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Gunawan T, Luk JW, Schwandt ML, Kwako LE, Vinson T, Horneffer Y, George DT, Koob GF, Ramchandani VA, Diazgranados N, Goldman D. Factors underlying the neurofunctional domains of the Addictions Neuroclinical Assessment assessed by a standardized neurocognitive battery. Transl Psychiatry 2024; 14:271. [PMID: 38956031 PMCID: PMC11219746 DOI: 10.1038/s41398-024-02987-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 06/20/2024] [Accepted: 06/26/2024] [Indexed: 07/04/2024] Open
Abstract
The Addictions Neuroclinical Assessment (ANA) is a neurobiologically-informed framework designed to understand the etiology and heterogeneity of Alcohol Use Disorder (AUD). Previous studies validated the three neurofunctional domains of ANA: Incentive Salience (IS), Negative Emotionality (NE) and Executive Function (EF) using secondary data. The present cross-sectional observational study assessed these domains in an independent, prospective clinical sample. Adults across the drinking spectrum (N = 300) completed the ANA battery, a standardized collection of behavioral tasks and self-report assessments. Factor analyses were used to identify latent factors underlying each domain. Associations between identified domain factors were evaluated using structural equation models. Receiver operating characteristics analyses were used to determine factors with the strongest ability to classify individuals with problematic drinking and AUD. We found (1) two factors underlie the IS domain: alcohol motivation and alcohol insensitivity. (2) Three factors were identified for the NE domain: internalizing, externalizing, and psychological strength. (3) Five factors were found for the EF domain: inhibitory control, working memory, rumination, interoception, and impulsivity. (4) These ten factors showed varying degrees of cross-correlations, with alcohol motivation, internalizing, and impulsivity exhibiting the strongest correlations. (5) Alcohol motivation, alcohol insensitivity, and impulsivity showed the greatest ability in classifying individuals with problematic drinking and AUD. Thus, the present study identified unique factors underlying each ANA domain assessed using a standardized assessment battery. These results revealed additional dimensionality to the ANA domains, bringing together different constructs from the field into a single cohesive framework and advancing the field of addiction phenotyping. Future work will focus on identifying neurobiological correlates and identifying AUD subtypes based on these factors.
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Affiliation(s)
- Tommy Gunawan
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA.
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA.
| | - Jeremy W Luk
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Melanie L Schwandt
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Laura E Kwako
- Division of Treatment and Recovery, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Tonette Vinson
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Yvonne Horneffer
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - David T George
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - George F Koob
- Office of the Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Vijay A Ramchandani
- Human Psychopharmacology Laboratory, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Nancy Diazgranados
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - David Goldman
- Office of the Clinical Director, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
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Schroeder PA, Collantoni E, Lohmann J, Butz MV, Plewnia C. Virtual reality assessment of a high-calorie food bias: Replication and food-specificity in healthy participants. Behav Brain Res 2024; 471:115096. [PMID: 38849007 DOI: 10.1016/j.bbr.2024.115096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 05/07/2024] [Accepted: 06/04/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND Theoretical models and behavioural studies indicate faster approach behaviour for high-calorie food (approach bias) among healthy participants. A previous study with Virtual Reality (VR) and online motion-capture quantified this approach bias towards food and non-food cues in a controlled VR environment with hand movements. The aim of this study was to test the specificity of a manual approach bias for high-calorie food in grasp movements compared to low-calorie food and neutral objects of different complexity, namely, simple balls and geometrically more complex office tools. METHODS In a VR setting, healthy participants (N = 27) repeatedly grasped or pushed high-calorie food, low-calorie food, balls and office tools in randomized order with 30 item repetitions. All objects were rated for valence and arousal. RESULTS High-calorie food was less attractive and more arousing in subjective ratings than low-calorie food and neutral objects. Movement onset was faster for high-calorie food in push-trials, but overall push responses were comparable. In contrast, responses to high-calorie food relative to low-calorie food and to control objects were faster in grasp trials for later stages of interaction (grasp and collect). Non-parametric tests confirmed an approach bias for high-calorie food. CONCLUSION A behavioural bias for food was specific to high-calorie food objects. The results confirm the presence of bottom-up advantages in motor-cognitive behaviour for high-calorie food in a non-clinical population. More systematic variations of object fidelity and in clinical populations are outstanding. The utility of VR in assessing approach behaviour is confirmed in this study by exploring manual interactions in a controlled environment.
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Affiliation(s)
- Philipp A Schroeder
- Department of Psychology, University of Tübingen, Schleichstr. 4, Tübingen 72076, Germany; German Center for Mental Health (DZPG), Germany.
| | - Enrico Collantoni
- Department of Neuroscience, University of Padova, Italy; Padova Neuroscience Center, University of Padova, Italy
| | - Johannes Lohmann
- Cognitive Modeling, Department of Computer Science, University of Tübingen, Sand 14, Tübingen 72076, Germany
| | - Martin V Butz
- Department of Psychology, University of Tübingen, Schleichstr. 4, Tübingen 72076, Germany; Cognitive Modeling, Department of Computer Science, University of Tübingen, Sand 14, Tübingen 72076, Germany
| | - Christian Plewnia
- German Center for Mental Health (DZPG), Germany; Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Calwerstr. 14, Tübingen 72076, Germany
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Gehlenborg J, Miegel F, Moritz S, Scheunemann J, Yassari AH, Jelinek L. Implicit aggressive self-concept in patients with obsessive-compulsive disorder: Results from an approach-avoidance task. J Behav Ther Exp Psychiatry 2024; 83:101927. [PMID: 38064875 DOI: 10.1016/j.jbtep.2023.101927] [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: 03/29/2023] [Revised: 11/13/2023] [Accepted: 11/21/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND AND OBJECTIVES Patients with obsessive-compulsive disorder (OCD) have reported higher anger and aggression than healthy individuals in previous studies using explicit measures. However, studies using implicit measures have demonstrated mixed results. The aim of the present study was to investigate implicit aggressiveness in OCD using an approach-avoidance task (AAT). METHODS Seventy-eight patients with OCD and 37 healthy controls underwent structured clinical interviews and measures of anger, OCD, and depressive symptoms as well as a computerized AAT that included aggressive, peaceful, negative, and positive stimuli. RESULTS In line with previous studies, patients with OCD reported higher scores on explicit anger. With respect to the implicit measure, repeated measures ANOVAs did not show any differences in mean reaction times for pushing compared to pulling aggressive versus peaceful and negative versus positive words. However, analyses of specific OCD symptom dimensions demonstrated significantly faster reaction times for pulling compared to pushing aggressive words for patients with high scores in the OCD symptom dimensions obsessing and hoarding. LIMITATIONS Eighty percent of patients with OCD showed psychiatric comorbidities and all were seeking treatment. CONCLUSION The present study supports previous studies reporting the absence of higher aggressiveness in patients with OCD compared to healthy controls using implicit measures. However, in contrast to previous studies, we found an implicit approach bias towards aggressive self-statements for OCD patients scoring high in the symptom dimensions obsessing and hoarding compared to healthy controls. Future studies should further elucidate putative functional relationships between different OCD symptom dimensions and implicit aggressiveness.
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Affiliation(s)
- Josefine Gehlenborg
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, D-20246, Hamburg, Germany.
| | - Franziska Miegel
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, D-20246, Hamburg, Germany
| | - Steffen Moritz
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, D-20246, Hamburg, Germany
| | - Jakob Scheunemann
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, D-20246, Hamburg, Germany
| | - Amir-Hosseyn Yassari
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, D-20246, Hamburg, Germany
| | - Lena Jelinek
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, D-20246, Hamburg, Germany
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Bahri MRZ, Tayim N, Fakhrou A, Davoudi M. Associations between Adverse Childhood Experiences and Gambling Severity in Youth Online Gamblers: The Mediating Roles of Internalizing, Attention and Externalizing Problems. J Gambl Stud 2024:10.1007/s10899-024-10320-8. [PMID: 38802628 DOI: 10.1007/s10899-024-10320-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND This study examined the association between Adverse Childhood Experiences (ACEs) and Gambling Severity (gambling severity), considering the mediating roles of internalizing, externalizing, and attention among youth online gamblers. METHODS 762 youth (agemean±SD= 15.03 ± 2.40; agerange = 10-18 years; 75.3% boys) completed the Persian Gambling Disorder Screening Questionnaire (GDSQ-P), Pediatric Symptom Checklist - Youth Report (Y-PSC), and Behavioral Risk Factor Surveillance System Questionnaire (ACE's section, modified by authors). The analysis was done using the SMART PLS software. RESULTS The reliability and discriminant validity of the provided model were assessed using Partial Least Squares-Structural Equation Modeling (PLS-SEM). According to the results of the PLS-SEM analysis, the present model demonstrated suitable levels of reliability and validity. Adverse Childhood Experiences (ACEs) significantly affected attention, internalizing, externalizing problems, and gambling severity. Additionally, the level of gambling was directly correlated with ACEs. Moreover, the indirect influence of the independent variable on the dependent variable via the mediators was found to be statistically significant (P < .001).These findings suggest that externalizing behaviors, attention problems, and internalizing symptoms mediate the effect of ACEs on gambling severity. Lastly, fitness indices indicated that our proposed model fit the data well (SRMR = 0.06, d_ULS = 1.15, Chi-square = 1291.461, and NFI = 0.71). CONCLUSION Our study found that ACEs significantly influence gambling severity among youth online gamblers, with internalizing, externalizing, and attention problems mediating this relationship. Practical implications include integrating ACE screening and targeted interventions for associated mental health issues into youth gambling prevention programs to mitigate the risk of problematic gambling behavior.
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Affiliation(s)
| | - Natalie Tayim
- Department of Psychology, School of Social Sciences and Humanities, Doha Institute for Graduate Studies, Doha, Qatar
| | - Abdulnaser Fakhrou
- Department of Psychological Sciences, College of Education, Qatar University, Doha, Qatar
| | - Mohammadreza Davoudi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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Kennis M, Dewitte M, T'Sjoen G, Stinkens K, Sack AT, Duecker F. The behavioral component of sexual inhibition and its relation with testosterone levels: An fMRI study in transgender and cisgender individuals. Psychoneuroendocrinology 2024; 163:106963. [PMID: 38342056 DOI: 10.1016/j.psyneuen.2024.106963] [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: 07/22/2023] [Revised: 11/22/2023] [Accepted: 01/11/2024] [Indexed: 02/13/2024]
Abstract
Many transgender individuals report having difficulties with initiating and seeking sexual contacts. Relatively to cisgender individuals, transgender individuals are more likely to avoid sexual activity, indicating that the groups might differ in the neural underpinnings of the behavioral component of sexual inhibition. In this fMRI study, transgender (n = 33) and cisgender (n = 34) participants performed an Approach Avoidance Task (AAT) assessing sexual inhibition. We found that over the entire sample, the task elicited brain activation commonly associated with general and sexual inhibition, for instance in the bilateral insula, right inferior parietal lobule, and right inferior and middle frontal gyri. Upon investigating group differences between transgender and cisgender participants, we mainly found similarities in neural activation during the task. However, there were group differences in regions involved in decision making processes (left middle temporal gyrus) and sexual response inhibition (right anterior cingulate cortex and left inferior parietal lobule). In order to investigate whether these group differences were modulated by testosterone levels, we performed ROI-analyses assessing the relationship between testosterone and neural activation during the AAT (controlling for sex assigned at birth), but no correlations were found. On the whole brain level, however, we found that testosterone correlated positively with cerebral activation in the right claustrum (a region associated with sexual arousal) during the approach of sexual stimuli in the transgender group. Overall, these findings indicate that transgender and cisgender individuals mostly show similarities in their neural response to a sexual Approach-Avoidance task, and that testosterone levels are unlikely to play an important role.
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Affiliation(s)
- M Kennis
- Maastricht University, Department of Cognitive Neuroscience, Maastricht, The Netherlands; Maastricht Brain Imaging Center, Maastricht, The Netherlands; Maastricht University, Department of Clinical Psychological Science, Maastricht, The Netherlands.
| | - M Dewitte
- Maastricht University, Department of Clinical Psychological Science, Maastricht, The Netherlands
| | - G T'Sjoen
- Ghent University Hospital, Department of Endocrinology, Ghent, Belgium; Ghent University Hospital, Center for Sexology and Gender, Ghent, Belgium
| | - K Stinkens
- Hospital Oost-Limburg, Department of Endocrinology, Genk, Belgium; Hospital Oost-Limburg, Gender Center, Genk, Belgium
| | - A T Sack
- Maastricht University, Department of Cognitive Neuroscience, Maastricht, The Netherlands; Maastricht Brain Imaging Center, Maastricht, The Netherlands; Maastricht University, Center for Integrative Neuroscience, Maastricht, The Netherlands
| | - F Duecker
- Maastricht University, Department of Cognitive Neuroscience, Maastricht, The Netherlands; Maastricht Brain Imaging Center, Maastricht, The Netherlands
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Sklenarik SM, Potenza MN, Astur RS. Avoidance biases for vaping stimuli among college students with electronic-cigarette use. Addict Behav 2024; 151:107934. [PMID: 38101120 DOI: 10.1016/j.addbeh.2023.107934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/06/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023]
Abstract
Previous research has suggested that individuals who smoke demonstrate a behavioral tendency to approach rather than avoid smoking-related stimuli (i.e., approach bias). This study assessed whether 149 undergraduates with varying levels of e-cigarette use demonstrated an approach bias for vaping-related stimuli on an Approach-Avoidance Task (AAT). In contrast to our hypotheses, participants with e-cigarette use demonstrated a significant avoidance bias to vaping-related stimuli, and this effect appeared to be primarily driven by female e-cigarette users. Further, we found that more severe e-cigarette use was associated with numerous adverse outcomes, including reduced quality of life and increased vaping cravings, depressive symptoms, perceived stress, and cannabis use severity. Overall, our findings elucidate various negative impacts of e-cigarette use and suggest a potential role for sex differences in approach-avoidance tendencies toward vaping-related stimuli among young adults.
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Affiliation(s)
- Skyler M Sklenarik
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA.
| | - Marc N Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA; Child Study Center, Yale University School of Medicine, New Haven, CT 06520, USA; Department of Neuroscience, Yale University, New Haven, CT 06510, USA; The Connecticut Council on Problem Gambling, Wethersfield, CT 06109, USA; The Connecticut Mental Health Center, New Haven, CT 06519, USA; Wu Tsai Institute, Yale University, New Haven, CT 06510, USA.
| | - Robert S Astur
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA.
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Schenkel EJ, Rinck M, Wiers RW, Becker ES, Muhlig S, Schoeneck R, Lindenmeyer J. Implementing Approach-Bias Modification as Add-On to Varieties of Clinical Treatment for Alcohol Use Disorders: Results of a Multicenter RCT. Eur Addict Res 2024; 30:94-102. [PMID: 38503273 DOI: 10.1159/000537811] [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: 08/28/2023] [Accepted: 02/02/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION Abstinence rates after inpatient treatment for alcohol use disorder (AUD) are modest (1-year rate around 50%). One promising approach is to re-train the automatically activated action tendency to approach alcohol-related stimuli (alcohol-approach bias) in AUD patients, as add-on to regular treatment. As efficacy has been demonstrated in well-controlled randomized controlled trials, the important next step is to add alcohol-approach-bias modification (alcohol-ApBM) to varieties of existing treatments for AUD. Therefore, this prospective, multicenter implementation-RCT examined whether adding alcohol-ApBM to regular treatments (various abstinence-oriented treatments including both individual and group-based interventions) would significantly increase abstinence rates compared to receiving regular treatment only, in a variety of naturalistic settings with different therapeutic approaches. METHODS A total of 1,586 AUD inpatients from 9 German rehabilitation clinics were randomly assigned to receive either ApBM in addition to regular treatment or not. Training satisfaction of patients and therapists was measured after training. Success rates were determined at 3, 6, and 12 months post-treatment. RESULTS Return rates of the post-treatment assessments varied greatly between clinics, often being low (18-76%). Nevertheless, ApBM significantly increased success rates after 3 months. After 6 and 12 months, the differences were not significant. ApBM was evaluated mostly positively by patients and therapists. DISCUSSION/CONCLUSION ApBM was an effective add-on to regular treatment of AUD at 3 months follow-up, across a variety of AUD treatment settings. However, low return rates for the clinical outcomes reduced the effect size of ApBM considerably. The application of ApBM proved feasible in varying clinical settings, offering the opportunity to modify automatic processes and to promote abstinence.
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Affiliation(s)
- Edwin J Schenkel
- Department of Psychology, Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Germany
- Salus Clinic Lindow, Lindow, Germany
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Mike Rinck
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Reinout W Wiers
- Department of Psychology, Addiction Development and Psychopathology (ADAPT) Lab, ABC and Yield Research Priority Areas, University of Amsterdam, Amsterdam, The Netherlands
| | - Eni S Becker
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Stephan Muhlig
- Department of Psychology, Chemnitz University of Technology, Chemnitz, Germany
| | | | - Johannes Lindenmeyer
- Department of Psychology, Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Germany
- Salus Clinic Lindow, Lindow, Germany
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van der Baan HS, Collot D'Escury-Koenigs DAL, Wiers DRW. The effectiveness of cognitive bias modification in reducing substance use in detained juveniles: An RCT. J Behav Ther Exp Psychiatry 2024; 82:101916. [PMID: 37837770 DOI: 10.1016/j.jbtep.2023.101916] [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: 03/16/2022] [Revised: 04/28/2023] [Accepted: 09/28/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND AND OBJECTIVE Young offenders show high levels of substance use. Treatment programs within detention settings are less effective. Cognitive bias modification (CBM) is a promising supplement to substance use treatment. This study tests the effectiveness of CBM in young offenders to reduce cannabis and alcohol use, and delinquent recidivism. METHOD A randomized controlled trial added CBM to treatment as usual (TAU), among 181 youth in juvenile detention centers. In a factorial design, participants were randomly assigned to either active- or sham-training for two varieties of CBM, targeting attentional-bias (AtB) and approach-bias (ApB) for their most used substance. Substance use was measured with the Alcohol and Cannabis Use Disorder Identification Tests. Delinquent recidivism was measured with the International Self-Report Delinquency (ISRD) survey. RESULTS At pretest, participants showed AtB but no ApB for both substances. For alcohol, a decrease was found in AtB in the active-training group. For cannabis, a decrease was found in AtB for both active- and sham-training groups. Regardless of condition, no effects were found on substance use or ISRD scores at follow-up. LIMITATIONS The sample is judicial, not clinical, as is the setting. TAU and participant goals are not necessarily substance related. CONCLUSIONS Young offenders show a significant attentional-bias towards substance cues. CBM changed attentional-biases but not substance use. Combining CBM with a motivational intervention is advised. Follow-up research should better integrate CBM with running treatment programs. New developments regarding CBM task design could be used that link training better to treatment.
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Affiliation(s)
- Hans S van der Baan
- Department of Psychology, University of Amsterdam, PB 15916, 1001 NK, Amsterdam, the Netherlands; Department of Pedagogical Sciences, Utrecht University, PB 15916, 1001 NK, Amsterdam, the Netherlands.
| | | | - Dr Reinout W Wiers
- Developmental Psychopathology at the Department of Psychology, Universiteit van Amsterdam, Co-Chair Urban Mental Health, Uva.nl/Urban-Mental-Health, PB 15916, 1001 NK, Amsterdam, the Netherlands.
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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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Prior K, Salemink E, Piggott M, Manning V, Wiers RW, Teachman BA, Teesson M, Baillie AJ, Mahoney A, McLellan L, Newton NC, Stapinski LA. Web-Based Cognitive Bias Modification Program for Young People With Social Anxiety and Hazardous Alcohol Use: Feasibility, Acceptability, and Preliminary Efficacy Study. JMIR Form Res 2023; 7:e46008. [PMID: 37878363 PMCID: PMC10632924 DOI: 10.2196/46008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/24/2023] [Accepted: 06/09/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Interpretation bias modification (IBM) and approach bias modification (ApBM) cognitive retraining interventions can be efficacious adjunctive treatments for improving social anxiety and alcohol use problems. However, previous trials have not examined the combination of these interventions in a young, comorbid sample. OBJECTIVE This study aims to describe the feasibility, acceptability, and preliminary efficacy of a web-based IBM+ApBM program for young adults with social anxiety and hazardous alcohol use ("Re-Train Your Brain") when delivered in conjunction with treatment as usual (TAU). METHODS The study involved a 3-arm randomized controlled pilot trial in which treatment-seeking young adults (aged 18-30 y) with co-occurring social anxiety and hazardous alcohol use were randomized to receive (1) the "integrated" Re-Train Your Brain program, where each session included both IBM and ApBM (50:50 ratio), plus TAU (35/100, 35%); (2) the "alternating" Re-Train Your Brain program, where each session focused on IBM or ApBM in an alternating pattern, plus TAU (32/100, 32%); or (3) TAU only (33/100, 33%). Primary outcomes included feasibility and acceptability, and secondary efficacy outcomes included changes in cognitive biases, social anxiety symptoms, and alcohol use. Assessments were conducted at baseline, after the intervention period (6 weeks after baseline), and 12 weeks after baseline. RESULTS Both Re-Train Your Brain program formats were feasible and acceptable for young adults. When coupled with TAU, both integrated and alternating programs resulted in greater self-reported improvements than TAU only in anxiety interpretation biases (at the 6-week follow-up; Cohen d=0.80 and Cohen d=0.89) and comorbid interpretation biases (at the 12-week follow-up; Cohen d=1.53 and Cohen d=1.67). In addition, the alternating group reported larger improvements over the control group in generalized social anxiety symptoms (at the 12-week follow-up; Cohen d=0.83) and alcohol cravings (at the 6-week follow-up; Cohen d=0.81). There were null effects on all other variables and no differences between the intervention groups in efficacy outcomes. CONCLUSIONS Should these findings be replicated in a larger randomized controlled trial, Re-Train Your Brain has the potential to be a scalable, low-cost, and non-labor-intensive adjunct intervention for targeting interpretation and comorbidity biases as well as generalized anxiety and alcohol-related outcomes in the real world. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12620001273976; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364131. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/28667.
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Affiliation(s)
- Katrina Prior
- Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Elske Salemink
- Experimental Psychopathology Lab, Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands
| | - Monique Piggott
- Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Victoria Manning
- Eastern Health Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Bethany A Teachman
- Department of Psychology, School of Arts and Sciences, University of Virginia, Charlottesville, VA, United States
| | - Maree Teesson
- Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Andrew J Baillie
- Sydney School of Health Sciences, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Alison Mahoney
- Clinical Research Unit for Anxiety and Depression, St Vincent's Public Hospital, Sydney, Australia
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Lauren McLellan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Nicola C Newton
- Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Lexine A Stapinski
- Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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11
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DeGrace S, Romero-Sanchiz P, Tibbo P, Barrett S, Arenella P, Cosman T, Atasoy P, Cousijn J, Wiers R, Keough MT, Yakovenko I, O'Connor R, Wardell J, Rudnick A, Nicholas Carleton R, Heber A, Stewart SH. Do trauma cue exposure and/or PTSD symptom severity intensify selective approach bias toward cannabis cues in regular cannabis users with trauma histories? Behav Res Ther 2023; 169:104387. [PMID: 37625353 DOI: 10.1016/j.brat.2023.104387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/16/2023] [Accepted: 08/19/2023] [Indexed: 08/27/2023]
Abstract
Trauma cue-elicited activation of automatic cannabis-related cognitive biases are theorized to contribute to comorbid posttraumatic stress disorder and cannabis use disorder. This phenomenon can be studied experimentally by combining the trauma cue reactivity paradigm (CRP) with cannabis-related cognitive processing tasks. In this study, we used a computerized cannabis approach-avoidance task (AAT) to assess automatic cannabis (vs. neutral) approach bias following personalized trauma (vs. neutral) CRP exposure. We hypothesized that selective cannabis (vs. neutral) approach biases on the AAT would be larger among participants with higher PTSD symptom severity, particularly following trauma (vs. neutral) cue exposure. We used a within-subjects experimental design with a continuous between-subjects moderator (PTSD symptom severity). Participants were exposed to both a trauma and neutral CRP in random order, completing a cannabis AAT (cannabis vs. neutral stimuli) following each cue exposure. Current cannabis users with histories of psychological trauma (n = 50; 34% male; mean age = 37.8 years) described their most traumatic lifetime event, and a similarly-detailed neutral event, according to an established interview protocol that served as the CRP. As hypothesized, an AAT stimulus type x PTSD symptom severity interaction emerged (p = .042) with approach bias greater to cannabis than neutral stimuli for participants with higher (p = .006), but not lower (p = .36), PTSD symptom severity. Contrasting expectations, the stimulus type x PTSD symptoms effect was not intensified by trauma cue exposure (p = .19). Selective cannabis approach bias may be chronically activated in cannabis users with higher PTSD symptom severity and may serve as an automatic cognitive mechanism to help explain PTSD-CUD co-morbidity.
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Affiliation(s)
- S DeGrace
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada.
| | - P Romero-Sanchiz
- School of Psychology, University of Sussex Sussex House, Falmer, Brighton, BN1 9RH, United Kingdom
| | - P Tibbo
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada
| | - S Barrett
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4R2, Canada
| | - P Arenella
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada
| | - T Cosman
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada
| | - P Atasoy
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4R2, Canada
| | - J Cousijn
- Universiteit van Amsterdam, Department of Psychology, Nieuwe Achtergracht 129-B, 1018 WT, Amsterdam, Netherlands
| | - R Wiers
- Universiteit van Amsterdam, Department of Psychology, Nieuwe Achtergracht 129-B, 1018 WT, Amsterdam, Netherlands
| | - M T Keough
- York University, Department of Psychology, 4700 Keele St, North York, ON, M3J 1P3, Canada
| | - I Yakovenko
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada; Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4R2, Canada
| | - R O'Connor
- Concordia University, Department of Psychology, 7141 Sherbrooke West PY-146, Montreal, QC, H4B 1R6, Canada
| | - J Wardell
- York University, Department of Psychology, 4700 Keele St, North York, ON, M3J 1P3, Canada
| | - A Rudnick
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada
| | - R Nicholas Carleton
- University of Regina, Department of Psychology, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - A Heber
- McMaster University, Department of Psychiatry and Behavioural Neurosciences, 100 West 5th Street, Hamilton, ON, Canada
| | - S H Stewart
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada; Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4R2, Canada
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12
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Singh G, Campbell EM, Hogeveen J, Witkiewitz K, Claus ED, Cavanagh JF. Affective imagery boosts the reward related delta power in hazardous drinkers. Psychiatry Res Neuroimaging 2023; 334:111685. [PMID: 37506424 PMCID: PMC10574688 DOI: 10.1016/j.pscychresns.2023.111685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/09/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
The Reward Positivity (RewP) is an event-related potential component with a delta band spectral representation that is elicited by reward receipt. Evidence suggests that RewP is modulated by both reward probability as well as affective valuation ("liking"). Here we determined whether RewP is a marker of enhanced hedonic salience of alcohol images in hazardous drinkers. We recruited 54 participants (Hazardous Drinkers = 28, Control = 26) who completed a reinforcement learning task with affective versus alcohol imagery during feedback. The learning task used images of puppies vs. alcohol paired with reinforcing feedback. Both groups rated categories of affective images (puppies, scenery, babies, neutral) similarly, but the hazardous drinking group rated alcohol significantly higher. There were no group differences in performance or in RewP amplitudes, even as a function of alcohol imagery. Contrary to prior findings, we did not observe a significant correlation between alcohol image rating and alcohol-specific RewP amplitude, although we did observe this relationship with the alcohol-specific delta band spectral representation of RewP. Within hazardous drinking group, there was significant correlation between hazardous drinking (AUDIT score) and alcohol-specific RewP indicating an inter-individual influence of drinking habits on affect specific RewP. These findings suggest a domain-specific enhancement of reward responsiveness in hazardous drinkers.
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Affiliation(s)
- Garima Singh
- The University of New Mexico, Albuquerque, NM, United States of America.
| | - Ethan M Campbell
- The University of New Mexico, Albuquerque, NM, United States of America
| | - Jeremy Hogeveen
- The University of New Mexico, Albuquerque, NM, United States of America
| | - Katie Witkiewitz
- The University of New Mexico, Albuquerque, NM, United States of America
| | - Eric D Claus
- Mind Research Network, Albuquerque, New Mexico and The Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - James F Cavanagh
- The University of New Mexico, Albuquerque, NM, United States of America
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13
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Ascone L, Wirtz J, Mellentin AI, Kugler D, Bremer T, Schadow F, Hoppe S, Jebens C, Kühn S. Transferring the approach avoidance task into virtual reality: a study in patients with alcohol use disorder versus healthy controls. VIRTUAL REALITY 2023; 27:2711-2722. [PMID: 37614715 PMCID: PMC10442255 DOI: 10.1007/s10055-023-00835-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/02/2023] [Indexed: 08/25/2023]
Abstract
Study aims were to (I) transfer the measurement of the approach bias (Apb) related to alcoholic stimuli via the Approach Avoidance Task (AAT) into Virtual Reality (VR), (II) check whether measuring Apb in VR leads to similar or different results compared to the classical PC-based version, (III) check the validity of VR versus PC-based bias scores in terms of relatedness to clinical variables. Different 'grasping-conditions' were tested and contrasted in VR concerning (Ia) feasibility (performance): (1) never grasp, (2) always grasp, (3) grasp when PULLing stimuli towards oneself. (Ib) Differences in the bias scores between patients with alcohol use disorder (AUD) and healthy controls (HC) were examined for each grasping-condition. (II) PC-based bias scores were computed and contrasted for AUD versus HC. (III) Correlations of the different VR- versus PC-based bias scores with AUD symptom severity and impulsivity were checked to evaluate validity. (Ia) Grasping-condition 1, followed by 3, showed acceptable (> 50%) and good (> 80%) rates of correct performances allowing for robust median estimation. (Ib) Significant differences in the resulting bias scores emerged between AUD and HC only for grasping-condition 1 (p = 0.034) and 3 at trend-level (p = 0.093). For grasping-condition 1 the Apb Median for AUD was different from zero at a non-significant trend-level (p = 0.064). (II) The PC-based bias scores did not discriminate between AUD versus HC groups. (III) Grasping-condition 1 and 3 VR-based bias scores correlated significantly with impulsivity. In sum, transferring the AAT into VR is feasible, valid, and best implemented without an additional grasping-component when using the VR-controller. This way of Apb assessment represents a viable, perhaps even superior, alternative to PC-based assessments. Trial registration The trial was pre-registered at AsPredicted #76854: 'Transferring the approach avoidance task into virtual reality', 10/13/2021; prior to any analyses being undertaken.
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Affiliation(s)
- Leonie Ascone
- Neuronal Plasticity Working Group, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Janina Wirtz
- Neuronal Plasticity Working Group, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Angelina Isabella Mellentin
- Unit for Clinical Alcohol Research, Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, J. B. Winsløwvej 18, 5000 Odense C, Denmark
- Brain Research-Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
- Center for Digital Psychiatry (CEDIP), Heden 11, 5000 Odense C, Region of Southern Denmark Denmark
| | - Dimitrij Kugler
- Neuronal Plasticity Working Group, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Thomas Bremer
- University of Applied Sciences, Treskowallee 8, 10318 Berlin, Germany
| | - Friedrich Schadow
- University of Applied Sciences, Treskowallee 8, 10318 Berlin, Germany
| | - Stine Hoppe
- Department of Clinical Psychology and Psychotherapy, Christian-Albrechts-University Kiel, Christian-Albrechts-Platz 4, 24118 Kiel, Germany
| | - Charlotte Jebens
- Department of Clinical Psychology and Psychotherapy, Christian-Albrechts-University Kiel, Christian-Albrechts-Platz 4, 24118 Kiel, Germany
| | - Simone Kühn
- Neuronal Plasticity Working Group, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Lentzeallee 94, 14195 Berlin, Germany
- Max Planck-UCL Center for Computational Psychiatry and Ageing Research, Max Planck Institute for Human Development, Lentzeallee 94, 14195 Berlin, Germany
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14
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Laurens MC, Postel MG, Brusse-Keizer M, Pieterse ME, Ben Allouch S, Bohlmeijer ET, Salemink E. Augmenting outpatient alcohol treatment as usual with online approach bias modification training: A double-blind randomized controlled trial. Addict Behav 2023; 142:107630. [PMID: 36881944 DOI: 10.1016/j.addbeh.2023.107630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 01/21/2023] [Accepted: 01/23/2023] [Indexed: 01/28/2023]
Abstract
Previous research shows that automatic tendency to approach alcohol plays a causal role in problematic alcohol use and can be retrained by Approach Bias Modification (ApBM). ApBM has been shown to be effective for patients diagnosed with alcohol use disorder (AUD) in inpatient treatment. This study aimed to investigate the effectiveness of adding an online ApBM to treatment as usual (TAU) in an outpatient setting compared to receiving TAU with an online placebo training. 139 AUD patients receiving face-to-face or online treatment as usual (TAU) participated in the study. The patients were randomized to an active or placebo version of 8 sessions of online ApBM over a 5-week period. The weekly consumed standard units of alcohol (primary outcome) was measured at pre-and post-training, 3 and 6 months follow-up. Approach tendency was measured pre-and-post ApBM training. No additional effect of ApBM was found on alcohol intake, nor other outcomes such as craving, depression, anxiety, or stress. A significant reduction of the alcohol approach bias was found. This research showed that approach bias retraining in AUD patients in an outpatient treatment setting reduces the tendency to approach alcohol, but this training effect does not translate into a significant difference in alcohol reduction between groups. Explanations for the lack of effects of ApBM on alcohol consumption are treatment goal and severity of AUD. Future ApBM research should target outpatients with an abstinence goal and offer alternative, more user-friendly modes of delivering ApBM training.
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Affiliation(s)
- Melissa C Laurens
- Department of Psychology, Health and Technology, Centre for eHealth and Well-being Research, University of Twente, Enschede, Netherlands; Research Group Technology, Health & Care, Saxion University of Applied Sciences, Enschede, Netherlands.
| | - Marloes G Postel
- Research Group Technology, Health & Care, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Marjolein Brusse-Keizer
- Medical School Twente, Medisch Spectrum Twente, Enschede, Netherlands; Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, Netherlands
| | - Marcel E Pieterse
- Department of Psychology, Health and Technology, Centre for eHealth and Well-being Research, University of Twente, Enschede, Netherlands
| | - Somaya Ben Allouch
- Informatics Institute, University of Amsterdam, Netherlands; Research Group Digital Life, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Ernst T Bohlmeijer
- Department of Psychology, Health and Technology, Centre for eHealth and Well-being Research, University of Twente, Enschede, Netherlands
| | - Elske Salemink
- Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands
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15
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Rosenthal A, Chen K, Beck A, Romanczuk-Seiferth N. Modifying Pavlovian-to-instrumental transfer by approach avoidance training in healthy subjects: a proof of concept study. Sci Rep 2023; 13:10074. [PMID: 37344561 PMCID: PMC10284857 DOI: 10.1038/s41598-023-37083-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 06/15/2023] [Indexed: 06/23/2023] Open
Abstract
The modulation of instrumental action by conditioned Pavlovian cues is hypothesized to play a role in the emergence and maintenance of maladaptive behavior. The Pavlovian to Instrumental transfer task (PIT) is designed to examine the magnitude of the influence of cues on behavior and we aim to manipulate the motivational value of Pavlovian cues to reduce their effect on instrumental responding. To this end, we utilized a joystick-based modification of approach and avoidance propensities that has shown success in clinical populations. To examine changes in PIT, we subjected 35 healthy participants to a series of experimental procedures: (1) Instrumental training was followed by (2) Pavlovian conditioning of neutral stimuli that were associated with monetary reward or loss. (3) In a subsequent joystick task, approach and avoidance tendencies toward conditioned cues were assessed. (4) In a transfer test, the PIT effect as the impact of conditioned cues on instrumental behavior was measured. (5) The explicit knowledge of cue-reward contingencies was assessed in a forced-choice phase. (6, 7) systematic joystick training was followed by a posttest (8) the transfer task and forced-choice test were repeated. We found no effect of training on approach-avoidance propensities in the context of this proof of concept study. A higher response rate towards negative stimuli during PIT after systematic training compared to sham training was seen. On the other hand, we saw an increased PIT effect after sham training. These results contribute to the understanding of the strength of the influence of cues on instrumental behavior. Our findings further stress the importance of context, instructions and operationalization of instrumental behavior in the framework of transfer effects.
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Affiliation(s)
- Annika Rosenthal
- Department of Psychiatry and Neurosciences|CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Ke Chen
- Department of Psychiatry and Neurosciences|CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Anne Beck
- Faculty of Health, Health and Medical University, Campus Potsdam, Potsdam, Germany
| | - Nina Romanczuk-Seiferth
- Department of Psychiatry and Neurosciences|CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychology, Clinical Psychology and Psychotherapy, MSB Medical School Berlin, Berlin, Germany
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16
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Galvin HR, Boffo M, Snippe L, Collins P, Pronk T, Salemink E, Wiers RW, Stewart SH. Losing sight of Luck: Automatic approach tendencies toward gambling cues in Canadian moderate- to high-risk gamblers - A replication study. Addict Behav 2023; 145:107778. [PMID: 37364524 DOI: 10.1016/j.addbeh.2023.107778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 04/20/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023]
Abstract
Evidence for approach bias tendencies to underly automatic behavioural impulses towards seeking out gambling activities in the presence of appetitive salient cues was first shown by Boffo et al. (2018) in a Dutch sample. Relative to non-problem gamblers, moderate-to-high-risk gamblers demonstrated stronger approach tendencies towards gambling-related stimuli compared with neutral ones. Moreover, gambling approach bias was associated with past-month gambling behaviour and predictive of gambling activity persistence over time. The current study aimed to replicate these findings within a Canadian sample evaluating the concurrent and longitudinal correlates of gambling approach bias. The study was conducted online, available throughout Canada. Twenty-seven non-treatment-seeking moderate-to-high-risk gamblers and 26 non-problem gamblers community-recruited via multiple channels (i.e., internet and newspaper advertisements, land-based flyers, and university recruitment portals). Participants completed two online assessment sessions 6-months apart. Each session included (1) self-report measures of gambling behaviour (frequency, duration, and expenditure), (2) self-report assessment of problem gambling severity (PGSI), and (3) a gambling approach-avoidance task, utilising culturally relevant stimuli tailored to individual gambling habits. However, our study failed to replicate Boffo et al. (2018) findings in a Canadian sample. Relative to non-problem gamblers, moderate-to-high-risk gamblers did not exhibit greater approach bias tendencies towards gambling-related stimuli compared to neutral stimuli. Moreover, gambling approach bias was not predictive of prospective gambling behaviour (frequency, duration, or expenditure) or severity of gambling problems. Reported results do not provide evidence for approach tendencies contributing to problematic gambling behaviour in a Canadian sample of moderate-to-high-risk gamblers compared to non-problematic gambler controls. Further replications on the topic are needed. Future research should evaluate approach tendencies within the gambling context, considering the potential impact of task reliability to assess approach bias in light of individual gambling modality preferences.
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Affiliation(s)
- Harriet R Galvin
- Department of Psychology, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA Rotterdam, the Netherlands.
| | - Marilisa Boffo
- Department of Psychology, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA Rotterdam, the Netherlands
| | - Leroy Snippe
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology and Center for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - Pam Collins
- Psychology & Neuroscience Department, Dalhousie University, Halifax, Canada
| | - Thomas Pronk
- Behavioural Science Lab, Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Elske Salemink
- Experimental Psychopathology Lab, Department of Clinical Psychology, Utrecht University, the Netherlands
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology and Center for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - Sherry H Stewart
- Psychology & Neuroscience Department, Dalhousie University, Halifax, Canada
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17
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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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18
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Beckenstrom AC, Coloma PM, Dawson GR, Finlayson AK, Malik A, Post A, Steiner MA, Potenza MN. Use of experimental medicine approaches for the development of novel psychiatric treatments based on orexin receptor modulation. Neurosci Biobehav Rev 2023; 147:105107. [PMID: 36828161 PMCID: PMC10165155 DOI: 10.1016/j.neubiorev.2023.105107] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/08/2023] [Accepted: 02/18/2023] [Indexed: 02/25/2023]
Abstract
Despite progress in understanding the pathological mechanisms underlying psychiatric disorders, translation from animal models into clinical use remains a significant bottleneck. Preclinical studies have implicated the orexin neuropeptide system as a potential target for psychiatric disorders through its role in regulating emotional, cognitive, and behavioral processes. Clinical studies are investigating orexin modulation in addiction and mood disorders. Here we review performance-outcome measures (POMs) arising from experimental medicine research methods which may show promise as markers of efficacy of orexin receptor modulators in humans. POMs provide objective measures of brain function, complementing patient-reported or clinician-observed symptom evaluation, and aid the translation from preclinical to clinical research. Significant challenges include the development, validation, and operationalization of these measures. We suggest that collaborative networks comprising clinical practitioners, academics, individuals working in the pharmaceutical industry, drug regulators, patients, patient advocacy groups, and other relevant stakeholders may provide infrastructure to facilitate validation of experimental medicine approaches in translational research and in the implementation of these approaches in real-world clinical practice.
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Affiliation(s)
- Amy C Beckenstrom
- P1vital Ltd, Manor House, Howbery Business Park, Wallingford OX10 8BA, UK.
| | - Preciosa M Coloma
- Idorsia Pharmaceuticals Ltd, Hegenheimermattweg 91, Allschwil 4123, Switzerland
| | - Gerard R Dawson
- P1vital Ltd, Manor House, Howbery Business Park, Wallingford OX10 8BA, UK
| | - Ailidh K Finlayson
- P1vital Ltd, Manor House, Howbery Business Park, Wallingford OX10 8BA, UK; Department of Psychology, University of Bath, Claverton Down, Bath BA2 7AY, UK
| | - Asad Malik
- P1vital Ltd, Manor House, Howbery Business Park, Wallingford OX10 8BA, UK
| | - Anke Post
- Corlieve Therapeutics, Swiss Innovation Park, Hegenheimermattweg 167A, 4123 Allschwil, Switzerland
| | | | - Marc N Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center, Yale School of Medicine, 1 Church Street, Room 726, New Haven, CT 06510, USA; Connecticut Mental Health Center, 34 Park Street, New Haven, CT 06519, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; The Wu Tsai Institute, Yale University, 100 College St, New Haven, CT 06510, USA
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19
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TÜRKOĞLU S, GÖNÜL AS, AMADO S, EKER Ç. Türk İçecek Resim Setinin Geçerliği ve Standardizasyonu: Bilişsel Yanlılık Ölçümü ve Modifikasyon Paradigmaları İçin Kontrollü Resim Seti. EGE TIP DERGISI 2023. [DOI: 10.19161/etd.1205014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
Amaç: Bu çalışmada alkol içerikli uyaranlara ilişkin bilişsel yanlılık ölçüm ve modifikasyonu araştırmalarında kullanılabilecek, Türk örneklemi üzerinde geçerliliği ve standardizasyonu yapılmış içecek resim seti oluşturulması amaçlanmıştır.
Gereç ve Yöntem: Alkollü ve alkolsüz içecek resimleri 3 pasif bağlamda (dolu bir şişede içecek, boş bir bardakla dolu bir şişe ve dolu bir bardakla dolu bir şişe içecek) ve 3 aktif bağlamda (içecek servis edilirken, açılırken ve tüketilirken) fotoğraflanmıştır. Sonrasında 120 üniversite öğrencisine Alkol Kullanım Bozukluğu Tarama Testi, içecek resimlerini tanıma ve derecelendirme deneyleri uygulanmıştır.
Bulgular: Türk İçecek Resim Seti kolaylıkla tanınabilen, popülasyon tarafından sıklıkla tüketilen içecek resimlerinden oluşmaktadır. Alkollü içecek resimleri ağır içici grupta daha fazla içme isteği uyandırabilmiştir. Pasif bağlamda sunulan içecekler aktif resimlere göre daha hızlı tanınmıştır.
Sonuç: Türk İçecek Resim Seti, alkol bağımlılığında örtük bilişsel süreçleri araştırmak için çeşitli deneysel paradigmalarda kullanılabilecektir.
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Affiliation(s)
- Sevgül TÜRKOĞLU
- Ege Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı
| | - Ali Saffet GÖNÜL
- Ege Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı
| | - Sonia AMADO
- EGE ÜNİVERSİTESİ, EDEBİYAT FAKÜLTESİ, PSİKOLOJİ BÖLÜMÜ, PSİKOLOJİ PR
| | - Çağdaş EKER
- Ege Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı
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TÜRKOĞLU S, AMADO S, GÖNÜL AS, EKER Ç. Comparison of Alcohol Attentional Bias and Alcohol Craving Among Alcohol Abusers and Non-Abusers. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2022. [DOI: 10.18863/pgy.1095312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The aim of this research is to investigate implicit cognitive process underlying alcohol craving and relationship between alcohol attentional bias and alcohol craving by using visual probe task. Current study examined whether alcohol abusers show attentional bias toward alcohol related task compared with non- abusers and causal relationship between alcohol attentional bias and alcohol craving. Firstly, participants were divided two groups (non abusers- abusers) and they were completed alcohol craving scale to determinate their alcohol craving level. Then, participants alcohol attentional bias was investigated using the visual probe task. In this task, images (alcohol-related and neutral) were presented for 500 ms on a computer screen. After that, probe (*, asterisk) was presented. Participants were asked to decide the place of the probe place by using keyboard keys within 1500 ms. Participants reaction time and number of correct and incorrect answers during the test. According to results, alcohol abuser group’s reaction times were faster than non-abuser when probe was associated with alcohol picture but not in neutral trials. These results suggested that, alcohol abusers showed significantly greater attentional bias to alcohol related pictures than non- abusers. From this point, investigation of alcohol attentional bias might be important component of alcohol dependence in terms of the alcohol relapse risk and determination of the alcohol craving.
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Affiliation(s)
- Sevgül TÜRKOĞLU
- EGE ÜNİVERSİTESİ, MADDE BAĞIMLILIĞI, TOKSİKOLOJİ VE İLAÇ BİLİMLERİ ENSTİTÜSÜ
| | - Sonia AMADO
- EGE ÜNİVERSİTESİ, EDEBİYAT FAKÜLTESİ, PSİKOLOJİ BÖLÜMÜ, PSİKOLOJİ PR
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Bolt G, Piercy H, Barnett A, Manning V. ‘A circuit breaker’ – Interrupting the alcohol autopilot: A qualitative exploration of participants’ experiences of a personalised mHealth approach bias modification intervention for alcohol use. Addict Behav Rep 2022; 16:100471. [DOI: 10.1016/j.abrep.2022.100471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/02/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022] Open
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Allen MT, Shields MM, Myers CE. Distressed (Type D) personality is predicted by avoidance: evidence from a computer-based avatar task. PeerJ 2022; 10:e14302. [PMID: 36320564 PMCID: PMC9618263 DOI: 10.7717/peerj.14302] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/05/2022] [Indexed: 01/24/2023] Open
Abstract
Background One personality type associated with poor health outcomes is distressed (Type D) personality which involves high levels of both social inhibition (SI) and negative affectivity (NA). Type D is also linked to psychopathologies such as post-traumatic stress disorder (PTSD), anxiety disorders, and depression. One mechanism through which personality temperament may result in these psychopathologies is avoidance. Recently, a computer-based measure designed to assess avoidant behaviors, in which the participant guides the behavior of an avatar interacting with strangers in social situations, has been found to be related to various forms of avoidance. In the current study, we extended this work with the avatar avoidance task to determine its relationship to distressed (Type D) personality. We hypothesized that Type D personality, along with SI, but not NA, would be positively related to avatar avoidance scores. We also hypothesized that avatar avoidance scores would be higher in Type D individuals than non-Type D individuals. Methods A total of 302 undergraduates completed the Distressed Type D Personality Scale (DS-14), and a computer-based avatar avoidance task. Results Type D and SI, and NA to a lesser degree, were positively correlated with avoidance scores on the avatar task. Furthermore, regression analyses revealed that Type D and SI scores were best predicted by a model including avoidance scores and education level while NA scores were best predicted by a model including avoidance scores. Standard cut-off scores on the DS-14 scale resulted in four groups (i.e., low SI and NA, high SI, high NA, and Type D) which significantly differed in avoidance scores. Specifically, Type D individuals had higher avoidance scores than the other three groups. Taken together these findings support a role for avoidance in Type D personality. The computer-based avatar avoidance task may be particularly relevant as an ecologically valid measure to identify avoidance in a virtual setting for use with individuals expressing Type D personality who may be unwilling or unable to accurately self-report or describe their own avoidant tendencies.
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Affiliation(s)
- M. Todd Allen
- School of Psychological Sciences, University of Northern Colorado, Greeley, CO, USA
| | - Michelle M. Shields
- School of Psychological Sciences, University of Northern Colorado, Greeley, CO, USA
| | - Catherine E. Myers
- Department of Pharmacology, Physiology & Neuroscience, Rutgers University—New Jersey Medical School, Newark, NJ, USA,Department of Veterans Affairs, VA Medical Center, East Orange, NJ, USA
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Seesink HJ, Schaap-Jonker H, Ostafin B, Lokman JC, Wiers RW. Protocol for an RCT on cognitive bias modification for alcohol use disorders in a religion-based rehabilitation program. BMJ Open 2022; 12:e060820. [PMID: 36130749 PMCID: PMC9494557 DOI: 10.1136/bmjopen-2022-060820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Alcohol-related cues trigger relapse in patients with alcohol use disorders (AUDs). These cues may automatically activate motivational approach tendencies. Through computerised cognitive bias modification (CBM), the tendencies of patients with AUD to approach alcohol can be reduced. The present protocol describes a training intervention with approach bias modification (ApBM) incorporating religion-related stimuli as an alternative to alcohol to improve the effectiveness of CBM in a religion-based rehabilitation centre. AUD is often related to patients' religious attitudes in this treatment context. The religion-adapted ApBM, therefore, combines training in avoidance of alcohol-related motivational cues and an approach to religion-based motivational cues. This combination's effectiveness will be compared with a standard ApBM and to a sham ApBM. METHODS AND ANALYSIS Using a double-blind multiarm parallel randomised controlled trial procedure (ratio 1:1:1), 120 patients with AUD will be randomised into 1 of 3 conditions (religion-adapted ApBM, standard ApBM or sham ApBM) with personalised stimuli. The interventions are delivered over 4 consecutive days during an inpatient detoxification programme in addition to treatment as usual. Assessments occur before the start of the training and after the fourth training session, with follow-up assessments after 1 and 4 months. A multivariate analysis of variance will be used with the primary outcomes, the percentage of days abstinent and meaning in life 4-month follow-up. Secondary outcomes include differences in reported training satisfaction and symptoms of AUD. ETHICS AND DISSEMINATION This study has been reviewed and approved by the Medical Research Ethics Committee Academic Medical Center Amsterdam (Reference number: 2020_251). Further, study results will be published in peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER NL75499.018.20.
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Affiliation(s)
- Henk-Jan Seesink
- Department of Research, De Hoop ggz, Dordrecht, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Centre for Research and Innovation in Christian Mental Health Care, Eleos/De Hoop, Hoevelaken, The Netherlands
| | - Hanneke Schaap-Jonker
- Centre for Research and Innovation in Christian Mental Health Care, Eleos/De Hoop, Hoevelaken, The Netherlands
- Department of Religion and Theology, Faculteit der Geesteswetenschappen, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Brian Ostafin
- Experimental and Clinical Psychology, Department of Psychology, Rijksuniversiteit Groningen Faculteit Gedrags en Maatschappijwetenschappen, Groningen, The Netherlands
| | - John C Lokman
- Department of Psychiatry, Amsterdam UMC - University Medical Centers, Amsterdam, The Netherlands
| | - Reinout W Wiers
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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Solzbacher J, Czeszumski A, Walter S, König P. Evidence for the embodiment of the automatic approach bias. Front Psychol 2022; 13:797122. [PMID: 36160565 PMCID: PMC9505509 DOI: 10.3389/fpsyg.2022.797122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 07/07/2022] [Indexed: 11/24/2022] Open
Abstract
Tendencies of approach and avoidance seem to be a universal characteristic of humans. Specifically, individuals are faster in avoiding than in approaching negative stimuli and they are faster in approaching than in avoiding positive stimuli. The existence of this automatic approach-avoidance bias has been demonstrated in many studies. Furthermore, this bias is thought to play a key role in psychiatric disorders like drug addiction and phobias. However, its mechanisms are far from clear. Theories of embodied cognition postulate that the nature of gestures plays a key role in this process. To shed light on the role of the involved gesture we employed a 2 × 2 factorial design with two types of stimuli. Participants had either to approach positive and avoid negative stimuli (congruent conditions) or to avoid positive stimuli and approach negative stimuli (incongruent conditions). Further, they responded either with a joystick or a button press on a response pad. Participants reacted faster in congruent conditions, i.e., avoiding negative stimuli and approaching positive stimuli, than in incongruent conditions. This replicates the known approach and avoidance bias. However, direct analysis of the button press condition revealed no reaction time advantage for congruent trials compared to incongruent trials. In contrast, in the joystick condition participants were significantly faster performing congruent reactions than incongruent reactions. This interaction, a significant reaction time advantage, when the response is enacted by moving a joystick towards or away from the body provides evidence that approach-avoidance tendencies have a crucial bodily component.
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Affiliation(s)
- Johannes Solzbacher
- Institute of Cognitive Science, Osnabrück University, Osnabrück, Germany
- *Correspondence: Johannes Solzbacher,
| | - Artur Czeszumski
- Institute of Cognitive Science, Osnabrück University, Osnabrück, Germany
- Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Sven Walter
- Institute of Cognitive Science, Osnabrück University, Osnabrück, Germany
| | - Peter König
- Institute of Cognitive Science, Osnabrück University, Osnabrück, Germany
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Chen K, Garbusow M, Sebold M, Kuitunen-Paul S, Smolka MN, Huys QJ, Zimmermann US, Schlagenhauf F, Heinz A. Alcohol approach bias is associated with both behavioral and neural Pavlovian-to-instrumental transfer effects in alcohol-dependent patients. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022. [PMID: 37519476 PMCID: PMC10382691 DOI: 10.1016/j.bpsgos.2022.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Background Even after qualified detoxification, alcohol-dependent (AD) patients may relapse to drinking alcohol despite their decision to abstain. Two mechanisms may play important roles. First, the impact of environmental cues on instrumental behavior (i.e., Pavlovian-to-instrumental transfer [PIT] effect), which was found to be stronger in prospectively relapsing AD patients than in abstaining patients. Second, an automatic approach bias toward alcohol stimuli was observed in AD patients, and interventions targeting this bias reduced the relapse risk in some studies. Previous findings suggest a potential behavioral and neurobiological overlap between these two mechanisms. Methods In this study, we examined the association between alcohol approach bias and both behavioral and neural non-drug-related PIT effects in AD patients after detoxification. A total of 100 AD patients (17 females) performed a PIT task and an alcohol approach/avoidance task. Patients were followed for 6 months. Results A stronger alcohol approach bias was associated with both a more pronounced behavioral PIT effect and stronger PIT-related neural activity in the right nucleus accumbens. Moreover, the association between alcohol approach bias and behavioral PIT increased with the severity of alcohol dependence and trait impulsivity and was stronger in patients who relapsed during follow-up in the exploratory analysis. Conclusions These findings indicate partial behavioral and neurobiological overlap between alcohol approach bias and the PIT effect assessed with our tasks. The association was stronger in patients with more severe alcohol dependence.
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Cofresí RU, Kohen CB, Motschman CA, Wiers RW, Piasecki TM, Bartholow BD. Behavioral response bias and event-related brain potentials implicate elevated incentive salience attribution to alcohol cues in emerging adults with lower sensitivity to alcohol. Addiction 2022; 117:892-904. [PMID: 34697852 PMCID: PMC8904297 DOI: 10.1111/add.15728] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 10/04/2021] [Indexed: 12/15/2022]
Abstract
AIMS This study used a behavioral approach-avoidance task including images of alcoholic beverages to test whether low sensitivity to alcohol (LS) is a phenotypical marker of a dispositional propensity to attribute bottom-up incentive value to naturally conditioned alcohol cues. DESIGN, SETTING AND PARTICIPANTS Experimental study with a measured individual difference variable at a university psychology laboratory in Missouri, MO, USA. Participants were 178 emerging adults (aged 18-20 years) varying in self-reported sensitivity to alcohol's acute effects. MEASUREMENTS Participants completed the alcohol approach-avoidance task while behavior (response time; RT) and the electroencephalogram (EEG) were recorded. Stimulus-locked event-related potentials (ERPs) provided indices of integrated (top-down and bottom-up) stimulus incentive value (P3 amplitude) and conflict between top-down task demands and bottom-up response propensities (N450 amplitude). FINDINGS Linear mixed models showed faster RT for 'alcohol-approach' relative to 'alcohol-avoid' trials for lower-sensitivity (LS) [meanD ± standard errorD (MD ± SED ) = 29.51 ± 9.74 ms, t(328) = 3.03, P = 0.003] but not higher-sensitivity (HS) individuals (MD ± SED = 2.27 ± 9.33 ms, t(328) = 0.243, P = 0.808). There was enhanced N450 amplitude (response conflict) for alcohol-avoid relative to alcohol-approach trials for LS participants (MD ± SED = 0.811 ± 0.198 μV, Z = 4.108, P < 0.001) and enhanced N450 amplitude for alcohol-approach relative to alcohol-avoid for HS participants (MD ± SED = 0.419 ± 0.188 μV, Z = 2.235, P = 0.025). There was also enhanced P3 amplitude for alcohol-approach relative to alcohol-avoid for LS (MD ± SED = 0.825 ± 0.204 μV, Z = 4.045, P < 0.001) but not HS (MD ± SED = 0.013 ± 0.194 μV, Z = 0.068, P = 0.946). CONCLUSIONS Findings from a human laboratory study appear to support the notion that low sensitivity to alcohol indexes a propensity to attribute bottom-up incentive value to naturally conditioned alcohol cues.
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Affiliation(s)
- Roberto U. Cofresí
- Department of Psychological Sciences, University of Missouri,Corresponding author: Roberto Cofresí, University of Missouri, Department of Psychological Sciences, Columbia, MO, 65211. Phone: 469-323-0181
| | - Casey B. Kohen
- Department of Psychological Sciences, University of Missouri
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Sklenarik S, Potenza MN, Astur RS. Avoidance tendencies toward cannabis stimuli in a college sample. J Addict Dis 2022; 40:489-500. [PMID: 35356853 DOI: 10.1080/10550887.2022.2028540] [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: 10/18/2022]
Abstract
Individuals with addictions often exhibit approach bias, or the relatively automatic action tendency to approach rather than avoid addiction-related stimuli. The current study used a cannabis-Approach-Avoidance Task (AAT) to assess approach-avoidance tendencies toward cannabis stimuli among 211 undergraduate college students with varying levels of cannabis use. Frequency and severity of cannabis use was assessed using the Cannabis Use Disorder Identification Test - Short Form (CUDIT-R). The sample did not demonstrate a significant approach or avoidance bias toward cannabis stimuli; instead, participants were significantly slower to approach and avoid cannabis stimuli relative to neutral stimuli. Individuals with problematic cannabis use who met criteria for a possible cannabis use disorder (CUD) based on CUDIT-R criteria were significantly slower to avoid but not to approach cannabis stimuli compared to individuals with nonuse and non-problematic use. Moreover, increased frequency and severity of cannabis use was significantly associated with increased reaction times to avoid cannabis stimuli. Findings appear to differ from some previous studies examining approach-avoidance tendencies toward cannabis, suggesting that the role of cognitive biases in cannabis use is complex and should be further investigated.
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Affiliation(s)
- Skyler Sklenarik
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Marc N Potenza
- Departments of Psychiatry and Neuroscience and Child Study Center, Yale University School of Medicine, New Heaven, CT, USA.,Connecticut Council on Problem Gambling, Wethersfield, CT, USA.,Connecticut Mental Health Center, New Heaven, CT, USA
| | - Robert S Astur
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
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The roles of implicit approach motivation and explicit reward in excessive and problematic use of social networking sites. PLoS One 2022; 17:e0264738. [PMID: 35294452 PMCID: PMC8926255 DOI: 10.1371/journal.pone.0264738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/15/2022] [Indexed: 11/30/2022] Open
Abstract
Despite growing concerns about the addictive potential of social networking sites (SNSs), little is known about the precise neural, cognitive, and emotional processes underpinning compulsive SNS behaviours, such as excessive checking of SNSs. Recent evidence points to the important role of reward in SNS behaviours and one avenue to examine reward processes related to SNSs is the use of behavioural paradigms that allow for the measurement of implicit motivational responses, such as the approach avoidance task (AAT). The AAT has been successfully utilised to capture changes in unconscious reward processes in substance use disorders and other behavioural addictions, with faster approach reactions to addiction-related stimuli reflecting increased wanting/urges to have/consume the reward. In the present study 411 young adults completed an online Visual Approach/Avoidance by the Self Task (VAAST) with social media and control logos as well as other subjective (explicit) measures of reward experience related to SNSs. Our results showed that across participants SNS logos elicited strong approach reactions (compared to control stimuli) and that stronger SNS approach tendencies predicted more frequent SNS checking. Importantly, increased approach motivation was not associated with more problematic use. However, both checking frequency and problematic use were related to alterations of explicit reward processing, including the subjective experience of SNS urges or wanting. We conclude that changes in automatic approach motivation towards SNS stimuli are common in most SNS users, which suggests that implicit imbuement of social media with reward has become pervasive among young adults. Problematic SNS use however may be more reliably indicated by changes in explicit reward processing, such as subjective wanting.
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Martins JS, Joyner KJ, McCarthy DM, Morris DH, Patrick CJ, Bartholow BD. Differential brain responses to alcohol-related and natural rewards are associated with alcohol use and problems: Evidence for reward dysregulation. Addict Biol 2022; 27:e13118. [PMID: 34877771 PMCID: PMC8891069 DOI: 10.1111/adb.13118] [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: 04/25/2021] [Revised: 10/15/2021] [Accepted: 11/04/2021] [Indexed: 12/17/2022]
Abstract
Multiple theoretical perspectives posit that drug use leads to biased valuation of drug-related reward, at the expense of naturally occurring rewarding activities (i.e., reward dysregulation). Recent research suggests that the comparative balance of drug-related and nondrug-related reward valuation is a powerful determinant of substance misuse and addiction. We examined differential neurophysiological responses-indexed with the P3 component of the event-related potential (ERP)-elicited by visual alcohol cues and cues depicting natural reward as a neurobiological indicator of problematic drinking. Nondependent, young adult drinkers (N = 143, aged 18-30 years) completed questionnaire measures assessing alcohol use and problems, and viewed alcohol cues (pictures of alcoholic beverages), high-arousing natural reward cues (erotica, adventure scenes), nonalcoholic beverage cues, and neutral scenes (e.g., household items) while ERPs were recorded. When examined separately, associations of P3-ERP reactivity to alcohol cues and natural reward cues with alcohol use and problems were weak. However, differential P3 response to the two types of cues (i.e., reward dysregulation P3) showed consistent and robust associations with all indices of alcohol use and problems and differentiated high-risk from lower-risk drinkers. The current results support the idea that the differential incentive-motivational value of alcohol, relative to naturally rewarding activities, is associated with increased risk for substance misuse and dependence, and highlight a novel neurophysiological indicator-the reward dysregulation P3-of this differential reward valuation.
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Bradshaw H, Gassen J, Prokosch M, Boehm G, Hill S. Control over pathogen exposure and basal immunological activity influence disgust and pathogen-avoidance motivation. Cogn Emot 2022; 36:568-580. [PMID: 35138227 DOI: 10.1080/02699931.2022.2031905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Disgust is reasoned to operate in conjunction with the immune system to help protect the body from illness. However, less is known about the factors that impact the degree to which individuals invest in pathogen avoidance (disgust) versus pathogen management (prophylactic immunological activity). Here, we examine the role that one's control over pathogen contact plays in resolving such investment trade-offs, predicting that (a) those from low control environments will invest less in pathogen-avoidance strategies and (b) investment in each of these two strategies will occur in a compensatory fashion (i.e. they will be traded off with one other). Across four studies, we found support for these predictions, using a variety of manipulations and measures. By providing novel insights into how one's control over pathogen exposure influences disgust sensitivity and immune system activity, the current research poses an important contribution to the literature on disgust, pathogen avoidance, and the immune system.
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Affiliation(s)
- Hannah Bradshaw
- Department of Psychology, Washington & Jefferson College, Washington, PA, USA
| | - Jeff Gassen
- Department of Anthropology, Baylor University, Waco, TX, USA
| | - Marjorie Prokosch
- Florida Institute for Built Environment Resilience, University of Florida, Gainesville, FL, USA
| | - Gary Boehm
- Department of Psychology, Texas Christian University, Fort Worth, TX, USA
| | - Sarah Hill
- Department of Psychology, Texas Christian University, Fort Worth, TX, USA
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Busch N, Schmidt R, Hilbert A. Executive Functions of Adults with Binge-Eating Disorder: The Role of Weight Status and Psychopathology. Brain Sci 2021; 12:6. [PMID: 35053750 PMCID: PMC8773845 DOI: 10.3390/brainsci12010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/13/2021] [Accepted: 12/17/2021] [Indexed: 11/17/2022] Open
Abstract
Findings on executive functions (EFs) in binge-eating disorder (BED) are inconsistent and possibly biased by associated comorbidities. This study aimed to identify whether distinct levels of physical and mental comorbidity are related to EFs in BED. General and food-specific EFs in n = 77 adults with BED were compared to population-based norms and associations with weight status, depressive symptoms, and eating disorder psychopathology were analyzed. To detect within-sample patterns of EF performance, k-means clustering was applied. The results indicated that participants' general EFs were within the average range with slight deficits in alertness. While depression and eating disorder psychopathology were unrelated to EFs, weight status was associated with food-specific attentional bias that was significantly higher in obesity class 2 than in overweight/obesity class 1 and obesity class 3. Four meaningful clusters with distinct strengths and impairments in general and food-specific EFs but without differences in clinical variables were identified. Altogether, adults with BED showed few specific deficits compared to normative data. Performance was unrelated to depression and eating disorder psychopathology, while weight status was associated with food-specific EFs only. The results highlight the need for longitudinal studies to evaluate the relevance of EFs in BED development and maintenance in neurologically healthy adults.
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Affiliation(s)
| | | | - Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Philipp-Rosenthal-Strasse 55, 04103 Leipzig, Germany; (N.B.); (R.S.)
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Mathew AS, Rech MA, Lee HJ. Evaluating the role of Approach-Avoidance Training on action-tendencies in individuals with skin-picking disorder: A preliminary randomized experiment. J Behav Addict 2021; 10:827-838. [PMID: 34388110 PMCID: PMC8997211 DOI: 10.1556/2006.2021.00031] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/31/2021] [Accepted: 05/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Pathological skin-picking (PSP) or excoriation disorder is a destructive behavior that affects 1-2% of the general population. The purpose of this pilot study was to evaluate the effect of a computerized behavior modification task on action-tendencies (i.e., approach or avoidance) in adults with PSP. We aimed to modify these action-tendencies by having participants with PSP complete the Approach-Avoidance Training (AAT) task, using a joystick to simulate an approach (=pull) or avoidance (=push) response. METHOD Forty-five participants diagnosed with PSP were randomized to one of three training conditions: (1) Avoidance Training (AvT; n = 15), (2) Approach Training (ApT; n = 15), or (3) Placebo Training (PT; n = 15). We hypothesized that after training, those in the AvT would have the greatest reduction in behavioral approach (i.e., their overall reaction time [RT] to approach pictures of irregular skin stimuli). RESULTS Results of the pre-training assessment task revealed a positive correlation between behavioral approach to irregular skin stimuli and skin-picking severity as assessed by the Skin Picking Scale-Revised (SPS-R). After training, a lower behavioral approach and urges to pick were found in the AvT and PT groups, while those in the ApT reported higher behavioral approach and urges to pick. At two-week follow-up, no significant changes on the SPS-R were reported between groups. DISCUSSION Our preliminary data suggest that the AAT is a promising avenue of research to develop as a cognitive intervention to address an excessive behavioral approach tendency that characterizes skin-picking problems.
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Affiliation(s)
- Abel S. Mathew
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Madeline A. Rech
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Han-Joo Lee
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA,Corresponding author. E-mail:
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Tzavella L, Lawrence NS, Button KS, Hart EA, Holmes NM, Houghton K, Badkar N, Macey E, Braggins AJ, Murray FC, Chambers CD, Adams RC. Effects of go/no-go training on food-related action tendencies, liking and choice. ROYAL SOCIETY OPEN SCIENCE 2021; 8:210666. [PMID: 34457346 PMCID: PMC8385366 DOI: 10.1098/rsos.210666] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/03/2021] [Indexed: 05/16/2023]
Abstract
Inhibitory control training effects on behaviour (e.g. 'healthier' food choices) can be driven by changes in affective evaluations of trained stimuli, and theoretical models indicate that changes in action tendencies may be a complementary mechanism. In this preregistered study, we investigated the effects of food-specific go/no-go training on action tendencies, liking and impulsive choices in healthy participants. In the training task, energy-dense foods were assigned to one of three conditions: 100% inhibition (no-go), 0% inhibition (go) or 50% inhibition (control). Automatic action tendencies and liking were measured pre- and post-training for each condition. We found that training did not lead to changes in approach bias towards trained foods (go and no-go relative to control), but we warrant caution in interpreting this finding as there are important limitations to consider for the employed approach-avoidance task. There was only anecdotal evidence for an effect on food liking, but there was evidence for contingency learning during training, and participants were on average less likely to choose a no-go food compared to a control food after training. We discuss these findings from both a methodological and theoretical standpoint and propose that the mechanisms of action behind training effects be investigated further.
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Affiliation(s)
- Loukia Tzavella
- Brain Research Imaging Centre, Cardiff University, Cardiff CF24 4HQ, UK
| | | | | | | | | | | | - Nina Badkar
- School of Psychology, University of Exeter, Exeter EX4 4QG, UK
| | - Ellie Macey
- School of Psychology, University of Exeter, Exeter EX4 4QG, UK
| | | | | | | | - Rachel C. Adams
- Brain Research Imaging Centre, Cardiff University, Cardiff CF24 4HQ, UK
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Prior K, Salemink E, Wiers RW, Teachman BA, Piggott M, Newton NC, Teesson M, Baillie AJ, Manning V, McLellan LF, Mahoney A, Stapinski LA. A Web-Based Cognitive Bias Modification Intervention (Re-train Your Brain) for Emerging Adults With Co-occurring Social Anxiety and Hazardous Alcohol Use: Protocol for a Multiarm Randomized Controlled Pilot Trial. JMIR Res Protoc 2021; 10:e28667. [PMID: 34255726 PMCID: PMC8295835 DOI: 10.2196/28667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/26/2021] [Accepted: 05/26/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Alcohol use and anxiety disorders commonly co-occur, resulting in a more severe clinical presentation and poorer response to treatment. Research has shown that approach bias modification (ApBM) and interpretation bias modification (IBM) cognitive retraining interventions can be efficacious adjunctive treatments that improve outcomes for alcohol use and social anxiety, respectively. However, the acceptability, feasibility, and clinical utility of combining ApBM and IBM programs to optimize treatments among comorbid samples are unknown. It is also unclear whether integrating ApBM and IBM within each training session or alternating them between each session is more acceptable and efficacious. OBJECTIVE This paper describes the protocol for a randomized controlled pilot trial investigating the feasibility, acceptability, and preliminary efficacy of the Re-train Your Brain intervention-an adjunct web-based ApBM+IBM program-among a clinical sample of emerging adults with hazardous alcohol use and social anxiety. METHODS The study involves a three-arm randomized controlled pilot trial in which treatment-seeking emerging adults (18-30 years) with co-occurring hazardous alcohol use and social anxiety will be individually randomized to receive the Re-train Your Brain integrated program, delivered with 10 biweekly sessions focusing on both social anxiety and alcohol each week, plus treatment as usual (TAU; ie, the model of care provided in accordance with standard practice at their service; n=30); the Re-train Your Brain alternating program, delivered with 10 biweekly sessions focusing on social anxiety one week and alcohol the next week, plus TAU (n=30); or TAU only (n=30). Primary outcomes include feasibility (uptake, follow-up rates, treatment adherence, attrition, and adverse events) and acceptability (system usability, client satisfaction, user experience, and training format preference). Secondary efficacy outcomes include changes in alcohol approach and interpretation biases, social anxiety, and alcohol use (eg, drinks per day, binge drinking, drinking motives, severity of dependence, and cravings). The primary end point will be posttreatment (6 weeks postbaseline), with a secondary end point at 3 months postbaseline. Descriptive statistics will be conducted for primary outcomes, whereas intention-to-treat, multilevel mixed effects analysis for repeated measures will be performed for secondary outcomes. RESULTS This study is funded from 2019 to 2023 by Australian Rotary Health. Recruitment is expected to be completed by mid-2022 to late 2022, with follow-ups completed by early 2023. CONCLUSIONS This study will be the first to evaluate whether an ApBM+IBM program is acceptable to treatment-seeking, emerging adults and whether it can be feasibly delivered via the web, in settings where it will ultimately be used (eg, at home). The findings will broaden our understanding of the types of programs that emerging adults will engage with and whether the program may be an efficacious treatment option for this comorbidity. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12620001273976; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364131. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/28667.
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Affiliation(s)
- Katrina Prior
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Elske Salemink
- Experimental Psychopathology Lab, Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT) Lab, Department of Psychology, University of Amsterdam, Amsterdam, Netherlands.,Center for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands
| | - Bethany A Teachman
- Department of Psychology, School of Arts and Sciences, University of Virginia, Virginia, VA, United States
| | - Monique Piggott
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
| | - Andrew J Baillie
- Sydney School of Health Sciences, The University of Sydney, Sydney, Australia
| | - Victoria Manning
- Eastern Health Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
| | - Lauren F McLellan
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Alison Mahoney
- Clinical Research Unit for Anxiety and Depression, St Vincent's Public Hospital, Sydney, Australia
| | - Lexine A Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia
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Piercy H, Manning V, Staiger PK. Pushing or Pulling Your "Poison": Clinical Correlates of Alcohol Approach and Avoidance Bias Among Inpatients Undergoing Alcohol Withdrawal Treatment. Front Psychol 2021; 12:663087. [PMID: 34113294 PMCID: PMC8186551 DOI: 10.3389/fpsyg.2021.663087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/12/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Alcohol approach bias, the tendency to automatically move toward alcohol cues, has been observed in people who drink heavily. However, surprisingly, some alcohol-dependent patients demonstrate an alcohol avoidance bias. This inconsistency could be explained by the clinical or demographic profile of the population studied, yet this has not been examined in approach bias modification (ABM) trials to date. We aimed to determine the proportion of patients with an approach or avoidance bias, assess whether they differ on demographic and drinking measures, and to examine the clinical correlates of approach bias. Method: These research questions were addressed using baseline data from 268 alcohol-dependent patients undergoing inpatient withdrawal treatment who then went on to participate in a trial of ABM. Results: At trial entry (day 3 or 4 of inpatient withdrawal), 155 (57.8%) had an alcohol approach bias and 113 (42.2%) had an avoidance bias. These two groups did not differ on any demographic or relevant drinking measures. Approach bias was significantly and moderately associated with total standard drinks consumed in the past 30 days (r = 0.277, p = 0.001) but no other indices of alcohol consumption or problem severity. Conclusion: Whilst the majority of alcohol-dependent patients showed an alcohol approach bias, those with an avoidance bias did not differ in demographic or clinical characteristics, and the strength of approach bias related only to recent consumption. Further research is needed to develop more accurate and personally tailored measures of approach bias, as these findings likely reflect the poor reliability of standard approach bias measures.
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Affiliation(s)
- Hugh Piercy
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia.,Turning Point, Eastern Health, Melbourne, VIC, Australia
| | - Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia.,Turning Point, Eastern Health, Melbourne, VIC, Australia
| | - Petra K Staiger
- School of Psychology, Deakin University, Geelong, VIC, Australia.,Centre for Drug Use, Addictive and Antisocial Behaviour Research, Deakin University, Geelong, VIC, Australia
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36
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Juneau C, Shankland R, Knäuper B, Dambrun M. Mindfulness and equanimity moderate approach/avoidance motor responses. Cogn Emot 2021; 35:1085-1098. [PMID: 34006174 DOI: 10.1080/02699931.2021.1927674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A person's tendency to approach pleasant stimuli and to avoid unpleasant stimuli reflects a basic psychological phenomenon. The present research aimed to investigate the extent to which mindfulness practices and trait equanimity can attenuate this motivational process. In two studies, participants were asked to perform an Approach/Avoidance Task (AAT). In Study 1 (N = 84), prior to completing the AAT, participants were randomly assigned to one of two guided mindfulness-based meditation conditions (breathing or body-scan) or to an active control condition. In Study 2 (N = 71), which controlled for mindfulness practice, motor responses to the AAT were compared by level of equanimity of the participants (low vs. high). The results revealed that breathing meditation practice and trait equanimity significantly moderated participants' motor responses to the AAT, and that the body-scan meditation did not moderate these responses. Bayesian analyses showed that participants in the breathing meditation group (Study 1) and those with higher equanimity (Study 2) showed a reduction of bias in their motor responses to the AAT. These results suggest that meditation practice and trait equanimity may promote a decrease in automatic motivational approach and avoidance tendencies evoked by positive and negative stimuli.
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Affiliation(s)
| | | | | | - Michaël Dambrun
- Université Clermont Auvergne, LAPSCO, Clermont-Ferrand, France
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37
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The effect of television advertising on soft drink consumption: Individual vulnerabilities in approach bias and inhibitory control. Appetite 2021; 165:105300. [PMID: 34000329 DOI: 10.1016/j.appet.2021.105300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 11/21/2022]
Abstract
Continual exposure to soft drink cues in the environment is thought to be a major contributor to the rising consumption of soft drinks. This study investigated the effect of one such cue, television advertising, on soft drink choice and intake. Within the context of dual-process models, we examined whether any such effects would be stronger for individuals with an automatic tendency to reach for soft drinks (approach bias) or a difficulty resisting soft drinks (poor inhibitory control). Participants (N = 127; 18-25 years) viewed television advertisements for either soft drinks or control (non-sweetened) beverages. Approach bias and inhibitory control were assessed by soft drink versions of the approach-avoidance and go/no-go tasks, respectively. Participants who had viewed the soft drink advertisements were more likely to choose a soft drink as their first drink than those who had viewed the control advertisements. This effect was stronger for participants with an approach bias for soft drinks. In addition, participants with poorer inhibitory control chose more soft drinks overall following the soft drink advertisements. Although exposure to soft drink advertisements did not affect soft drink intake in the taste test, participants with poorer inhibitory control consumed more of the soft drinks. In line with dual-process models, individuals with strong automatic tendencies or poor self-regulatory control were more responsive to television advertising for soft drinks. At a practical level, these cognitive vulnerabilities provide potential targets for intervention to help resist soft drink cues.
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38
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Sebold M, Garbusow M, Cerci D, Chen K, Sommer C, Huys QJM, Nebe S, Rapp M, Veer IM, Zimmermann US, Smolka MN, Walter H, Heinz A, Friedel E. Association of the OPRM1 A118G polymorphism and Pavlovian-to-instrumental transfer: Clinical relevance for alcohol dependence. J Psychopharmacol 2021; 35:566-578. [PMID: 33726538 PMCID: PMC8155738 DOI: 10.1177/0269881121991992] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Pavlovian-to-instrumental transfer (PIT) quantifies the extent to which a stimulus that has been associated with reward or punishment alters operant behaviour. In alcohol dependence (AD), the PIT effect serves as a paradigmatic model of cue-induced relapse. Preclinical studies have suggested a critical role of the opioid system in modulating Pavlovian-instrumental interactions. The A118G polymorphism of the OPRM1 gene affects opioid receptor availability and function. Furthermore, this polymorphism interacts with cue-induced approach behaviour and is a potential biomarker for pharmacological treatment response in AD. In this study, we tested whether the OPRM1 polymorphism is associated with the PIT effect and relapse in AD. METHODS Using a PIT task, we examined three independent samples: young healthy subjects (N = 161), detoxified alcohol-dependent patients (N = 186) and age-matched healthy controls (N = 105). We used data from a larger study designed to assess the role of learning mechanisms in the development and maintenance of AD. Subjects were genotyped for the A118G (rs1799971) polymorphism of the OPRM1 gene. Relapse was assessed after three months. RESULTS In all three samples, participants with the minor OPRM1 G-Allele (G+ carriers) showed increased expression of the PIT effect in the absence of learning differences. Relapse was not associated with the OPRM1 polymorphism. Instead, G+ carriers displaying increased PIT effects were particularly prone to relapse. CONCLUSION These results support a role for the opioid system in incentive salience motivation. Furthermore, they inform a mechanistic model of aberrant salience processing and are in line with the pharmacological potential of opioid receptor targets in the treatment of AD.
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Affiliation(s)
- Miriam Sebold
- Department of Psychiatry and
Psychotherapy, Charité – Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health,
Berlin, Germany
- Department for Social and Preventive
Medicine, University of Potsdam, Potsdam, Germany
| | - Maria Garbusow
- Department of Psychiatry and
Psychotherapy, Charité – Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health,
Berlin, Germany
| | - Deniz Cerci
- Klinik für Forensische Psychiatrie,
Universitätsmedizin Rostock, Rostock, Germany
| | - Ke Chen
- Department of Psychiatry and
Psychotherapy, Charité – Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health,
Berlin, Germany
| | | | - Quentin JM Huys
- Division of Psychiatry, University
College London, London, UK
- Max Planck UCL Centre for Computational
Psychiatry and Ageing Research, University College London, London, UK
| | - Stephan Nebe
- Department of Economics, University of
Zurich, Zurich, Switzerland
| | - Michael Rapp
- Department for Social and Preventive
Medicine, University of Potsdam, Potsdam, Germany
| | - Ilya M Veer
- Department of Psychiatry and
Psychotherapy, Charité – Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health,
Berlin, Germany
| | - Ulrich S Zimmermann
- Technical University of Dresden,
Dresden, Germany
- Department of Addiction Medicine and
Psychotherapy, kbo Isar-Amper-Klinikum, Munich, Germany
| | | | - Henrik Walter
- Department of Psychiatry and
Psychotherapy, Charité – Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health,
Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and
Psychotherapy, Charité – Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health,
Berlin, Germany
| | - Eva Friedel
- Department of Psychiatry and
Psychotherapy, Charité – Universitätsmedizin Berlin, corporate member of Freie
Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health,
Berlin, Germany
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Czeszumski A, Albers F, Walter S, König P. Let Me Make You Happy, and I'll Tell You How You Look Around: Using an Approach-Avoidance Task as an Embodied Emotion Prime in a Free-Viewing Task. Front Psychol 2021; 12:604393. [PMID: 33790829 PMCID: PMC8005526 DOI: 10.3389/fpsyg.2021.604393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/18/2021] [Indexed: 11/29/2022] Open
Abstract
The embodied approach of human cognition suggests that concepts are deeply dependent upon and constrained by an agent's physical body's characteristics, such as performed body movements. In this study, we attempted to broaden previous research on emotional priming, investigating the interaction of emotions and visual exploration. We used the joystick-based approach-avoidance task to influence the emotional states of participants, and subsequently, we presented pictures of news web pages on a computer screen and measured participant's eye movements. As a result, the number of fixations on images increased, the total dwell time increased, and the average saccade length from outside of the images toward the images decreased after the bodily congruent priming phase. The combination of these effects suggests increased attention to web pages' image content after the participants performed bodily congruent actions in the priming phase. Thus, congruent bodily interaction with images in the priming phase fosters visual interaction in the subsequent exploration phase.
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Affiliation(s)
- Artur Czeszumski
- Institute of Cognitive Science, Universität Osnabrück, Osnabrück, Germany
| | - Friederike Albers
- Institute of Cognitive Science, Universität Osnabrück, Osnabrück, Germany
| | - Sven Walter
- Institute of Cognitive Science, Universität Osnabrück, Osnabrück, Germany
| | - Peter König
- Institute of Cognitive Science, Universität Osnabrück, Osnabrück, Germany.,Institut für Neurophysiologie und Pathophysiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
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40
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Heitmann J, de Jong PJ. Attentional Bias in Alcohol and Cannabis Use Disorder Outpatients as Indexed by an Odd-One-Out Visual Search Task: Evidence for Speeded Detection of Substance Cues but Not for Heightened Distraction. Front Psychol 2021; 12:626326. [PMID: 33679545 PMCID: PMC7928358 DOI: 10.3389/fpsyg.2021.626326] [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: 11/05/2020] [Accepted: 01/26/2021] [Indexed: 11/13/2022] Open
Abstract
Current cognitive models of addiction imply that speeded detection and increased distraction from substance cues might both independently contribute to the persistence of addictive behavior. Speeded detection might lower the threshold for experiencing craving, whereas increased distraction might further increase the probability of entering a bias-craving-bias cycle, thereby lowering the threshold for repeated substance use. This study was designed to examine whether indeed both attentional processes are involved in substance use disorders. Both attentional processes were indexed by an Odd-One-Out visual search task in individuals diagnosed with alcohol use disorder (AUD; n = 63) and cannabis use disorder (CUD; n = 28). To test whether the detection and/or the distraction component are characteristic for AUD and CUD, their indices were compared with matched individuals without these diagnoses (respectively, n = 63 and n = 28). Individuals with CUD showed speeded detection of cannabis cues; the difference in detection between AUD and the comparison group remained inconclusive. Neither the AUD nor the CUD group showed more distraction than the comparison groups. The sample size of the CUD group was relatively small. In addition, participants made relatively many errors in the attentional bias (AB) task, which might have lowered its sensitivity to detect ABs. The current study provided no support for the proposed role of increased distraction in CUD and AUD. The findings did, however, provide support for the view that speeded detection might be involved in CUD. Although a similar trend was evident for AUD, the evidence was weak and remained therefore inconclusive.
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Affiliation(s)
- Janika Heitmann
- Verslavingszorg Noord Nederland, Groningen, Netherlands.,Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
| | - Peter J de Jong
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
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41
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Voegtle E, Dombret S, Bonabi A, Friederich HC, Brockmeyer T. Approach avoidance training to curb consumption of sugar-sweetened beverages - A pilot randomized controlled trial in healthy volunteers. Appetite 2021; 162:105194. [PMID: 33705891 DOI: 10.1016/j.appet.2021.105194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 11/29/2022]
Abstract
Elevated consumption of sugar-sweetened beverages (SSBs) contributes to overweight and obesity. Automatic action tendencies like an approach bias might promote the consumption of SSBs. We investigated whether an Approach-Avoidance Training (AAT) reduces this approach bias and related behaviors like craving for and consumption of SSBs. Fifty-six healthy participants, with a self-reported SSB consumption of at least 330 ml per day, were randomized to 6 sessions of real or sham AAT. In the real AAT condition, participants were trained to react with avoidance movements to pictures of SSBs in an implicit learning paradigm (i.e. participants were instructed to respond to a task-irrelevant feature), whereas in the sham AAT condition the same pictures were used but no systematic (avoidance) reaction was trained. Approach bias, craving for SSB and SSB intake in a bogus taste test were assessed. Real AAT was not superior to sham AAT in any outcome measure. AAT in its current form and as a stand-alone intervention does not appear to be effective in reducing SSB consumption.
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Affiliation(s)
- Elisabeth Voegtle
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Goettingen, Goettingen, Germany
| | - Sophia Dombret
- Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Anahita Bonabi
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Goettingen, Goettingen, Germany
| | - Hans-Christoph Friederich
- Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; Center for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Timo Brockmeyer
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Goettingen, Goettingen, Germany; Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
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Van Dessel P, Tibboel H. Assessing the influence of warnings with testimonies from former smokers on smoking and quitting behaviour. Br J Health Psychol 2021; 26:917-934. [PMID: 33554386 DOI: 10.1111/bjhp.12512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 01/05/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Cigarette pack warnings are widely used internationally for reducing smoking behaviour. Current warnings typically consist of a textual or graphic warning that smoking can lead to negative (health) outcomes. Though these warnings have proven benefits, they also have important limitations. Most notably, they do not produce beneficial changes in important cognitive determinants of smoking cessation such as self-efficacy to refrain from smoking and they do not reduce smoking for specific subsets of the target population. Recent studies provide evidence for the effectiveness of health warnings that include health-related testimonies from former smokers. METHODS We designed cigarette pack warnings that consist of more general testimonial statements from former smokers, selected in a pilot study for their potential impact on two important cognitive determinants of smoking (i.e., self-efficacy beliefs and outcome expectancies). In the main study, online participants were either exposed to the new testimonial warnings, to graphic health warnings, or to text-only health warnings on four separate occasions during a 24-h window. RESULTS In a sample of 416 daily smokers, we observed beneficial changes in self-reported cigarette smoking, craving, quit intentions, evaluations of smoking, self-efficacy, and outcome expectancies, immediately after viewing the warnings a first time and after multiple exposures. These effects were comparable for participants in the three warning type groups, with some (small) differences for changes in outcome expectancies and craving. CONCLUSIONS Warnings with general testimonies from former smokers might provide a useful evidence-based addition to currently used cigarette pack health warnings.
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Affiliation(s)
- Pieter Van Dessel
- Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium
| | - Helen Tibboel
- Erasmus School of Social and Behavior Sciences, Erasmus University Rotterdam, The Netherlands
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Mellentin AI, Cox WM, Fadardi JS, Martinussen L, Mistarz N, Skøt L, Rømer Thomsen K, Mathiasen K, Lichtenstein M, Nielsen AS. A Randomized Controlled Trial of Attentional Control Training for Treating Alcohol Use Disorder. Front Psychiatry 2021; 12:748848. [PMID: 34899419 PMCID: PMC8661535 DOI: 10.3389/fpsyt.2021.748848] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/22/2021] [Indexed: 11/20/2022] Open
Abstract
Background: There is consistent evidence that community and clinical samples of individuals with an alcohol use disorder (AUD) have attentional biases toward alcohol cues. The alcohol attentional control training program (AACTP) has shown promise for retraining these biases and decreasing alcohol consumption in community samples of excessive drinkers. However, there is a lack of evidence regarding the effectiveness of ACTP in clinical AUD samples. The main aim of the present study is to investigate whether primary pharmacological and psychological, evidence-based alcohol treatment can be enhanced by the addition of a gamified AACTP smartphone application for patients with an AUD. Design and Methods: The study will be implemented as a randomized controlled trial. A total of 317 consecutively enrolled patients with AUD will be recruited from alcohol outpatient clinics in Denmark. Patients will be randomized to one of three groups upon initiation of primary alcohol treatment: Group A: a gamified AACTP smartphone application + treatment as usual (TAU); Group B: a gamified AACTP sham-control application + TAU; or Group C: only TAU. Treatment outcomes will be assessed at baseline, post-treatment, and at 3- and 6-month follow-ups. Repeated measures MANOVA will be used to compare the trajectories of the groups over time on alcohol attentional bias, alcohol craving, and drinking reductions. It is hypothesized that Group A will achieve better treatment outcomes than either Group B or Group C. Perspectives: Because attentional bias for alcohol cues is proportional to the amount of alcohol consumed, and these biases are not addressed within current evidence-based treatment programs, this study is expected to provide new evidence regarding the effectiveness of the gamified AACTP in a clinical population. Furthermore, due to promising results found using AACTP in community samples of excessive drinkers, there is a high probability that the AACTP treatment in this study will also be effective, thereby allowing AACTP to be readily implemented in clinical settings. Finally, we expect that this study will increase the effectiveness of evidence-based AUD treatment and introduce a new, low-cost gamified treatment targeting patients with an AUD. Overall, this study is likely to have an impact at the scientific, clinical, and societal levels. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT05102942?term=NCT05102942&draw=2&rank=1, identifier: NCT05102942.
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Affiliation(s)
- Angelina Isabella Mellentin
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Brain Research-Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Centre for Telepsychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - W Miles Cox
- School of Human and Behavioral Sciences, Bangor University, Bangor, United Kingdom
| | - Javad S Fadardi
- Cognitive Health Laboratory, Department of Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Laila Martinussen
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Nicolaj Mistarz
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lotte Skøt
- Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Kristine Rømer Thomsen
- Centre for Alcohol and Drug Research, Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - Kim Mathiasen
- Centre for Telepsychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Mia Lichtenstein
- Centre for Telepsychiatry, Mental Health Services in the Region 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 (BRIDGE), Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Onie S, Gong S, Manwaring E, Grageda D, Webb K, Yuen WS, Most SB. Validation of the Australian beverage picture set: A controlled picture set for cognitive bias measurement and modification paradigms. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Sandersan Onie
- School of Psychology, UNSW Sydney, Kensington, NSW, Australia,
| | - Sharon Gong
- School of Psychology, UNSW Sydney, Kensington, NSW, Australia,
| | | | - Dayanna Grageda
- School of Psychology, UNSW Sydney, Kensington, NSW, Australia,
| | - Kyra Webb
- School of Psychology, UNSW Sydney, Kensington, NSW, Australia,
| | - Wing See Yuen
- School of Psychology, UNSW Sydney, Kensington, NSW, Australia,
| | - Steven B. Most
- School of Psychology, UNSW Sydney, Kensington, NSW, Australia,
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Prior K, Salemink E, Wiers RW, Teachman BA, Piggott M, Newton NC, Teesson M, Baillie AJ, Campbell S, Stapinski LA. Acceptability and Co-Development of an Online Cognitive Bias Modification Intervention for Emerging Adults With Hazardous Alcohol Use and Social Anxiety: A Mixed Methods Study. Alcohol Clin Exp Res 2020; 44:2283-2297. [PMID: 33146919 DOI: 10.1111/acer.14452] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/30/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Approach bias modification (ApBM) and interpretation bias modification (IBM) are two promising adjunct treatments for alcohol use and social anxiety, respectively. However, the acceptability of combining ApBM and IBM into one program for people who experience both of these disorders is unknown. The present study describes the codevelopment of a new, hybrid ApBM + IBM program and provides insight into the perceptions of acceptability from service providers and emerging adults. METHODS Service providers (n = 14) and emerging adults aged 18 to 25 years with lived experience of hazardous alcohol use and heightened social anxiety (n = 15) were recruited via online advertisements and through existing networks. All participants were shown a beta version of the program and asked to complete qualitative and quantitative questions to ascertain feedback on the program's acceptability and suggestions for improvement. RESULTS Themes emerged relating to the ApBM + IBM program's quality and usefulness, appropriateness, motivation and engagement, and potential clinical value. The program was well received and deemed acceptable for the target age group. It was rated particularly highly with regard to the overall quality and ease of use. Emerging adults had fewer suggestions for how the intervention might be revised; however, there were suggestions from both groups regarding the need for a compelling rationale at the outset of treatment and a suggestion to include a motivational interviewing and psychoeducational-based module prior to the first training session, to increase user buy-in and engagement. CONCLUSIONS The current findings reflect positively on the acceptability of a hybrid ApBM + IBM for emerging adults with co-occurring hazardous alcohol use and social anxiety. Service providers and emerging adults identified a number of ways to improve the design and implementation of the program, which will likely improve adherence to, and outcomes of, the intervention when added as an adjunct to treatment as usual.
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Affiliation(s)
- Katrina Prior
- The Matilda Centre for Research in Mental Health and Substance Use, (KP, NCN, MT, LAS), The University of Sydney, Sydney, New South Wales, Australia
| | - Elske Salemink
- Faculty of Social and Behavioural Sciences, (ES), Utrecht University, Utrecht, The Netherlands
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT)-lab, (RWW), Department of Psychology & Center for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Bethany A Teachman
- Department of Psychology, (BAT), School of Arts and Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Monique Piggott
- The University of New South Wales, (MP), Sydney, New South Wales, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, (KP, NCN, MT, LAS), The University of Sydney, Sydney, New South Wales, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, (KP, NCN, MT, LAS), The University of Sydney, Sydney, New South Wales, Australia
| | - Andrew J Baillie
- Faculty of Medicine & Health, (AJB), Sydney School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Samuel Campbell
- Turning Point, (SC), Monash University, Melbourne, Victoria, Australia
| | - Lexine A Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, (KP, NCN, MT, LAS), The University of Sydney, Sydney, New South Wales, Australia
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Stop! - The automatic tendency of action, inhibition and frontal activation in individuals with alcohol-use disorder in abstinence. Int J Psychophysiol 2020; 158:123-135. [PMID: 33075432 DOI: 10.1016/j.ijpsycho.2020.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 07/02/2020] [Accepted: 08/03/2020] [Indexed: 11/20/2022]
Abstract
Studying the functioning of the frontal lobe during the performance of an inhibitory activity according to automatic tendency of action would allow a better understanding of the relationship between the reflexive and impulsive system described in the dual-process models. This study aims to prove which is the inhibitory capacity and the underlying brain activity of people with alcohol-use disorder in abstinence with a greater avoidance tendency compared to those with a higher approach tendency and healthy controls. In order to group participants with AUD, the total approach/avoidance index (TAAI) - obtained from the modified alcohol approach/avoidance task - was used, therefore resulting in three groups: TAAI- (TAAI < Percentile 35: n = 20), TAAI± (TAAI = Percentile 35-65: n = 20) and TAAI+ (TAAI > Percentile 65: n = 20). In addition to this, 15 healthy controls were recruited. They all had an electroencephalographic recording while completing the modified stop-signal task. The results showed that the TAAI+ group had a worse inhibition compared to healthy controls. Moreover, the TAAI+ group showed a hyperactivation of the inferior frontal gyrus, precentral gyrus and orbital gyrus compared to the healthy controls group and the TAAI- group. The results obtained reflect that those people with AUD with a tendency to approach alcohol have a worse inhibitory capacity and a frontal hyperactivation. Moreover, people with AUD with an avoidance tendency to alcohol have also been found to have a similar inhibitory capacity and frontal activation to healthy controls.
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Abstract
Approach and avoidance tendencies have helped explain phenomena as diverse as addiction (Mogg, Field, & Bradley, 2005), phobia (Rinck & Becker, 2007), and intergroup discrimination (Bianchi, Carnaghi, & Shamloo, 2018; Degner, Essien, & Reichardt, 2016). When the original approach-avoidance task (AAT; Solarz, 1960) that measures these tendencies was redesigned to run on regular desktop computers, it made the task much more flexible but also sacrificed some important behavioral properties of the original task-most notably its reliance on physical distance change (Chen & Bargh, 1999). Here, we present a new, mobile version of the AAT that runs entirely on smartphones and combines the flexibility of modern tasks with the behavioral properties of the original AAT. In addition, it can easily be deployed in the field and, next to traditional reaction time measurements, includes the novel measurement of response force. In two studies, we demonstrate that the mobile AAT can reliably measure known approach-avoidance tendencies toward happy and angry faces both in the laboratory and in the field.
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Duijndam S, Kupper N, Denollet J, Karreman A. Social inhibition and approach-avoidance tendencies towards facial expressions. Acta Psychol (Amst) 2020; 209:103141. [PMID: 32717654 DOI: 10.1016/j.actpsy.2020.103141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 07/09/2020] [Accepted: 07/15/2020] [Indexed: 10/23/2022] Open
Abstract
This study examined how different manifestations of social inhibition (behavioral inhibition, interpersonal sensitivity, and social withdrawal) are related to automatic approach/avoidance behaviors in a social context. A sample of 115 undergraduate students and 20 adults from the general population (Mage = 24.8, SD = 11.4; 75% women) were assessed with the 15-item Social Inhibition Questionnaire (SIQ15). During a facial expression version of the Approach-Avoidance Task (AAT), participants reacted to images of emotional facial expressions (angry, happy, and neutral) or to control images (neutral objects) in portrait or landscape formats by pulling a joystick towards themselves (approach) or pushing it away from themselves (avoidance). The superordinate social inhibition construct was not associated with approach/avoidance tendencies. However, individuals high in the interpersonal sensitivity domain of social inhibition showed stronger approach tendencies for happy and neutral facial expressions compared to neutral objects, which may relate to their focus on seeking the approval of others.
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Borg C, Pawłowska A, van Stokkum R, Georgiadis JR, de Jong PJ. The Influence of Sexual Arousal on Self-Reported Sexual Willingness and Automatic Approach to Models of Low, Medium, and High Prior Attractiveness. JOURNAL OF SEX RESEARCH 2020; 57:872-884. [PMID: 31729895 DOI: 10.1080/00224499.2019.1687641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Anecdotal evidence suggests that sexual attraction is flexible, and that high levels of sexual arousal can promote sexual willingness and approach tendencies toward a priori low attractive mates. This experimental study tested whether heightened sexual arousal can lower the threshold for sexual willingness and automatic approach tendencies toward potential sex partners of low and medium attractiveness. Heterosexual male (n =54) and female (n =61) participants were randomly assigned to a sexual arousal or control condition. Approach tendencies were indexed using a reaction time task. Sexual willingness was indexed using participant ratings of willingness to kiss and to consider having sex with same- and other-sex models of low, medium, and high attractiveness. Overall, participants showed stronger approach to models of high and medium than of low attractiveness. Sexual arousal weakened this differential responding but did not result in a robust increase of approach toward less attractive other-sex or same-sex models. Sexual willingness toward less attractive models was not affected by sexual arousal. Independent of condition, women reported greater sexual willingness toward same-sex models. The current pattern of findings does not support the notion that sexual arousal promotes automatic approach and sexual willingness to a broader array of sex partners.
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Affiliation(s)
- Charmaine Borg
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen
| | - Aleksandra Pawłowska
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen
| | - Robin van Stokkum
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen
| | - Janniko R Georgiadis
- Department of Biomedical Sciences of Cells & Systems / Section Anatomy & Medical Physiology, University of Groningen, University Medical Center Groningen
| | - Peter J de Jong
- Department of Clinical Psychology & Experimental Psychopathology, University of Groningen
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Abstract
Abstract
Purpose of Review
Alcohol use disorder (AUD) is a burdening chronic condition that is characterized by high relapse rates despite severe negative consequences. There has been a recent emergence of interest in (neuro)therapeutic intervention strategies that largely involve the detrimental change in mechanisms linked to addiction disorders. Most prominently, the latter include habitual decision-making, cue-induced behavioral tendencies, as well as the amplifying effects of stressful events on drinking behavior. This article discusses these learning mechanisms and modification thereof as possible targets of (neuro)therapeutic interventions for AUD.
Recent Findings
Psychological therapies that target dysregulated neurocognitive processes underlying addictive behavior may hold promise as effective treatments for AUD.
Summary
Despite the progression in psychological and neuroscience research in the field of AUD, many behavioral interventions fail to systematically integrate and apply such findings into treatment development. Future research should focus on the targeted modification of the aforementioned processes.
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