Does Cognitive Bias Modification Training During Alcohol Withdrawal Reduce Craving?

Introduction and Aims: Relapse commonly occurs within the first few weeks of leaving inpatient withdrawal, often due to alcohol‐related cues in the environment inducing intense craving. In a randomised controlled trial, computerised cognitive bias modification training (CBM) was found to increase abstinence rates. This paper examines the impact of four sessions of CBM training on craving scores both immediately post‐training and 2 weeks post‐discharge. Design and Methods: A randomised control trial where 69 alcohol‐dependent patients received all four sessions of either CBM training where they were implicitly trained to make avoidance movements (pushing a joystick) in response to pictures of alcoholic beverages and approach movements (pulling a joystick) or four sessions of sham training (responding to neutral stimuli). Craving was assessed using the Alcohol Craving Questionnaire‐short‐form revised at baseline, post‐training and 2 weeks post‐discharge for 61 (90%) participants. Results: Paired tests revealed a significant reduction in craving score in the CBM group (P < 0.001, d = 0.92) and controls (P < 0.01, d = 0.49) immediately post‐training, and in the CBM group at follow up (P < 0.05, d = 0.57), but not controls (P = 0.72, d = 0.07). However, repeated measures anova revealed a significant main effect of time (P < 0.001, η2 = 0.36) both post‐training and post‐discharge, but no significant group x time interaction (P = 0.11, η2 = 0.04) at either time‐point. Discussion and Conclusions: The findings suggest that CBM may reduce alcohol craving in alcohol‐dependent individuals during acute withdrawal phase and particularly post‐discharge. However, a larger sample is needed to determine whether the reductions following CBM exceed those that would occur naturally over time.