The Virtual Cooking Task: A Preliminary Comparison Between Neuropsychological and Ecological Virtual Reality Tests to Assess Executive Functions Alterations in Patients Affected by Alcohol Use Disorder

Author(s):  
Irene Alice Chicchi Giglioli ◽  
Bartolomé Pérez Gálvez ◽  
Andrea Gil Granados ◽  
Mariano Alcañiz Raya
2019 ◽  
Vol 8 (8) ◽  
pp. 1153 ◽  
Author(s):  
Alexandra Ghiţă ◽  
Olga Hernández-Serrano ◽  
Yolanda Fernández-Ruiz ◽  
Miquel Monras ◽  
Lluisa Ortega ◽  
...  

Background: This study is part of a larger project aiming to develop a virtual reality (VR) software to be implemented as a clinical tool for patients diagnosed with alcohol use disorder (AUD). The study is based on previous research in which we identified factors that elicit craving for alcohol in a sample of AUD patients, and which led to the development of a virtual reality software to be used in cue exposure treatments of alcohol use disorder (ALCO-VR). The main objective of this study was to test the effectiveness of ALCO-VR to elicit cue-induced craving and anxiety responses among social drinkers (SD) and AUD patients. Our secondary objective was to explore which responses (cue-induced craving or anxiety) can best differentiate between AUD patients and the SD group. Method: Twenty-seven individuals (13 AUD patients and 14 SD) participated in this study after giving written informed consent. Their anxiety and alcohol craving levels were measured by different instruments at different stages of the procedure. The VR equipment consisted of Oculus Rift technology, and the software consisted of the ALCO-VR platform. Results: Our data indicate that the ALCO-VR software can elicit responses of anxiety and alcohol craving, especially in the group of AUD patients. The cue-induced anxiety response differentiated AUD patients and the SD group better than the cue-induced craving response. Conclusions: The general interest in applying new technologies to the assessment and treatment of mental health disorders has led to the development of immersive real-life simulations based on the advantages of VR technology. Our study concluded that the ALCO-VR software can elicit anxiety and craving responses and that cue-induced anxiety responses can distinguish between AUD and SD groups better than cue-induced craving. The data on craving and anxiety were assessed consistently by different instruments. In addition, we consider that ALCO-VR is able to ecologically assess cue-induced anxiety and alcohol craving levels during exposure to VR alcohol-related environments.


2020 ◽  
Vol 9 (9) ◽  
pp. 3018
Author(s):  
Olga Hernández-Serrano ◽  
Alexandra Ghiţă ◽  
Natàlia Figueras-Puigderrajols ◽  
Jolanda Fernández-Ruiz ◽  
Miquel Monras ◽  
...  

Background/Objective: Determining the predictive variables associated with levels of alcohol craving can ease the identification of patients who can benefit from treatments. This study aimed to describe changes (improvement or no change/deterioration) in alcohol craving levels and explore the predictors of these changes from admission to discharge in outpatients with alcohol use disorder (AUD) undergoing treatment-as-usual (TAU), or treatment-as-usual supplemented with virtual reality cue-exposure therapy (TAU + VR-CET). Method: A prospective cohort study was conducted amongst 42 outpatients with AUD (n = 15 TAU + VR-CET and n = 27 TAU) from a clinical setting. Changes in the levels of alcohol craving between admission and discharge were assessed with the Multidimensional Alcohol Craving Scale. Sociodemographic characteristics (age, gender, education, and socioeconomic and civil status), cognitive-affective behavioral patterns (AUD severity, abstinence duration, psychiatric comorbidity, state anxiety, attentional bias, and substance use), and type of treatment (TAU + VR-CET and only TAU) were also evaluated. Results: The TAU + VR-CET group showed greater changes of improvement in the levels of alcohol craving than the TAU group (χ2 = 10.996; p = 0.001). Intragroup changes in alcohol craving from pre to post-treatment were significant in the TAU + VR-CET group (χ2 = 13.818; p = 0.003) but not within the TAU group (χ2 = 2.349; p = 0.503). The odds of an improvement in any of the craving levels between pre- and post-test was 18.18 (1/0.055) times higher in the TAU + VR-CET group with respect to the TAU group. The use of illicit drugs in the month prior to the test increased the odds of having a positive change by 18.18 (1/0.055) with respect to not having consumed. Conclusions: Including VR-CET in TAU programs may provide benefits in the treatment of AUDs mainly among patients with intense alcohol craving and individuals having used illicit substances prior to treatment.


2020 ◽  
Author(s):  
Pedro Gamito ◽  
Jorge Oliveira ◽  
Marcelo Matias ◽  
Elsa Cunha ◽  
Rodrigo Brito ◽  
...  

BACKGROUND Alcohol use disorder has been associated with diverse physical and mental morbidities. Among the main consequences of chronic and excessive alcohol use are cognitive and executive deficits. Some of these deficits may be reversed in specific cognitive and executive domains with behavioral approaches consisting in cognitive training. The advent of computer-based interventions may leverage these improvements, but RCTs of digital interactive-based interventions are still scarce. OBJECTIVE The aim is to explore whether a cognitive training approach using virtual reality exercises based on activities of daily living is feasible for improving cognitive function of patients with alcohol use disorder undergoing residential treatment, as well as to estimate the effect size for this intervention to power future definitive RCTs. METHODS A two-arm pilot randomized controlled trial with a sample of 36 individuals recovering from alcohol use disorder in a therapeutic community assigned to a therapist-guided virtual reality-based cognitive training combined with treatment-as-usual or a control group with treatment-as-usual without cognitive training. A comprehensive neuropsychological battery of tests was used both at pre and post assessments, including global cognition, executive functions, attention, visual memory and cognitive flexibility. RESULTS In order to control for potential effects of global cognition and executive functions at baseline, these domains were controlled in the statistical analysis for each individual outcome. Results indicate effects (P < .05) of the intervention on attention (in 2 out of 5 outcomes) and cognitive flexibility (in 2 out of 6 outcomes), with effect sizes in significant comparisons being larger for attention than for cognitive flexibility. Patient retention in cognitive training was high, in line with previous studies. CONCLUSIONS Overall data suggest specific contributions of reality-based cognitive training in improving attention ability and cognitive flexibility of patients recovering from alcohol use disorder. CLINICALTRIAL ClinicalTrials.gov NCT04505345; https://clinicaltrials.gov/show/NCT04505345


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Angelina Isabella Mellentin ◽  
Anette Søgaard Nielsen ◽  
Leonie Ascone ◽  
Janina Wirtz ◽  
Jerzy Samochowiec ◽  
...  

2021 ◽  
Vol 12 ◽  
Author(s):  
Alexandra Ghiţă ◽  
Olga Hernández-Serrano ◽  
Jolanda Fernández-Ruiz ◽  
Manuel Moreno ◽  
Miquel Monras ◽  
...  

Aims: Attentional bias (AB), alcohol craving, and anxiety have important implications in the development and maintenance of alcohol use disorder (AUD). The current study aims to test the effectiveness of a Virtual Reality Cue-Exposure Therapy (VR-CET) to reduce levels of alcohol craving and anxiety and prompt changes in AB toward alcohol content.Method: A 49-year-old male participated in this study, diagnosed with severe AUD, who also used tobacco and illicit substances on an occasional basis and who made several failed attempts to cease substance misuse. The protocol consisted of six VR-CET booster sessions and two assessment sessions (pre- and post-VR-CET) over the course of 5 weeks. The VR-CET program consisted of booster therapy sessions based on virtual reality (VR) exposure to preferred alcohol-related cues and contexts. The initial and final assessment sessions were focused on exploring AB, alcohol craving, and anxiety using paper-and-pencil instruments and the eye-tracking (ET) and VR technologies at different time points.Results: Pre and post assessment sessions indicated falls on the scores of all instruments assessing alcohol craving, anxiety, and AB.Conclusions: This case report, part of a larger project, demonstrates the effectiveness of the VR-CET booster sessions in AUD. In the post-treatment measurements, a variety of instruments showed a change in the AB pattern and an improvement in craving and anxiety responses. As a result of the systematic desensitization, virtual exposure gradually reduced the responses to significant alcohol-related cues and contexts. The implications for AB, anxiety and craving are discussed.


Author(s):  
Silke Behrendt ◽  
Barbara Braun ◽  
Randi Bilberg ◽  
Gerhard Bühringer ◽  
Michael Bogenschutz ◽  
...  

Abstract. Background: The number of older adults with alcohol use disorder (AUD) is expected to rise. Adapted treatments for this group are lacking and information on AUD features in treatment seeking older adults is scarce. The international multicenter randomized-controlled clinical trial “ELDERLY-Study” with few exclusion criteria was conducted to investigate two outpatient AUD-treatments for adults aged 60+ with DSM-5 AUD. Aims: To add to 1) basic methodological information on the ELDERLY-Study by providing information on AUD features in ELDERLY-participants taking into account country and gender, and 2) knowledge on AUD features in older adults seeking outpatient treatment. Methods: baseline data from the German and Danish ELDERLY-sites (n=544) were used. AUD diagnoses were obtained with the Mini International Neuropsychiatric Interview, alcohol use information with Form 90. Results: Lost control, desired control, mental/physical problem, and craving were the most prevalent (> 70 %) AUD-symptoms. 54.9 % reported severe DSM-5 AUD (moderate: 28.2 %, mild: 16.9 %). Mean daily alcohol use was 6.3 drinks at 12 grams ethanol each. 93.9 % reported binging. More intense alcohol use was associated with greater AUD-severity and male gender. Country effects showed for alcohol use and AUD-severity. Conclusion: European ELDERLY-participants presented typical dependence symptoms, a wide range of severity, and intense alcohol use. This may underline the clinical significance of AUD in treatment-seeking seniors.


Author(s):  
Jennis Freyer-Adam ◽  
Sophie Baumann ◽  
Inga Schnuerer ◽  
Katja Haberecht ◽  
Ulrich John ◽  
...  

Zusammenfassung. Ziel: Persönliche Beratungen können bei stationären Krankenhauspatienten Alkoholkonsum und Mortalität reduzieren. Sie sind jedoch mit hohen Kosten verbunden, wenn aus Public-Health-Erfordernis viele Menschen einer Bevölkerung erreicht werden müssen. Computerbasierte Interventionen stellen eine Alternative dar. Jedoch ist ihre Wirksamkeit im Vergleich zu persönlichen Beratungen und im Allgemeinkrankenhaus noch unklar. Eine quasi-randomisierte Kontrollgruppenstudie „Die Bedeutung der Vermittlungsform für Alkoholinterventionen bei Allgemeinkrankenhauspatienten: Persönlich vs. Computerisiert“ soll dies untersuchen. Design und Methoden werden beschrieben. Methode: Über 18 Monate sind alle 18- bis 64-jährigen Patienten auf Stationen der Universitätsmedizin Greifswald mittels Alcohol Use Disorder Identification Test (AUDIT) zu screenen. Frauen/Männer mit AUDIT-Consumption ≥ 4/5 und AUDIT < 20 werden einer von drei Gruppen zugeordnet: persönliche Intervention (Beratungen zur Konsumreduktion), computerbasierte Intervention (individualisierte Rückmeldebriefe und Broschüren) und Kontrollgruppe. Beide Interventionen erfolgen im Krankenhaus sowie telefonisch bzw. postalisch nach 1 und 3 Monaten. In computergestützten Telefoninterviews nach 6, 12, 18 und 24 Monaten wird Alkoholkonsum erfragt. Schlussfolgerung: Das Studienvorhaben, sofern erfolgreich umgesetzt, ist geeignet die längerfristige Wirksamkeit einer persönlichen und computerbasierten Intervention im Vergleich zu untersuchen.


Sign in / Sign up

Export Citation Format

Share Document