Treatment of Alcohol Use Disorder With Adjunctive Addiction-Focused EMDR: A Feasibility Study

2019 ◽  
Vol 13 (3) ◽  
pp. 187-220
Author(s):  
Wiebren Markus ◽  
Cindy de Kruijk ◽  
Hellen K. Hornsveld ◽  
Gerdien H. de Weert–van Oene ◽  
Eni S. Becker ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Feasibility Study ◽  
Alcohol Use Disorder ◽  
Treatment Options ◽  
Drinking Behavior ◽  
Multiple Baseline ◽  
Treatment As Usual ◽  
Baseline Design ◽  
Evidence Based Treatment ◽  
Emdr Therapy

Alcohol use disorder (AUD) treatment presents a serious challenge. While there are evidence-based treatment options available, there is still a substantial group of treatment-seeking patients who do not complete regular AUD treatment. In addition, accomplished reductions in drinking behavior during treatment are often lost posttreatment. Therefore, both feasibility and effectiveness of AUD treatment are important. Innovative interventions, such as addiction-focused eye movement desensitization and reprocessing (AF-EMDR) therapy (Markus & Hornsveld, 2017), may hold promise as adjunctive treatments. Here the results of a feasibility study of adjunctive AF-EMDR therapy in outpatients with AUD and without comorbid posttraumatic stress disorder (PTSD) are described. A multiple baseline design across four participants was used. They received AF-EMDR alongside treatment as usual (TAU). The results suggest that, while challenging, AF-EMDR therapy in outpatients with AUD can be safe, acceptable, and feasible. Whether it is effective, under what conditions and for whom, requires further study however.

scholarly journals Efficacy and tolerability of baclofen in a U.S. community population with alcohol use disorder: a dose-response, randomized, controlled trial

2021 ◽  
Author(s):  
James C. Garbutt ◽  
Alexei B. Kampov-Polevoy ◽  
Cort Pedersen ◽  
Melissa Stansbury ◽  
Robyn Jordan ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Controlled Trial ◽  
Treatment Options ◽  
Double Blind ◽  
Randomized Controlled ◽  
Main Effect ◽  
Dsm Iv ◽  
Drop Outs ◽  
Positive Effect

AbstractIdentification of new medications for alcohol use disorder (AUD) is important for improving treatment options. Baclofen, a GABAB agonist, has been identified as a potential pharmacotherapy for AUD. In a 16-week double-blind, randomized, placebo-controlled trial, we investigated 30 and 90 mg/day of baclofen compared to placebo and examined effects of dose, sex, and level of pretreatment drinking. One hundred and twenty participants with DSM-IV alcohol dependence (age 46.1 (sd = 10.1) years, 51.7% male) were randomized after exclusion for unstable medical/psychiatric illness and/or dependence on drugs other than nicotine. Seventy-three participants completed the trial. A main effect of baclofen was found [%HDD (F(2,112) = 4.16, p = 0.018, d = 0.51 95%CI (0.06–0.95), 13.6 fewer HDD) and %ABST (F(2,112) = 3.68, p = 0.028, d = 0.49 95%CI (0.04–0.93), 12.9 more abstinent days)] and was driven by the 90 mg/day dose. A sex × dose interaction effect was present for both %HDD (F(2,110) = 5.48, p = 0.005) and %ABST (F(2,110) = 3.19, p = 0.045). Men showed a marginally positive effect for 90 mg/day compared to PBO (%HDD t(110) = 1.88, p = 0.063, d = 0.36 95%CI (−0.09–0.80), 15.8 fewer HDD days; %ABST t(110) = 1.68 (p = 0.096, d = 0.32 95%CI (−0.12–0.76), 15.7 more ABST)) with no effect for 30 mg/day. Women showed a positive effect for 30 mg/day (%HDD, t(110) = 3.19, p = 0.002, d = 0.61 95%CI (0.16–1.05), 26.3 fewer HDD days; %ABST t(110) = 2.73, p = 0.007, d = 0.52 95%CI (0.07–0.96), 25.4 more ABST days) with marginal effects for 90 mg/day on %ABST (p = 0.06) with drop-outs/dose reduction from sedative side-effects of 59% in women at 90 mg/day compared to 5% for men. These findings support the hypothesis that baclofen has efficacy in AUD and suggest that dose and sex be further explored as potential moderators of baclofen response and tolerability.

scholarly journals Behavioural cue reactivity to alcohol and non-alcohol-related stimuli among individuals with severe alcohol use disorder: an fMRI study with a visual task

2020 ◽  
Author(s):  
Shou Fukushima ◽  
Hironori Kuga ◽  
Naoya Oribe ◽  
Takeo Mutou ◽  
Takefumi Yuzuriha ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Brain Activity ◽  
Cue Reactivity ◽  
Drinking Behavior ◽  
Significant Negative Correlation ◽  
Blood Oxygen Level Dependent ◽  
Posterior Cingulate Cortex ◽  
Alcoholic Beverages ◽  
Bold Responses

AbstractPatients with alcohol use disorder (AUD) have difficulties controlling alcohol cravings and thus exhibit increased use and earlier relapse. Although patients tend to respond more strongly to alcohol-related images compared with non-alcohol-related images, few researchers examined the factors that modulate cravings. Here, we examined whole-brain blood oxygen level-dependent (BOLD) responses to behavioural cues in individuals with AUD and healthy controls (HCs). The participants included 24 patients with severe AUD and 15 HCs. We presented four beverage images (juice, drinking juice, sake, and drinking sake) and compared participant BOLD responses between the two groups. Multiple comparisons revealed that the AUD group had lower BOLD responses compared with the HC group to images of drinking juice in the left precuneus (p = 0.036) and the left posterior cingulate cortex (PCC) (p = 0.044) and higher BOLD responses to images of drinking sake in the left PCC (p = 0.044). Furthermore, compared to the HCs, the AUD patients had decreased BOLD responses associated with cue reactivity to drinking juice in the left precuneus during the period from 15 to 18 s (p = 0.004, df = 37) and 18 to 21 s (p = 0.002, df = 37). Using the Spearman correlation, we found a significant negative correlation between BOLD responses in the left PCC of the AUD patients and Mini–Mental State Examination (MMSE) scores (r = −0.619, p = 0.001). Our findings suggest that HCs and severe AUD patients differ in their responses not to images of alcoholic beverages but those related to alcohol drinking behavior. Thus, these patients appear to have different patterns of brain activity. This information may aid clinicians in developing treatments for patients with AUD.

Physical exercise in the treatment of alcohol use disorder (AUD) patients affects their drinking habits: A randomized controlled trial

2018 ◽  
Vol 47 (4) ◽  
pp. 462-468 ◽  
Author(s):  
Kurt Jensen ◽  
Charlotte Nielsen ◽  
Claus Thorn Ekstrøm ◽  
Kirsten K. Roessler
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Training Stimulus ◽  
Controlled Trial ◽  
Control Group ◽  
Treatment As Usual ◽  
Drinking Habits ◽  
Training Frequency ◽  
Significant Difference ◽  
Group A

Aim: The aim of this study is to compare the effect of exercise training on physical capacity and alcohol consumption in alcohol use disorder (AUD) patients. Methods: One hundred and five AUD patients were randomly assigned to treatment as usual combined with running and brisk walking for 30–45 min twice a week, either in small supervised groups (GR) or individually (IND), or to a control group with no running (C). Assessments were made after 6 and 12 months of training. Results: Training volume was estimated as 36 min per training bout at an intensity of 78% of HRmax with no differences between GR and IND ( p>.05). A highly significant reduction in training frequency was seen in both training groups after the first month ( p<.0001). Only IND increased VO2max, by 5.7% ( p<.05), while no differences were seen between GR, IND and C. Alcohol intake decreased from 219 to 41 units per 30 days as the average for the entire sample with no significant difference of drinking outcomes between groups ( p<.0001). Conclusions: We saw an effect on drinking habits after running in both groups. However, no additional effect was seen when compared with the control group. A drop in the training frequency during the intervention might have resulted in an insignificant training stimulus.

scholarly journals The training game SALIENCE for the therapy of alcohol use disorder

2019 ◽  
Vol 26 (1) ◽  
pp. 499-512 ◽  
Author(s):  
Sabine Vollstädt-Klein ◽  
Philip Mildner ◽  
Jan Malte Bumb ◽  
Damian Karl ◽  
Christoph Ueberle ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Feasibility Study ◽  
Game Design ◽  
Alcohol Use Disorder ◽  
Standard Treatment ◽  
Real Life ◽  
Daily Basis ◽  
Web Based ◽  
Group 2 ◽  
Group 1

The feasibility study was aimed to develop a web-based gaming tool for the therapy of alcohol use disorder to offer patients a cue-exposure-based extinction and decision training, enhanced with virtual reality. To increase the training effect, patients playfully experience situations that resemble critical real-life situations. For implementing the game, a combination of HTML5 and JavaScript was used. The application comes with an administrator interface, to allow editing the game content. Initially, we included 21 patients (Group 1), 18 suffering from alcohol use disorder and 3 using cannabis (18/3 male/female, mean age 39 ± 13 years). Considering the iterative process of a feasibility study, we developed the game design as suggested by participants of Group 1 and additionally included 11 novel participants (Group 2) (11 suffering from an alcohol use disorder, 7/4 male/female, mean age 46 ± 14 years). Basically, the game was very well received. Usability ratings were generally high, even in patients with little computer experience. Both groups rated the application as realistic, and would generally be willing to play it on a daily basis. Given that SALIENCE is inexpensive, easily available, and engaging, it might be a reasonable add-on intervention to the standard treatment of alcohol use disorder.

scholarly journals Online cognitive behavior therapy for adolescents with excessive worry: a multiple baseline design feasibility study

mHealth ◽  
2020 ◽  
Vol 6 ◽  
pp. 5-5
Author(s):  
Tove Wahlund ◽  
Maral Jolstedt ◽  
Erik Andersson ◽  
Sarah Vigerland ◽  
Sean Perrin ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Multiple Baseline ◽  
Cognitive Behavior ◽  
Multiple Baseline Design ◽  
Baseline Design

The Association Between Impulsivity and Relapse in Patients With Alcohol Use Disorder: A Literature Review

2020 ◽  
Author(s):  
Wilco Sliedrecht ◽  
Hendrik G Roozen ◽  
Katie Witkiewitz ◽  
Ranne de Waart ◽  
Geert Dom
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Treatment Options ◽  
Careful Consideration ◽  
Self Report ◽  
Future Research ◽  
Impulsive Choice ◽  
Cognitive Behavioural ◽  
Trait Impulsivity ◽  
Future Work

Abstract Aim Impulsivity has been identified as a key relapse risk factor in patients with alcohol use disorder (AUD); however, the inherent characteristics of this relationship have been largely understudied. The heterogeneity of AUD and variation in impulsivity constructs require careful consideration to inform future work examining the relationship. This study sought to review empirical findings examining facets of impulsivity and AUD relapse. Methods A systematic search strategy was employed to capture studies on impulsivity measures related to AUD relapse. Impulsivity measures were qualitatively organized in terms of ‘trait impulsivity’—typically measured by self-report questionnaires—and ‘behavioural impulsivity’, i.e. ‘motor impulsivity’, ‘impulsive choice’ and ‘reflection impulsivity, assessed with cognitive–behavioural tasks. Results Seventeen peer-reviewed papers were identified. Relapse outcomes varied substantially in relation to impulsivity measures. Twelve papers included aspects of ‘trait impulsivity’, and nine studies included ‘behavioural impulsivity’ measures, from which five studies dealt with the ‘impulsive choice’ subcategory. The Barratt Impulsivity Scale was the self-report questionnaire that was most frequently used. Conclusions All three included facets of impulsivity (‘trait-, motor- and impulsive choice impulsivity’) were associated with AUD relapse, but none seemed to be superior to another. This study confirmed that research on the relation between impulsivity and AUD relapse is relatively scarce. Future research and treatment options are proposed.

scholarly journals Effects of cortisol administration on craving during in vivo exposure in patients with alcohol use disorder

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Leila M. Soravia ◽  
Franz Moggi ◽  
Dominique J.-F. de Quervain
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Underlying Mechanism ◽  
Double Blind ◽  
Extinction Memory ◽  
Exposure Sessions ◽  
Novel Treatment Strategies

AbstractAlcohol-associated memories and craving play a crucial role in the development and maintenance of alcohol use disorder (AUD). As treatment options are limited in AUD, novel treatment strategies focus on the manipulation of alcohol-associated memories. The stress hormone cortisol affects various memory processes, and first clinical studies have shown that it inhibits the retrieval of disorder-specific memories and enhances extinction memory. This study aimed to investigate the effects of a single oral administration of cortisol on craving in patients with AUD during repeated in vivo exposure to alcohol pictures and the preferred alcoholic drink. In a double-blind, block-randomized, placebo-controlled cross-over design, 46 patients with AUD were treated with two sessions of in vivo exposure to alcohol. Cortisol (20 mg) or placebo was orally administered 1 h before each test day. Craving, stress, and cortisol were repeatedly measured during exposure sessions. Results show, that cortisol administration had distinct effects on craving depending on the severity of AUD and test day. While cortisol administration significantly enhanced craving during exposure on the first test day in patients with less severe AUD, it reduced craving in patients with more severe AUD. Independent of the cortisol administration, repeated in vivo exposure reduced craving from test day 1 to test day 2. In conclusion, adding cortisol to in vivo exposure might be a promising approach for reducing the strength of alcohol-associated memories and might promote the consolidation of extinction memory in patients with severe AUD. However, the differential effect of cortisol on craving depending on AUD severity cannot be conclusively explained and highlights the need for future studies elucidating the underlying mechanism.

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