背景:患有酒精使用障碍(AUD)的患者倾向于在环境中选择性地接近酒精线索,表现出酒精接近的偏见。酒精方法-偏倚修饰(Alcohol-ApBM)可有效提高AUD患者的禁欲率,但其提出的工作机制(减少酒精接近偏差)的证据有限。此外,并非所有患者都能从酒精-ApBM中受益,以前的研究没有确定可靠的治疗前预测酒精-ApBM有效性。因此,目前的研究集中在酒精-ApBM训练过程中的学习过程。具体来说,我们研究了Alcohol-ApBM治疗过程中的回避倾向的变化是否可以预测住院治疗后的禁欲.
方法:德国543名AUD患者的训练数据(70%为男性,M=47.96,SD=9.08),在住院治疗期间接受酒精-ApBM训练,用于检查训练期间学习的各个方面是否预测治疗出院后1年的禁欲,分别与酒精-ApBM有效性的潜在社会人口统计学和临床调节者相互作用。
结果:总体而言,观察到六个Alcohol-ApBM培训课程的成功学习;也就是说,随着时间的推移,对酒精刺激的接近趋势降低。然而,没有一个被检查的学习参数可以预测禁欲,既不单独也不与临床或社会人口统计学变量结合。
结论:先前的研究表明,酒精-ApBM是针对AUD的禁欲治疗的有效附加药物,这项研究表明,学习发生在酒精-ApBM训练期间。然而,训练期间的特定学习参数不能预测治疗出院后1年的禁欲.因此,我们无法具体说明在1年后哪些患者最有可能从ApBM的禁欲中获益.
BACKGROUND: Patients with alcohol use disorder (AUD) tend to selectively approach alcohol cues in the environment, demonstrating an alcohol-approach bias. Alcohol-approach-bias modification (Alcohol-ApBM) effectively increases abstinence rates in patients with AUD when added to abstinence-focused treatment, but the evidence for its proposed working mechanism (reduction of the alcohol-approach bias) is limited. Moreover, not all patients benefit from Alcohol-ApBM, and previous research did not identify reliable pretreatment predictors of Alcohol-ApBM effectiveness. Therefore, the current study focused on learning processes during the Alcohol-ApBM training itself. Specifically, we examined whether changes in approach-avoidance tendencies over the course of Alcohol-ApBM would predict abstinence after inpatient treatment.
METHODS: The training data of 543 AUD patients in Germany (70% male, M = 47.96, SD = 9.08), receiving Alcohol-ApBM training during inpatient treatment, were used to examine whether various aspects of learning during training predicted abstinence 1 year after treatment discharge, both separately and in interaction with potential sociodemographic and clinical moderators of Alcohol-ApBM effectiveness.
RESULTS: Overall, successful learning across six Alcohol-ApBM training sessions was observed; that is, the approach tendency toward alcoholic stimuli was reduced over time. However, none of the examined learning parameters were predictive of abstinence, neither separately nor in combination with clinical or sociodemographic variables.
CONCLUSIONS: Previous studies have shown that Alcohol-ApBM is an effective add-on to abstinence-focused treatment for AUD, and this study showed that learning took place during Alcohol-ApBM training. However, specific learning parameters during training did not predict abstinence 1 year after treatment discharge. Therefore, we cannot specify which patients are most likely to benefit from ApBM with regard to abstinence after 1 year.