Protocol for a Randomised Controlled Trial of Cognitive Bias Modification Training During Inpatient Withdrawal from Alcohol Use Disorder

Overview

Journal Trials

Publisher Biomed Central

Specialties General Medicine
Pharmacology

Date 2018 Nov 2

PMID 30382877

Citations 3

Authors

Victoria Manning

Joshua B B Garfield

Samuel C Campbell

John Reynolds

Petra K Staiger

Jarrad A G Lum

Kate Hall

Reinout W Wiers

Dan I Lubman

Antonio Verdejo-Garcia

Affiliations

Soon will be listed here.

Abstract

Background: People with alcohol use disorders often exhibit an "alcohol approach bias", the automatically triggered action tendency to approach alcohol. Approach bias is likely to persist following withdrawal from alcohol, and contribute to the high rate of relapse following withdrawal treatment. Cognitive bias modification (CBM) training has been shown to attenuate approach biases and lead to reduced relapse rates. However, no large multisite trial of CBM specifically within a residential withdrawal treatment setting has previously been conducted. This study aims to test whether CBM delivered during residential withdrawal treatment leads to reduced relapse rates and reduced use of acute health services following discharge, and to test possible moderators of CBM's effect on alcohol use.

Methods: Three hundred alcohol-dependent inpatients are being recruited from three withdrawal treatment units in the Melbourne metropolitan area. Participants complete baseline measures of alcohol approach bias and cue-evoked desire for alcohol, followed by four daily sessions of computerised CBM training (or sham training if randomised to the control group). Approach bias and cue-evoked desire are re-assessed following the fourth training session. Follow-up assessments administered 2 weeks and 3, 6, and 12 months following discharge from the withdrawal treatment unit compare abstinence rates and acute and emergency healthcare service use between conditions. Pre-admission and follow-up substance use is derived from the timeline follow-back method, and approach bias towards alcohol with a computerised Approach Avoidance Task.

Discussion: This study is the first multisite randomised controlled trial of cognitive bias modification delivered during acute alcohol withdrawal treatment. Withdrawal is theoretically an ideal period to deliver neurocognitive interventions due to heightened neuroplasticity and cognitive recovery. If effective, the low cost and easy implementation of CBM training means it could be widely used as a standard part of alcohol withdrawal treatment to improve treatment outcomes. Moderation analyses may help better determine whether certain subgroups of patients are most likely to benefit from it and therefore should be prioritised for CBM during alcohol withdrawal treatment.

Trial Registration: Version 4 of the protocol (dated 1 August 2017) is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12617001241325 . Registered on 25 August 2017 (retrospectively registered).

Citing Articles

Alcohol use in the year following approach bias modification during inpatient withdrawal: secondary outcomes from a double-blind, multi-site randomized controlled trial.

Manning V, Garfield J, Reynolds J, Staiger P, Piercy H, Bonomo Y Addiction. 2022; 117(11):2837-2846.

PMID: 35792053 PMC: 9796776. DOI: 10.1111/add.15989.

A Systematic Review of the Balloon Analogue Risk Task (BART) in Alcohol Research.

Canning J, Schallert M, Larimer M Alcohol Alcohol. 2021; 57(1):85-103.

PMID: 33592622 PMC: 8753779. DOI: 10.1093/alcalc/agab004.

Personalized Approach Bias Modification Smartphone App ("SWIPE") to Reduce Alcohol Use Among People Drinking at Hazardous or Harmful Levels: Protocol for an Open-Label Feasibility Study.

Manning V, Piercy H, Garfield J, Lubman D JMIR Res Protoc. 2020; 9(8):e21278.

PMID: 32795989 PMC: 7455870. DOI: 10.2196/21278.

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