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Luo M, Gan Q, Fu Y, Chen Z. Cue-reactivity targeted smoking cessation intervention in individuals with tobacco use disorder: a scoping review. Front Psychiatry 2023; 14:1167283. [PMID: 37743997 PMCID: PMC10512743 DOI: 10.3389/fpsyt.2023.1167283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Objectives Cue-reactivity is a critical step leading to the emergence of addictive psychology and the triggering of addictive behaviors within the framework of addiction theory and is considered a significant risk factor for addiction-related behaviors. However, the effect of cue-reactivity targeted smoking cessation intervention and the cue-reactivity paradigms used in the randomized controlled trials varies, which introduces more heterogeneity and makes a side-by-side comparison of cessation responses difficult. Therefore, the scoping review aims to integrate existing research and identify evidence gaps. Methods We searched databases in English (PubMed and Embase) and Chinese (CNKI and Wanfang) using terms synonymous with 'cue' and 'tobacco use disorder (TUD)' to April 2023, and via hand-searching and reference screening of included studies. Studies were included if they were randomized controlled trials taking cue-reactivity as an indicator for tobacco use disorder (TUD) defined by different kinds of criteria. Results Data were extracted on each study's country, population, methods, timeframes, outcomes, cue-reactivity paradigms, and so on. Of the 2,944 literature were retrieved, 201 studies met the criteria and were selected for full-text screening. Finally, 67 pieces of literature were selected for inclusion and data extraction. The results mainly revealed that non-invasive brain stimulation and exercise therapy showed a trend of greater possibility in reducing subjective craving compared to the remaining therapies, despite variations in the number of research studies conducted in each category. And cue-reactivity paradigms vary in materials and mainly fall into two main categories: behaviorally induced craving paradigm or visually induced craving paradigm. Conclusion The current studies are still inadequate in terms of comparability due to their heterogeneity, cue-reactivity can be conducted in the future by constructing a standard library of smoking cue materials. Causal analysis is suggested in order to adequately screen for causes of addiction persistence, and further explore the specific objective cue-reactivity-related indicators of TUD.
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Affiliation(s)
- Miaoling Luo
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
| | - Quan Gan
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Yu Fu
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
| | - Zhuangfei Chen
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
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Vitzthum K, Cerci D. A Qualitative Investigation of Staff Feedback on an Online Learning Module on Smoking Cessation in a German Healthcare Company. Healthcare (Basel) 2023; 11:1774. [PMID: 37372892 PMCID: PMC10298186 DOI: 10.3390/healthcare11121774] [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: 05/17/2023] [Revised: 06/06/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Quitting smoking is a powerful way for patients to improve their own wellbeing and to significantly reduce the risk of health problems. Evidence shows that health professionals can effectively intervene in order to prevent and stop tobacco smoking in their patients. Online learning modules have proved to be effective in terms of transferring knowledge and skills. In an urban community hospital setting in Germany, a novel e-learning course for staff on the treatment of tobacco dependence was implemented in 2021. In this study, we analyzed free-text feedback of participants completing this online module in order to examine the feasibility and acceptance of this new format. We were able to reach a reasonable proportion of staff. Our qualitative analysis showed that most feedback was positive and described the module as well-designed and helpful. Some staff, however, expressed extremely negative views and did not see smoking cessation support as essential to their role in healthcare. We argue that in order to achieve a shift in attitude in healthcare staff, a change in German policy is required which includes the creation of smoke-free environments and the adherence to smoke-free policies on hospital sites. Furthermore, the provision of smoking cessation support in line with the WHO Framework Convention on Tobacco Control and a true understanding of the role of all healthcare professionals in promoting health of patients and staff will be essential.
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Affiliation(s)
- Karin Vitzthum
- Institut für Tabakentwöhnung und Raucherprävention, Vivantes Netzwerk für Gesundheit GmbH, 13407 Berlin, Germany
| | - Deniz Cerci
- Klinik für Forensische Psychiatrie, Universitätsmedizin Rostock, 18147 Rostock, Germany
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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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Jouhki H, Oksanen A. To Get High or to Get Out? Examining the Link between Addictive Behaviors and Escapism. Subst Use Misuse 2022; 57:202-211. [PMID: 34809536 DOI: 10.1080/10826084.2021.2002897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background: Escapism is a tendency to seek escape and distraction from reality or real-life problems. Past research regards escapism as a negative inducement that leads to adverse consequences when combined with substance use and other addictive activities. Existing knowledge on escapism's connection to addiction is mostly based on studies with restricted populations and lacks a comprehensive view.Objectives: Using an extensive data set, our aim was to investigate whether escapism has a consistent association with different types of addictive behaviors. In this study, we examined (1) the extent to which escapism is related to alcohol consumption, smoking, drug use, and gambling and (2) whether escapism moderates the relation between problem drinking and life satisfaction.Methods: We used cross-sectional survey data from a nationally representative stratified random sample of 2,285 respondents aged 16 to 80 years (mean [M] 45.18; standard deviation [SD] 18.75; 51.25% males) living in Finland. Linear and logistic regression models estimated the association of escapism and alcohol consumption, smoking, drug use, and gambling. The second part of the analysis focused on life satisfaction.Results: Escapism was associated with alcohol consumption, smoking and drug use, but not with gambling. Escapism moderated the association between life satisfaction and problematic alcohol use, indicating that problem drinking with escapist motives predicts lower life satisfaction than problematic alcohol use alone.Conclusions/Importance: Escapism bears a consistent relation to substance use and is a particularly strong predictor of alcohol consumption. Escapism can serve as an initial motive, a reinforcer, and an amplifier of addictive behaviors.
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Affiliation(s)
- Hannu Jouhki
- Faculty of Social Sciences, Tampere University, Tampere, Finland.,A-Clinic Foundation, Helsinki, Finland
| | - Atte Oksanen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
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Langener S, Van Der Nagel J, van Manen J, Markus W, Dijkstra B, De Fuentes-Merillas L, Klaassen R, Heitmann J, Heylen D, Schellekens A. Clinical Relevance of Immersive Virtual Reality in the Assessment and Treatment of Addictive Disorders: A Systematic Review and Future Perspective. J Clin Med 2021; 10:3658. [PMID: 34441953 PMCID: PMC8396890 DOI: 10.3390/jcm10163658] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/10/2021] [Accepted: 08/14/2021] [Indexed: 02/02/2023] Open
Abstract
(1) Background: Virtual reality (VR) has been investigated in a variety of psychiatric disorders, including addictive disorders (ADs); (2) Objective: This systematic review evaluates the current evidence of immersive VR (using head-mounted displays) in the clinical assessment and treatment of ADs; (3) Method: PubMed and PsycINFO were queried for publications up to November 2020; (4) Results: We screened 4519 titles, 114 abstracts and 85 full-texts, and analyzed 36 articles regarding the clinical assessment (i.e., diagnostic and prognostic value; n = 19) and treatment (i.e., interventions; n = 17) of ADs. Though most VR assessment studies (n = 15/19) showed associations between VR-induced cue-reactivity and clinical parameters, only two studies specified diagnostic value. VR treatment studies based on exposure therapy showed no or negative effects. However, other VR interventions like embodied and aversive learning paradigms demonstrated positive findings. The overall study quality was rather poor; (5) Conclusion: Though VR in ADs provides ecologically valid environments to induce cue-reactivity and provide new treatment paradigms, the added clinical value in assessment and therapy remains to be elucidated before VR can be applied in clinical care. Therefore, future work should investigate VR efficacy in randomized clinical trials using well-defined clinical endpoints.
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Affiliation(s)
- Simon Langener
- Human Media Interaction, University of Twente, 7522 NB Enschede, The Netherlands; (J.V.D.N.); (R.K.); (D.H.)
- Tactus Addiction Centre, 7418 ET Deventer, The Netherlands;
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
| | - Joanne Van Der Nagel
- Human Media Interaction, University of Twente, 7522 NB Enschede, The Netherlands; (J.V.D.N.); (R.K.); (D.H.)
- Tactus Addiction Centre, 7418 ET Deventer, The Netherlands;
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
| | - Jeannette van Manen
- Tactus Addiction Centre, 7418 ET Deventer, The Netherlands;
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
| | - Wiebren Markus
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
- IrisZorg Addiction Care, 6835 HZ Arnhem, The Netherlands
| | - Boukje Dijkstra
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
- Radboud University Medical Centre, 6525 GC Nijmegen, The Netherlands
- Novadic-Kentron, Network for Addiction Treatment Service, 5261 LX Vught, The Netherlands
| | - Laura De Fuentes-Merillas
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
- Novadic-Kentron, Network for Addiction Treatment Service, 5261 LX Vught, The Netherlands
| | - Randy Klaassen
- Human Media Interaction, University of Twente, 7522 NB Enschede, The Netherlands; (J.V.D.N.); (R.K.); (D.H.)
| | - Janika Heitmann
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, 9712 CP Groningen, The Netherlands
| | - Dirk Heylen
- Human Media Interaction, University of Twente, 7522 NB Enschede, The Netherlands; (J.V.D.N.); (R.K.); (D.H.)
| | - Arnt Schellekens
- Nijmegen Institute for Scientist-Practitioners in Addiction, 6525 GD Nijmegen, The Netherlands; (W.M.); (B.D.); (L.D.F.-M.); (J.H.); (A.S.)
- Radboud University Medical Centre, 6525 GC Nijmegen, The Netherlands
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Tsamitros N, Sebold M, Gutwinski S, Beck A. Virtual Reality-Based Treatment Approaches in the Field of Substance Use Disorders. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-021-00377-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Abstract
Purpose
Substance use disorders (SUD) are burdening chronic conditions characterized by high relapse rates despite severe negative consequences. Substance-related cues that elicit craving by means of automatic physiological and behavioural responses have long been suggested to predict relapse. One major mechanism contributing to relapse behaviour are cue-induced behavioural approach tendencies towards the addictive agent. Recently, there has been an emerging interest in virtual reality (VR)-based approaches to assess and modify craving and its related responses. This review aims at elucidating (1) VR techniques applied in the field of SUD, (2) VR as an induction/assessment tool for biopsychological correlates of craving and (3) VR-based therapeutic approaches.
Findings
There is an emerging number of studies focusing on different substances of abuse incorporating VR in craving induction/assessment as well as therapy. Despite some limitations as missing of randomized controlled clinical trials with large samples and missing data on the long-term effects of VR treatment, the VR approach showed consistent results in eliciting and reducing craving across different substances.
Summary
This review suggests virtual reality as a promising tool for the assessment and treatment of craving among individuals with substance use disorders. Because of its ecological validity, VR unifies the benefits of a laboratory setting with the advantages of a realistic environment. Further studies with large samples and randomized controlled clinical trials using more homogenous VR techniques as well as assessment of objective biophysiological craving markers are required.
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Martingano AJ, Persky S. Virtual reality expands the toolkit for conducting health psychology research. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2021; 15. [DOI: 10.1111/spc3.12606] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Alison Jane Martingano
- Social and Behavioral Research Branch National Human Genome Research Institute Bethesda Maryland USA
| | - Susan Persky
- Social and Behavioral Research Branch National Human Genome Research Institute Bethesda Maryland USA
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