Combining approach bias modification with working memory training during inpatient alcohol withdrawal: an open-label pilot trial of feasibility and acceptability

Autor: Katherine Mroz, Petra K. Staiger, Kate Hall, Joshua B.B. Garfield, Victoria Manning, Antonio Verdejo-García, Dan I. Lubman
Rok vydání: 2019
Předmět:
Male
lcsh:Social pathology. Social and public welfare. Criminology
medicine.medical_treatment
030508 substance abuse
Pilot Projects
Craving
Alcohol use disorder
lcsh:HV1-9960
0302 clinical medicine
030212 general & internal medicine
media_common
Alcohol Abstinence
lcsh:Public aspects of medicine
Health Policy
Alcohol detoxification
Middle Aged
Cognitive training
Substance Withdrawal Syndrome
Substance abuse
Alcoholism
Psychiatry and Mental health
Withdrawal
Female
medicine.symptom
Detoxification
0305 other medical science
Psychology
Adult
Working memory training
medicine.medical_specialty
Adolescent
media_common.quotation_subject
Approach bias
Short Report
Young Adult
03 medical and health sciences
medicine
Humans
Learning
Inpatients
Cognitive Behavioral Therapy
Working memory
lcsh:RA1-1270
Patient Acceptance of Health Care
Abstinence
medicine.disease
Physical therapy
Feasibility Studies
Cognitive bias
Zdroj: Substance Abuse Treatment, Prevention, and Policy
Substance Abuse Treatment, Prevention, and Policy, Vol 14, Iss 1, Pp 1-6 (2019)
ISSN: 1747-597X
DOI: 10.1186/s13011-019-0209-2
Popis: Background According to contemporary neurocognitive models, addiction is maintained by the biasing of information-processing and decision-making systems towards relatively automatic, impulsive, reward-seeking responses to drug-related stimuli, and away from more controlled, deliberative, “reflective” states of processing that could result in decisions to delay or avoid drug use. Cognitive training programs aimed at either countering “impulsive” processing or enhancing “reflective” processing alone have shown promise. However, there has been no attempt to simultaneously target both aspects of processing with a combined training program. We aimed to test the feasibility and acceptability of a novel ‘dual-training’ program targeting both processes during residential alcohol withdrawal, and to measure abstinence rates following discharge. Methods Thirty-seven patients undergoing alcohol withdrawal at a residential unit participated in this open-label pilot feasibility study. We tested a 4-session program of dual cognitive training targeting both impulsive (approach bias) and reflective (working memory) aspects of processing. Descriptive statistics were used to examine feasibility (training uptake and completion rates) and acceptability (withdrawal from the study; participants’ ratings of the tasks). Alcohol abstinence rates were examined 2-weeks post-discharge. Results Seven participants withdrew after commencing training. Twenty-six (70%) completed the 4-session training protocol, and four completed 3 sessions before discharging. Among participants who provided ratings, nearly all (93%) rated the training as interesting. Most (87%) indicated that they felt it had improved their attention. However, most did not feel it had decreased their craving for alcohol. At 2-weeks post-discharge, 16 (53%) participants reported abstaining from alcohol. For comparison, an earlier pilot trial in the same setting found a 68% abstinence rate with approach bias training alone, and 47% abstinence in a non-training control group. Conclusions Dual training during residential alcohol detoxification appears to be both acceptable and feasible, suggesting that future research is warranted to test its effectiveness at reducing likelihood of relapse.
Databáze: OpenAIRE
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