Learning to resist the urge: a double-blind, randomized controlled trial investigating alcohol-specific inhibition training in abstinent patients with alcohol use disorder

Tschümperlin, Raphaela M.; Stein, Maria; Batschelet, Hallie Margareta; Moggi, Franz; Soravia, Leila (2019). Learning to resist the urge: a double-blind, randomized controlled trial investigating alcohol-specific inhibition training in abstinent patients with alcohol use disorder. Trials, 20(1), p. 402. BioMed Central 10.1186/s13063-019-3505-2

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Background: Alcohol use disorder (AUD) leads to a significant individual and societal burden. To achieve higher therapy success rates, therapeutic interventions still need to be improved. Most current neuroscientific conceptualizations of AUD focus on the imbalance between an enhanced automatic reaction to alcohol cues and impaired inhibition. Complementary to traditional relapse prevention strategies, novel computerized training interventions aim to directly alter these processes. This study tests a computerized alcohol-specific inhibition training in a large clinical sample and investigates its effects on behavioral, experimental and neurophysiological outcomes. It also analyzes whether variations in inhibition difficulty and/or endogenous cortisol levels during training impact these effects. Methods: This is a double-blind, randomized controlled trial (RCT) with 246 inpatients with AUD participating. After baseline assessment, participants are randomly assigned to one of three computerized Go-NoGo-based inhibition training interventions (two alcohol-specific versions with different Go/NoGo ratios, or neutral control training) and one of two intervention times (morning/afternoon), resulting in six study arms. All patients perform six training sessions within 2 weeks. Endogenous cortisol is measured in 80 patients before and after the first training session. Inhibitory control and implicit associations towards alcohol are assessed pre and post training, at which point electroencephalography (EEG) is additionally measured in 60 patients. Patients’ alcohol consumption and relevant psychological constructs (e.g., craving, self-efficacy, treatment motivation) are measured at discharge and at 3-, 6- and 12-month follow-ups. Fifty healthy participants are assessed (20 with EEG) at one time point as a healthy control group. Discussion: This study investigates the effects of a computerized, alcohol-specific inhibition training for the first time in patients with AUD. Results should give insight into the effectiveness of this potential add-on to standard AUD treatment, including proximal and distal measures and effects on behavioral, experimental and neurophysiological measures. Information about working mechanisms and potential optimizations of this training are gathered through variations regarding difficulty of inhibition training and training time. This study may thus contribute to a deepened understanding of AUD and the improvement of its evidence-based treatment. Trial registration: ClinicalTrials.gov, ID: NCT02968537. Registered on 18 November 2016.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Translational Research Center
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Tschümperlin, Raphaela Martina; Stein, Maria; Batschelet, Hallie Margareta; Moggi, Franz and Soravia, Leila

Subjects:

100 Philosophy > 150 Psychology
600 Technology > 610 Medicine & health

ISSN:

1745-6215

Publisher:

BioMed Central

Funders:

[42] Schweizerischer Nationalfonds

Language:

English

Submitter:

Raphaela Martina Tschümperlin

Date Deposited:

14 Aug 2019 13:38

Last Modified:

23 Oct 2019 02:53

Publisher DOI:

10.1186/s13063-019-3505-2

PubMed ID:

31277683

Uncontrolled Keywords:

Alcohol use disorder, Alcohol-specific inhibition training, EEG, Cortisol, Go-NoGo Task (GNG), Stop-Signal Task (SST), Implicit Association Test (IAT), Residential treatment, Drinking outcome

BORIS DOI:

10.7892/boris.132183

URI:

https://boris.unibe.ch/id/eprint/132183

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