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. and Verdejo-Garcia, Antonio 2016, Cognitive bias modification training during inpatient alcohol detoxification reduces early relapse: a randomized controlled trial, Alcoholism: clinicla and experimental research, vol. 40, no. 9, pp. 2011-2019, doi: 10.1111/acer.13163.

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Title Cognitive bias modification training during inpatient alcohol detoxification reduces early relapse: a randomized controlled trial
Author(s) Manning, Victoria
Staiger, Petra K.ORCID iD for Staiger, Petra K.
Hall, KateORCID iD for Hall, Kate
Garfield, Joshua B.B.
Flaks, Gabriella
Leung, Daniel
Hughes, Laura K.ORCID iD for Hughes, Laura K.
Lum, Jarrad A.G.ORCID iD for Lum, Jarrad A.G.
Lubman, Dan I.
Verdejo-Garcia, Antonio
Journal name Alcoholism: clinicla and experimental research
Volume number 40
Issue number 9
Start page 2011
End page 2019
Total pages 9
Publisher Wiley-Blackwell Publishing
Place of publication Chichester, Eng.
Publication date 2016-09
ISSN 0145-6008
Keyword(s) abstinence
cognitive bias modification
inpatient withdrawal
randomized controlled trial
Summary BACKGROUND: Relapse is common in alcohol-dependent individuals and can be triggered by alcohol-related cues in the environment. It has been suggested that these individuals develop cognitive biases, in which cues automatically capture attention and elicit an approach action tendency that promotes alcohol seeking. The study aim was to examine whether cognitive bias modification (CBM) training targeting approach bias could be delivered during residential alcohol detoxification and improve treatment outcomes.

METHODS: Using a 2-group parallel-block (ratio 1:1) randomized controlled trial with allocation concealed to the outcome assessor, 83 alcohol-dependent inpatients received either 4 sessions of CBM training where participants were implicitly trained to make avoidance movements in response to pictures of alcoholic beverages and approach movements in response to pictures of nonalcoholic beverages, or 4 sessions of sham training (controls) delivered over 4 consecutive days during the 7-day detoxification program. The primary outcome measure was continuous abstinence at 2 weeks postdischarge. Secondary outcomes included time to relapse, frequency and quantity of alcohol consumption, and craving. Outcomes were assessed in a telephonic follow-up interview.

RESULTS: Seventy-one (85%) participants were successfully followed up, of whom 61 completed all 4 training sessions. With an intention-to-treat approach, there was a trend for higher abstinence rates in the CBM group relative to controls (69 vs. 47%, p = 0.07); however, a per-protocol analysis revealed significantly higher abstinence rates among participants completing 4 sessions of CBM relative to controls (75 vs. 45%, p = 0.02). Craving score, time to relapse, mean drinking days, and mean standard drinks per drinking day did not differ significantly between the groups.

CONCLUSIONS: 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.
Language eng
DOI 10.1111/acer.13163
Field of Research 170299 Cognitive Sciences not elsewhere classified
1103 Clinical Sciences
1701 Psychology
1109 Neurosciences
Socio Economic Objective 920414 Substance Abuse
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Research Society on Alcoholism
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Document type: Journal Article
Collections: Faculty of Health
School of Psychology
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