scholarly journals Acceptability and Co‐Development of an Online Cognitive Bias Modification Intervention for Emerging Adults With Hazardous Alcohol Use and Social Anxiety: A Mixed Methods Study

2020 ◽  
Vol 44 (11) ◽  
pp. 2283-2297
Author(s):  
Katrina Prior ◽  
Elske Salemink ◽  
Reinout W. Wiers ◽  
Bethany A. Teachman ◽  
Monique Piggott ◽  
...  
2021 ◽  
Author(s):  
Katrina Prior ◽  
Elske Salemink ◽  
Reinout W Wiers ◽  
Bethany A Teachman ◽  
Monique Piggott ◽  
...  

BACKGROUND Alcohol use and anxiety disorders commonly co-occur, resulting in a more severe clinical presentation and poorer response to single-disorder treatments. Research has shown that Approach Bias Modification (ApBM) and Interpretation Bias Modification (IBM) cognitive re-training interventions can be efficacious adjunctive treatments that improve outcomes for alcohol use and social anxiety symptoms, respectively. However, the acceptability, feasibility and clinical utility of combining ApBM and IBM programs to optimise standard treatments among comorbid samples is unknown. It is also unclear as to whether integrating ApBM and IBM within each training session, or alternating them between each session, is more acceptable and efficacious. OBJECTIVE This paper describes the study protocol for a randomized controlled pilot trial investigating the feasibility, acceptability, and preliminary efficacy of the ‘Re-Train Your Brain’ intervention – an adjunct web-based ApBM+IBM program – among a clinical sample of emerging adults with hazardous alcohol use and social anxiety. METHODS The study involves a 3-arm randomized controlled pilot trial in which treatment-seeking emerging adults (18-30 years) with co-occurring hazardous alcohol use and social anxiety disorder symptoms will be individually randomized to receive: (1) the Re-Train Your Brain ‘integrated’ program, delivered with 10 bi-weekly sessions focusing on both social anxiety and alcohol each week (50:50 ratio), plus treatment as usual (TAU i.e., the model of care provided in accordance with standard practice at their service; n=30); (2) the Re-Train Your Brain ‘alternating’ program, delivered with 10 bi-weekly sessions focusing on social anxiety one week and alcohol the next week in an alternating pattern, plus TAU (n=30); or (3) TAU only (n=30). Primary outcomes include feasibility (uptake, follow-up rates, treatment adherence, attrition, adverse events) and acceptability (system usability, client satisfaction, user experience, training format preference). Secondary efficacy outcomes include changes in alcohol approach and interpretation biases, social anxiety symptoms, and alcohol use (e.g., average drinks per day, binge-drinking, alcohol use motives, severity of alcohol dependence, alcohol craving). The primary endpoint will be post-treatment (6 weeks post-baseline), with a secondary endpoint at 3 months post-baseline. Descriptive statistics will be conducted for primary outcomes, while intention-to-treat multi-level mixed effects analysis for repeated measures will be performed for secondary outcomes. RESULTS The study is funded from 2019―2023 by Australian Rotary Health. Recruitment is expected to be complete by mid―late 2022, with follow-ups completed by early 2023. CONCLUSIONS The study will be the first to evaluate whether an ApBM+IBM program is acceptable to treatment-seeking emerging adults and whether it is feasible to deliver it online, in settings where it will ultimately be used (e.g., at home). The findings will broaden our understanding of the types of programs that emerging adults will engage with, and whether there is preliminary evidence of it being an efficacious treatment option for this comorbidity. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620001273976


PLoS ONE ◽  
2017 ◽  
Vol 12 (4) ◽  
pp. e0175107 ◽  
Author(s):  
Haining Liu ◽  
Xianwen Li ◽  
Buxin Han ◽  
Xiaoqian Liu

2019 ◽  
Vol 10 (3) ◽  
pp. 204380871987527 ◽  
Author(s):  
Xiran Sun ◽  
Ranming Yang ◽  
Qin Zhang ◽  
Jing Xiao ◽  
Chieh Li ◽  
...  

To address the unmet need for treatment of social anxiety disorder in China, it is timely and relevant to identify more effective, accessible, economic, and easily disseminated interventions. The present study examined the effect of an eight-session program for cognitive bias modification for interpretation (CBM-I). Smartphones were used in the training of reducing interpretation bias and social anxiety of Chinese undergraduates with high social anxiety. In total, 38 participants were randomly assigned to either a CBM-I training group ( n = 19) or a control group ( n = 19). As a result, the CBM-I training group provided more positive interpretations in ambiguous situations and less social anxiety than the control group. Results indicate that CBM-I training via smartphones can effectively promote positive interpretations of ambiguous situations and relieve social anxiety. CBM-I via smartphones may have clinical utility when applied as a multisession intervention of social anxiety for Chinese undergraduates.


Author(s):  
Melvyn W. B. Zhang ◽  
Helen E. Smith

In recent years, advances in experimental psychology have led to a better understanding in automatic, unconscious processes, referred to as attentional and approach biases amongst individuals with substance use disorders. Attentional biases refer to the relatively automatic tendencies for attention to be preferentially allocated towards substance-related cues. Whereas, approach bias refers to the relatively automatic behavioral tendencies of individuals to reach out to substance-related cues in their natural environment. While, several reviews confirm the existence of these biases, and the effectiveness of bias modification, the conduct of cognitive bias modification amongst substance-using individuals is not without its challenges. One of these is that cognitive biases, both attentional and approach biases, are not universally present; and several individual differences factors modulate the magnitude of the biases. Another challenge that investigators faced in their conduct of cognitive bias modification relates to the selection of the appropriate task for bias assessment and modification. Other challenges intrinsic to cognitive bias modification intervention relates to that of participant attrition, much like conventional psychotherapies. Negative findings, of the absence of biases at baseline, or the lack of effectiveness of bias modification have been reported in studies of cognitive bias modification. All these challenges could have an impact on bias assessment and modification. In this perspective paper, we will explore the literature surrounding each of these challenges and discuss potential measures that could be undertaken to mitigate these clinical and research challenges.


2018 ◽  
Author(s):  
Melvyn Zhang ◽  
Jiangbo Ying ◽  
Guo Song ◽  
Daniel S S Fung ◽  
Helen Smith

BACKGROUND Cognitive biases refer to automatic attentional or interpretational tendencies, which result in individuals with addictive disorders to automatically attend to substance-related stimuli and those with anxiety disorders to attend to threatening stimuli. To date, several studies have examined the efficacy of cognitive bias modification, and meta-analytical studies have synthesized the evidence for overall efficacy. The clinical utility of cognitive bias modification interventions has previously been limited to the confines of a laboratory, but recent advances in Web technologies can change this. OBJECTIVE This scoping review aimed to determine the scope of Web-based cognitive bias interventions and highlight their effectiveness. METHODS Databases (PubMed and MEDLINE, EMBASE, PsycINFO, ScienceDirect, and Cochrane Central) were searched from inception to December 5, 2017. The following search terminologies were used: (“attention bias” OR “cognitive bias” OR “approach bias” OR “avoidance bias” OR “interpretative bias”) AND (“Internet” OR “Web” OR “Online”). The methods for this scoping review are based on the previously published protocol. For the synthesis of the evidence, a narrative synthesis was undertaken, as a meta-analysis was not appropriate, given the lack of reported effect sizes and the heterogeneity in the outcomes reported. RESULTS Of the 2674 unique articles identified, we identified 22 randomized controlled studies that met our inclusion criteria: alcohol use disorder (n=2), tobacco use disorder (n=2), depressive disorder (n=3), anxiety and depressive symptoms in adolescents (n=3), obsessive-compulsive disorder (OCD; n=2), social anxiety disorder (n=9), and anxiety disorder (n=1). The sample sizes of these studies ranged from 16 to 434 participants. There is preliminary evidence to suggest that Web-based interventions could reduce biases among adolescents with heightened symptoms of anxiety and depression and among individuals with OCD. CONCLUSIONS This is the first scoping review that mapped out the scope of cognitive bias modification interventions for psychiatric disorders. Web-based interventions have been applied predominantly for social anxiety and addictive disorders. Larger cohorts must be used in future studies to better determine the effectiveness of Web-based cognitive bias interventions.


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