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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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Zech HG, Gable P, van Dijk WW, van Dillen LF. Test-retest reliability of a smartphone-based approach-avoidance task: Effects of retest period, stimulus type, and demographics. Behav Res Methods 2023; 55:2652-2668. [PMID: 35915356 PMCID: PMC9342838 DOI: 10.3758/s13428-022-01920-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2022] [Indexed: 11/25/2022]
Abstract
The approach-avoidance task (AAT) is an implicit task that measures people's behavioral tendencies to approach or avoid stimuli in the environment. In recent years, it has been used successfully to help explain a variety of health problems (e.g., addictions and phobias). Unfortunately, more recent AAT studies have failed to replicate earlier promising findings. One explanation for these replication failures could be that the AAT does not reliably measure approach-avoidance tendencies. Here, we first review existing literature on the reliability of various versions of the AAT. Next, we examine the AAT's reliability in a large and diverse sample (N = 1077; 248 of whom completed all sessions). Using a smartphone-based, mobile AAT, we measured participants' approach-avoidance tendencies eight times over a period of seven months (one measurement per month) in two distinct stimulus sets (happy/sad expressions and disgusting/neutral stimuli). The mobile AAT's split-half reliability was adequate for face stimuli (r = .85), but low for disgust stimuli (r = .72). Its test-retest reliability based on a single measurement was poor for either stimulus set (all ICC1s < .3). Its test-retest reliability based on the average of all eight measurements was moderately good for face stimuli (ICCk = .73), but low for disgust stimuli (ICCk = .5). Results suggest that single-measurement AATs could be influenced by unexplained temporal fluctuations of approach-avoidance tendencies. These fluctuations could be examined in future studies. Until then, this work suggests that future research using the AAT should rely on multiple rather than single measurements.
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Affiliation(s)
- Hilmar G Zech
- Leiden University, Leiden, The Netherlands.
- Technical University Dresden, Dresden, Germany.
| | | | - Wilco W van Dijk
- Leiden University, Leiden, The Netherlands
- Knowledge Centre Psychology and Economic Behaviour, Leiden, The Netherlands
| | - Lotte F van Dillen
- Leiden University, Leiden, The Netherlands
- Knowledge Centre Psychology and Economic Behaviour, Leiden, The Netherlands
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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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Wu X, Du J, Jiang H, Zhao M. Application of Digital Medicine in Addiction. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (SCIENCE) 2022; 27:144-152. [PMID: 34866856 PMCID: PMC8627382 DOI: 10.1007/s12204-021-2391-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/20/2021] [Indexed: 10/29/2022]
Affiliation(s)
- Xiaojun Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Jiang Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Haifeng Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030 China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 201108 China
- CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, 200031 China
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6
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Wang J, Chen Y, Zhang H. Electrophysiological evidence of enhanced early attentional bias toward sexual images in individuals with tendencies toward cybersex addiction. J Behav Addict 2021; 10:1036-1047. [PMID: 34817398 PMCID: PMC8987427 DOI: 10.1556/2006.2021.00082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/15/2021] [Accepted: 10/28/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND AIMS Attentional bias is a key factor in addictive behavior maintenance. However, whether attentional bias has a similar effect on cybersex addiction is unclear. We investigated differences in the attentional processing of sexually explicit images between individuals with high tendencies toward cybersex addiction (TCA) versus low tendencies using behavioral and electrophysiological indices. METHODS Twenty-eight individuals with high TCA and 29 with low TCA performed an addiction Stroop task comprising sexual and neutral images in colored frames. Participants were asked to respond to the frame color and not the image contents, and behavioral and event-related potentials were recorded. RESULTS Behaviorally, an addiction Stroop interference effect was found in the high TCA group, as shown by the longer reaction times to judge the frame colors of sexual images. Electrophysiologically, a P200 (150-220 ms) enhancement was present in response to sexual images compared with neutral ones, which was absent in the low TCA group. The event-related potential correlates with the addiction Stroop interference effect, indicating that the attentional bias underlying the addiction Stroop interference operates at an automatic level. A general, sexually related bias was found in the late positive potential (300-700 ms) amplitude, although between-group differences were insignificant. DISCUSSION AND CONCLUSIONS These findings indicate that sexual stimuli grab the attentional resources of individuals with high TCA at early automatic stages of attentional processing. Increased cue reactivity to sexual stimuli may contribute to pornographic consumption and play a crucial role in sustaining problematic excessive use of online pornography.
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Affiliation(s)
| | | | - Hui Zhang
- School of Psychology, Chengdu Medical College, Chengdu, 610500, China
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7
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Wen S, Wiers RW, Boffo M, Grasman RP, Pronk T, Larsen H. Subtypes of smokers in a randomized controlled trial of a web-based smoking cessation program and their role in predicting intervention non-usage attrition: Implications for the development of tailored interventions. Internet Interv 2021; 26:100473. [PMID: 34765460 PMCID: PMC8569479 DOI: 10.1016/j.invent.2021.100473] [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: 05/02/2021] [Revised: 10/11/2021] [Accepted: 10/14/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Web-based smoking interventions hold potential for smoking cessation; however, many of them report low intervention usage (i.e., high levels of non-usage attrition). One strategy to counter this issue is to tailor such interventions to user subtypes if these can be identified and related to non-usage attrition outcomes. The aim of this study was two-fold: (1) to identify and describe a smoker typology in participants of a web-based smoking cessation program and (2) to explore subtypes of smokers who are at a higher risk for non-usage attrition (i.e., early dropout times). METHODS We conducted secondary analyses of data from a large randomized controlled trial (RCT) that investigated effects of a web-based Cognitive Bias Modification intervention in adult smokers. First, we conducted a two-step cluster analysis to identify subtypes of smokers based on participants' baseline characteristics (including demographics, psychological and smoking-related variables, N = 749). Next, we conducted a discrete-time survival analysis to investigate the predictive value of the subtypes on time until dropout. RESULTS We found three distinct clusters of smokers: Cluster 1 (25.2%, n = 189) was characterized by participants being relatively young, highly educated, unmarried, light-to-moderate smokers, poly-substance users, and relatively high scores on sensation seeking and impulsivity; Cluster 2 (41.0%, n = 307) was characterized by participants being older, with a relatively high socio-economic status (SES), moderate-to-heavy smokers and regular drinkers; Cluster 3 (33.8%, n = 253) contained mostly females of older age, and participants were further characterized by a relatively low SES, heavy smoking, and relatively high scores on hopelessness, anxiety sensitivity, impulsivity, depression, and alcohol use. Additionally, Cluster 1 was more likely to drop out at the early stage of the intervention compared to Cluster 2 (adjusted Hazard Ratio (HR adjusted) = 1.51, 95% CI = [1.25, 1.83]) and Cluster 3 (HR adjusted = 1.52, 95% CI = [1.25, 1.86]). CONCLUSIONS We identified three clusters of smokers that differed on a broad range of characteristics and on intervention non-usage attrition patterns. This highlights the heterogeneity of participants in a web-based smoking cessation program. Also, it supports the idea that such interventions could be tailored to these subtypes to prevent non-usage attrition. The subtypes of smokers identified in this study need to be replicated in the field of e-health outside the context of RCT; based on the smoker subtypes identified in this study, we provided suggestions for developing tailored web-based smoking cessation intervention programs in future research.
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Affiliation(s)
- Si Wen
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands,Corresponding author at: Addiction Development and Psychopathology (ADAPT)-Lab, Department of Psychology, University of Amsterdam, Postbus 15916, 1001 NK Amsterdam, the Netherlands.
| | - Reinout W. Wiers
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands,Center for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - Marilisa Boffo
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands,Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Raoul P.P.P. Grasman
- Programme group Psychological Methods, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Thomas Pronk
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands,Open Science Tools (PsychoPy)-Lab, School of Psychology, University of Nottingham, Nottingham, United Kingdom of Great Britain and Northern Ireland
| | - Helle Larsen
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
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Gehlenborg J, Göritz AS, Moritz S, Lüdtke T, Kühn S. Imaginal Retraining Reduces Craving for Tobacco in 1-Year Controlled Follow-Up Study. Eur Addict Res 2021; 28:68-79. [PMID: 34569480 DOI: 10.1159/000518678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/23/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Imaginal retraining is a self-help technique that adapts the principles of approach bias modification to the imagination. Imaginal retraining has been shown to reduce craving and addictive behaviours in 3 randomized controlled trials (RCTs) on problematic alcohol consumption, overweight, and tobacco use. To date, there have been no studies evaluating the long-term efficacy of the intervention. The aim of the present study was to generate first hypotheses on the long-term efficacy of imaginal retraining in smokers in a controlled 1-year follow-up study. MATERIALS AND METHODS We recontacted the 345 participants who had taken part in an RCT on imaginal retraining for smokers 1 year later. The survey was carried out online and assessed craving for tobacco (primary outcome), smoking behaviour, well-being, and subjective appraisal. Individuals who applied the technique at least once during the previous year were categorized as the training group, whereas participants who never performed the training were categorized as the no-training group. Data were analysed using linear mixed models (LMMs). The study was preregistered as DRKS00021044. RESULTS The completion rate was 45.5%. Less than 40% used the intervention at least once in the previous 12 months. LMM analyses showed a significant reduction in craving for tobacco for the training compared to the no-training group after 1 year. No significant group differences emerged in smoking behaviour, depressive symptoms, or quality of life. Subjective appraisal of the intervention was favorable, similar to the initial study. CONCLUSION The present study provides preliminary support for the long-term efficacy of imaginal retraining on craving for tobacco but not on smoking behaviour, highlighting the importance of multimodal treatment concepts in smoking cessation that target a variety of maintaining factors. Future studies need to investigate the long-term efficacy of the intervention in prospective RCTs that test alternative ways of conveying the technique to improve adherence.
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Affiliation(s)
- Josefine Gehlenborg
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Anja S Göritz
- Department of Occupational and Consumer Psychology, University of Freiburg, Freiburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Thies Lüdtke
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
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Tayama J, Shimazu A, Ogawa S, Nakaya N. Effect of internet-based attention bias modification on the anxiety of Japanese workers: A randomized controlled trial. J Occup Health 2021; 63:e12229. [PMID: 33932320 PMCID: PMC8088281 DOI: 10.1002/1348-9585.12229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/18/2021] [Accepted: 04/09/2021] [Indexed: 11/08/2022] Open
Abstract
Objectives This study comprised a randomized controlled trial to examine the effect of internet‐based attention bias modification (iABM) on reducing workers' anxiety. Methods In total, 300 eligible participants were randomized according to sex and age; 180 were assigned to the intervention group and 120 to the control group. The word stimuli used in the iABM included eight positive words and eight neutral words. Participants were instructed to indicate the positive word's position as quickly and accurately as possible by tapping one of the two directions on display. The intervention included five sessions per participant over 1 month, resulting in a total of 600 trials. The main outcome measure was the total state anxiety score of the State‐Trait Anxiety Inventory (STAI). Results There was no significant difference in the net change in STAI scores between the intervention and control groups. The mean reaction time of the fifth session was significantly shorter than the mean reaction time of the first session. Furthermore, although there was no effect on the index of effect size Δ, the paired t‐test showed a significant decrease in the anxiety score. Conclusions The iABM intervention in this study did not enhance the amelioration of workers' anxiety when compared with the control condition.
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Affiliation(s)
- Jun Tayama
- Faculty of Human Sciences, Waseda University, Saitama, Japan
| | - Akihito Shimazu
- Faculty of Policy Management, Keio University, Kanagawa, Japan
| | - Sayaka Ogawa
- Center for Health and Community Medicine, Nagasaki University, Nagasaki, Japan
| | - Naoki Nakaya
- Department of Health Sciences, Saitama Prefectural University, Saitama, Japan
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10
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Zlomuzica A, Lange M, Reher S, Machulska A, Rinck M. The effects of psychological stress on approach tendencies for smoking-related cues in smokers. Eur J Neurosci 2021; 55:2581-2591. [PMID: 33964028 DOI: 10.1111/ejn.15295] [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: 12/07/2020] [Revised: 04/19/2021] [Accepted: 04/22/2021] [Indexed: 11/30/2022]
Abstract
Stress may potentiate the chronification of nicotine addiction, but the exact mechanisms remain elusive. We performed an explorative pilot study examining the effects of psychological stress, administered via the socially evaluated cold pressor task (SECPT), on implicit approach bias for smoking-related cues in smokers in the approach-avoidance task (AAT). Smokers (N = 24) were subjected to the stress or control condition of the SECPT by using a within-subject design. Consistent with previous findings, a strong approach bias for smoking-related cues in the AAT was found in smokers. Exposure to stress did not affect the general bias for smoking-related cues in the AAT relative to the control condition of the SECPT. In additional explorative analyses, an interaction among carbon monoxide (CO) levels in expired air, cortisol levels, and stress on approach bias for smoking-related cues was found. Higher CO levels, possibly due to recent smoking, prior to stress exposure were associated with an approach bias for smoking-related cues. Our results suggest that CO levels in interaction with stress can modulate implicit, automatic processing in the context of nicotine addiction. Our findings might provide novel cues to how stress influences cigarette craving and smoking behavior.
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Affiliation(s)
- Armin Zlomuzica
- Behavioral and Clinical Neuroscience, Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany
| | - Miriam Lange
- Behavioral and Clinical Neuroscience, Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany
| | - Sarah Reher
- Behavioral and Clinical Neuroscience, Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany
| | - Alla Machulska
- Department of Clinical Psychology, University of Siegen, Siegen, Germany
| | - Mike Rinck
- Behavioral and Clinical Neuroscience, Mental Health Research and Treatment Center, Ruhr University Bochum, Bochum, Germany.,Behavioral Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
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