Learning to resist the urge: a double-blind, randomized controlled trial investigating alcohol-specific inhibition training in abstinent patients with alcohol use disorder
Abstract Background Alcohol use disorder (AUD) leads to a significant individual and societal burden. To achieve higher therapy success rates, therapeutic interventions still need to be improved. Most current neuroscientific conceptualizations of AUD focus on the imbalance between an enhanced automa...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-07-01
|
| Series: | Trials |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13063-019-3505-2 |
| _version_ | 1818035674115211264 |
|---|---|
| author | Raphaela M. Tschuemperlin Maria Stein Hallie M. Batschelet Franz Moggi Leila M. Soravia |
| author_facet | Raphaela M. Tschuemperlin Maria Stein Hallie M. Batschelet Franz Moggi Leila M. Soravia |
| author_sort | Raphaela M. Tschuemperlin |
| collection | DOAJ |
| description | Abstract Background Alcohol use disorder (AUD) leads to a significant individual and societal burden. To achieve higher therapy success rates, therapeutic interventions still need to be improved. Most current neuroscientific conceptualizations of AUD focus on the imbalance between an enhanced automatic reaction to alcohol cues and impaired inhibition. Complementary to traditional relapse prevention strategies, novel computerized training interventions aim to directly alter these processes. This study tests a computerized alcohol-specific inhibition training in a large clinical sample and investigates its effects on behavioral, experimental and neurophysiological outcomes. It also analyzes whether variations in inhibition difficulty and/or endogenous cortisol levels during training impact these effects. Methods This is a double-blind, randomized controlled trial (RCT) with 246 inpatients with AUD participating. After baseline assessment, participants are randomly assigned to one of three computerized Go-NoGo-based inhibition training interventions (two alcohol-specific versions with different Go/NoGo ratios, or neutral control training) and one of two intervention times (morning/afternoon), resulting in six study arms. All patients perform six training sessions within 2 weeks. Endogenous cortisol is measured in 80 patients before and after the first training session. Inhibitory control and implicit associations towards alcohol are assessed pre and post training, at which point electroencephalography (EEG) is additionally measured in 60 patients. Patients’ alcohol consumption and relevant psychological constructs (e.g., craving, self-efficacy, treatment motivation) are measured at discharge and at 3-, 6- and 12-month follow-ups. Fifty healthy participants are assessed (20 with EEG) at one time point as a healthy control group. Discussion This study investigates the effects of a computerized, alcohol-specific inhibition training for the first time in patients with AUD. Results should give insight into the effectiveness of this potential add-on to standard AUD treatment, including proximal and distal measures and effects on behavioral, experimental and neurophysiological measures. Information about working mechanisms and potential optimizations of this training are gathered through variations regarding difficulty of inhibition training and training time. This study may thus contribute to a deepened understanding of AUD and the improvement of its evidence-based treatment. Trial registration ClinicalTrials.gov, ID: NCT02968537. Registered on 18 November 2016. |
| first_indexed | 2024-12-10T06:58:48Z |
| format | Article |
| id | doaj.art-6cea47d05bb84b2ab1dbeaf26f129dc9 |
| institution | Directory Open Access Journal |
| issn | 1745-6215 |
| language | English |
| last_indexed | 2024-12-10T06:58:48Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Trials |
| spelling | doaj.art-6cea47d05bb84b2ab1dbeaf26f129dc92022-12-22T01:58:22ZengBMCTrials1745-62152019-07-0120111610.1186/s13063-019-3505-2Learning to resist the urge: a double-blind, randomized controlled trial investigating alcohol-specific inhibition training in abstinent patients with alcohol use disorderRaphaela M. Tschuemperlin0Maria Stein1Hallie M. Batschelet2Franz Moggi3Leila M. Soravia4Translational Research Center, University Hospital of Psychiatry, University of BernTranslational Research Center, University Hospital of Psychiatry, University of BernTranslational Research Center, University Hospital of Psychiatry, University of BernTranslational Research Center, University Hospital of Psychiatry, University of BernTranslational Research Center, University Hospital of Psychiatry, University of BernAbstract Background Alcohol use disorder (AUD) leads to a significant individual and societal burden. To achieve higher therapy success rates, therapeutic interventions still need to be improved. Most current neuroscientific conceptualizations of AUD focus on the imbalance between an enhanced automatic reaction to alcohol cues and impaired inhibition. Complementary to traditional relapse prevention strategies, novel computerized training interventions aim to directly alter these processes. This study tests a computerized alcohol-specific inhibition training in a large clinical sample and investigates its effects on behavioral, experimental and neurophysiological outcomes. It also analyzes whether variations in inhibition difficulty and/or endogenous cortisol levels during training impact these effects. Methods This is a double-blind, randomized controlled trial (RCT) with 246 inpatients with AUD participating. After baseline assessment, participants are randomly assigned to one of three computerized Go-NoGo-based inhibition training interventions (two alcohol-specific versions with different Go/NoGo ratios, or neutral control training) and one of two intervention times (morning/afternoon), resulting in six study arms. All patients perform six training sessions within 2 weeks. Endogenous cortisol is measured in 80 patients before and after the first training session. Inhibitory control and implicit associations towards alcohol are assessed pre and post training, at which point electroencephalography (EEG) is additionally measured in 60 patients. Patients’ alcohol consumption and relevant psychological constructs (e.g., craving, self-efficacy, treatment motivation) are measured at discharge and at 3-, 6- and 12-month follow-ups. Fifty healthy participants are assessed (20 with EEG) at one time point as a healthy control group. Discussion This study investigates the effects of a computerized, alcohol-specific inhibition training for the first time in patients with AUD. Results should give insight into the effectiveness of this potential add-on to standard AUD treatment, including proximal and distal measures and effects on behavioral, experimental and neurophysiological measures. Information about working mechanisms and potential optimizations of this training are gathered through variations regarding difficulty of inhibition training and training time. This study may thus contribute to a deepened understanding of AUD and the improvement of its evidence-based treatment. Trial registration ClinicalTrials.gov, ID: NCT02968537. Registered on 18 November 2016.http://link.springer.com/article/10.1186/s13063-019-3505-2Alcohol use disorderAlcohol-specific inhibition trainingEEGCortisolGo-NoGo Task (GNG)Stop-Signal Task (SST) |
| spellingShingle | Raphaela M. Tschuemperlin Maria Stein Hallie M. Batschelet Franz Moggi Leila M. Soravia Learning to resist the urge: a double-blind, randomized controlled trial investigating alcohol-specific inhibition training in abstinent patients with alcohol use disorder Trials Alcohol use disorder Alcohol-specific inhibition training EEG Cortisol Go-NoGo Task (GNG) Stop-Signal Task (SST) |
| title | Learning to resist the urge: a double-blind, randomized controlled trial investigating alcohol-specific inhibition training in abstinent patients with alcohol use disorder |
| title_full | Learning to resist the urge: a double-blind, randomized controlled trial investigating alcohol-specific inhibition training in abstinent patients with alcohol use disorder |
| title_fullStr | Learning to resist the urge: a double-blind, randomized controlled trial investigating alcohol-specific inhibition training in abstinent patients with alcohol use disorder |
| title_full_unstemmed | Learning to resist the urge: a double-blind, randomized controlled trial investigating alcohol-specific inhibition training in abstinent patients with alcohol use disorder |
| title_short | Learning to resist the urge: a double-blind, randomized controlled trial investigating alcohol-specific inhibition training in abstinent patients with alcohol use disorder |
| title_sort | learning to resist the urge a double blind randomized controlled trial investigating alcohol specific inhibition training in abstinent patients with alcohol use disorder |
| topic | Alcohol use disorder Alcohol-specific inhibition training EEG Cortisol Go-NoGo Task (GNG) Stop-Signal Task (SST) |
| url | http://link.springer.com/article/10.1186/s13063-019-3505-2 |
| work_keys_str_mv | AT raphaelamtschuemperlin learningtoresisttheurgeadoubleblindrandomizedcontrolledtrialinvestigatingalcoholspecificinhibitiontraininginabstinentpatientswithalcoholusedisorder AT mariastein learningtoresisttheurgeadoubleblindrandomizedcontrolledtrialinvestigatingalcoholspecificinhibitiontraininginabstinentpatientswithalcoholusedisorder AT halliembatschelet learningtoresisttheurgeadoubleblindrandomizedcontrolledtrialinvestigatingalcoholspecificinhibitiontraininginabstinentpatientswithalcoholusedisorder AT franzmoggi learningtoresisttheurgeadoubleblindrandomizedcontrolledtrialinvestigatingalcoholspecificinhibitiontraininginabstinentpatientswithalcoholusedisorder AT leilamsoravia learningtoresisttheurgeadoubleblindrandomizedcontrolledtrialinvestigatingalcoholspecificinhibitiontraininginabstinentpatientswithalcoholusedisorder |