Cue-Elicited Anxiety and Alcohol Craving as Indicators of the Validity of ALCO-VR Software: A Virtual Reality Study

Abstract

Background: This study is part of a larger project aiming to develop a virtual reality (VR) software to be implemented as a clinical tool for patients diagnosed with alcohol use disorder (AUD). The study is based on previous research in which we identified factors that elicit craving for alcohol in a sample of AUD patients, and which led to the development of a virtual reality software to be used in cue exposure treatments of alcohol use disorder (ALCO-VR). The main objective of this study was to test the effectiveness of ALCO-VR to elicit cue-induced craving and anxiety responses among social drinkers (SD) and AUD patients. Our secondary objective was to explore which responses (cue-induced craving or anxiety) can best differentiate between AUD patients and the SD group. Method: Twenty-seven individuals (13 AUD patients and 14 SD) participated in this study after giving written informed consent. Their anxiety and alcohol craving levels were measured by different instruments at different stages of the procedure. The VR equipment consisted of Oculus Rift technology, and the software consisted of the ALCO-VR platform. Results: Our data indicate that the ALCO-VR software can elicit responses of anxiety and alcohol craving, especially in the group of AUD patients. The cue-induced anxiety response differentiated AUD patients and the SD group better than the cue-induced craving response. Conclusions: The general interest in applying new technologies to the assessment and treatment of mental health disorders has led to the development of immersive real-life simulations based on the advantages of VR technology. Our study concluded that the ALCO-VR software can elicit anxiety and craving responses and that cue-induced anxiety responses can distinguish between AUD and SD groups better than cue-induced craving. The data on craving and anxiety were assessed consistently by different instruments. In addition, we consider that ALCO-VR is able to ecologically assess cue-induced anxiety and alcohol craving levels during exposure to VR alcohol-related environments.

Predictors of Changes in Alcohol Craving Levels during a Virtual Reality Cue Exposure Treatment among Patients with Alcohol Use Disorder

“…There were consistent results across these studies, with a great reduction in levels of alcohol craving at post-therapy assessment sessions [ 51 , 52 , 53 ]. We followed a similar procedure in terms of software development, VR-CET approach, or number of therapy sessions [ 54 ].…”

Attentional Bias, Alcohol Craving, and Anxiety Implications of the Virtual Reality Cue-Exposure Therapy in Severe Alcohol Use Disorder: A Case Report

“…The MACS total score indicated a “moderate alcohol craving” throughout daily life activities, particularly in the previous week before the assessment ( Guardia Serecigni et al, 2004 ). The total MACS-VR score was translated into an “intense craving for alcohol” immediately after the assessment part of the “ALCO-VR” software, as a result of cue-induced alcohol craving ( Ghiţă et al, 2019b ). These scores were consistent with the self-reported subjective craving on the VAS-C during the VR assessment task.…”

“…The patients self-reported a wide range of alcoholic beverages and we included a menu of 22 alcoholic drinks in the VR platform. Hence, based on patients’ experiences, the second study of the project emphasized the development and validation of the “ALCO-VR” platform ( Ghiţă et al, 2019b ). A third study carried out as part of the project aimed to develop an AB assessment task using the ET technology.…”

Reliability assessment of temporal discounting measures in virtual reality environments

“…The present experimental set-up might be a viable tool to improve the ecological validity of cue-reactivity research in gambling disorder. VR has previously been used to study cuereactivity in gambling disorder [34,79,80] , but also smokers [81] and alcoholics [31] . Our design extends these previous approaches in several ways.…”

“…Recent research has exploited the development of high-performance virtual reality (VR) technology to increase the ecological validity of stimuli presented in studies of cue-exposure [31] , counterconditioning [32] and equilibrium training [33] . By equipping participants with headmounted VR-glasses and sufficient space to navigate within the VR-environment, a strong sense of immersion can be created, which in turn generates more realistic stimulation.…”