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Ferreira S, Virgolino A, Ribeiro C, Pombo S, Bacelar-Nicolau L. Effectiveness of Neuropsychological Rehabilitation in the Recovery of Executive Deficits in Patients with Alcohol Use Disorder: A Systematic Review Protocol. ACTA MEDICA PORT 2024; 37:262-266. [PMID: 37668530 DOI: 10.20344/amp.19804] [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: 02/18/2023] [Accepted: 06/29/2023] [Indexed: 09/06/2023]
Abstract
INTRODUCTION Changes in executive functions associated with alcohol consumption are frequently found in alcohol use disorder. Neuropsychological rehabilitation can play an essential role as an effective treatment in the recovery from these deficits, leading to the maintenance of abstinence. However, there are still some uncertainties regarding its impact on the recovery of deficits in executive functions. Our purpose is to present a protocol for a systematic review aiming to assess which neuropsychological rehabilitation programs are effective in the recovery of executive deficits in patients with alcohol use disorder. METHODS We will search the following databases: PubMed, Cochrane Library (CENTRAL), Web of Science, and Scopus, as well as the list of references of the identified studies. Screening, data extraction, and synthesis, as well as evaluation of the risk of bias, will be carried out by two reviewers independently, using ROBINS-I and RoB 2. Disagreements will be resolved using a third additional reviewer. Primary outcomes will correspond to changes in executive functions, following a neuropsychological rehabilitation program in patients with alcohol use disorder. The evidence will be synthesized using a narrative description of neuropsychological rehabilitation programs and the indicators of their effectiveness will be identified. The neuropsychological rehabilitation programs for executive functions will be assessed considering their different components and their impact on the recovery of these functions. The review described in this protocol will allow the development of guidelines for the design of more effective rehabilitation programs for clinical populations with alcohol use disorder.
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Affiliation(s)
- Sónia Ferreira
- Unidade de Tratamento e Reabilitação de Alcoólicos. Centro Hospitalar Psiquiátrico de Lisboa. Lisboa; Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Ana Virgolino
- Instituto de Saúde Ambiental. Faculdade de Medicina. Universidade de Lisboa. Lisboa; Laboratório Associado TERRA. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Cristina Ribeiro
- Faculdade de Medicina. Universidade de Lisboa. Lisboa; Instituto de Medicina Preventiva e Saúde Pública. Clínica Universitária de Medicina Geral e Familiar. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Samuel Pombo
- Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Leonor Bacelar-Nicolau
- Instituto de Saúde Ambiental. Faculdade de Medicina. Universidade de Lisboa. Lisboa; Laboratório Associado TERRA. Faculdade de Medicina. Universidade de Lisboa. Lisboa; Instituto de Medicina Preventiva e Saúde Pública & Área Disciplinar Autónoma de Bioestatística (Laboratório de Biomatemática). Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
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Bolt GL, Piercy H, Bradshaw J, Manning V. Smartphone-delivered approach bias modification for reducing harmful drinking amongst middle-older age adults: Secondary analyses of a single-arm pilot study. Drug Alcohol Rev 2024. [PMID: 38444082 DOI: 10.1111/dar.13827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 01/24/2024] [Accepted: 02/08/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Novel, scalable, low-cost interventions are needed to reduce harmful drinking amongst middle-older adults. Approach bias modification (ApBM) is a promising form of cognitive training for preventing/reducing alcohol use that can be delivered via smartphone. This study explored the acceptability and preliminary effectiveness of smartphone delivered and personalised ApBM amongst Australians ≥55 years, an age cohort at risk of alcohol-related harms. METHODS Secondary analyses in a middle-older adult subsample (≥55 years, n = 289) of an open-label pilot study using a retrospective, repeated measures design. We explored acceptability (adherence, user mobile acceptability ratings, free-text responses) and preliminary effectiveness (changes in drinking quantity and frequency, craving, dependence and proportion drinking within government-recommended guidelines) of two sessions/week over 4 weeks of evidence-based ApBM training, adapted to include personalisation and smartphone delivery amongst Australians ≥55 years. RESULTS Although minor adaptations to training were suggested, the intervention was acceptable amongst survey completers, with 72% training adherence. Relative to baseline, there was a significant increase in the proportion of drinking within recommended single-session and weekly guidelines post-training (from 25% to 41% and 6% to 28%, respectively, p < 0.001), with past-week standard drinks significantly decreasing by 18% (p < 0.001) and significant reductions in drinking days, mean craving and dependence scores (p < 0.001). DISCUSSION AND CONCLUSIONS Findings suggest smartphone ApBM is acceptable amongst middle-to-older aged Australians and may support this 'at risk' cohort to remain within government-recommended alcohol consumption guidelines to optimise healthy aging, although, in the context of a single-arm study, preliminary results should be interpreted cautiously.
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Affiliation(s)
- Georgia L Bolt
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
- Neuropsychology Service, Turning Point, Eastern Health, Melbourne, Australia
- Neuropsychology Department, Austin Health, Melbourne, Australia
| | - Hugh Piercy
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
- Neuropsychology Service, Turning Point, Eastern Health, Melbourne, Australia
| | - Jennifer Bradshaw
- Neuropsychology Department, Austin Health, Melbourne, Australia
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
- Neuropsychology Service, Turning Point, Eastern Health, Melbourne, Australia
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Snippe L, Boffo M, Galvin H, Willemen R, Pronk T, Dom G, Wiers RW. How We Lost 90% of Participants on a Bad Bet: Results from a Pilot Randomized Controlled Trial on Cognitive Bias Modification in Problem Gamblers. J Gambl Stud 2023:10.1007/s10899-023-10263-6. [PMID: 38006537 DOI: 10.1007/s10899-023-10263-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 11/27/2023]
Abstract
Whilst opportunities to participate in gambling have increased, access to support for problem gamblers is lacking behind. This lack of balance calls for improved and accessible intervention methods. The present double-blind randomized controlled trial (RCT) explored the effectiveness of two interventions targeting automatic cognitive processes, known as Attentional Bias Modification (AtBM) and Approach Bias Modification (ApBM). It was hypothesized these interventions would reduce gambling behavior and reduce or reverse targeted biases. Participants (N = 331) were community-recruited Flemish (35%) and Dutch (65%) adult problem gamblers motivated to reduce or stop their gambling who received either six sessions of active training (AtBM or ApBM) or of the corresponding sham-training (sham-AtBM or sham-ApBM). Due to high attrition rates (90.1% up to the intervention phase) the study was terminated before completion, since it would greatly limit the validity of any results. A post hoc qualitative study was performed on a subset of participants to gain insight into contributing factors for the high attrition rate. Issues negatively impacting participants' motivation to complete the program were identified, as well as elements of the program that received approval. The results from this study provide a first insight into the potential of the use of online cognitive bias modification (CBM) interventions in problem gambling (PG). Suggestions and directions for future studies are discussed.
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Affiliation(s)
- Leroy Snippe
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS, Amsterdam, The Netherlands.
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UAntwerp), Wilrijk, Belgium.
| | - Marilisa Boffo
- Department of Psychology, Education and Child Studies (DPECS), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Harriet Galvin
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS, Amsterdam, The Netherlands
- Department of Psychology, Education and Child Studies (DPECS), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | - Thomas Pronk
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS, Amsterdam, The Netherlands
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp (UAntwerp), Wilrijk, Belgium
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS, Amsterdam, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
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4
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Williams DM, Rhodes RE. Guidelines for assessment of affect-related constructs. Front Psychol 2023; 14:1253477. [PMID: 38022955 PMCID: PMC10651742 DOI: 10.3389/fpsyg.2023.1253477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Research on affect-related constructs as determinants of health behavior is increasing. The Affect and Health Behavior Framework (AHBF) provides a schematic structure to label, organize, and integrate affect-related constructs. To further facilitate research and theory development in health behavior science, the purpose of the present paper is to provide a critical review and guidelines for assessment of the affect-related constructs in the AHBF. The paper is organized based on the categories of constructs in the AHBF: Affective response to health behavior, incidental affect, affect processing, and affectively charged motivation. Future research should work toward parsing constructs where possible as well as identifying overlap. Researchers are advised to consider conceptual underpinnings and methodological nuances when assessing affect-related constructs in order to build a cumulative science of affective determinants of health behavior.
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Affiliation(s)
- David M. Williams
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
| | - Ryan E. Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
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Van Dessel P, Cummins J, Wiers RW. ABC-training as a new intervention for hazardous alcohol drinking: Two proof-of-principle randomized pilot studies. Addiction 2023; 118:2141-2155. [PMID: 37349262 DOI: 10.1111/add.16271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 05/18/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND AND AIMS ABC-training is a new intervention to encourage health behavior change that targets the automatic activation of adaptive beliefs (i.e. automatic inferences). The aim of this proof-of-principle study was to test the effectiveness of web-based ABC-training to change outcome expectancies of alcohol drinking in a sample of hazardous drinkers. DESIGN One exploratory and one confirmatory experiment with two between-subject conditions (online ABC- and control-training) and assessments at baseline and 1 week later (after three sessions of training). SETTING Participants recruited on Prolific Academic completed the web-based study. PARTICIPANTS Adults with self-reported hazardous alcohol drinking (Experiment 1: 193 adults, United Kingdom, age mean = 46.7 years; Experiment 2: 282 adults, different nationalities, age mean = 38.3 years). INTERVENTION AND COMPARATOR ABC-training involved completing an online task that required choosing personally relevant alternative behaviors to drinking alcohol in personally relevant antecedent contexts to attain personally important outcomes. Comparator was control-training, in which participants selected both the alternative behaviors and alcohol drinking an equal number of times. Training was completed at baseline, after 3 days and after 1 week. MEASUREMENTS Primary outcome was change in automatic and self-reported (negative/positive) outcome expectancies of alcohol drinking from baseline to after 1 week. Secondary outcomes were change in weekly alcohol consumption, self-efficacy, craving and motivation (and approach-alcohol associations in Experiment 1). Moderators were baseline outcome scores, motivation, age and alcohol dependency. FINDINGS Findings of this study are as follows: stronger increase in negative outcome expectancies after ABC- than control-training (Experiment 1: self-report, 95% confidence interval of difference scores (CIdiff ) = [0.04, Inf]; automatic, CIdiff = [0.01, Inf]; Experiment 2: self-report, CIdiff = [0.16, Inf]; automatic, CIdiff = [0.002, Inf]). Stronger reduction in self-reported positive outcome expectancies after ABC- than control-training (Experiment 1: CIdiff = [-Inf, -0.01]; Experiment 2: CIdiff = [-Inf, -0.21]) but mixed findings on automatic positive outcome expectancies (Experiment 1: CIdiff = [-Inf, 0.02]; Experiment 2: CIdiff = [-Inf, -0.001]). CONCLUSIONS ABC-training may change outcome expectancies of alcohol consumption, but testing of clinically relevant effects in other samples is warranted.
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Affiliation(s)
- Pieter Van Dessel
- Learning and Implicit Processes (LIP) Lab, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Jamie Cummins
- Learning and Implicit Processes (LIP) Lab, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT) Laboratory, Department of Psychology and Center for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
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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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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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8
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Biggs AT, Littlejohn LF. Cognitive Coaching in Special Operations: Design Principles and Best Practices. ERGONOMICS IN DESIGN 2022. [DOI: 10.1177/10648046221144484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Cognitive enhancement platforms have received growing interest as a means to improve workplace performance. Among the many commercial and professional organizations exploring cognitive training, the United States military has begun exploring the potential added value of cognitive enhancement tools. Whereas most platforms offer automated or algorithm-based solutions to support cognitive training, special operations have developed the role of a cognitive coach to support training. The current discussion provides several lessons learned when trying to bridge cognitive systems and enhancement tools within military operations that should apply to any organization seeking to improve cognitive performance among already high-performing personnel.
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Affiliation(s)
- Adam T. Biggs
- Naval Special Warfare Command, San Diego, CA California, United States
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Nejati V, Fallah F, Raskin S. Inhibitory Control Training Improves Attention Deficit-Hyperactivity Disorder Symptoms and Externalizing Behavior. Clin Child Psychol Psychiatry 2022:13591045221144356. [PMID: 36474404 DOI: 10.1177/13591045221144356] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Based on dysexecutive function theory of Attention deficit-hyperactivity disorder (ADHD), inhibitory control plays a crucial role in ADHD symptoms and respective behavioral problems. METHODS In the present study, 30 preschoolers with ADHD were recruited in a random clinical trial design in two control and intervention groups. The Flanker and Go/No-Go tasks, Swanson, Nolan, and Pelham Rating Scale, and Child Behavior Checklist were used for assessment at baseline, after the intervention, and 1-month follow-up sessions. The program for attentive rehabilitation of inhibition and selective attention (PARISA) was used for intervention in 10-12 sessions. RESULTS Findings showed an improvement in prepotent inhibition and interference control in the intervention group. Furthermore, the hyperactivity/impulsivity symptoms were ameliorated, and the externalizing behavioral problems were improved after the intervention. CONCLUSION Inhibitory control in preschoolers with ADHD is trainable, and the training gain could be transferred to ADHD symptoms and externalizing behavior.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, 48512Shahid Beheshti University, Tehran, Iran
| | - Fatemeh Fallah
- Department of Psychology, 68106Islamic Azad University, Tehran, Iran
| | - Sarah Raskin
- Department of Psychology, 8809Trinity College, Hartford, CT, USA
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Lawrence NS, Porter L, Staiger PK. The ‘Go’s and the ‘No-Go’s of response-inhibition training to food: lessons learned from trials. Curr Opin Behav Sci 2022. [DOI: 10.1016/j.cobeha.2022.101229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Simpson T, Sistad R, Brooks JT, Newberger NG, Livingston NA. Seeking care where they can: A systematic review of global trends in online alcohol treatment utilization among non-veteran and veteran women. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 5:100116. [PMID: 36844155 PMCID: PMC9948922 DOI: 10.1016/j.dadr.2022.100116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/21/2022] [Accepted: 11/04/2022] [Indexed: 11/19/2022]
Abstract
Background Findings from a person-level meta-analysis of online alcohol intervention trials suggest that women disproportionately seek out such interventions (Riper et al., 2018). Although women may be a "hidden population" that is particularly drawn to online alcohol interventions, trial design features may explain women's apparent over-representation in these trials. Methods This systematic review examined associations between gender-tailored recruitment/inclusion criteria and proportions of women enrolled in online alcohol intervention trials, evaluated whether community samples have greater proportions of women than clinical samples, and compared country-specific average proportions of women in trials to country-specific proportions of women with Alcohol Use Disorder (AUD). Results Forty-four trials met inclusion/exclusion criteria, 34 community samples and 10 drawn from clinical settings; 4 studies included U.S. veterans and were examined separately. The average proportion of community-recruited women across the studies was 51.20% and the average proportion of clinically-recruited women was 35.81%, a difference that was statistically significant. Across the countries with relevant trials, the expected proportion of those with AUD who are women is 27.1% (World Population Review, 2022). Only 2 studies used targeted recruitment for women so no between-group tests were conducted. There was not a statistically significant difference in the proportion of women across trials that did and did not use gender-tailored alcohol inclusion criteria. Conclusions Results from this systematic review suggest that study design factors do not account for the marked over-representation of women in online alcohol interventions, indicating that women are indeed a "hidden population" whose needs should be understood and accommodated.
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Affiliation(s)
- Tracy Simpson
- Center of Excellence in Substance Addiction Treatment & Education, VA Puget Sound Healthcare System, Seattle, WA, USA,University of Washington School of Medicine, Seattle, WA, USA,Corresponding author at: 1660 S. Columbian Way (S-116-CESATE), Seattle, WA 98108, USA.
| | - Rebecca Sistad
- VA Boston Healthcare System, Boston, MA, USA,Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Jack T. Brooks
- VA Boston Healthcare System, Boston, MA, USA,Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Noam G. Newberger
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
| | - Nicholas A. Livingston
- VA Boston Healthcare System, Boston, MA, USA,Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA,National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
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12
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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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Sasso A, Hernández-Alava M, Holmes J, Field M, Angus C, Meier P. Strategies to cut down drinking, alcohol consumption, and usual drinking frequency: Evidence from a British online market research survey. Soc Sci Med 2022; 310:115280. [PMID: 35994876 DOI: 10.1016/j.socscimed.2022.115280] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/30/2022] [Accepted: 08/09/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Relatively little is known about how risky drinkers attempt to moderate their drinking in the absence of specialist support. The broader literature has identified multiple potential strategies that people use to cope with temptation when trying to control health-risk behaviours. This study aims to identify types of alcohol moderation strategies used by British adults, and to explore how concurrent alcohol consumption differs across moderation strategies, focusing on the important role of usual drinking frequency. METHODS We use a continuous repeat cross-sectional survey and one-week drinking diary collected by the market research company Kantar; these provide detailed information on alcohol consumption during a diary week and on how individuals try to moderate alcohol use for 49,204 British adults trying to reduce their drinking from 2013 to 2019. We use Latent Class Analysis (LCA) to identify predominant types of moderation strategies. With a three-step method, we also analyse the associations between adopting different moderation strategies, measures of frequency and intensity of drinking events, and usual drinking frequency. RESULTS We found evidence of four alcohol moderation strategies: 29% of individuals use a pre-commitment-focused strategy (having fewer drinking occasions), two set of individuals adopt self-control strategies within drinking occasions (specifically 28% select smaller drinks and 5% have fewer drinks), while 38% adopt a mixed strategy that involves all three. Those using commitment tend to have a higher average consumption per drinking occasion but lower overall weekly consumption compared to those using self-control. Weekly alcohol consumption is particularly high among individuals who are usual everyday drinkers and use self-control to cut down drinking. CONCLUSION This analysis provides a useful platform for further work, using prospective or intervention designs, to test the relative effectiveness of different moderation strategies for alcohol consumers who want to reduce their alcohol consumption.
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Affiliation(s)
- Alessandro Sasso
- Sheffield Alcohol Research Group (SARG), School of Health and Related Research, University of Sheffield, UK; Health Economics and Decision Science (HEDS), School of Health and Related Research, University of Sheffield, UK.
| | - Mónica Hernández-Alava
- Health Economics and Decision Science (HEDS), School of Health and Related Research, University of Sheffield, UK
| | - John Holmes
- Sheffield Alcohol Research Group (SARG), School of Health and Related Research, University of Sheffield, UK
| | - Matt Field
- Department of Psychology, University of Sheffield, UK
| | - Colin Angus
- Sheffield Alcohol Research Group (SARG), School of Health and Related Research, University of Sheffield, UK
| | - Petra Meier
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, UK
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14
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Hughes LK, Hayden MJ, Bos J, Lawrence NS, Youssef GJ, Borland R, Staiger PK. A Randomised Controlled Trial of Inhibitory Control Training for Smoking Cessation: Outcomes, Mediators and Methodological Considerations. Front Psychol 2021; 12:759270. [PMID: 34803842 PMCID: PMC8595834 DOI: 10.3389/fpsyg.2021.759270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/08/2021] [Indexed: 12/03/2022] Open
Abstract
Objective: Inhibitory control training (ICT) has shown promise for improving health behaviours, however, less is known about its mediators of effectiveness. The current paper reports whether ICT reduces smoking-related outcomes such as craving and nicotine dependence, increases motivation to quit and whether reductions in smoking or craving are mediated by response inhibition or a devaluation of smoking stimuli. Method: Adult smokers (minimum 10 cigarettes per day; N = 107, Mage = 46.15 years, 57 female) were randomly allocated to receive 14 days of smoking-specific ICT (named INST; a go/no-go task where participants were trained to not respond to smoking stimuli) or active control training (participants inhibited responding toward neutral stimuli). Participants were followed up to 3-months post-intervention. This trial was preregistered (Australian and New Zealand Clinical Trials Registry ID: ACTRN12617000252314; URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370204). Results: There were no significant differences between ICT and active control training groups. Specifically, participants in both groups showed significant reductions in craving, nicotine dependence, motivation and a devaluation (reduced evaluation) of smoking-stimuli up to 3-months follow-up compared to baseline. Inhibition and devaluation of smoking stimuli did not act as mediators. Devaluation of smoking stimuli was an independent predictor of smoking and craving at follow-up. Conclusion: Inhibitory control training (ICT) was no more effective at reducing smoking-related outcomes compared to the active control group, however, significant improvements in craving, dependence indicators and evaluation of smoking stimuli were observed across both groups. A return to basic experimental research may be required to understand the most effective ICT approach to support smoking cessation.
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Affiliation(s)
- Laura K Hughes
- School of Psychology, Deakin University, Geelong, VIC, Australia.,Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Melissa J Hayden
- School of Psychology, Deakin University, Geelong, VIC, Australia.,Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, VIC, Australia.,Centre for Drug Use, Addictive and Anti-social Behaviour Research (CEDAAR), Deakin University, Geelong, VIC, Australia
| | - Jason Bos
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | | | - George J Youssef
- School of Psychology, Deakin University, Geelong, VIC, Australia.,Centre for Drug Use, Addictive and Anti-social Behaviour Research (CEDAAR), Deakin University, Geelong, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Ron Borland
- Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Petra K Staiger
- School of Psychology, Deakin University, Geelong, VIC, Australia.,Centre for Drug Use, Addictive and Anti-social Behaviour Research (CEDAAR), Deakin University, Geelong, VIC, Australia
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15
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Irizar P, Jones A, Christiansen P, Goodwin L, Gage SH, Roberts C, Knibb G, Cooke R, Rose AK. Longitudinal associations with alcohol consumption during the first COVID-19 lockdown: Associations with mood, drinking motives, context of drinking, and mental health. Drug Alcohol Depend 2021; 226:108913. [PMID: 34315105 PMCID: PMC8567536 DOI: 10.1016/j.drugalcdep.2021.108913] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/18/2021] [Accepted: 05/24/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Coronavirus (COVID-19) resulted in lockdown measures in the UK, which has impacted alcohol use. Alcohol is often used as a coping mechanism and there are public health concerns regarding excessive consumption due to the pandemic. We aimed to longitudinally assess drinking behaviors, and associated factors, during the first UK government-mandated lockdown. METHODS An online survey was distributed through social media (8th April 2020, onwards). Fortnightly follow up surveys were emailed to participants. The primary outcome measure was 'weekly unit consumption' and data was collected on a range of potentially related factors: demographics, factors relating to COVID-19 (e.g., health, work status), drinking motives, context of drinking, drinking intentions, mood, depression and anxiety. FINDINGS A total of 539 self-selected participants completed the baseline survey, with 186 completing at least 3 follow up surveys for multilevel modelling analysis. Personal coping motives, anxiety, drinking at home alone, and drinking at home with others were positively associated with alcohol consumption during lockdown. The following baseline measures also predicted increased consumption: male gender, lower education, and higher AUDIT scores (based on behavior prior to lockdown). Findings were consistent when utilizing an inverse probability weight to account for predictors of attrition (female, younger age, higher baseline AUDIT scores). CONCLUSIONS Those already drinking at hazardous levels were more likely to increase their consumption, as were those who were drinking to cope. As we recover from the pandemic, there is a need for widespread alcohol support, and certain groups may need targeted support.
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Affiliation(s)
- Patricia Irizar
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom.
| | - Andrew Jones
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom
| | - Paul Christiansen
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom
| | - Laura Goodwin
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom,Liverpool Centre for Alcohol Research, United Kingdom
| | - Suzanne H Gage
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom,Liverpool Centre for Alcohol Research, United Kingdom
| | - Carl Roberts
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom
| | - Graeme Knibb
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom
| | - Richard Cooke
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom,Liverpool Centre for Alcohol Research, United Kingdom
| | - Abigail K Rose
- Department of Psychology, Institute of Population Health, University of Liverpool, United Kingdom,Liverpool Centre for Alcohol Research, United Kingdom
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16
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Cardiorespiratory Fitness Predicts Higher Inhibitory Control in Patients With Substance Use Disorder. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2021. [DOI: 10.1123/jcsp.2019-0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Impaired inhibitory control has been shown in individuals with substance use disorder (SUD). Cardiorespiratory fitness has been described as a potential factor to improve inhibitory control; however, the benefits in individuals with SUD are unclear. The aim of this study was to investigate the relationship between cardiorespiratory fitness with general and drug-specific inhibitory control in individuals with SUD. Sixty-two male participants under treatment for SUD performed a general and drug-specific inhibitory control test (go/no-go) and a cardiorespiratory fitness test. Cardiorespiratory fitness, age, and years of drug use were inversely associated with reaction time for both general and drug-specific inhibitory control. In addition, the regression models showed that cardiorespiratory fitness predicts general and drug-specific inhibitory control adjusted for age and time of drug use. However, cardiorespiratory fitness predicts equally both general and drug-specific inhibitory control. These findings suggest that increasing cardiorespiratory fitness could provide benefits in the inhibitory function of individuals with SUD.
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17
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Mistarz N, Nielsen AS, Andersen K, Goudriaan AE, Skøt L, Mathiasen K, Michel TM, Mellentin AI. Brain+ AlcoRecover: A Randomized Controlled Pilot-Study and Feasibility Study of Multiple-Domain Cognitive Training Using a Serious Gaming App for Treating Alcohol Use Disorders. Front Psychiatry 2021; 12:727001. [PMID: 34658960 PMCID: PMC8517229 DOI: 10.3389/fpsyt.2021.727001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Patients with alcohol use disorder (AUD) exhibit deficits in various cognitive domains, including executive functioning, working memory, and learning and memory, which impede the effectiveness of conventional AUD treatment and enhance relapse. Mobile health (mHealth) services are promising in terms of delivering cognitive training in gamified versions. So far, studies examining the effects of mHealth-based cognitive training in AUD patients have, however, focused on specific rather than multiple cognitive domains and overlooked the importance of clinical outcomes. Furthermore, research has yet to investigate the acceptability and feasibility of this type of cognitive training. Aims: The aims of this pilot study are to examine (1) whether using smartphone-based, multi-domain cognitive training with gamified elements as part of conventional treatment for AUD indicate effect, and (2) whether the intervention is acceptable and feasible as a part of conventional treatment for AUD. Methods: Patients from the alcohol outpatient clinic, Odense Municipality, Denmark will be invited to participate in the study on a consecutive basis until a total of 60 patients have been recruited. The study will be performed as a combined parallel randomized controlled trial (RCT) and qualitative feasibility study. The patients will be randomly assigned to one of two groups. The intervention group (n = 30) will receive smartphone-based, multi-domain cognitive training with gamified elements together with treatment as usual (TAU). The active control group (n = 30) will receive a sham version of the same cognitive training together with TAU. Cognitive outcomes will be assessed via the training application at baseline and post-treatment. Clinical outcomes will be assessed at baseline, post-treatment, and at 6-month follow-up using the Addiction Severity Index. Furthermore, the 30 patients randomized to the intervention group will be invited to participate in the second phase, that is the feasibility study, at post-treatment. A questionnaire inquiring about the use of mHealth treatment in general will be administered. Further, feedback regarding functionality and meaningfulness of the application in addition to other qualitative aspects relating to the use of the application will be collected. The patients will also be asked to provide suggestions about how to improve and potentially implement the tool. Implications: It is anticipated that this pilot study will provide tentative evidence for the effectiveness of smartphone-based, multi-domain cognitive training as well as information about the usability and feasibility of this type of training, including acceptability and compliance. The study will also contribute with feedback derived from the patients about how to improve and implement the tool. If promising, the findings will be used to plan a large-scale RCT. Since cognitive deficits are not addressed in current treatments for AUD, gamified cognitive training delivered through smartphones may increase the effectiveness of current treatment for AUD as well as introduce more mHealth-based treatment that is both accessible and cost-effective.
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Affiliation(s)
- Nicolaj Mistarz
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Anette Søgaard Nielsen
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Brain Research-Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Kjeld Andersen
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Anneke E Goudriaan
- Amsterdam University Medical Centers, Department of Psychiatry, University of Amsterdam, Amsterdam, Netherlands.,Department of Research, Amsterdam Institute for Addiction Research, Arkin, Amsterdam, Netherlands
| | - Lotte Skøt
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Kim Mathiasen
- Centre for Telepsychiatry, Mental Health Services of Southern Denmark, Odense, Denmark
| | - Tanja Maria Michel
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Angelina Isabella Mellentin
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Brain Research-Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Centre for Telepsychiatry, Mental Health Services of Southern Denmark, Odense, Denmark
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18
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Abstract
Alcohol use disorder (AUD) commonly is associated with compromise in neurobiological and/or neurobehavioral processes. The severity of this compromise varies across individuals and outcomes, as does the degree to which recovery of function is achieved. This narrative review first summarizes neurobehavioral, neurophysiological, structural, and neurochemical aberrations/deficits that are frequently observed in people with AUD after detoxification. Subsequent sections review improvements across these domains during recovery, taking into account modulators of recovery to the extent permitted. Where appropriate, the discussion includes work integrating outcomes across domains, leveraging the strengths of diverse experimental methods. Interventions to ameliorate neurobiological or neurobehavioral deficits do not constitute a primary objective of this review. However, their consideration is a logical inclusion. Therefore, a limited introduction to existing methods is also presented.
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Affiliation(s)
- Sara Jo Nixon
- Department of Psychiatry, University of Florida, Gainesville, Florida.,Center for Addiction Research & Education, University of Florida, Gainesville, Florida
| | - Ben Lewis
- Department of Psychiatry, University of Florida, Gainesville, Florida.,Center for Addiction Research & Education, University of Florida, Gainesville, Florida
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19
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Spechler PA, Stewart JL, Kuplicki R, Paulus MP. Parsing impulsivity in individuals with anxiety and depression who use Cannabis. Drug Alcohol Depend 2020; 217:108289. [PMID: 33002704 PMCID: PMC7736515 DOI: 10.1016/j.drugalcdep.2020.108289] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Individuals with anxiety/depression may impulsively use cannabis to acutely induce positive affect and attenuate aversive mood states. However, few studies have attempted to parse impulsivity displayed by anxious/depressed cannabis users. This investigation examined what aspects of impulsivity characterize those individuals using self-report and functional MRI (fMRI) measures. METHODS Individuals with any lifetime anxiety/depression diagnoses and problematic cannabis use ("Anx/Dep+CB"; n=42) were compared to a propensity score-matched group with very low cannabis use ("Anx/Dep-lowCB"; n=42), and a healthy control group (n=37). Impulsivity was measured using the UPPS-P Impulsivity Questionnaire and the Stop Signal Task (SST) during fMRI. For UPPS-P, regression models estimated group-by-impulsivity subscale interactions with post-hoc pairwise tests. For the SST, similar regression models were estimated with four a-priori regions of interest (ROIs; right opercularis, orbitalis, dorsal and ventral anterior insula) during stop-success and stop-failure processing. Null SST findings were followed up using Bayes factor analysis to quantify the evidence in support of the null hypothesis. RESULTS For the UPPS-P, a significant group-by-subscale interaction indicated that the Anx/Dep+CB group exhibited higher levels of impulsivity on the negative- and positive-urgency subscales relative to both comparison groups. Higher negative-urgency correlated with heavier lifetime cannabis use across groups. For the SST, there were no ROI task activation differences. Bayes factor analysis determined the null findings were at least three times more likely than the alternative hypothesis for all ROIs. CONCLUSIONS Impulsivity under periods of heightened affect, but not motor response inhibitions, characterized anxious/depressed individuals who use cannabis.
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Affiliation(s)
- Philip A Spechler
- Laureate Institute for Brain Research. 6655 S. Yale Ave., Tulsa, OK 74136. USA.
| | - Jennifer L Stewart
- Laureate Institute for Brain Research. 6655 S. Yale Ave., Tulsa, OK 74136. USA; University of Tulsa, Tulsa, OK, USA
| | - Rayus Kuplicki
- Laureate Institute for Brain Research. 6655 S. Yale Ave., Tulsa, OK 74136. USA
| | - Martin P Paulus
- Laureate Institute for Brain Research. 6655 S. Yale Ave., Tulsa, OK 74136. USA; University of Tulsa, Tulsa, OK, USA
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20
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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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21
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Dai W, Palmer R, Sunderrajan A, Durantini M, Sánchez F, Glasman LR, Chen FX, Albarracín D. More behavioral recommendations produce more change: A meta-analysis of efficacy of multibehavior recommendations to reduce nonmedical substance use. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2020; 34:709-725. [PMID: 32309956 PMCID: PMC7572872 DOI: 10.1037/adb0000586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Death and morbidity associated with substance use have risen continuously over the last few decades, increasing the need for rigorous examination of promising programs. Interventions attempting to change multiple behaviors have been designed to address interconnected problems such as use of both alcohol and drugs. This meta-analysis aimed to examine the efficacy of multibehavior interventions to curb nonmedical substance use in relation to the theoretical relation among different substance use behaviors. Specifically, our synthesis aimed to estimate the optimal number of recommendations for intervention efficacy and evaluate the impact of different combinations of recommendations on intervention efficacy. A synthesis of multibehavior interventions addressing nonmedical substance use was conducted to measure behavioral changes between the pretest and the follow-up. These changes were then compared across different numbers of recommendations. Sixty-nine reports and 233 effect sizes (k of conditions = 155, n = 28,295) were included. A positive linear relation was found between the number of targeted behaviors and intervention efficacy, which was stronger for drug use than alcohol use. Furthermore, recommendations on drug use worked better when paired with recommendations targeting other behaviors, whereas recommendations on alcohol use worked more independently. Lastly, multibehavior interventions were especially efficacious when delivered by experts. Overall, our synthesis indicated that targeting multiple substances is beneficial for changing drug use outcomes, but less so for alcohol use outcomes. Therefore, in the current substance use epidemic, innovative multibehavior programs appear to hold promise, especially to combat nonmedical drug use. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Wenhao Dai
- Department of Psychology, University of Illinois, Urbana-Champaign
| | - Ryan Palmer
- Department of Psychology, University of Illinois, Urbana-Champaign
| | | | - Marta Durantini
- Department of Psychology, University of Illinois, Urbana-Champaign
| | - Flor Sánchez
- Departamento de Psicología Social, Universidad Autónoma de Madrid
| | - Laura R. Glasman
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin
| | - Fan Xuan Chen
- Department of Psychology, University of Illinois, Urbana-Champaign
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22
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Wen S, Larsen H, Boffo M, Grasman RPPP, Pronk T, van Wijngaarden JBG, Wiers RW. Combining Web-Based Attentional Bias Modification and Approach Bias Modification as a Self-Help Smoking Intervention for Adult Smokers Seeking Online Help: Double-Blind Randomized Controlled Trial. JMIR Ment Health 2020; 7:e16342. [PMID: 32383682 PMCID: PMC7244992 DOI: 10.2196/16342] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/25/2019] [Accepted: 01/26/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Automatically activated cognitive motivational processes such as the tendency to attend to or approach smoking-related stimuli (ie, attentional and approach bias) have been related to smoking behaviors. Therefore, these cognitive biases are thought to play a role in maintaining smoking behaviors. Cognitive biases can be modified with cognitive bias modification (CBM), which holds promise as an easy-access and low-cost online intervention. However, little is known about the effectiveness of online interventions combining two varieties of CBM. Targeting multiple cognitive biases may improve treatment outcomes because these biases have been shown to be relatively independent. OBJECTIVE This study aimed to test the individual and combined effects of two web-based CBM varieties-attentional bias modification (AtBM) and approach bias modification (ApBM)-in a double-blind randomized controlled trial (RCT) with a 2 (AtBM: active versus sham) × 2 (ApBM: active versus sham) factorial design. METHODS A total of 504 adult smokers seeking online help to quit smoking were randomly assigned to 1 of 4 experimental conditions to receive 11 fully automated CBM training sessions. To increase participants' intrinsic motivation to change their smoking behaviors, all participants first received brief, automated, tailored feedback. The primary outcome was point prevalence abstinence during the study period. Secondary outcomes included daily cigarette use and attentional and approach bias. All outcomes were repeatedly self-assessed online from baseline to the 3-month follow-up. For the examination of training effects on outcome changes, an intention-to-treat analysis with a multilevel modeling (MLM) approach was adopted. RESULTS Only 10.7% (54/504) of the participants completed all 11 training sessions, and 8.3% (42/504) of the participants reached the 3-month follow-up assessment. MLM showed that over time, neither AtBM or ApBM nor a combination of both differed from their respective sham training in point prevalence abstinence rates (P=.17, P=.56, and P=.14, respectively), and in changes in daily cigarette use (P=.26, P=.08, and P=.13, respectively), attentional bias (P=.07, P=.81, and P=.15, respectively), and approach bias (P=.57, P=.22, and P=.40, respectively), while daily cigarette use decreased over time across conditions for all participants (P<.001). CONCLUSIONS This RCT provides no support for the effectiveness of combining AtBM and ApBM in a self-help web-based smoking cessation intervention. However, this study had a very high dropout rate and a very low frequency of training usage, indicating an overall low acceptability of the intervention, which precludes any definite conclusion on its efficacy. We discuss how this study can inform future designs and settings of online CBM interventions. TRIAL REGISTRATION Netherlands Trial Register NTR4678; https://www.trialregister.nl/trial/4678.
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Affiliation(s)
- Si Wen
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Helle Larsen
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Marilisa Boffo
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | | | - Thomas Pronk
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | | | - Reinout W Wiers
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
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23
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Field M, Puddephatt JA, Goodwin L, Owens L, Reaves D, Holmes J. Benefits of temporary alcohol restriction: a feasibility randomized trial. Pilot Feasibility Stud 2020; 6:9. [PMID: 32021698 PMCID: PMC6995140 DOI: 10.1186/s40814-020-0554-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 01/22/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Participation in temporary alcohol abstinence campaigns such as 'Dry January' may prompt enduring reductions in alcohol consumption. A randomized controlled trial (RCT) is required to establish any long-term benefits or negative consequences of temporary abstinence. In the present study, we randomized heavy drinkers to complete or intermittent alcohol abstinence for 4 weeks, in order to evaluate the feasibility of conducting a large-scale RCT. METHODS This was a mixed methods feasibility study in which we explored recruitment and retention to a randomized trial, compliance with alcohol abstinence instructions and barriers to compliance, and acceptability of study procedures (primary feasibility outcomes). A community sample of women aged between 40 and 60 who drank in excess of 28 alcohol units per week were randomized to abstain from alcohol for 4 weeks either completely or intermittently (at least four abstinent days per week). To monitor compliance, both groups provided regular breath samples on a cellular breathalyser. A subsample completed a semi-structured interview that probed barriers to compliance with abstinence instructions and acceptability of study procedures. RESULTS Within 5 months, we recruited, screened and randomized 25 participants (20% of participants who responded to advertisements: 14 in the complete abstinence group, 11 in the intermittent abstinence group), 24 of whom were retained throughout the 28-day intervention period. Participants in both groups tended to comply with the instructions: the median number of breathalyser-verified abstinent days was 24 (IQR = 15.5-25.0; 86% of target) in the complete abstinence group versus 12 (IQR = 10-15; 75% of target) in the intermittent abstinence group. Semi-structured interviews identified some barriers to compliance and methodological issues that should be considered in future research. No adverse events were reported. CONCLUSIONS It is feasible to recruit heavy drinking women from community settings and randomize them to either complete or intermittent abstinence from alcohol for 4 weeks. The majority of participants were retained in the study and compliance with the abstinence instructions was good, albeit imperfect. A comprehensive RCT to compare temporary alcohol abstinence with other alcohol reduction strategies on long-term alcohol consumption is feasible. Findings from such a trial would inform implementation of alcohol campaigns and interventions.
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Affiliation(s)
- Matt Field
- Department of Psychology, University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield, S1 2LT UK
| | - Jo-Anne Puddephatt
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Laura Goodwin
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Lynn Owens
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Danielle Reaves
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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24
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Satchell LP, Johnson HL, Hudson CA, Harper CA. Dispositional Disinhibition and Alcohol Use Disorders: Personality, Risk Appraisal and Problematic Alcohol Consumption. Subst Use Misuse 2020; 55:209-217. [PMID: 31847657 DOI: 10.1080/10826084.2019.1662809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: The relationship between psychopathic personality and problematic alcohol consumption could be important for understanding risk and potential interventions. This existing work on psychopathy and alcohol abuse is typically conducted in criminal and hospitalized populations and little attention has been paid to investigating the general populations' psychopathic personality and problematic consumption of alcohol. The psychopathy-focused Triarchic Psychopathy Measure (TriPM) and the more general Reinforcement Sensitivity Theory of personality (RST) focus on individual differences related to low self-control and sensation seeking, and could relate to problematic alcohol consumption in non-forensic samples. The current study brings together RST and psychopathic personality traits to predict alcohol use disorders. We hypothesize that impulsivity and anxiety predict problematic alcohol consumption and related risk appraisal. Methods: We analyzed data from a sample of 349 general population participants who had completed measures of the TriPM, RST, alcohol use disorders (AUDIT), and their perceived negative outcomes of high risk behavior with the Cognitive Appraisal of Risky Events (CARE) measure. Results: We find some evidence that TriPM's disinhibition and RST's anxious personality traits relate to AUDIT scores. We find limited evidence that personality traits predict the negative appraisal of risky events, but alcohol use was related to increased perceptions of the negative outcomes of alcohol consumption. Conclusions: Overall this study shows that individual differences do relate to problematic alcohol consumption but not the appraisal of risks related to alcohol consumption. This has implications for the structuring of intervention for those at-risk of problematic consumption of alcohol.
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Affiliation(s)
- Liam P Satchell
- Department of Psychology, University of Winchester, Winchester, UK
| | - Henry L Johnson
- School of Human and Social Sciences, University of West London, Brentford, UK
| | | | - Craig A Harper
- School of Social Sciences, Nottingham Trent University, Nottingham, UK
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25
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Nixon SJ, Lewis B. Cognitive training as a component of treatment of alcohol use disorder: A review. Neuropsychology 2019; 33:822-841. [PMID: 31448949 DOI: 10.1037/neu0000575] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Cognitive training is an effective means of improving performance in a range of populations. Whether it may serve to facilitate cognitive recovery and longer-term outcomes in persons with alcohol use disorders (AUDs) is unclear. Here, we review historical and current literature and offer perspectives for model development and potential implementation. METHOD We considered a large literature regarding the nature of alcohol-related compromise, early efforts to clarify the nature of recovery and current models and methods underlying cognitive training paradigms. We then constructed a narrative review demonstrating evolving frameworks and empirical data informing the critical review of cognitive training methods as a means of mitigating compromise and facilitating functional outcomes. RESULTS Cognitive improvement with abstinence is generally noted, but training protocols may enhance performance and generalize benefit to untrained, but highly similar, tasks. Transfer of training to dissimilar tasks and functional outcomes is uncommonly reported. It is noteworthy that some work suggests that clinician ratings for participants are improved. Inconsistency in sample characteristics, training protocols, and outcome measures constrain general conclusions while suggesting opportunities for study and development. CONCLUSIONS Cognitive training protocols have shown benefit in a variety of populations but have been examined infrequently in persons with AUDs. This overview indicates significant opportunity for cognitive improvement and recovery and thus a strong potential role for training protocols. However, supportive data are not robustly obtained. We suggest that one step in bridging this gap is the implementation of a conceptual framework incorporating contextual, behavioral, and neurobiological variables. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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26
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Remmerswaal D, Jongerling J, Jansen PJ, Eielts C, Franken IHA. Impaired subjective self-control in alcohol use: An ecological momentary assessment study. Drug Alcohol Depend 2019; 204:107479. [PMID: 31518888 DOI: 10.1016/j.drugalcdep.2019.04.043] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 04/08/2019] [Accepted: 04/10/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND While both theory and empirical findings have supported impaired self-control as a crucial factor in understanding problem drinking, little is known about the relationship of self-control and drinking in naturalistic settings. The present study uses Ecological Momentary Assessment (EMA) to examine the predictive relationships between impaired subjective self-control, craving and alcohol use in everyday life. METHODS A sample of 172 regular drinkers responded on their smartphone to three random prompts each day for seven days in which amount of perceived self-control and craving were measured with self-report. In the meantime, participants were instructed to initiate an EMA report when they started drinking alcohol. RESULTS Findings supported the hypotheses that impaired self-control and higher craving levels were prospectively related to the likelihood that people will drink. That is, on random assessments that preceded drinking (i.e., were within two hours of drinking), perceived self-control was lower and craving was higher compared to random assessments that were not followed by drinking. Additionally, during drink consumption, impaired self-control and craving were associated with a higher amount of expected alcohol consumption. Findings further indicated that subjective self-control acted as a moderator of the relationship between craving and alcohol consumption during drinking occasions. CONCLUSIONS By using a smartphone mobile application, this study showed that impaired subjective self-control and craving are prospectively related to alcohol use in the real-world. Furthermore, findings are consistent with theories of addiction that substance use might be associated with the interplay of control processes and increased motivation.
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Affiliation(s)
- Danielle Remmerswaal
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, the Netherlands.
| | - Joran Jongerling
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, the Netherlands
| | - Pauline J Jansen
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, the Netherlands
| | - Charly Eielts
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, the Netherlands
| | - Ingmar H A Franken
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, the Netherlands
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27
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Giving pork the chop: Response inhibition training to reduce meat intake. Appetite 2019; 141:104315. [DOI: 10.1016/j.appet.2019.06.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/16/2019] [Accepted: 06/05/2019] [Indexed: 01/16/2023]
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28
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Aulbach MB, Knittle K, Haukkala A. Implicit process interventions in eating behaviour: a meta-analysis examining mediators and moderators. Health Psychol Rev 2019; 13:179-208. [PMID: 30676235 DOI: 10.1080/17437199.2019.1571933] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Dual-process models integrate deliberative and impulsive mental systems and predict dietary behaviours better than deliberative processes alone. Computerised tasks such as the Go/No-Go, Stop-Signal, Approach-Avoidance, and Evaluative Conditioning have been used as interventions to directly alter implicit biases. This meta-analysis examines the effects of these tasks on dietary behaviours, explores potential moderators of effectiveness, and examines implicit bias change as a proposed mechanism. Thirty randomised controlled trials testing implicit bias interventions (47 comparisons) were included in a random-effects meta-analysis, which indicated small cumulative effects on eating-related behavioural outcomes (g = -0.17, CI95 = [-0.29; -0.05], p = .01) and implicit biases (g = -0.18, CI95 = [-0.34; -0.02], p = .02). Task type moderated these effects, with Go/No-Go tasks producing larger effects than other tasks. Effects of interventions on implicit biases were positively related to effects on eating behaviour (B = 0.42, CI95 = [0.02; 0.81], p = .03). Go/No-Go tasks seem to have most potential for altering dietary behaviours through implicit processes. While changes in implicit biases seem related to the effects of these interventions on dietary outcomes, more research should explore whether repeated exposure to implicit bias interventions may have any practical intervention value in real world settings.
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Affiliation(s)
- Matthias B Aulbach
- a Faculty of Social Sciences, Social Psychology , University of Helsinki , Helsinki , Finland
| | - Keegan Knittle
- a Faculty of Social Sciences, Social Psychology , University of Helsinki , Helsinki , Finland
| | - Ari Haukkala
- a Faculty of Social Sciences, Social Psychology , University of Helsinki , Helsinki , Finland
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29
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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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30
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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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