Mobile Phone Cognitive Bias Modification Research Platform for Substance Use Disorders: Protocol for a Feasibility Study

A Smartphone App for Attentional Bias Retraining in Smokers: Mixed Methods Pilot Study

BACKGROUND

Smoking is a global health threat. Attentional bias influences smoking behaviors. Although attentional bias retraining has shown benefits and recent advances in technology suggest that attentional bias retraining can be delivered via smartphone apps, there is a paucity of research on this topic.

OBJECTIVE

This study aims to address this gap by exploring the use of attentional bias retraining via a novel smartphone app using a mixed methods pilot study. In the quantitative phase, it is hypothesized that participants in the training group who undertake attentional bias retraining via the app should have decreased levels of attentional bias, subjective craving, and smoking frequency, compared with those in the control group who do not undertake attentional bias retraining. The qualitative phase explores how the participants perceive and experience the novel app.

METHODS

In all, 10 adult smokers (3 females and 7 males) between the ages of 26 and 56 years (mean 34.4 years, SD 9.97 years) were recruited. The participants were randomly allocated to the training and control groups. In weeks 1 and 3, participants from both groups attempted the standard visual probe task and rated their smoking frequency and subjective craving. In week 2, the participants in the training group attempted the modified visual probe task. After week 3, participants from both groups were interviewed about their views and experiences of the novel app.

RESULTS

The results of the quantitative analysis did not support this study's hypothesis. The qualitative data were analyzed using thematic analysis. The results yielded 5 themes: ease, helpfulness, unhelpful aspects, barriers, and refinement.

CONCLUSIONS

Findings from the qualitative study were consistent with those from previous studies on health-related smartphone apps. The qualitative results were helpful in understanding the user perspectives and experiences of the novel app, indicating that future research in this innovative area is necessary.

Effects of visual search task on attentional bias and stress response under pressure

BACKGROUND

it has always been a problem for athletes that their performance is out of order due to pressure in major competitions. The change of attention pattern and the emergence of stress response (SR) caused by negative affect (NA) are the direct reasons for the greater impact on the performance of athletes. It is a hot topic to explore how to improve attention bias (AB) and SR of athletes in stressful situations.

OBJECTIVE

the study aimed to analyze the improvement effect of visual search task (VST) training on AB and SR of athletes under pressure situations.

METHODS

62 male basketball players with national level 2 or above of Shenyang sports institute were divided into experimental group (EG) and control group (CG). Visual search task training program was used in the EG (happy, sad, disgusted, neutral faces) and sham training program was used in the CG (all faces with neutral expression) for two months. Under the stress situation, attention behavior of all subjects before and after training was tested. Physiological coherence and autonomic balance system were used to record heart rate variability synchronously. Parallel frequency domain analysis was divided into very low frequency band (VLF), low frequency (LF), high frequency (HF) and total spectrum (TP). The normalized treatment obtained indexes such as HFnorm, LFnorm, and LF/HF. The e-prime 2.0 software was adopted to obtain the attention bias score. The Positive and Negative Affect Scale (PANAS) and the self-rating stress scale were adopted for evaluation before and after training.

RESULTS

the self-rating pressure in the two groups was lower than that before the training, and the pressure in the experimental group was lower than that in the control group (P < 0.05). After training, the positive emotion of the experimental group was higher than that of the control group, and the EG was lower than that of the CG (P < 0.05). After training, the score of attention bias of happy and neutral faces in the EG was higher than that of theCG, while the score of attention bias of sad and disgusted faces was lower than that of the CG (P < 0.05). After training, LF/HF and LFnorm in the EG were lower than those in the CG, and HFnorm was higher than those in the CG (P < 0.05).

CONCLUSIONS

the training of visual search task can effectively improve the athletes' PA and AB of positive information, reduce the attention bias of negative information and psychological pressure, and relieve theSR.

Co-designing a Mobile Gamified Attention Bias Modification Intervention for Substance Use Disorders: Participatory Research Study

Background

Advances in experimental psychology have highlighted the need to modify underlying automatic cognitive biases, such as attentional biases. The effectiveness of bias modification has been well studied for substance use disorders. With recent advances in technology, it is now possible to work outside the laboratory with Web-based and mobile-based attention bias interventions. Gamification technologies might also help diminish the repetitiveness of the task and increase the intrinsic motivation to train. The inconsistent findings of the impact of gaming on the effectiveness of mobile interventions call for further work to better understand the needs of patients (users) and health care professionals.

Objective

The aim of this study was to involve patients, together with health care professionals, in the design of a gamified mobile attention bias modification intervention for substance use disorders.

Methods

The participatory design research method adopted is that of a user-oriented design approach in the form of a future workshop. In the first phase of the workshop, participants shared their critique of an attention bias modification intervention. In the second phase of the workshop, participants were asked to brainstorm features. Participants were also shown gamification approaches and asked to consider if gaming elements could enhance the existing app. In the last phase, participants were asked to sketch a new prototype.

Results

Three co-design workshops were conducted with health care professionals, inpatients, and outpatients. There were 20 participants, consisting of 10 health care professionals and 10 patients. When asked to identify the limitations in the existing app, common issues identified were those of the design, visual probe task, and the included images. Outpatients were also concerned with the safety of administration of the intervention. In the brainstorming sessions, health care professionals made recommendations as to how the stimulus, the mechanism of responding, and the presentation of the scores could be enhanced. Inpatient participants recommended the addition of functionalities, such as information on the harms associated with the substance use, and for there to be enhancements in the design, images, and task. Outpatient participants perceived a need to improve the images and presentation of the results and recommended the inclusion of gaming features. There were differences in opinion on the inclusion of gaming features, as only health care professionals endorsed their inclusion. In the last phase of the workshop, participants were tasked with the conceptualization of prototypes, and the commonality in the design was for a gradual shortening of the interval for stimulus/image presentation.

Conclusions

The results from this research will guide the development of an app that meets the specific needs of patients and is still based on a pre-existing validated task paradigm.