Protocol for a randomised controlled trial of cognitive bias modification training during inpatient withdrawal from alcohol use disorder

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 treat...

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Main 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
Format: Article
Language:English
Published: BMC 2018-11-01
Series:Trials
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13063-018-2999-3
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author 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
author_facet 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
author_sort Victoria Manning
collection DOAJ
description 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).
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spelling doaj.art-d475c386e8994f8fa8e292794a92fcde2022-12-21T18:57:01ZengBMCTrials1745-62152018-11-0119111210.1186/s13063-018-2999-3Protocol for a randomised controlled trial of cognitive bias modification training during inpatient withdrawal from alcohol use disorderVictoria Manning0Joshua B. B. Garfield1Samuel C. Campbell2John Reynolds3Petra K. Staiger4Jarrad A. G. Lum5Kate Hall6Reinout W. Wiers7Dan I. Lubman8Antonio Verdejo-Garcia9Turning Point, Eastern HealthTurning Point, Eastern HealthTurning Point, Eastern HealthAlfred Health and Faculty of Medicine, Nursing and Health Sciences, Monash UniversitySchool of Psychology, Deakin UniversitySchool of Psychology, Deakin UniversitySchool of Psychology, Deakin UniversityAddiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of AmsterdamTurning Point, Eastern HealthTurning Point, Eastern HealthAbstract 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).http://link.springer.com/article/10.1186/s13063-018-2999-3Alcohol use disorderCognitive biasApproach biasAlcohol withdrawal treatmentRelapseAbstinence
spellingShingle 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
Protocol for a randomised controlled trial of cognitive bias modification training during inpatient withdrawal from alcohol use disorder
Trials
Alcohol use disorder
Cognitive bias
Approach bias
Alcohol withdrawal treatment
Relapse
Abstinence
title Protocol for a randomised controlled trial of cognitive bias modification training during inpatient withdrawal from alcohol use disorder
title_full Protocol for a randomised controlled trial of cognitive bias modification training during inpatient withdrawal from alcohol use disorder
title_fullStr Protocol for a randomised controlled trial of cognitive bias modification training during inpatient withdrawal from alcohol use disorder
title_full_unstemmed Protocol for a randomised controlled trial of cognitive bias modification training during inpatient withdrawal from alcohol use disorder
title_short Protocol for a randomised controlled trial of cognitive bias modification training during inpatient withdrawal from alcohol use disorder
title_sort protocol for a randomised controlled trial of cognitive bias modification training during inpatient withdrawal from alcohol use disorder
topic Alcohol use disorder
Cognitive bias
Approach bias
Alcohol withdrawal treatment
Relapse
Abstinence
url http://link.springer.com/article/10.1186/s13063-018-2999-3
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