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Larsen JK, Hollands GJ, Garland EL, Evers AWM, Wiers RW. Be more mindful: Targeting addictive responses by integrating mindfulness with cognitive bias modification or cue exposure interventions. Neurosci Biobehav Rev 2023; 153:105408. [PMID: 37758008 DOI: 10.1016/j.neubiorev.2023.105408] [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: 06/20/2023] [Revised: 09/01/2023] [Accepted: 09/22/2023] [Indexed: 09/29/2023]
Abstract
This review provides an overview of the most prominent neurocognitive effects of cognitive bias modification (CBM), cue-exposure therapy and mindfulness interventions for targeting addictive responses. It highlights the key insights that have stemmed from cognitive neuroscience and brain imaging research and combines these with insights from behavioural science in building a conceptual model integrating mindfulness with response-focused CBM or cue-exposure interventions. This furthers our understanding of whether and how mindfulness strategies may i) facilitate or add to the induced response-focused effects decreasing cue-induced craving, and ii) further weaken the link between craving and addictive responses. Specifically, awareness/monitoring may facilitate, and decentering may add to, response-focused effects. Combined awareness acceptance strategies may also diminish the craving-addiction link. The conceptual model presented in this review provides a specific theoretical framework to deepen our understanding of how mindfulness strategies and CBM or cue-exposure interventions can be combined to greatest effect. This is important in both suggesting a roadmap for future research, and for the further development of clinical interventions.
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Affiliation(s)
- Junilla K Larsen
- Behavioural Science Institute, Radboud University, PO Box 9104, 6500 HE Nijmegen, the Netherlands.
| | - Gareth J Hollands
- EPPI Centre, UCL Social Research Institute, University College London, UK
| | - Eric L Garland
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Salt Lake City, USA
| | - Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Leiden University, NL, and Medical Delta, Leiden University, TU Delft and Erasmus University, UK
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam and Centre for Urban Mental Health, University of Amsterdam, the Netherlands
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2
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McPhee MD, Hendershot CS. Meta-analysis of acute alcohol effects on response inhibition. Neurosci Biobehav Rev 2023; 152:105274. [PMID: 37277010 DOI: 10.1016/j.neubiorev.2023.105274] [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: 02/17/2023] [Revised: 05/11/2023] [Accepted: 06/02/2023] [Indexed: 06/07/2023]
Abstract
Alcohol intoxication impairs response inhibition; however, discrepant findings have been reported regarding the magnitude and moderators of this effect. This meta-analysis of human laboratory studies aimed to quantify acute effects of alcohol on response inhibition and evaluate moderators of this effect. Eligible studies examined alcohol's effects on response inhibition with the Go/No-Go (GNG) task (n = 1616 participants) or Stop Signal Task (SST) (n = 1310 participants). Results revealed a detrimental effect of acute alcohol on response inhibition overall (g = 0.411, 95 % CI [0.350, 0.471]), with similar effects in studies using GNG (g = 0.431, SE = 0.031) and SST (g = 0.366, SE = 0.063). Effect sizes were larger in studies involving higher breath alcohol concentration levels and under GNG conditions that established a prepotent response set. These findings establish the magnitude, precision, and potential moderators of alcohol's effects on inhibitory control, furthering understanding of a key neurobehavioral mechanism proposed to underlie alcohol-related impulsivity and impaired control over consumption.
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Affiliation(s)
- Matthew D McPhee
- Rotman Research Institute, Baycrest Academy for Research and Education, 3560 Bathurst Street, Toronto M6A2E1, Ontario, Canada.
| | - Christian S Hendershot
- Bowles Center for Alcohol Studies, 104 Manning Drive, Chapel Hill, NC 27599-7178, USA; Department of Psychiatry, University of North Carolina at Chapel Hill, 104 Manning Drive, Chapel Hill, NC 27599-7178, USA
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3
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Caudle MM, Klaming R, Fong C, Harlé K, Taylor C, Spadoni A, Bomyea J. Approach avoidance training versus Sham in veterans with alcohol use disorder: protocol for a randomized controlled trial. BMC Psychiatry 2023; 23:499. [PMID: 37438722 PMCID: PMC10337098 DOI: 10.1186/s12888-023-04961-z] [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: 05/24/2023] [Accepted: 06/14/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Alcohol use disorder (AUD) is highly prevalent and commonly co-occurs with other psychiatric disorders among Veterans. Provisional evidence supports the use of Approach Avoidance Training (AAT) - a form of computer-delivered cognitive bias modification designed to target implicit approach bias for alcohol-related cues - as an adjunctive program to treat AUD. However, the extent to which AAT is effective for improving AUD recovery outcomes in outpatient Veteran samples and those with psychiatric comorbidities has been understudied to date. Here we describe a double-blind randomized controlled trial of AAT versus a comparison condition (Sham) being conducted in Veterans with comorbid psychiatric conditions completing outpatient standard care. METHODS One hundred thirty-six Veterans currently receiving outpatient treatment for AUD will be recruited for this randomized controlled trial with parallel group assignment. Participants will be randomized to either 6 weeks of AAT (n = 68) or Sham (n = 68) training in conjunction with usual care. Assessments will occur at baseline and 6 weeks, 3 months, and 6 months post-baseline. Primary outcome variables will include functional consequences of drinking. Secondary outcome variables will include alcohol consumption, and behavioral indicators of alcohol approach bias. A subset of participants (n = 51) will also complete functional magnetic resonance imaging (fMRI) to assess neural response during an alcohol approach bias assessment. DISCUSSION This study is the first randomized controlled trial of AAT administered as an adjunctive treatment to standard care in Veterans with AUD and comorbid psychiatric disorders. Additionally, behavioral and neuroimaging data will be used to determine the extent to which AAT targets approach bias for alcohol cues. If effective, AAT may be a promising low-cost adjunctive treatment option for individuals with AUD. REGISTRY NAME AAT for Alcohol Use Disorder in Veterans. TRIAL REGISTRATION ClinicalTrials.gov: NCT05372029; Date of Registration: 5/9/2022.
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Affiliation(s)
- M M Caudle
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, University of California, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120, USA
| | - R Klaming
- Department of Veteran Affairs Medical Center, 3350 La Jolla Village Dr, San Diego, CA, 92161, USA
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, San Diego, CA, 92093, USA
| | - C Fong
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, University of California, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120, USA
| | - K Harlé
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, San Diego, CA, 92093, USA
- VA San Diego Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr, San Diego, CA, 92161, USA
| | - C Taylor
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, San Diego, CA, 92093, USA
| | - A Spadoni
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, San Diego, CA, 92093, USA
- VA San Diego Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr, San Diego, CA, 92161, USA
| | - J Bomyea
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr, La Jolla, San Diego, CA, 92093, USA.
- VA San Diego Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr, San Diego, CA, 92161, USA.
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4
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Houben K. How does Go/No-Go training lead to food devaluation? Separating the effects of motor inhibition and response valence. Cogn Emot 2023; 37:763-776. [PMID: 37144522 DOI: 10.1080/02699931.2023.2208339] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/01/2023] [Accepted: 04/20/2023] [Indexed: 05/06/2023]
Abstract
Palatable, unhealthy food stimuli can be devalued via Go/No-Go (GNG) training that consistently pairs such stimuli with motor inhibition. However, it remains unclear whether this devaluation is caused via learned associations with motor inhibition or via inferential learning based on the valence of emitted motor responses. The present research disentangles the effects of motor assignment and response valence in GNG training through task instructions. In two studies, chocolate stimuli were consistently paired with motor inhibition ("no-go") or with motor excitation ("go"). Task instructions indicated that no-go responses were negatively valenced ("do not take") and that go responses were positively valenced ("take"), or identified no-go responses as positively valenced ("keep") and go as negatively valenced ("throw away"). The results show an effect of response valence on chocolate evaluations, but no effect of motor assignment: Chocolate stimuli were consistently devalued following pairings with a negatively valenced response, regardless of whether this response entailed motor inhibition or excitation. These findings align best with an inferential account of GNG training, suggesting that devaluation effects critically depend on inferential processes regarding motor response valence. GNG training procedures may, therefore, be optimised by disambiguating the valence of go and no-go motor responses prior to training.
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Affiliation(s)
- Katrijn Houben
- Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
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5
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Stein M, Soravia LM, Tschuemperlin RM, Batschelet HM, Jaeger J, Roesner S, Keller A, Gomez Penedo JM, Wiers RW, Moggi F. Alcohol-specific inhibition training in patients with alcohol use disorder: a multi-centre, double-blind randomized clinical trial examining drinking outcome and working mechanisms. Addiction 2023; 118:646-657. [PMID: 36468408 DOI: 10.1111/add.16104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 11/16/2022] [Indexed: 12/07/2022]
Abstract
AIMS For the first time, to our knowledge, in a clinical sample with alcohol use disorder (AUD), this study compared the effects of two versions of alcohol-specific inhibition training (Alc-IT) on drinking outcomes and on experimental parameters assessing two possible working mechanisms: stimulus devaluation and inhibitory enhancement. DESIGN Multi-centre, double-blind, three-arm clinical RCT with 3-, 6- and 12-month follow-up comparing standard Alc-IT, improved Alc-IT and an active control condition. SETTING Three specialized AUD treatment centres in Switzerland. PARTICIPANTS A total of 242 detoxified, recently abstinent patients with severe AUD (18-60 years; 29.8% female). INTERVENTION AND COMPARATOR Both interventions [standard Alc-IT (n = 84) and improved Alc-IT (n = 79)] and the comparator [unspecific inhibition training (n = 79)] consisted of six sessions of a modified inhibitory task (Go/NoGo task) with alcohol-related and neutral stimuli. Both versions of Alc-IT required response inhibition in alcohol-related trials but differed in Go/NoGo ratios (standard: 50/50; improved: 75/25), with improved Alc-IT posing higher inhibitory demands. The control condition, an unspecific inhibition training, featured alcohol-related pictures in Go as well as NoGo trials. MEASUREMENTS The primary outcome, percentage of days abstinent, was assessed at 3-month follow-up with a time-line follow-back interview. FINDINGS The group receiving improved Alc-IT showed a significantly higher percentage of days abstinent at 3-month follow-up compared with the control group [γcontrol = 74.30; γimproved = 85.78; β = 11.48, 95% confidence interval (CI) = 2.57, 20.40, P = 0.012, adjusted r2 = 0.062], while for standard Alc-IT no effect significantly different from zero was detected (γstandard = 70.95; β = -3.35, 95% CI = -12.20, 5.50, P = 0.457, adjusted r2 = -0.04). CONCLUSIONS Alcohol-specific inhibition training with high inhibitory demands increased days abstinent at 3-month follow-up in patients with severe alcohol use disorder. Such an improved, inhibitory-demanding, alcohol-specific inhibition training outperformed the standard version of alcohol-specific inhibition training, suggesting an inhibitory working mechanism.
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Affiliation(s)
- Maria Stein
- University Hospital of Psychiatry and Psychotherapy, Translational Research Center, University of Bern, Bern, Switzerland.,Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Bern, Bern, Switzerland
| | - Leila M Soravia
- University Hospital of Psychiatry and Psychotherapy, Translational Research Center, University of Bern, Bern, Switzerland.,Clinic Suedhang, Center for Treatment of Addictive Disorders, Kirchlindach, Switzerland
| | - Raphaela M Tschuemperlin
- University Hospital of Psychiatry and Psychotherapy, Translational Research Center, University of Bern, Bern, Switzerland.,Clinic Suedhang, Center for Treatment of Addictive Disorders, Kirchlindach, Switzerland
| | - Hallie M Batschelet
- University Hospital of Psychiatry and Psychotherapy, Translational Research Center, University of Bern, Bern, Switzerland
| | - Joshua Jaeger
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Bern, Bern, Switzerland.,Clinic Suedhang, Center for Treatment of Addictive Disorders, Kirchlindach, Switzerland
| | - Susanne Roesner
- Forel Clinic, Addiction Treatment Center, Ellikon an der Thur, Switzerland
| | - Anne Keller
- Forel Clinic, Addiction Treatment Center, Ellikon an der Thur, Switzerland
| | | | - Reinout W Wiers
- Addiction, Development and Psychopathology (ADAPT-) Labotratory, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands.,Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - Franz Moggi
- University Hospital of Psychiatry and Psychotherapy, Translational Research Center, University of Bern, Bern, Switzerland
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6
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Houben K, Aulbach M. Is there a difference between stopping and avoiding? A review of the mechanisms underlying Go/No-Go and Approach-Avoidance training for food choice. Curr Opin Behav Sci 2023. [DOI: 10.1016/j.cobeha.2022.101245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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7
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van Alebeek H, Veling H, Blechert J. Disentangling go/no-go from motivational orientation to foods: approaching is more than just responding. Food Qual Prefer 2023. [DOI: 10.1016/j.foodqual.2023.104821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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8
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How go/no-go training changes behavior: A value-based decision-making perspective. Curr Opin Behav Sci 2022. [DOI: 10.1016/j.cobeha.2022.101206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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9
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Itzkovitch A, Bar Or M, Schonberg T. Cue-approach training for food behavior. Curr Opin Behav Sci 2022. [DOI: 10.1016/j.cobeha.2022.101202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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10
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Reichl D, Enewoldsen N, Müller A, Steins-Loeber S. Pilot testing of an adaptive, individualized inhibitory control training for binge drinking: first evidence on feasibility, acceptance, and efficacy. PSYCHOLOGICAL RESEARCH 2022; 87:1267-1283. [PMID: 35994096 PMCID: PMC9395788 DOI: 10.1007/s00426-022-01725-4] [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: 03/16/2022] [Accepted: 08/04/2022] [Indexed: 11/28/2022]
Abstract
Background Deficits in inhibitory control seem to promote habit behavior and therefore play an important role in the development and maintenance of addictive diseases. Although several training approaches have been suggested, there is a considerable lack of knowledge about the best way to improve inhibitory control. Based on a literature review regarding shortcomings of existing trainings, an individualized, adaptive inhibitory control training was developed. We aimed to assess feasibility and acceptance of this training and to provide preliminary results on its efficacy regarding inhibitory control and binge drinking. Methods Sixty-one individuals (30 female) with binge drinking behavior were randomly allocated to either an experimental group receiving three sessions of the inhibitory control training or a waitlist control group receiving no training. Before and after the training, the participants performed a Go/NoGo task to assess inhibitory control (commission errors and false reaction time), completed a questionnaire on drinking-related self-control, and reported drinking behavior. Results Although the training was feasible and accepted by participants, it did not affect self-control over drinking, inhibitory control or drinking behavior. The relationship between session number and false reaction time was linear for alcohol stimuli, but squared for neutral stimuli. Conclusion Although our findings have to be interpreted in the light of some shortcomings, they demonstrate that further research is needed to enhance our understanding of how to improve inhibitory control and which factors might moderate this process. Supplementary Information The online version contains supplementary material available at 10.1007/s00426-022-01725-4.
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Affiliation(s)
- Daniela Reichl
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich University Bamberg, Markusplatz 3, 96047, Bamberg, Germany.
| | - Niklas Enewoldsen
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich University Bamberg, Markusplatz 3, 96047, Bamberg, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich University Bamberg, Markusplatz 3, 96047, Bamberg, Germany
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11
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Almeida-Antunes N, Vasconcelos M, Crego A, Rodrigues R, Sampaio A, López-Caneda E. Forgetting Alcohol: A Double-Blind, Randomized Controlled Trial Investigating Memory Inhibition Training in Young Binge Drinkers. Front Neurosci 2022; 16:914213. [PMID: 35844233 PMCID: PMC9278062 DOI: 10.3389/fnins.2022.914213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background Binge Drinking (BD) has been associated with altered inhibitory control and augmented alcohol-cue reactivity. Memory inhibition (MI), the ability to voluntarily suppress unwanted thoughts/memories, may lead to forgetting of memories in several psychiatric conditions. However, despite its potential clinical implications, no study to date has explored the MI abilities in populations with substance misuse, such as binge drinkers (BDs). Method This study—registered in the NIH Clinical Trials Database (ClinicalTrials.gov identifier: NCT05237414)—aims firstly to examine the behavioral and electroencephalographic (EEG) correlates of MI among college BDs. For this purpose, 45 BDs and 45 age-matched non/low-drinkers (50% female) will be assessed by EEG while performing the Think/No-Think Alcohol task, a paradigm that evaluates alcohol-related MI. Additionally, this work aims to evaluate an alcohol-specific MI intervention protocol using cognitive training (CT) and transcranial direct current stimulation (tDCS) while its effects on behavioral and EEG outcomes are assessed. BDs will be randomly assigned to one MI training group: combined [CT and verum tDCS applied over the right dorsolateral prefrontal cortex (DLPFC)], cognitive (CT and sham tDCS), or control (sham CT and sham tDCS). Training will occur in three consecutive days, in three sessions. MI will be re-assessed in BDs through a post-training EEG assessment. Alcohol use and craving will be measured at the first EEG assessment, and both 10-days and 3-months post-training. In addition, behavioral and EEG data will be collected during the performance of an alcohol cue reactivity (ACR) task, which evaluates attentional bias toward alcoholic stimuli, before, and after the MI training sessions. Discussion This study protocol will provide the first behavioral and neurofunctional MI assessment in BDs. Along with poor MI abilities, BDs are expected to show alterations in event-related potentials and functional connectivity patterns associated with MI. Results should also demonstrate the effectiveness of the protocol, with BDs exhibiting an improved capacity to suppress alcohol-related memories after both combined and cognitive training, along with a reduction in alcohol use and craving in the short/medium-term. Collectively, these findings might have major implications for the understanding and treatment of alcohol misuse. Clinical Trial Registration [www.ClinicalTrials.gov], identifier [NCT05237414].
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Affiliation(s)
- Natália Almeida-Antunes
- Psychological Neuroscience Laboratory, Psychology Research Center, University of Minho, Braga, Portugal
| | - Margarida Vasconcelos
- Psychological Neuroscience Laboratory, Psychology Research Center, University of Minho, Braga, Portugal
| | - Alberto Crego
- Psychological Neuroscience Laboratory, Psychology Research Center, University of Minho, Braga, Portugal
| | - Rui Rodrigues
- Psychological Neuroscience Laboratory, Psychology Research Center, University of Minho, Braga, Portugal
| | - Adriana Sampaio
- Psychological Neuroscience Laboratory, Psychology Research Center, University of Minho, Braga, Portugal
| | - Eduardo López-Caneda
- Psychological Neuroscience Laboratory, Psychology Research Center, University of Minho, Braga, Portugal
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12
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Liu H, Holland RW, Blechert J, Quandt J, Veling H. Devaluation of NoGo stimuli is both robust and fragile. Cogn Emot 2022; 36:876-893. [PMID: 35467479 DOI: 10.1080/02699931.2022.2067132] [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: 11/03/2022]
Abstract
Consistently not responding to stimuli during go/no-go training leads to lower evaluations of these NoGo stimuli. How this NoGo-devaluation-effect can be explained has remained unclear. Here, we ran three experiments to test the hypothesis that people form stimulus-stop-associations during the training, which predict the strength of the devaluation-effect. In Experiment 1, we tried to simultaneously measure the stimulus-stop-associations and NoGo-devaluation, but we failed to find these effects. In Experiment 2, we measured NoGo-devaluation with established procedures from previous work, and stimulus-stop-associations with a novel separate task. Results revealed a clear NoGo-devaluation-effect, which remained visible across multiple rating blocks. Interestingly, this devaluation-effect disappeared when stimulus-stop-associations were measured before stimulus evaluations, and there was no evidence supporting the formation of the stimulus-stop-associations. In Experiment 3, we found evidence for the acquisition of stimulus-stop-associations using an established task from previous work, but this time we found no subsequent NoGo-devaluation-effect. The present research suggests that the NoGo-devaluation-effect and stimulus-stop-associations can be found with standard established procedures, but that these effects are very sensitive to alterations of the experimental protocol. Furthermore, we failed to find evidence for both effects within the same experimental protocol, which has important theoretical and applied implications.
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Affiliation(s)
- Huaiyu Liu
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Rob W Holland
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Jens Blechert
- Department of Psychology and Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Julian Quandt
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Harm Veling
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
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13
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‘Don't stop believing’: The role of training beliefs in cognitive bias modification paradigms. Appetite 2022; 174:106041. [DOI: 10.1016/j.appet.2022.106041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 11/15/2022]
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14
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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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15
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Pennington CR, Jones A, Bartlett JE, Copeland A, Shaw DJ. Raising the bar: improving methodological rigour in cognitive alcohol research. Addiction 2021; 116:3243-3251. [PMID: 33999479 DOI: 10.1111/add.15563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/29/2021] [Accepted: 04/28/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND AIMS A range of experimental paradigms claim to measure the cognitive processes underpinning alcohol use, suggesting that heightened attentional bias, greater approach tendencies and reduced cue-specific inhibitory control are important drivers of consumption. This paper identifies methodological shortcomings within this broad domain of research and exemplifies them in studies focused specifically on alcohol-related attentional bias. ARGUMENT AND ANALYSIS We highlight five main methodological issues: (i) the use of inappropriately matched control stimuli; (ii) opacity of stimulus selection and validation procedures; (iii) a credence in noisy measures; (iv) a reliance on unreliable tasks; and (v) variability in design and analysis. This is evidenced through a review of alcohol-related attentional bias (64 empirical articles, 68 tasks), which reveals the following: only 53% of tasks use appropriately matched control stimuli; as few as 38% report their stimulus selection and 19% their validation procedures; less than 28% used indices capable of disambiguating attentional processes; 22% assess reliability; and under 2% of studies were pre-registered. CONCLUSIONS Well-matched and validated experimental stimuli, the development of reliable cognitive tasks and explicit assessment of their psychometric properties, and careful consideration of behavioural indices and their analysis will improve the methodological rigour of cognitive alcohol research. Open science principles can facilitate replication and reproducibility in alcohol research.
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Affiliation(s)
| | - Andrew Jones
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | | | - Amber Copeland
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Daniel J Shaw
- School of Psychology, Aston University, Birmingham, UK
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16
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Transcranial direct current stimulation combined with alcohol cue inhibitory control training reduces the risk of early alcohol relapse: A randomized placebo-controlled clinical trial. Brain Stimul 2021; 14:1531-1543. [PMID: 34687964 DOI: 10.1016/j.brs.2021.10.386] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/08/2021] [Accepted: 10/18/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Approximately half of all people with alcohol use disorder (AUD) relapse into alcohol reuse in the next few weeks after a withdrawal treatment. Brain stimulation and cognitive training represent recent forms of complementary interventions in the context of AUD. OBJECTIVE To evaluate the clinical efficacy of five sessions of 2 mA bilateral transcranial direct current stimulation (tDCS) for 20 min over the dorsolateral prefrontal cortex (DLPFC) (left cathodal/right anodal) combined with alcohol cue inhibitory control training (ICT) as part of rehabilitation. The secondary outcomes were executive functioning (e.g. response inhibition) and craving intensity, two mechanisms strongly related to abstinence. METHODS A randomized clinical trial with patients (n = 125) with severe AUD at a withdrawal treatment unit. Each patient was randomly assigned to one of four conditions, in a 2 [verum vs. sham tDCS] x 2 [alcohol cue vs. neutral ICT] factorial design. The main outcome of treatment was the abstinence rate after two weeks or more (up to one year). RESULTS Verum tDCS improved the abstinence rate at the 2-week follow-up compared to the sham condition, independently of the training condition (79.7% [95% CI = 69.8-89.6] vs. 60.7% [95% CI = 48.3-73.1]; p = .02). A priori contrasts analyses revealed higher abstinence rates for the verum tDCS associated with alcohol cue ICT (86.1% [31/36; 95% CI = 74.6-97.6]) than for the other three conditions (64% [57/89; 95% CI = 54-74]). These positive clinical effects on abstinence did not persist beyond two weeks after the intervention. Neither the reduction of craving nor the improvement in executive control resulted specifically from prefrontal-tDCS and ICT. CONCLUSIONS AUD patients who received tDCS applied to DLPFC showed a significantly higher abstinence rate during the weeks following rehabilitation. When combined with alcohol specific ICT, brain stimulation may provide better clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov number NCT03447054 https://clinicaltrials.gov/ct2/show/NCT03447054.
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17
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Veling H, Verpaalen IAM, Liu H, Mosannenzadeh F, Becker D, Holland RW. How can food choice best be trained? Approach-avoidance versus go/no-go training. Appetite 2021; 163:105226. [PMID: 33766617 DOI: 10.1016/j.appet.2021.105226] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 02/02/2021] [Accepted: 03/17/2021] [Indexed: 11/26/2022]
Abstract
Behavior toward appetitive stimuli can be changed by motor response training procedures in which participants approach or respond to some stimuli and avoid or inhibit behavior to other stimuli. There is discussion in the literature whether effects are different when participants approach versus avoid stimuli during approach-avoidance training compared to when they respond versus not respond to stimuli during go/no-go training. Here, we directly compared effects of approach-avoidance training and go/no-go training on food choice within the same rigorous experimental protocol. Results showed that both training procedures influence food choice such that participants preferred Approach over Avoidance food items, and Go over NoGo food items, and these training effects were not statistically different. The present work suggests any inconsistencies in the literature on possible differences in effectiveness of these training procedures may be explained by differences in methods employed. The present work also raises new theoretical and applied questions about motor response training as a means to change behavior.
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Affiliation(s)
- Harm Veling
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands.
| | - Iris A M Verpaalen
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands
| | - Huaiyu Liu
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands
| | | | - Daniela Becker
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands
| | - Rob W Holland
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands
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18
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Chung T, Witkiewitz K, Ruddock H, Franken I, Verbruggen F, Field M. Does alcohol cue inhibitory control training survive a context shift? PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2020; 34:783-792. [PMID: 32281817 PMCID: PMC7650386 DOI: 10.1037/adb0000580] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Inhibitory control training (ICT) is a novel psychological intervention that aims to improve inhibitory control in response to alcohol-related cues through associative learning. Laboratory studies have demonstrated reductions in alcohol consumption following ICT compared with control/sham training, but it is unclear if these effects are robust to a change of context. In a preregistered study, we examined whether the effects of ICT would survive a context shift from a neutral context to a seminaturalistic bar setting. In a mixed design, 60 heavy drinkers (40 female) were randomly allocated to receive either ICT or control/sham training in a neutral laboratory over 2 sessions. We developed a novel variation of ICT that used multiple stop signals to establish direct stimulus-stop associations. The effects of ICT/control were measured once in the same context and once following a shift to a novel (alcohol-related) context. Our dependent variables were ad libitum alcohol consumption following training, change in inhibitory control processes, and change in alcohol value. ICT did not reduce alcohol consumption in either context compared with the control group. Furthermore, we demonstrated no effects of ICT on inhibitory control processes or alcohol value. Bayesian analyses demonstrated overall support for the null hypotheses. This study failed to find any effects of ICT on alcohol consumption or candidate psychological mechanisms. These findings illustrate the difficulty in training alcohol-inhibition associations and add to a growing body of literature suggesting that ICT holds little evidential value as a psychological intervention for alcohol use disorders. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Ingmar Franken
- Department of Psychology, Education and Child Studies, Erasmus University
| | | | - Matt Field
- Department of Psychology, University of Sheffield
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19
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Han W, Zhang H, Han Y, Duan Z. Cognition-tracking-based strategies for diagnosis and treatment of minimal hepatic encephalopathy. Metab Brain Dis 2020; 35:869-881. [PMID: 32495311 PMCID: PMC7354280 DOI: 10.1007/s11011-020-00539-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 01/23/2020] [Indexed: 12/11/2022]
Abstract
Minimal hepatic encephalopathy (MHE), which shows mild cognitive impairment, is a subtle complication of cirrhosis that has been shown to affect daily functioning and quality of life. However, until 2014, relevant guidelines do not give much attention to the diagnosis and treatment of MHE, resulting in patients being ignored and denied the benefits of treatment. In this review, we summarize recent cognition-based research about (1) alteration of nerve cells, including astrocytes, microglial cells and neurons, in mild cognitive impairment in MHE; (2) comparison of methods in detecting cognitive impairment in MHE; and (3) comparison of methods for therapy of cognitive impairment in MHE. We hope to provide information about diagnosis and treatment of cognitive impairment in patients with MHE.
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Affiliation(s)
- Weijia Han
- Difficult & Complicated Liver Diseases and Artificial Liver Center, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Liver Failure and Artificial Liver Treatment Research, Beijing, China
| | - Huanqian Zhang
- Yidu Central Hospital of Weifang Medical College, Shandong, China
| | - Ying Han
- Department of Immunologic Liver Disease, Beijing YouAn Hospital, Capital Medical University, Beijing, China
| | - Zhongping Duan
- Difficult & Complicated Liver Diseases and Artificial Liver Center, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
- Beijing Municipal Key Laboratory of Liver Failure and Artificial Liver Treatment Research, Beijing, China.
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20
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Di Lemma LCG, Stancak A, Soto V, Fallon N, Field M. Event-related and readiness potentials when preparing to approach and avoid alcohol cues following cue avoidance training in heavy drinkers. Psychopharmacology (Berl) 2020; 237:1343-1358. [PMID: 32103280 PMCID: PMC7196951 DOI: 10.1007/s00213-020-05462-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 01/16/2020] [Indexed: 11/30/2022]
Abstract
RATIONALE Cue avoidance training (CAT) reduces alcohol consumption in the laboratory. However, the neural mechanisms that underlie the effects of this intervention are poorly understood. OBJECTIVES The present study investigated the effects of a single session of CAT on event-related and readiness potentials during preparation of approach and avoidance movements to alcohol cues. METHODS Heavy drinking young adults (N = 60) were randomly assigned to complete either CAT or control training. After training, we recorded participants' event-related and motor readiness potentials as they were preparing to respond. RESULTS In the CAT group, N200 amplitude was higher when preparing to approach rather than avoid alcohol pictures. In the control group, N200 amplitudes did not differ for approach and avoidance to alcohol pictures. Regarding the late positive potential (LPP), in the CAT group, the negativity of this was blunted when preparing to avoid alcohol pictures relative to when preparing to avoid control pictures. In the control group, the negativity of the LPP was blunted when preparing to approach alcohol pictures relative to when preparing to approach control pictures. There were no effects on motor readiness potentials. Behavioural effects indicated short-lived effects of training on reaction times during the training block that did not persist when participants were given time to prepare their motor response before executing it during the EEG testing block. CONCLUSIONS After a single session of CAT, the enhanced N200 when approaching alcohol cues may indicate the engagement of executive control to overcome the associations learned during training. These findings clarify the neural mechanisms that may underlie the effects of CAT on drinking behaviour.
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Affiliation(s)
- Lisa C G Di Lemma
- UK Centre for Tobacco and Alcohol Studies, Liverpool, UK.
- Faculty of Health and Social Care, University of Chester, Chester, UK.
| | - Andrej Stancak
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Vicente Soto
- Centre for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez, Las Condes, Santiago, Chile
| | - Nick Fallon
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Matt Field
- UK Centre for Tobacco and Alcohol Studies, Liverpool, UK
- Department of Psychology, University of Sheffield, Sheffield, UK
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21
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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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22
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Campanella S, Schroder E, Kajosch H, Hanak C, Veeser J, Amiot M, Besse-Hammer T, Hayef N, Kornreich C. Neurophysiological markers of cue reactivity and inhibition subtend a three-month period of complete alcohol abstinence. Clin Neurophysiol 2019; 131:555-565. [PMID: 31786051 DOI: 10.1016/j.clinph.2019.10.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 09/09/2019] [Accepted: 10/15/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Finding new tools for conventional management of alcohol disorders is a challenge for psychiatrists. Brain indications related to cognitive functioning could represent such an add-on tool. METHODS Forty alcohol-dependent inpatients undertook two cognitive event-related potential (ERP) tasks at the beginning and at the end of a 4-week detoxification program. These comprised a visual oddball task investigating cue reactivity and a Go/No-go task tagging inhibition using oddball P3d and No-go P3d ERP components. Three months after discharge, the patient group (N = 40) was split into two subgroups: patients who remained abstinent during this post-treatment period (90 days; n = 15), and patients who relapsed (mean time: 28.5 ± 26.2 days; n = 25). Pattern changes of both ERP markers (oddball P3d and No-go P3d) during the detoxification were compared to differentiate these populations. RESULTS Abstinent patients exhibited similar P3d responses devoted to alcohol cues in Sessions 1 and 2, but an increased No-go P3d devoted to No-go trials in alcohol-related contexts in Session 2 compared to Session 1. CONCLUSIONS Specific cue-reactivity and inhibitory neurophysiological markers subtend a further three-months of complete abstinence. SIGNIFICANCE Monitoring these ERP changes during detoxification may provide important clues regarding patients' future abstinence vs. relapse.
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Affiliation(s)
- Salvatore Campanella
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Belgium.
| | - Elisa Schroder
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Belgium
| | - Hendrik Kajosch
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Belgium
| | - Catherine Hanak
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Belgium
| | - Johannes Veeser
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Belgium
| | - Maud Amiot
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Belgium
| | - Tatiana Besse-Hammer
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Belgium
| | - Nabil Hayef
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Belgium
| | - Charles Kornreich
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Belgium
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23
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Food Addiction: Implications for the Diagnosis and Treatment of Overeating. Nutrients 2019; 11:nu11092086. [PMID: 31487791 PMCID: PMC6770567 DOI: 10.3390/nu11092086] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 08/14/2019] [Accepted: 08/21/2019] [Indexed: 12/14/2022] Open
Abstract
With the obesity epidemic being largely attributed to overeating, much research has been aimed at understanding the psychological causes of overeating and using this knowledge to develop targeted interventions. Here, we review this literature under a model of food addiction and present evidence according to the fifth edition of the Diagnostic and Statistical Manual (DSM-5) criteria for substance use disorders. We review several innovative treatments related to a food addiction model ranging from cognitive intervention tasks to neuromodulation techniques. We conclude that there is evidence to suggest that, for some individuals, food can induce addictive-type behaviours similar to those seen with other addictive substances. However, with several DSM-5 criteria having limited application to overeating, the term ‘food addiction’ is likely to apply only in a minority of cases. Nevertheless, research investigating the underlying psychological causes of overeating within the context of food addiction has led to some novel and potentially effective interventions. Understanding the similarities and differences between the addictive characteristics of food and illicit substances should prove fruitful in further developing these interventions.
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24
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Tschuemperlin RM, Stein M, Batschelet HM, Moggi F, Soravia LM. Learning to resist the urge: a double-blind, randomized controlled trial investigating alcohol-specific inhibition training in abstinent patients with alcohol use disorder. Trials 2019; 20:402. [PMID: 31277683 PMCID: PMC6612135 DOI: 10.1186/s13063-019-3505-2] [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: 11/20/2018] [Accepted: 06/10/2019] [Indexed: 12/19/2022] Open
Abstract
Background Alcohol use disorder (AUD) leads to a significant individual and societal burden. To achieve higher therapy success rates, therapeutic interventions still need to be improved. Most current neuroscientific conceptualizations of AUD focus on the imbalance between an enhanced automatic reaction to alcohol cues and impaired inhibition. Complementary to traditional relapse prevention strategies, novel computerized training interventions aim to directly alter these processes. This study tests a computerized alcohol-specific inhibition training in a large clinical sample and investigates its effects on behavioral, experimental and neurophysiological outcomes. It also analyzes whether variations in inhibition difficulty and/or endogenous cortisol levels during training impact these effects. Methods This is a double-blind, randomized controlled trial (RCT) with 246 inpatients with AUD participating. After baseline assessment, participants are randomly assigned to one of three computerized Go-NoGo-based inhibition training interventions (two alcohol-specific versions with different Go/NoGo ratios, or neutral control training) and one of two intervention times (morning/afternoon), resulting in six study arms. All patients perform six training sessions within 2 weeks. Endogenous cortisol is measured in 80 patients before and after the first training session. Inhibitory control and implicit associations towards alcohol are assessed pre and post training, at which point electroencephalography (EEG) is additionally measured in 60 patients. Patients’ alcohol consumption and relevant psychological constructs (e.g., craving, self-efficacy, treatment motivation) are measured at discharge and at 3-, 6- and 12-month follow-ups. Fifty healthy participants are assessed (20 with EEG) at one time point as a healthy control group. Discussion This study investigates the effects of a computerized, alcohol-specific inhibition training for the first time in patients with AUD. Results should give insight into the effectiveness of this potential add-on to standard AUD treatment, including proximal and distal measures and effects on behavioral, experimental and neurophysiological measures. Information about working mechanisms and potential optimizations of this training are gathered through variations regarding difficulty of inhibition training and training time. This study may thus contribute to a deepened understanding of AUD and the improvement of its evidence-based treatment. Trial registration ClinicalTrials.gov, ID: NCT02968537. Registered on 18 November 2016. Electronic supplementary material The online version of this article (10.1186/s13063-019-3505-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Raphaela M Tschuemperlin
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland.,Center for Treatment of Addictive Disorders, Clinic Suedhang, Kirchlindach, Switzerland
| | - Maria Stein
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland. .,Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Bern, Bern, Switzerland.
| | - Hallie M Batschelet
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Franz Moggi
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Leila M Soravia
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland.,Center for Treatment of Addictive Disorders, Clinic Suedhang, Kirchlindach, Switzerland
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25
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Ascheid S, Wessa M, Linke JO. Effects of valence and arousal on implicit approach/ avoidance tendencies: A fMRI study. Neuropsychologia 2019; 131:333-341. [PMID: 31153965 DOI: 10.1016/j.neuropsychologia.2019.05.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 05/28/2019] [Accepted: 05/29/2019] [Indexed: 01/02/2023]
Abstract
To date, it is still a matter of debate, whether valence or valence and arousal interactively foster implicit approach and avoidance tendencies, and which neural circuitries underlie these effects. To address these questions, we investigated the effects of valence and arousal on implicit approach/avoidance tendencies during fMRI in healthy volunteers (N=46). The implicit approach of positive social scenes was associated with shorter response preparation times and increased activation of the lingual, parahippocampal and fusiform gyri. Valence and arousal did not influence reaction times interactively, but we observed increased activation of prefrontal, motor, temporal, middle cingulate and parietal cortex during the approach of positive highly arousing and negative mildly arousing pictures, and the avoidance of positively mildly arousing and negative highly arousing pictures. These findings confirm the facilitation of implicit approach by positive scenes and advance our understanding regarding the neurobiological correlates of implicit approach-/avoidance biases.
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Affiliation(s)
- Sonja Ascheid
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes-Gutenberg University of Mainz, Germany
| | - Michèle Wessa
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes-Gutenberg University of Mainz, Germany
| | - Julia O Linke
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes-Gutenberg University of Mainz, Germany.
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26
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Carbine KA, Larson MJ. Quantifying the presence of evidential value and selective reporting in food-related inhibitory control training: a p-curve analysis. Health Psychol Rev 2019; 13:318-343. [DOI: 10.1080/17437199.2019.1622144] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Michael J. Larson
- Department of Psychology, Brigham Young University, Provo, UT, USA
- Neuroscience Center, Brigham Young University, Provo, UT, USA
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27
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Lindgren KP, Hendershot CS, Ramirez JJ, Bernat E, Rangel-Gomez M, Peterson KP, Murphy JG. A dual process perspective on advances in cognitive science and alcohol use disorder. Clin Psychol Rev 2019; 69:83-96. [PMID: 29680185 PMCID: PMC6181791 DOI: 10.1016/j.cpr.2018.04.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 04/04/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
Abstract
There is a tremendous global and national (US) burden associated with alcohol misuse and alcohol use disorder (AUD). Further, of the mental health disorders, AUD has the widest treatment gap. Thus, there is a critical need for improved understanding of the etiology, maintenance, and treatment of AUD. The application of cognitive science to the study of AUD has a longstanding history of attempting to meet this need. In this selective review, we identified and focused on four domains of recent (i.e., in the last decade) applications of cognitive science to the study of AUD: implicit cognitive biases, executive function, behavioral economic approaches to alcohol decision making, and functional connectivity neuroimaging. We highlighted advances within these four domains and considered them in the context of dual process models of addiction, which focus on the contribution and interplay of two complementary neurocognitive systems (impulsive and control systems). Findings across the domains were generally consistent with dual process models. They also suggest the need for further model refinements, including integrating behavioral economic approaches and findings from functional connectivity neuroimaging studies. Research evaluating candidate interventions associated with these domains is emergent but promising, suggesting important directions for future research.
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Affiliation(s)
- Kristen P Lindgren
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA.
| | - Christian S Hendershot
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Jason J Ramirez
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Edward Bernat
- Department of Psychology, University of Maryland, College Park, MD, USA
| | | | - Kirsten P Peterson
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - James G Murphy
- Department of Psychology, University of Memphis, Memphis, TN, USA
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28
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Lannoy S, Billieux J, Dormal V, Maurage P. Behavioral and Cerebral Impairments Associated with Binge Drinking in Youth: A Critical Review. Psychol Belg 2019; 59:116-155. [PMID: 31328014 PMCID: PMC6625552 DOI: 10.5334/pb.476] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 02/19/2019] [Indexed: 12/16/2022] Open
Abstract
Binge drinking is a widespread alcohol consumption pattern in youth that is linked to important behavioral and cerebral impairments, in both the short and the long term. From a critical review of the current literature on this topic, we conclude that binge drinkers display executive impairments, cerebral modifications, and problems with emotion-related processes. Five key empirical and theoretical topics are discussed to pave the way for future research in the field: (1) the specificity of the brain modifications observed in binge drinkers that may index a compensatory mechanism or result from multiple withdrawals; (2) the nature of the relationship between binge drinking and impairments, suggesting reciprocal influences between excessive alcohol consumption and executive deficits; (3) the possible recovery of brain and cognitive functioning after the cessation of binge drinking; (4) the validity of the continuum hypothesis, suggesting links between binge drinking and severe alcohol use disorders; and (5) the existing strategies to reduce binge drinking habits or rehabilitate the associated cognitive deficits. Future perspectives are described in relation to the questions raised to identify the crucial variables to be addressed in research and clinical practice.
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Affiliation(s)
- Séverine Lannoy
- Cognition Health Society Laboratory (C2S – EA 6291), Université de Reims Champagne-Ardenne, Reims, FR
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, BE
| | - Joël Billieux
- Addictive and Compulsive Behaviours Lab (ACB-Lab), Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, LU
| | - Valérie Dormal
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, BE
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, BE
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29
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Strickland JC, Hill JC, Stoops WW, Rush CR. Feasibility, Acceptability, and Initial Efficacy of Delivering Alcohol Use Cognitive Interventions via Crowdsourcing. Alcohol Clin Exp Res 2019; 43:888-899. [PMID: 30888705 DOI: 10.1111/acer.13987] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/10/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Inhibitory control training and working memory training are 2 cognitive interventions that have been considered for alcohol use disorder (AUD). Existing studies have typically relied on small samples that preclude the evaluation of small effects. Crowdsourcing is a sampling method that can address these limitations by effectively and efficiently recruiting large samples with varying health histories. This study tested the feasibility and acceptability of delivering cognitive training interventions via crowdsourcing. METHODS Participants with AUD were recruited from the crowdsourcing website Amazon Mechanical Turk (mTurk) (ClinicalTrials.gov; NCT03438539). Following completion of a baseline survey, participants were randomized to an inhibitory control, working memory, or control training condition. Participants were asked to complete training tasks daily over a 2-week period. Follow-up assessments evaluating acceptability measures and alcohol and soda consumption were completed immediately following and 2 weeks after training. RESULTS Response rates were satisfactory over the 2-week intervention period (65% of training tasks completed), and performance on training tasks was consistent with expected effects. A majority of participants indicated that they were satisfied with the study procedures (94.6%), would participate again (97.4%), and would consider incorporating the training task in their daily life (81.1%). Modest reductions in alcohol consumption were observed (e.g., 0.5 drinking day/wk), primarily in the inhibitory control group, and these effects were selective to alcohol use and did not extend to soda consumption. CONCLUSIONS These findings demonstrate the feasibility and acceptability of utilizing crowdsourcing methods for interventions development. Such a demonstration helps establish the crowdsourcing setting for future large sample studies testing novel interventions for AUD and other substance use disorders.
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Affiliation(s)
- Justin C Strickland
- Department of Psychology , University of Kentucky College of Arts and Sciences, Lexington, Kentucky
| | - J Chauncey Hill
- Department of Mathematics and Statistics , Washington University in St. Louis College of Arts and Sciences, St. Louis, Missouri
| | - William W Stoops
- Department of Psychology , University of Kentucky College of Arts and Sciences, Lexington, Kentucky.,Department of Behavioral Science , University of Kentucky College of Medicine, Lexington, Kentucky.,Department of Psychiatry , University of Kentucky College of Medicine, Lexington, Kentucky.,Center on Drug and Alcohol Research , University of Kentucky College of Medicine, Lexington, Kentucky
| | - Craig R Rush
- Department of Psychology , University of Kentucky College of Arts and Sciences, Lexington, Kentucky.,Department of Behavioral Science , University of Kentucky College of Medicine, Lexington, Kentucky.,Department of Psychiatry , University of Kentucky College of Medicine, Lexington, Kentucky
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30
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Batschelet HM, Stein M, Tschuemperlin RM, Soravia LM, Moggi F. Alcohol-Specific Computerized Interventions to Alter Cognitive Biases: A Systematic Review of Effects on Experimental Tasks, Drinking Behavior, and Neuronal Activation. Front Psychiatry 2019; 10:871. [PMID: 31998146 PMCID: PMC6970199 DOI: 10.3389/fpsyt.2019.00871] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 11/05/2019] [Indexed: 12/26/2022] Open
Abstract
Background: In patients with alcohol use disorder, novel interventions to increase abstinence have attracted growing attention. Interventions aimed at modifying cognitive biases linked to alcohol use [i.e. cognitive bias modification (CBM)] may serve as an add-on to standard therapy. This systematic review thoroughly aggregates existing data on the effects of three alcohol-specific computerized interventions, namely attentional bias modification (AtBM), approach bias modification (ApBM), and inhibition training (IT). In doing so, each CBM's effects on experimental tasks assessing the relevant biases, drinking behavior, and neurophysiology are summarized. Also, the influence of drinking behavior severity and motivation to change drinking behavior are discussed. Methods: A literature search was conducted in four databases for original research articles published between 2000 and May 2019. Studies were eligible if investigating the effects of alcohol-specific computerized interventions (AtBM, ApBM, IT) on drinking behavior, bias change, and/or neurophysiology. Forty eligible articles were classified as being either a non-clinical experimental lab study (ELS) or clinical randomized-controlled trial (RCT) and summarized. Results: While AtBM seems to influence attentional bias, its effects on drinking behavior are inconsistent. As for ApBM, the best effects on drinking behavior are obtained in clinical samples. Effects of ApBM on approach bias are mixed. Interestingly, those clinical RCTs which investigated ApBM effects on bias change as well as on drinking outcome, reported consistent effects in both measures (i.e. either effects on bias and drinking or no effects). Studies on IT are limited to non-clinical samples and show inconsistent effects on drinking behavior. Considering ITs effects on implicit semantic associations, most studies do not support the conceptualization of IT as a form of memory bias modification, while reports on IT's effects on inhibitory control are still incomplete. Conclusions about the overall influence of drinking behavior severity are hampered by the non-uniform use of sample descriptions. Conclusions: In clinical samples, ApBM has shown more consistent beneficial effects, while evidence on AtBM is more inconsistent, and data on IT still lacks important information. Conclusions about the influence of drinking behavior severity would be facilitated by a uniform use of clearly defined sample descriptions.
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Affiliation(s)
- Hallie M Batschelet
- University Hospital of Psychiatry, Translational Research Center, Division of Clinical Research, University of Bern, Bern, Switzerland
| | - Maria Stein
- University Hospital of Psychiatry, Translational Research Center, Division of Clinical Research, University of Bern, Bern, Switzerland.,Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Raphaela M Tschuemperlin
- University Hospital of Psychiatry, Translational Research Center, Division of Clinical Research, University of Bern, Bern, Switzerland.,Clinic Suedhang, Center for Treatment of Addictive Disorders, Kirchlindach, Switzerland
| | - Leila M Soravia
- University Hospital of Psychiatry, Translational Research Center, Division of Clinical Research, University of Bern, Bern, Switzerland.,Clinic Suedhang, Center for Treatment of Addictive Disorders, Kirchlindach, Switzerland
| | - Franz Moggi
- University Hospital of Psychiatry, Translational Research Center, Division of Clinical Research, University of Bern, Bern, Switzerland
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31
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Verdejo-Garcia A, Lorenzetti V, Manning V, Piercy H, Bruno R, Hester R, Pennington D, Tolomeo S, Arunogiri S, Bates ME, Bowden-Jones H, Campanella S, Daughters SB, Kouimtsidis C, Lubman DI, Meyerhoff DJ, Ralph A, Rezapour T, Tavakoli H, Zare-Bidoky M, Zilverstand A, Steele D, Moeller SJ, Paulus M, Baldacchino A, Ekhtiari H. A Roadmap for Integrating Neuroscience Into Addiction Treatment: A Consensus of the Neuroscience Interest Group of the International Society of Addiction Medicine. Front Psychiatry 2019; 10:877. [PMID: 31920740 PMCID: PMC6935942 DOI: 10.3389/fpsyt.2019.00877] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 11/06/2019] [Indexed: 01/01/2023] Open
Abstract
Although there is general consensus that altered brain structure and function underpins addictive disorders, clinicians working in addiction treatment rarely incorporate neuroscience-informed approaches into their practice. We recently launched the Neuroscience Interest Group within the International Society of Addiction Medicine (ISAM-NIG) to promote initiatives to bridge this gap. This article summarizes the ISAM-NIG key priorities and strategies to achieve implementation of addiction neuroscience knowledge and tools for the assessment and treatment of substance use disorders. We cover two assessment areas: cognitive assessment and neuroimaging, and two interventional areas: cognitive training/remediation and neuromodulation, where we identify key challenges and proposed solutions. We reason that incorporating cognitive assessment into clinical settings requires the identification of constructs that predict meaningful clinical outcomes. Other requirements are the development of measures that are easily-administered, reliable, and ecologically-valid. Translation of neuroimaging techniques requires the development of diagnostic and prognostic biomarkers and testing the cost-effectiveness of these biomarkers in individualized prediction algorithms for relapse prevention and treatment selection. Integration of cognitive assessments with neuroimaging can provide multilevel targets including neural, cognitive, and behavioral outcomes for neuroscience-informed interventions. Application of neuroscience-informed interventions including cognitive training/remediation and neuromodulation requires clear pathways to design treatments based on multilevel targets, additional evidence from randomized trials and subsequent clinical implementation, including evaluation of cost-effectiveness. We propose to address these challenges by promoting international collaboration between researchers and clinicians, developing harmonized protocols and data management systems, and prioritizing multi-site research that focuses on improving clinical outcomes.
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Affiliation(s)
- Antonio Verdejo-Garcia
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Valentina Lorenzetti
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Canberra, ACT, Australia
| | - Victoria Manning
- Eastern Health Clinical School Turning Point, Eastern Health, Richmond, VIC, Australia.,Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Hugh Piercy
- Eastern Health Clinical School Turning Point, Eastern Health, Richmond, VIC, Australia.,Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Raimondo Bruno
- School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Rob Hester
- School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - David Pennington
- San Francisco Veterans Affairs Health Care System (SFVAHCS), San Francisco, CA, United States.,Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Serenella Tolomeo
- School of Medicine, University of St Andrews, Medical and Biological Science Building, North Haugh, St Andrews, United Kingdom.,Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Shalini Arunogiri
- Eastern Health Clinical School Turning Point, Eastern Health, Richmond, VIC, Australia.,Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Marsha E Bates
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, United States
| | | | - Salvatore Campanella
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Stacey B Daughters
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Christos Kouimtsidis
- Department of Psychiatry, Surrey and Borders Partnership NHS Foundation Trust, Leatherhead, United Kingdom
| | - Dan I Lubman
- Eastern Health Clinical School Turning Point, Eastern Health, Richmond, VIC, Australia
| | - Dieter J Meyerhoff
- DVA Medical Center and Department of Radiology and Biomedical Imaging, University of California San Francisco, School of Medicine, San Francisco, CA, United States
| | - Annaketurah Ralph
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - Tara Rezapour
- Department of Cognitive Psychology, Institute for Cognitive Sciences Studies, Tehran, Iran
| | - Hosna Tavakoli
- Department of Cognitive Psychology, Institute for Cognitive Sciences Studies, Tehran, Iran.,Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehran Zare-Bidoky
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.,School of Medicine, Shahid-Sadoughi University of Medical Sciences, Yazd, Iran
| | - Anna Zilverstand
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | - Douglas Steele
- Medical School, University of Dundee, Ninewells Hospital, Scotland, United Kingdom
| | - Scott J Moeller
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States
| | - Martin Paulus
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, OK, United States
| | - Alex Baldacchino
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Hamed Ekhtiari
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, OK, United States
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32
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Jones A, McGrath E, Robinson E, Houben K, Nederkoorn C, Field M. A randomized controlled trial of inhibitory control training for the reduction of alcohol consumption in problem drinkers. J Consult Clin Psychol 2018; 86:991-1004. [PMID: 30507225 PMCID: PMC6277130 DOI: 10.1037/ccp0000312] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/15/2017] [Accepted: 04/12/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE We conducted a randomized controlled trial to compare the effects of three types of Internet-delivered Inhibitory Control Training (ICT) with each other and with an active control intervention on alcohol consumption in a community sample of problem drinkers. METHOD Two hundred and 46 heavy drinkers, who were motivated to reduce their alcohol consumption (mean age 41.32, 130 female) self-monitored their alcohol consumption for 1 week before being randomized to receive 1 of 3 variants of ICT (Associative No-Go, Associative Stop Signal, General Inhibition) or an active control. Participants then completed up to 14 ICT/control sessions on the Internet over a 4-week period, while regularly recording their alcohol consumption. RESULTS There were significant reductions in alcohol consumption across all groups over the 4-week training period (main effect of time, F(2, 402) = 77.12, p < .01, ηp2 = .28, BF10 > 99), however there were no differences between ICT groups, or between ICT groups and the active control group (Group × Time interaction, F(6, 402) = 1.10, p = .36, ηp2 = .02, BF10 = 0.03). Contrary to hypotheses, there were no changes in general inhibitory control, the disinhibiting effects of alcohol cues, or alcohol affective associations after ICT. CONCLUSIONS In this study, which attempted to translate findings from proof-of-concept laboratory studies into a viable behavior change intervention, we found that multiple sessions of ICT delivered over the Internet did not help heavy drinkers to reduce their alcohol consumption beyond nonspecific effects associated with taking part in a trial. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Katrijn Houben
- Faculty of Psychology and Neuroscience, Maastricht University
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33
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Leeman RF, Nogueira C, Wiers RW, Cousijn J, Serafini K, DeMartini KS, Bargh JA, O'Malley SS. A Test of Multisession Automatic Action Tendency Retraining to Reduce Alcohol Consumption Among Young Adults in the Context of a Human Laboratory Paradigm. Alcohol Clin Exp Res 2018; 42:803-814. [PMID: 29450895 DOI: 10.1111/acer.13613] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 02/05/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Young adult heavy drinking is an important public health concern. Current interventions have efficacy but with only modest effects, and thus, novel interventions are needed. In prior studies, heavy drinkers, including young adults, have demonstrated stronger automatically triggered approach tendencies to alcohol-related stimuli than lighter drinkers. Automatic action tendency retraining has been developed to correct this tendency and consequently reduce alcohol consumption. This study is the first to test multiple iterations of automatic action tendency retraining, followed by laboratory alcohol self-administration. METHODS A total of 72 nontreatment-seeking, heavy drinking young adults ages 21 to 25 were randomized to automatic action tendency retraining or a control condition (i.e., "sham training"). Of these, 69 (54% male) completed 4 iterations of retraining or the control condition over 5 days with an alcohol drinking session on Day 5. Self-administration was conducted according to a human laboratory paradigm designed to model individual differences in impaired control (i.e., difficulty adhering to limits on alcohol consumption). RESULTS Automatic action tendency retraining was not associated with greater reduction in alcohol approach tendency or less alcohol self-administration than the control condition. The laboratory paradigm was probably sufficiently sensitive to detect an effect of an experimental manipulation given the range of self-administration behavior observed, both in terms of number of alcoholic and nonalcoholic drinks and measures of drinking topography. CONCLUSIONS Automatic action tendency retraining was ineffective among heavy drinking young adults without motivation to change their drinking. Details of the retraining procedure may have contributed to the lack of a significant effect. Despite null primary findings, the impaired control laboratory paradigm is a valid laboratory-based measure of young adult alcohol consumption that provides the opportunity to observe drinking topography and self-administration of nonalcoholic beverages (i.e., protective behavioral strategies directly related to alcohol use).
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Affiliation(s)
- Robert F Leeman
- Department of Health Education and Behavior, University of Florida, Gainesville, Florida.,Yale School of Medicine, New Haven, Connecticut
| | | | - Reinout W Wiers
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Janna Cousijn
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | | | | | - John A Bargh
- Department of Psychology, Yale University, New Haven, Connecticut
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34
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Hendershot CS, Nona CN. A Review of Developmental Considerations in Human Laboratory Alcohol Research. CURRENT ADDICTION REPORTS 2017; 4:364-378. [PMID: 29326866 DOI: 10.1007/s40429-017-0173-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE OF REVIEW Human laboratory studies involving alcohol administration have generated critical knowledge about individual differences in risk for alcohol use disorder (AUD), but have primarily involved adult populations and cross-sectional research designs. Ethical constraints have largely precluded human laboratory alcohol research in adolescence, and prospective studies have been rare. This paper provides an overview of developmental considerations in human laboratory alcohol research, with a focus on studies conducted with youth. RECENT FINDINGS Recent human laboratory studies from Europe and Canada have examined aspects of alcohol response during late adolescence, while recent survey studies from the United States have highlighted methods for circumventing alcohol administration in studies of adolescents. SUMMARY Across several decades of research, exceedingly few laboratory studies have examined developmental differences in alcohol responses or utilized prospective designs. Efforts to prioritize prospective research would further clarify the role of alcohol sensitivity traits as predictors or markers of AUD onset and progression.
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Affiliation(s)
- Christian S Hendershot
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Christina N Nona
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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