The effect of approach bias modification on alcohol craving and its relationship to drinking outcomes

Joshua B.B. Garfield, John Reynolds, Lara R. Piccoli, Paul Gerard Sanfilippo, Jarrad A.G. Lum, Petra Karin Staiger, Dan Ian Lubman, Antonio Verdejo-Garcia, Victoria C. Manning

Research output: Contribution to journalMeeting Abstract


Introduction and Aims: Trials have shown that approach bias modification (ApBM) training reduces likelihood of relapse following alcohol withdrawal/rehabilitation treatment. However, few studies
have examined ApBM’s effect on alcohol craving or whether these effects mediate ApBM’s effect on relapse.
Design and Methods: In a randomised controlled trial, 300 alcohol withdrawal treatment (“detoxification”) clients received four sessions of either ApBM or sham-training (control). Measures of alcohol cravings included: the Alcohol Craving Questionnaire (administered at baseline, post-training and two-week follow-up); visual analogue scale ratings of craving intensity (before and after each session); and cue-induced wanting ratings in response to alcohol images (baseline and post-training). Post-discharge alcohol use was assessed at two-week follow-up.
Results: ApBM participants showed significantly more within-session reduction in visual analogue scale ratings (between pre-session and post-session ratings) than controls. All craving measures
showed between-session reductions (between session 1 and session 4), although these effects did not differ significantly between groups. Nevertheless, Alcohol Craving Questionnaire “Expectancy” and “Emotionality” sub-scale scores were lower in the ApBM group than control group following training (Expectancy subscale post-training: P=0.01; Emotionality subscale at 2-week follow-up: P=0.04). Per-protocol analysis suggested that reduced Expectancy scores partially mediated ApBM’s effect on alcohol abstinence.
Discussions and Conclusions: ApBM sessions acutely reduced alcohol craving intensity, but we did not find conclusive evidence of longer-term ApBM effects on craving. However, reduced expectancy of positive effects from alcohol may partially account for why ApBM helps people
remain abstinent, consistent with recent theories that ApBM may work by reducing the perceived rewarding value of alcohol.
Original languageEnglish
Pages (from-to)S27-S27
Number of pages1
JournalDrug and Alcohol Review
Issue numberS1
Publication statusPublished - 2021
EventAustralasian Professional Society on Alcohol and other Drugs Conference 2021 - virtual conference
Duration: 7 Nov 202111 Nov 2021
Conference number: 40th,present%20on%20evidence%2Dbased%20issues. (Volume 40, Issue S1 APSAD 2021 Conference, 7–10 November 2021, Virtual)

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