Approach bias modification training and consumption: A review of the literature

Abstract Background The act of smoking has been associated with the automatic activation of approach biases towards smoking-related stimuli. However, previous research has produced mixed findings when smokers are trained to avoid such smoking-related stimuli through the application of Approach Bias Modification (ApBM). As such, this study aimed to test an improved ApBM (ApBM +), where smokers were trained to approach personalized alternative activities for smoking in the context of increased craving, in addition to training smoking-avoidance responses. Methods Sixty-seven daily smokers motivated to quit (M age = 29.27, 58.2% female) were randomly assigned to seven sessions of either ApBM + (n = 26), standard-ApBM (n = 19), or sham-ApBM (n = 22), after a brief motivational smoking intervention. Primary outcomes of approach biases for smoking and for alternative activities and secondary outcomes of smoking-related behaviors were assessed at pre-test, post-test, and 1-month follow-up. Results Overall, no group differences by condition were demonstrated in changing approach biases or smoking-related behaviors at post-test and 1-month follow-up. A trend level indication for differences in changes of smoking-approach biases between sham-ApBM and ApBM + for relatively heavy smokers was found at post-test. This was primarily driven by a significant increase in smoking-approach biases within the sham-ApBM condition and a trend decrease in smoking-approach biases within the ApBM + condition. Conclusions Our findings did not provide support for the current ApBM + concerning improved effects across the whole sample. Diverging training effects on approach biases for smoking in relatively heavy smokers warrants further research, for which we provide some suggestions.

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Effects of Approach Bias Modification Training on Neural Cue Reactivity in Alcohol-Dependent Patients

Suchttherapie ◽

10.1055/s-0033-1351498 ◽

2013 ◽

Vol 14 (S 01) ◽

Cited By ~ 1

Author(s):

C Wiers ◽

C Stelzel ◽

C Gawron ◽

SQ Park ◽

T Gladwin ◽

...

Keyword(s):

Cue Reactivity ◽

Approach Bias ◽

Bias Modification ◽

Alcohol Dependent

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Approach bias modification training in bulimia nervosa and binge‐eating disorder: A pilot randomized controlled trial

International Journal of Eating Disorders ◽

10.1002/eat.23024 ◽

2019 ◽

Vol 52 (5) ◽

pp. 520-529 ◽

Cited By ~ 12

Author(s):

Timo Brockmeyer ◽

Hans‐Christoph Friederich ◽

Carolyn Küppers ◽

Sharmain Chowdhury ◽

Louisa Harms ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Eating Disorder ◽

Bulimia Nervosa ◽

Binge Eating ◽

Binge Eating Disorder ◽

Controlled Trial ◽

Approach Bias ◽

Randomized Controlled ◽

Bias Modification ◽

Pilot Randomized Controlled Trial

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SWiPE: a novel personalised approach bias modification smartphone application to reduce alcohol use among people drinking at hazardous levels: a feasibility, acceptability and preliminary effectiveness study (Preprint)

10.2196/preprints.31353 ◽

2021 ◽

Author(s):

Victoria Manning ◽

Hugh Piercy ◽

Joshua Benjamin Bernard Garfield ◽

Stuart Gregory Clark ◽

Mah Noor Andrabi ◽

...

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Rating Scale ◽

Controlled Trial ◽

Cognitive Intervention ◽

Alcohol Problems ◽

Open Label ◽

Approach Bias ◽

Audit Score ◽

Bias Modification

BACKGROUND Background: Approach Bias Modification (ApBM), a computerised cognitive intervention which trains people to “avoid” alcohol-related images and “approach” neutral/non-alcohol images, reduces the likelihood of relapse when administered during residential alcohol treatment. However, most individuals experiencing alcohol problems do not require, do not seek, or cannot access residential treatment. Smartphone-delivered ApBM could offer an easily-accessible intervention to reduce alcohol consumption which can be personalised (e.g., allowing selection of personally-relevant alcohol and positive training images) and gamified to optimise engagement. OBJECTIVE Objective: We examined the feasibility, acceptability and preliminary effectiveness of “SWiPE”, a gamified, personalised alcohol ApBM smartphone app, and explored alcohol consumption and craving outcomes, in people drinking at hazardous levels (AUDIT score of 8+) who wanted to reduce their alcohol use. METHODS Methods: We conducted an open-label trial in which frequency and quantity of alcohol consumption, severity of alcohol dependence, and craving were measured prior to participants downloading SWiPE. Participants (n=1309) were instructed to complete at least 2 sessions per week for 4 weeks. Recruitment and completion rates were indicators of feasibility. Functionality, aesthetics, and quality ratings were indicators of acceptability. Participants were prompted to report frequency and quantity of alcohol consumption each week during training, and 1-month after training, and completed measures of craving and dependence after 4-weeks of training. RESULTS Results: We recruited 1309 participants (mean age 47.0 years (SD 10.0); 57.9% female; mean AUDIT score 21.8 (SD 6.5)) over a 6-month period. Participants completed a median of 5 sessions (IQR 2-9), 409 (31.2%) completed at least 8 sessions and 455 (34.8%) completed the post-training survey. Mean Mobile Application Rating Scale scores were 4.4 (SD 0.5) for functionality, 4.2 (SD 0.5) for aesthetics and 3.4 (SD 0.8) for subjective quality. Among those who completed post-training assessment, mean past-week drinking days reduced from 5.1 (SD 2.0) pre-training to 4.2 (SD 2.3) in week 4 (t454=7.87; P<.001). Mean past-week standard drinks reduced from 32.8 (SD 22.1) to 24.7 (SD 20.1; t454=8.58; P<.001). Mean Craving Experience Questionnaire frequency scores reduced from 4.5 (SD 2.0) to 2.8 (SD 1.8; t435=19.39; P<.001). Severity of Dependence scores reduced from 7.7 (SD 3.0) to 6.0 (SD 3.2; t435=12.44; P<.001). In the 254 (19.4%) participants who completed a 1-month follow-up, mean past-week drinking days was 3.9 (SD 2.5) and mean standard drinks was 23.9 (SD 20.7), both significantly lower than at baseline (P<0.001). CONCLUSIONS Conclusion: The findings suggest SWiPE is feasible, acceptable and may be effective at reducing alcohol consumption and craving in a predominantly non-treatment seeking sample of adult Australians drinking at hazardous levels. SWiPE’s efficacy, relative to a control condition, now needs establishing in a randomised controlled trial. Smartphone-delivered personalised ApBM has the potential to be a highly scalable, widely-accessible support tool for reducing alcohol use.

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