Previous research shows that automatic tendency to approach alcohol plays a causal role in problematic alcohol use and can be retrained by Approach Bias Modification (ApBM). ApBM has been shown to be effective for patients diagnosed with alcohol use disorder (AUD) in inpatient treatment. This study aimed to investigate the effectiveness of adding an online ApBM to treatment as usual (TAU) in an outpatient setting compared to receiving TAU with an online placebo training. 139 AUD patients receiving face-to-face or online treatment as usual (TAU) participated in the study. The patients were randomized to an active or placebo version of 8 sessions of online ApBM over a 5-week period. The weekly consumed standard units of alcohol (primary outcome) was measured at pre-and post-training, 3 and 6 months follow-up. Approach tendency was measured pre-and-post ApBM training. No additional effect of ApBM was found on alcohol intake, nor other outcomes such as craving, depression, anxiety, or stress. A significant reduction of the alcohol approach bias was found. This research showed that approach bias retraining in AUD patients in an outpatient treatment setting reduces the tendency to approach alcohol, but this training effect does not translate into a significant difference in alcohol reduction between groups. Explanations for the lack of effects of ApBM on alcohol consumption are treatment goal and severity of AUD. Future ApBM research should target outpatients with an abstinence goal and offer alternative, more user-friendly modes of delivering ApBM training.
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BACKGROUNDS:Alcohol use among adolescents has become a major public health problem in the past decade and has large short- and long-term consequences on their health. The aim of this systematic review was to provide an overview of longitudinal cohort studies that have analyzed the association between the parent-child relationship (PCR) and change in alcohol use during adolescence.METHODS: A search of the literature from 1985 to July 2011 was conducted in Medline, PsycINFO, and EMBASE in order to identify longitudinal, general population studies regarding the influence of the PCR on alcohol use during adolescence. The studies were screened, and the quality of the relevant studies was assessed. A best-evidence synthesis was used to summarize the results.RESULTS: Twenty-eight relevant studies were identified. Five studies found that a negative PCR was associated with higher levels of alcohol use. Another seven papers only found this association for certain subgroups such as boys or girls, or a specific age group. The remaining sixteen studies did not find any association.CONCLUSIONS: We found weak evidence for a prospective association between the PCR and adolescent alcohol use. Further research to the association of the PCR with several types of alcohol use (e.g., initiation or abuse) and to the potential reversed causality of the PCR and alcohol use is required.
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Background: Recent theoretical models emphasize the role of impulsive processes in alcohol addiction, which can be retrained with computerized Cognitive Bias Modification (CBM) training. In this study, the focus is on action tendencies that are activated relatively automatically. Objective: The aim of the study is to examine the effectiveness of online CBM Alcohol Avoidance Training using an adapted Approach-Avoidance Task as a supplement to treatment as usual (TAU) in an outpatient treatment setting. Methods: The effectiveness of 8 online sessions of CBM Alcohol Avoidance Training added to TAU is tested in a double-blind, randomized controlled trial with pre- and postassessments, plus follow-up assessments after 3 and 6 months. Participants are adult patients (age 18 years or over) currently following Web-based or face-to-face TAU to reduce or stop drinking. These patients are randomly assigned to a CBM Alcohol Avoidance or a placebo training. The primary outcome measure is a reduction in alcohol consumption. We hypothesize that TAU + CBM will result in up to a 13-percentage point incremental effect in the number of patients reaching the safe drinking guidelines compared to TAU + placebo CBM. Secondary outcome measures include an improvement in health status and a decrease in depression, anxiety, stress, and possible mediation by the change in approach bias. Finally, patients’ adherence, acceptability, and credibility will be examined. Results: The trial was funded in 2014 and is currently in the active participant recruitment phase (since May 2015). Enrolment will be completed in 2019. First results are expected to be submitted for publication in 2020. Conclusions: The main purpose of this study is to increase our knowledge about the added value of online Alcohol Avoidance Training as a supplement to TAU in an outpatient treatment setting. If the added effectiveness of the training is proven, the next step could be to incorporate the intervention into current treatment.
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Alcoholgebruiksstoornis (AUD) is een groot probleem. Alleen al in de USA zijn er 15 miljoen mensen met een AUD en meer dan 950.000 Nederlanders drinkt overmatig. Wereldwijd is 3-8% van het aantal sterfgevallen en 5% van alle ziektes en letsels toe te schrijven aan AUD. Zorg staat voor uitdagingen. Zo krijgt meer dan de helft van de AUD-patiënten binnen een jaar na behandeling een terugval. Een oplossing hiervoor is de inzet van Cue-Exposure-Therapy (CET). Daarbij worden cliënten blootgesteld aan triggers d.m.v. objecten, mensen en omgevingen die zucht opwekken. Om op een realistische, veilige en gepersonaliseerde manier deze triggers te ervaren, wordt Virtual Reality ingezet (VRET). Op die manier worden coping-vaardigheden getraind om verlangen naar alcohol tegen te gaan. De effectiviteit van VRET is (klinisch) bewezen. De komst van AR-technologieën roept echter de vraag op om mogelijkheden van Augmented-Reality-Exposure-Therapy (ARET) te onderzoeken. ARET geniet dezelfde voordelen als VRET (zoals een realistische veilige ervaring). Maar omdat AR virtuele-componenten in de echte omgeving integreert, waarbij het lichaam zichtbaar is, roept het vermoedelijk een ander type ervaring op. Dit kan de ecologische validiteit van CET in de behandeling vergroten. Daarnaast is ARET goedkoper te ontwikkelen (minder virtuele elementen) en hebben cliënten/klinieken gemakkelijker toegang tot AR (via smartphone/tablet). Bovendien worden nieuwe AR-brillen ontwikkeld, die nadelen zoals een te klein smartphone-scherm oplossen. Ondanks de vraag vanuit behandelaars, is ARET nog nooit ontwikkeld en onderzocht rondom verslaving. In dit project wordt het eerste ARET-prototype ontwikkeld rondom AUD in de behandeling van alcoholverslaving. Het prototype wordt ontwikkeld op basis van Volumetric-Captured-Digital-Humans en toegankelijk gemaakt voor AR-brillen, tablets en smartphones. Het prototype wordt gebaseerd op RECOVRY, een door het consortium ontwikkelde VRET rondom AUD. Een prototype-test onder (ex)AUD-cliënten zal inzicht geven in behoeften en verbeterpunten vanuit patiënt en zorgverlener en in het effect van ARET in vergelijk met VRET.
Alcohol use disorder (AUD) is a major problem. In the USA alone there are 15 million people with an AUD and more than 950,000 Dutch people drink excessively. Worldwide, 3-8% of all deaths and 5% of all illnesses and injuries are attributable to AUD. Care faces challenges. For example, more than half of AUD patients relapse within a year of treatment. A solution for this is the use of Cue-Exposure-Therapy (CET). Clients are exposed to triggers through objects, people and environments that arouse craving. Virtual Reality (VRET) is used to experience these triggers in a realistic, safe, and personalized way. In this way, coping skills are trained to counteract alcohol cravings. The effectiveness of VRET has been (clinically) proven. However, the advent of AR technologies raises the question of exploring possibilities of Augmented-Reality-Exposure-Therapy (ARET). ARET enjoys the same benefits as VRET (such as a realistic safe experience). But because AR integrates virtual components into the real environment, with the body visible, it presumably evokes a different type of experience. This may increase the ecological validity of CET in treatment. In addition, ARET is cheaper to develop (fewer virtual elements) and clients/clinics have easier access to AR (via smartphone/tablet). In addition, new AR glasses are being developed, which solve disadvantages such as a smartphone screen that is too small. Despite the demand from practitioners, ARET has never been developed and researched around addiction. In this project, the first ARET prototype is developed around AUD in the treatment of alcohol addiction. The prototype is being developed based on Volumetric-Captured-Digital-Humans and made accessible for AR glasses, tablets and smartphones. The prototype will be based on RECOVRY, a VRET around AUD developed by the consortium. A prototype test among (ex)AUD clients will provide insight into needs and points for improvement from patient and care provider and into the effect of ARET compared to VRET.
Alcohol Use Disorder (AUD) involves uncontrollable drinking despite negative consequences, a challenge amplified in festivals. ARise is a project using Augmented Reality (AR) to prevent AUD by helping festival visitors refuse alcohol and other substances. Based on the first Augmented Reality Exposure Therapy (ARET) for clinical AUD treatment, ARise uses a smartphone app with AR glasses to project virtual humans that tempt visitors to drink alcohol. Users interact in a safe and personalized way with these virtual humans through phone, voice, and gesture interactions. The project gathers festival feedback on user experience, awareness, usability, and potential expansion to other substances.Societal issueHelping treatment of addiction and stimulate social inclusion.Benefit to societyMore people less patients: decrease health cost and increase in inclusion and social happiness.Collaborative partnersNovadic-Kentron, Thalamusa
