Abstract
Background: Approach bias, the tendency for drug/alcohol cues to automatically trigger unconscious impulses to approach drugs/alcohol is associated with relapse following treatment. Recent neuroscience findings point to marked neuroplasticity in the days following cessation of use, making detoxification an optimal time to re- train approach biases. In three pilot studies, we examine the feasibility, acceptability and effectiveness of computerized Approach Bias Modification (ABM) delivered during inpatient withdrawal.
Participants: Participants with moderate-severe alcohol (n=83-study 1, n=37-study
2) or methamphetamine (n=50-study 3) use disorder undergoing inpatient withdrawal at three inpatient units in Melbourne completed four consecutive days of ABM, with substance use outcomes examined 2-weeks post-discharge.
Results: In study 1, ABM increased alcohol abstinence rates by 30% relative to a sham-training condition, however in study 2 when it was combined with computerized adaptive working memory training abstinence rates increased by only 4.8%. Whilst considered acceptable by 82% of participants, only 70% completed all 4 sessions suggesting limited feasibility of ‘dual training’ (i.e., approach bias and working memory). In study 3, where participants were trained to avoid methamphetamine-images and approach neutral/healthy ones, we found lower completion rates (69%) but high acceptability (83%), with preliminary data suggesting high rates of abstinence from methamphetamine (65%).
Conclusion: These mixed findings on the utility and relapse prevention effects of ABM highlight the pragmatic/logistical challenges of delivering neurocognitive interventions during acute withdrawal. Future directions for CBM research (e.g., the use of more sophisticated and personalized avoidance and approach cues), optimal timing and dose will be discussed in the symposium.
Participants: Participants with moderate-severe alcohol (n=83-study 1, n=37-study
2) or methamphetamine (n=50-study 3) use disorder undergoing inpatient withdrawal at three inpatient units in Melbourne completed four consecutive days of ABM, with substance use outcomes examined 2-weeks post-discharge.
Results: In study 1, ABM increased alcohol abstinence rates by 30% relative to a sham-training condition, however in study 2 when it was combined with computerized adaptive working memory training abstinence rates increased by only 4.8%. Whilst considered acceptable by 82% of participants, only 70% completed all 4 sessions suggesting limited feasibility of ‘dual training’ (i.e., approach bias and working memory). In study 3, where participants were trained to avoid methamphetamine-images and approach neutral/healthy ones, we found lower completion rates (69%) but high acceptability (83%), with preliminary data suggesting high rates of abstinence from methamphetamine (65%).
Conclusion: These mixed findings on the utility and relapse prevention effects of ABM highlight the pragmatic/logistical challenges of delivering neurocognitive interventions during acute withdrawal. Future directions for CBM research (e.g., the use of more sophisticated and personalized avoidance and approach cues), optimal timing and dose will be discussed in the symposium.
| Original language | English |
|---|---|
| Number of pages | 1 |
| DOIs | |
| Publication status | Published - 2018 |
| Event | The International Society of Addiction Medicine Annual Meeting 2018 - Busan, Korea, South Duration: 3 Nov 2018 → 7 Nov 2018 Conference number: 20th https://www.tandfonline.com/doi/full/10.1080/08897077.2019.1613821 |
Conference
| Conference | The International Society of Addiction Medicine Annual Meeting 2018 |
|---|---|
| Abbreviated title | ISAM Annual Meeting |
| Country/Territory | Korea, South |
| City | Busan |
| Period | 3/11/18 → 7/11/18 |
| Internet address |