training assessment of attentional (Exp.1) or approach bias (Exp.2), energy drink consumption was measured by an ostensible taste test. Regular energy drink consumers showed both an attentional and an approach bias for energy drink cues. Cognitive bias modification successfully reduced both biases. However, neither attentional nor approach bias modification significantly reduced energy drink intake. The results lend some support to incentive sensitisation theory which emphasises the role of biased decision-making processes related to addictive behaviours.
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Affiliation(s)
- Eva Kemps
- School of Psychology, Flinders University, Adelaide, Australia
| | | | - Mikaela Cibich
- School of Psychology, Flinders University, Adelaide, Australia
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Machulska A, Kleinke K, Eiler TJ, Grünewald A, Brück R, Jahn K, Niehaves B, Gethmann CF, Klucken T. Retraining automatic action tendencies for smoking using mobile phone-based approach-avoidance bias training: A study protocol for a randomized controlled study. Trials 2019; 20:720. [PMID: 31831080 PMCID: PMC6909563 DOI: 10.1186/s13063-019-3835-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 10/23/2019] [Indexed: 01/12/2023] Open
Abstract
Background Automatic tendencies to approach drug-related cues have been linked to the development and maintainance of harmful drug-taking behavior. Recent studies have demonstrated that these automatic approach tendencies can be targeted directly by means of cognitive bias modification (CBM). Moreover, changing those approach tendencies may enhance treatment outcomes. However, training and therapy effects tend to be rather small and adherence to the training might be impaired by time-consuming multiple laboratory training sessions. Here, we present a protocol for a randomized controlled design to improve CBM training efficiency and facilitate access to the training by providing mobile-phone-based training sessions at home to current smokers motivated to quit smoking. Methods Participants (n = 100) are current smokers who smoke at least six cigarettes per day for at least 6 months and are willing to quit smoking. All participants attend a brief behavioral smoking cessation intervention (TAU) and are randomly assigned either to an experimental (TAU + training) or a control group. Participants in the experimental condition are given access to a training application (app) aimed at retraining automatic approach biases for smoking cues. Participants are instructed to perform the app training outside the laboratory context on a daily basis for 14 consecutive days. Participants in the control group do not receive the training. Primary outcome measures are changes in smoking-related approach biases and reductions in daily nicotine consumption as assessed at baseline, post-training and at 6-week follow up. Secondary outcome measures include approach biases for alternative stimuli or smoking stimuli to which participants were not exposed during training, attentional and association biases, biochemical outcomes, and self-reported smoking behavior, also measured at three different time points (baseline, post-training, and follow up). After completion of the study, smokers in the control condition will receive access to the training app. Discussion This randomized controlled trial is the first to test the effectiveness of an app-based CBM intervention as an adjunct to a brief smoking cessation intervention in smokers motivated to quit smoking. The results of this study can inform future research in the optimization and advancement of CBM treatment for addiction. Trial registration Current Controlled Trials, ISRCTN15690771. Registered on 20 November 2018.
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Affiliation(s)
- Alla Machulska
- Department of Clinical Psychology, University of Siegen, Adolf-Reichwein-Str. 2a, 57068, Siegen, Germany.
| | - Kristian Kleinke
- Department of Clinical Psychology, University of Siegen, Adolf-Reichwein-Str. 2a, 57068, Siegen, Germany
| | - Tanja Joan Eiler
- Department of Medical Informatics und Microsystems Engineering, University of Siegen, Siegen, Germany
| | - Armin Grünewald
- Department of Medical Informatics und Microsystems Engineering, University of Siegen, Siegen, Germany
| | - Rainer Brück
- Department of Medical Informatics und Microsystems Engineering, University of Siegen, Siegen, Germany
| | - Katharina Jahn
- Department of Business Informatics, University of Siegen, Siegen, Germany
| | - Björn Niehaves
- Department of Business Informatics, University of Siegen, Siegen, Germany
| | | | - Tim Klucken
- Department of Clinical Psychology, University of Siegen, Adolf-Reichwein-Str. 2a, 57068, Siegen, Germany
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Kriegler J, Wegener S, Richter F, Scherbaum N, Brand M, Wegmann E. Decision making of individuals with heroin addiction receiving opioid maintenance treatment compared to early abstinent users. Drug Alcohol Depend 2019; 205:107593. [PMID: 31634665 DOI: 10.1016/j.drugalcdep.2019.107593] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/18/2019] [Accepted: 07/27/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIMS Individuals with heroin addiction are prone to dysfunctional decision-making. They frequently choose the short-term rewarding option of drug intake despite experiencing long-term negative consequences. Opioid maintenance treatment (OMT) is the most common treatment of heroin addiction. METHODS In this study, 38 individuals in an early stage of abstinence from heroin addiction (ESA-HA individuals) at the end of inpatient detoxification treatment and 41 individuals in long-term OMT were examined. Decision-making was assessed by (I) a modified version of the Iowa Gambling Task (IGT) with drug-related stimuli focusing on decision-making under ambiguity and (II) the Game of Dice Task (GDT) assessing decision-making under objective risk. RESULTS OMT-individuals showed significantly better performance in the IGT than the ESA-HA-individuals. They also showed significantly less craving under exposure of drug-related pictures. In the GDT, OMT-individuals showed significantly less risky decision-making than ESA-HA-individuals. CONCLUSION The results suggest that patients receiving OMT show better functional decision-making and lower craving reactions. It could be assumed that the effectiveness of OMT in preventing relapse is linked to better decision-making and lower craving among these patients.
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Affiliation(s)
- Julia Kriegler
- LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Duisburg-Essen, Virchowstraße 174, 45147 Essen, Germany.
| | - Sophia Wegener
- Berufsförderungswerk Stralsund GmbH, Große Parower Straße 133, 18435 Stralsund, Germany.
| | - Francois Richter
- Suchthilfe direkt Essen GmbH, Hoffnungstraße 24, 45127 Essen, Germany.
| | - Norbert Scherbaum
- LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Duisburg-Essen, Virchowstraße 174, 45147 Essen, Germany.
| | - Matthias Brand
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Forsthausweg 2, 47057 Duisburg, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen, Germany.
| | - Elisa Wegmann
- General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Forsthausweg 2, 47057 Duisburg, Germany.
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Morys F, Janssen LK, Cesnaite E, Beyer F, Garcia-Garcia I, Kube J, Kumral D, Liem F, Mehl N, Mahjoory K, Schrimpf A, Gaebler M, Margulies D, Villringer A, Neumann J, Nikulin VV, Horstmann A. Hemispheric asymmetries in resting-state EEG and fMRI are related to approach and avoidance behaviour, but not to eating behaviour or BMI. Hum Brain Mapp 2019; 41:1136-1152. [PMID: 31750607 PMCID: PMC7267939 DOI: 10.1002/hbm.24864] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/09/2019] [Accepted: 10/31/2019] [Indexed: 02/06/2023] Open
Abstract
Much of our behaviour is driven by two motivational dimensions—approach and avoidance. These have been related to frontal hemispheric asymmetries in clinical and resting‐state EEG studies: Approach was linked to higher activity of the left relative to the right hemisphere, while avoidance was related to the opposite pattern. Increased approach behaviour, specifically towards unhealthy foods, is also observed in obesity and has been linked to asymmetry in the framework of the right‐brain hypothesis of obesity. Here, we aimed to replicate previous EEG findings of hemispheric asymmetries for self‐reported approach/avoidance behaviour and to relate them to eating behaviour. Further, we assessed whether resting fMRI hemispheric asymmetries can be detected and whether they are related to approach/avoidance, eating behaviour and BMI. We analysed three samples: Sample 1 (n = 117) containing EEG and fMRI data from lean participants, and Samples 2 (n = 89) and 3 (n = 152) containing fMRI data from lean, overweight and obese participants. In Sample 1, approach behaviour in women was related to EEG, but not to fMRI hemispheric asymmetries. In Sample 2, approach/avoidance behaviours were related to fMRI hemispheric asymmetries. Finally, hemispheric asymmetries were not related to either BMI or eating behaviour in any of the samples. Our study partly replicates previous EEG findings regarding hemispheric asymmetries and indicates that this relationship could also be captured using fMRI. Our findings suggest that eating behaviour and obesity are likely to be mediated by mechanisms not directly relating to frontal asymmetries in neuronal activation quantified with EEG and fMRI.
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Affiliation(s)
- Filip Morys
- Leipzig University Medical Centre, IFB Adiposity Diseases, Leipzig, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Lieneke K Janssen
- Leipzig University Medical Centre, IFB Adiposity Diseases, Leipzig, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Elena Cesnaite
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Frauke Beyer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Subproject A1/A5, CRC1052 "Obesity Mechanisms", University of Leipzig, Leipzig, Germany
| | | | - Jana Kube
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Brandenburg University of Technology Cottbus-Senftenberg, Cottbus, Germany
| | - Deniz Kumral
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,MindBrainBody Institute at the Berlin School of Mind and Brain, Humboldt-Universitaet zu Berlin, Berlin, Germany
| | - Franziskus Liem
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland.,Max Planck Research Group for Neuroanatomy & Connectivity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Nora Mehl
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Faculty of Psychology, Technical University Dresden, Dresden, Germany
| | - Keyvan Mahjoory
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,University of Muenster, Institute for Biomagnetism and Biosignal Analysis, Muenster, Germany
| | - Anne Schrimpf
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Michael Gaebler
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,MindBrainBody Institute at the Berlin School of Mind and Brain, Humboldt-Universitaet zu Berlin, Berlin, Germany
| | - Daniel Margulies
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Max Planck Research Group for Neuroanatomy & Connectivity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Brain and Spine Institute, Paris, France
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,MindBrainBody Institute at the Berlin School of Mind and Brain, Humboldt-Universitaet zu Berlin, Berlin, Germany
| | - Jane Neumann
- Leipzig University Medical Centre, IFB Adiposity Diseases, Leipzig, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Ernst-Abbe-Hochschule - University of Applied Sciences, Jena, Germany
| | - Vadim V Nikulin
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, National Research University Higher School of Economics, Moscow, Russia.,Department of Neurology, Charité - Medical University Berlin, Berlin, Germany
| | - Annette Horstmann
- Leipzig University Medical Centre, IFB Adiposity Diseases, Leipzig, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Subproject A1/A5, CRC1052 "Obesity Mechanisms", University of Leipzig, Leipzig, Germany.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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41
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Assessment of Automatically Activated Approach–Avoidance Biases Across Appetitive Substances. CURRENT ADDICTION REPORTS 2019. [DOI: 10.1007/s40429-019-00254-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Meule A, Richard A, Lender A, Dinic R, Brockmeyer T, Rinck M, Blechert J. Measuring approach-avoidance tendencies towards food with touchscreen-based arm movements. PSYCHOLOGICAL RESEARCH 2019; 84:1789-1800. [PMID: 31055649 PMCID: PMC7479004 DOI: 10.1007/s00426-019-01195-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 04/25/2019] [Indexed: 12/11/2022]
Abstract
Most tasks for measuring automatic approach-avoidance tendencies do not resemble naturalistic approach-avoidance behaviors. Therefore, we developed a paradigm for the assessment of approach-avoidance tendencies towards palatable food, which is based on arm and hand movements on a touchscreen, thereby mimicking real-life grasping or warding movements. In Study 1 (n = 85), an approach bias towards chocolate-containing foods was found when participants reached towards the stimuli, but not when these stimuli had to be moved on the touchscreen. This approach bias towards food observed in grab movements was replicated in Study 2 (n = 60) and Study 3 (n = 94). Adding task features to disambiguate distance change through either corresponding image zooming (Study 2) or emphasized self-reference (Study 3) did not moderate this effect. Associations between approach bias scores and trait and state chocolate craving were inconsistent across studies. Future studies need to examine whether touchscreen-based approach-avoidance tasks reveal biases towards other stimuli in the appetitive or aversive valence domain and relate to relevant interindividual difference variables.
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Affiliation(s)
- Adrian Meule
- Department of Psychology, University of Salzburg, Hellbrunner Straße 34, 5020, Salzburg, Austria.
- Center for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria.
| | - Anna Richard
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Anja Lender
- Department of Psychology, University of Salzburg, Hellbrunner Straße 34, 5020, Salzburg, Austria
- Center for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Radomir Dinic
- Department of MultiMedia Technology, Salzburg University of Applied Sciences, Puch, Austria
| | - Timo Brockmeyer
- Institute of Psychology, University of Goettingen, Göttingen, Germany
| | - Mike Rinck
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Jens Blechert
- Department of Psychology, University of Salzburg, Hellbrunner Straße 34, 5020, Salzburg, Austria
- Center for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
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43
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Web-based Approach Bias Modification in smokers: A randomized-controlled study. Behav Res Ther 2019; 116:52-60. [DOI: 10.1016/j.brat.2018.12.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 12/03/2018] [Indexed: 01/25/2023]
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44
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Turner D, Wittekind CE, Briken P, Fromberger P, Moritz S, Rettenberger M. Approach and Avoidance Biases Toward Sexual Stimuli and Their Association with the Dual Control Model of Sexual Response in Heterosexual Men. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:867-880. [PMID: 30238184 DOI: 10.1007/s10508-018-1289-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 09/18/2017] [Accepted: 08/06/2018] [Indexed: 06/08/2023]
Abstract
Many models of human behavior work in an interaction of a dual system. While one system usually represents controlled and reflective behavioral responses, the other system reflects automatic and impulsive actions. In the impulsive system, positive stimuli initiate approach reactions and negative cues avoidance reactions. Besides stimulus valence, the behavioral response triggered by the impulsive system is influenced by personality (e.g., the propensity to react with approach or avoidance biases in a specific situation). The present study applied a computerized Approach-Avoidance Task (AAT; Rinck & Becker, 2007) to assess automatic behavioral approach and avoidance biases toward sexual and neutral stimuli in heterosexual men (N = 40). Individual AAT-performance was furthermore related to sexual excitation (SES) and the two sexual inhibition factors (SIS1 and SIS2) as proposed by the Dual Control Model of sexual response (Bancroft & Janssen, 2000). Against our hypotheses, participants did not show a stronger approach bias toward sexually preferred (i.e., images of women) than sexually not preferred stimuli (i.e., images of men or children). However, stronger approach biases toward images of women were positively associated with sexual excitation and negatively correlated with sexual inhibition due to a threat of performance failure (SIS1) even after controlling for potential confounds (i.e., general behavioral activation and inhibition). The results support the importance of the influence of dispositional traits measured with the Dual Control Model of sexual response on approach and avoidance biases toward sexually preferred stimuli in heterosexual men.
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Affiliation(s)
- Daniel Turner
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Untere Zahlbacherstraße 8, 55131, Mainz, Germany.
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Charlotte E Wittekind
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, LMU, Munich, Germany
- Clinical Neuropsychology Unit, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peer Briken
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Peter Fromberger
- Clinic for Psychiatry and Psychotherapy, Forensic Psychiatry, Human Medical Center Georg-August University Göttingen, Göttingen, Germany
| | - Steffen Moritz
- Clinical Neuropsychology Unit, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Rettenberger
- Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Centre for Criminology (Kriminologische Zentralstelle - KrimZ), Wiesbaden, Germany
- Department of Psychology, Johannes Gutenberg-University Mainz, Mainz, Germany
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Approach bias retraining to augment smoking cessation: Study protocol for a randomized controlled trial. Contemp Clin Trials Commun 2019; 14:100340. [PMID: 30899837 PMCID: PMC6406622 DOI: 10.1016/j.conctc.2019.100340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 02/15/2019] [Accepted: 02/24/2019] [Indexed: 11/23/2022] Open
Abstract
Heavy users and addicted individuals have shown to develop an approach action tendency - or approach bias - toward stimuli related to the substance of interest. Emerging evidence points to approach bias retraining (ABR) as an effective aid for the treatment of addictive behaviors. The current study seeks to extend this work by testing, in a pilot study, whether standard smoking cessation treatment involving cognitive-behavioral therapy (CBT) and nicotine replacement therapy can be augmented by ABR. To this end, we will randomly assign 100 adult smokers to either ABR-augmented treatment or placebo-augmented treatment and compare the two conditions on short-term and long-term abstinence rates. The hope is that the findings of this study can inform treatment development for adult smokers.
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46
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Approach-avoidance modification as an add-on in smoking cessation: A randomized-controlled study. Behav Res Ther 2019; 114:35-43. [DOI: 10.1016/j.brat.2018.12.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 12/04/2018] [Accepted: 12/04/2018] [Indexed: 11/17/2022]
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47
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Eiler TJ, Grünewald A, Machulska A, Klucken T, Jahn K, Niehaves B, Gethmann CF, Brück R. A Preliminary Evaluation of Transferring the Approach Avoidance Task into Virtual Reality. ADVANCES IN INTELLIGENT SYSTEMS AND COMPUTING 2019. [DOI: 10.1007/978-3-030-23762-2_14] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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48
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Stop Pushing Me Away: Relative Level of Facebook Addiction Is Associated With Implicit Approach Motivation for Facebook Stimuli. Psychol Rep 2018; 122:2012-2025. [DOI: 10.1177/0033294118798624] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The use of Facebook and other social media sites has increased to the point that some consider it to be a behavioral addiction. Previously, research has used the Approach–Avoidance Task to measure implicit approach and withdrawal tendencies in response to a variety of stimuli, including alcohol, desserts, cigarettes, spiders, and cannabis. When responding to these types of stimuli, individuals typically evidence an approach bias toward appetitive images and a withdrawal bias in response to undesirable and/or fearful stimuli. The present study was designed to test the validity of an adapted version of the Approach–Avoidance Task by investigating how self-reported Facebook addiction tendencies, measured via the Bergen Facebook Addiction Scale, predicted automatic approach tendencies toward Facebook-related stimuli using the Facebook-Approach–Avoidance Task. Participants with higher self-reported tendencies of Facebook addiction tended to approach Facebook-related stimuli faster. The present study is the first to indicate a relationship between self-reported Facebook addiction tendencies and implicit approach motivation using a behavioral measure. This finding provides initial support for the use of the Facebook-Approach–Avoidance Task as a measure of Facebook addiction, and further validation could lead to the development of additional assessment and training paradigms in the future.
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49
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Mehl N, Mueller-Wieland L, Mathar D, Horstmann A. Retraining automatic action tendencies in obesity. Physiol Behav 2018; 192:50-58. [DOI: 10.1016/j.physbeh.2018.03.031] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 03/11/2018] [Accepted: 03/27/2018] [Indexed: 11/26/2022]
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50
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Oliver S, Kemps E. Motivational and implicit processes contribute to incidental physical activity. Br J Health Psychol 2018; 23:820-842. [PMID: 29804313 DOI: 10.1111/bjhp.12318] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 04/17/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Physical activity can prevent health risks and even a slight increase in physical activity benefits health. This study investigated potential contributing factors to incidental physical activity. DESIGN A two-part correlational study examined whether motivational properties (autonomous and controlled motivation) in interaction with implicit processes (implicit attitudes, attentional, and approach-avoid biases) contribute to incidental physical activity. METHODS Participants (N = 103) recorded a 7-day step count to measure incidental physical activity. Implicit attitudes, attentional, and approach-avoid biases were measured using the SC-IAT, dot probe, and manikin tasks, respectively. Autonomous and controlled motivation were measured using the Perceived Locus of Causality Questionnaire. RESULTS Implicit attitudes and autonomous and controlled motivation were independently associated with incidental physical activity. Both autonomous and controlled motivation (when controlling for the other motivation-type) in interaction with approach bias contributed to incidental physical activity levels; motivation was positively associated with step count in participants with high avoid bias scores. Motivation did not interact with attentional bias to contribute to levels of incidental physical activity when controlling for motivation-type. CONCLUSIONS Findings showed that elements from self-determination theory and dual process models relate to incidental physical activity behaviour. Specifically, autonomous motivation and certain implicit processes contributed to incidental physical activity engagement. This study provides an important first step towards understanding the psychological mechanisms that contribute to incidental physical activity. Statement of contribution What is already known on this subject? Motivation and implicit processes individually contribute to incidental physical activity behaviour. Autonomous motivation, rather than controlled motivation, primarily contributes to physical activity behaviour. What does this study add? Motivational and implicit processes together contribute to predicting levels of incidental physical activity. Both autonomous and controlled motivation contribute to levels of incidental physical activity. Certain implicit processes also play a role in incidental physical activity engagement.
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Affiliation(s)
- Stacey Oliver
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Eva Kemps
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
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