Cognitive Bias Modification Training During Inpatient Alcohol Detoxification Reduces Early Relapse: A Randomized Controlled Trial

Manning, Victoria; Staiger, Petra K.; Hall, Kate; Garfield, Joshua B.B.; Flaks, Gabriella; Leung, Daniel; Hughes, Laura K.; Lum, Jarrad A. G.; Lubman, Dan I.; Verdejo-García, Antonio

doi:10.1111/acer.13163

Cited by 113 publications

(125 citation statements)

References 34 publications

(47 reference statements)

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“…Another useful addition could be to include craving induction with imagery or stress manipulations (Sinha, ). In the current study, patients were already abstinent, and a previous study also found an effect of CBM during detoxification (Manning et al., ). It may be more useful to do an intervention while patients feel stronger automatic or subjective approach tendencies toward the alcohol.…”

Section: Discussionsupporting

confidence: 68%

“…In these paradigms, relatively automatic responses are retrained into more beneficial reactions with computerized training. Several CBM studies (mostly with another variety of CBM: approach bias retraining) have shown positive findings in alcohol‐dependent populations (Eberl et al., ; Manning et al., ; Rinck et al., in press; Schoenmakers et al., ; Wiers et al., ). This clinical study focused on attentional bias modification (ABM), in which participants are trained to no longer focus attention on alcohol‐related stimuli.…”

mentioning

confidence: 99%

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A Clinical Trial with Combined Transcranial Direct Current Stimulation and Attentional Bias Modification in Alcohol‐Dependent Patients

Uyl

Gladwin

Lindenmeyer

et al. 2018

Alcoholism Clin & Exp Res

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BackgroundModifying attentional processes with attentional bias modification (ABM) might be a relevant add‐on to treatment in addiction. This study investigated whether influencing cortical plasticity with transcranial direct current stimulation (tDCS) could increase training effects. tDCS could also help alcohol‐dependent patients to overcome craving and reduce relapse, independent of training. These approaches were combined to investigate effects in the treatment of alcoholism.MethodsNinety‐eight patients (analytical sample = 83) were randomly assigned to 4 groups in a 2‐by‐2 factorial design. Patients received 4 sessions of ABM (control or real training) combined with 2 mA tDCS (active: 20 minutes or sham: 30 seconds) over the left dorsolateral prefrontal cortex. Alcohol bias and craving were assessed, and treatment outcome was measured as relapse after 1 year.ResultsAttentional bias scores indicated that during the training only the group with active tDCS and real ABM displayed an overall avoidance bias (p < 0.05). From pre‐ to postassessment, there were no main or interaction effects of tDCS and ABM on the bias scores, craving, or relapse (p > 0.2). However, effects on relapse after active tDCS were in the expected direction.ConclusionsThere was no evidence of a beneficial effect of tDCS or ABM or the combination. Whether the absence of effect was due to issues with the outcome measurements (e.g., lack of craving, high dropout, and unreliable measurements) or aspects of the intervention should be further investigated.

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Section: Discussionsupporting

confidence: 68%

mentioning

confidence: 99%

A Clinical Trial with Combined Transcranial Direct Current Stimulation and Attentional Bias Modification in Alcohol‐Dependent Patients

Uyl

Gladwin

Lindenmeyer

et al. 2018

Alcoholism Clin & Exp Res

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“…Approach biases are thought to play an important role in (the transition to) heavy drinking (Lindgren et al., ; Robinson & Berridge, ). Moreover, after training dependent individuals to avoid alcohol cues instead of approaching them, relapse rates decreased (Eberl et al., ; Kakoschke, Kemps, & Tiggemann, ; Manning et al., ; Rinck, Wiers, Becker, & Lindenmeyer, ; Wiers, Eberl, Rinck, Becker, & Lindenmeyer, ; Wiers, Ludwig, et al., ; Wiers, Stelzel, et al., ). Yet, such a re‐training has not been successful in undergraduate students in terms of reducing approach biases and drinking behaviour (Lindgren et al., ).…”

Section: Discussionmentioning

confidence: 99%

Brain responses and approach bias to social alcohol cues and their association with drinking in a social setting in young adult males

Groefsema

Mies

Cousijn

et al. 2019

Eur J of Neuroscience

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Alcohol is mainly consumed in social settings, in which people often adapt their drinking behaviour to that of others, also called imitation of drinking. Yet, it remains unclear what drives this drinking in a social setting. In this study, we expected to see stronger brain and behavioural responses to social compared to non‐social alcohol cues, and these responses to be associated with drinking in a social setting. The sample consisted of 153 beer‐drinking males, aged 18–25 years. Brain responses to social alcohol cues were measured during an alcohol cue‐exposure task performed in an fMRI scanner. Behavioural responses to social alcohol cues were measured using a stimulus‐response compatibility task, providing an index of approach bias towards these cues. Drinking in a social setting was measured in a laboratory mimicking a bar environment. Specific brain responses to social alcohol cues were observed in the bilateral superior temporal sulcus and the left inferior parietal lobe. There was no approach bias towards social alcohol cues specifically; however, we did find an approach bias towards alcohol (versus soda) cues in general. Brain responses and approach bias towards social alcohol cues were unrelated and not associated with actual drinking. Thus, we found no support for a relation between drinking in a social setting on the one hand, and brain cue‐reactivity or behavioural approach biases to social alcohol cues on the other hand. This suggests that, in contrast to our hypothesis, drinking in a social setting may not be driven by brain or behavioural responses to social alcohol cues.

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“…Repetitive training tasks have decreased alcohol approach bias in hazardous-drinking students (Wiers et al, 2010) and inpatients in alcohol treatment, who exhibited a 13% reduction in relapse (compared to a control group) one year after treatment (Wiers et al, 2011). These CBM results have been replicated (Eberl et al, 2013) and extended (Manning et al, 2016) by showing a 30% reduction in relapse two weeks after patients completed a seven-day alcohol detoxification program that included a course of active CBM training compared to controls in a sham training condition. While the outcomes from these studies suggest that ABM and CBM may be promising clinical tools, other authors have cautioned that more experimental evidence is required to clarify research results from studies that have failed to note similar effects (Christiansen et al, 2015; Cristea et al, 2016; Field et al, 2013; Schoenmakers et al, 2007; Wiers et al, 2013).…”

Section: Introductionmentioning

confidence: 82%

A Single Session of Attentional Bias Modification Reduces Alcohol Craving and Implicit Measures of Alcohol Bias in Young Adult Drinkers

Luehring-Jones

Louis

Dennis-Tiwary

et al. 2017

Alcoholism Clin & Exp Res

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Background Attentional bias modification (ABM) techniques for reducing problematic alcohol consumption hold promise as highly-accessible and cost-effective treatment approaches. A growing body of literature has examined ABM as a potentially efficacious intervention for reducing drinking and drinking-related cognitions in alcohol-dependent individuals as well as those at-risk of developing problem drinking habits. Methods The present study tested the effectiveness of a single session of visual probe-based ABM training in a cohort of 60 non-treatment-seeking young adult drinkers, with a focus on examining mechanisms underlying training efficacy. Participants were randomly assigned to a single session of active ABM training or a sham training condition in a laboratory setting. Measures of implicit drinking-related cognitions (alcohol Stroop and an Implicit Association Test) and attentional bias (alcohol visual probe) were administered, and subjective alcohol craving was reported in response to in-vivo alcohol cues. Results Results showed that active ABM training, relative to sham, resulted in significant differences in measures of implicit alcohol-related cognition, alcohol-related attentional bias, and self-reports of alcohol craving. Mediation analysis showed that reductions in craving were fully mediated by ABM-related reductions in alcohol-Stroop interference scores, suggesting a previously undocumented relationship between the two measures. Conclusion Results document the efficacy of brief ABM to reduce both implicit and explicit processes related to drinking, and highlight the potential intervention-relevance of alcohol-related implicit cognitions in social drinkers.

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Cognitive Bias Modification Training During Inpatient Alcohol Detoxification Reduces Early Relapse: A Randomized Controlled Trial

Abstract: This is the first trial demonstrating the feasibility of CBM delivered during alcohol detoxification and supports earlier research suggesting it may be a useful, low-cost adjunctive treatment to improve treatment outcomes for alcohol-dependent patients.

Cited by 113 publications

References 34 publications

A Clinical Trial with Combined Transcranial Direct Current Stimulation and Attentional Bias Modification in Alcohol‐Dependent Patients

A Clinical Trial with Combined Transcranial Direct Current Stimulation and Attentional Bias Modification in Alcohol‐Dependent Patients

Brain responses and approach bias to social alcohol cues and their association with drinking in a social setting in young adult males

A Single Session of Attentional Bias Modification Reduces Alcohol Craving and Implicit Measures of Alcohol Bias in Young Adult Drinkers

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