Retraining Automatic Action Tendencies Changes Alcoholic Patients’ Approach Bias for Alcohol and Improves Treatment Outcome

Question 1

abstract van de studie

Answer 1

This study tested the effects of a new cognitive-bias modification (CBM) intervention that targeted an approach bias for alcohol
in 214 alcoholic inpatients. Patients were assigned to one of two experimental conditions, in which they were explicitly or
implicitly trained to make avoidance movements (pushing a joystick) in response to alcohol pictures, or to one of two control
conditions, in which they received no training or sham training. Four brief sessions of experimental CBM preceded regular
inpatient treatment. In the experimental conditions only, patients’ approach bias changed into an avoidance bias for alcohol.
This effect generalized to untrained pictures in the task used in the CBM and to an Implicit Association Test, in which alcohol
and soft-drink words were categorized with approach and avoidance words. Patients in the experimental conditions showed
better treatment outcomes a year later. These findings indicate that a short intervention can change alcoholics’ automatic
approach bias for alcohol and may improve treatment outcome

Question 2

A central paradox of addiction is that addicted people continue their self-destructive behavior despite knowledge of the consequences.

Answer 2

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Question 3

In the alcohol-AAT, participants are instructed to …..

Answer 3

respond with an approach movement (pulling a joystick) to pictures of one type and to respond with an avoidance movement (pushing a joystick) to pictures of another type.Pulling on the joystick increases the size of the picture, and pushing on it decreases the size. This zooming effect generates a sensation of approach or avoidance, respectively.

Question 4

All patients followed regular cognitive-behavior treatment for inpatients. A year after treatment discharge, patients’ treatment outcome was assessed.

Answer 4

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Question 5

tasks at pretest and posttest

Answer 5

• craving on likert scale
• IAT
• alcohol AAT

Question 6

the 2 experimental conditions

Answer 6

In the first experimental condition (explicit instruction), patients were instructed to respond to pictures of alcohol by mak-
ing an avoidance movement (pushing the joystick) and to pictures of nonalcoholic soft drinks by making an approach movement
(pulling the joystick; see Fig. S3 in the Supplemental Material). To distinguish the task from the assessment task used during pretest and posttest, in which all patients were instructed to react to the format of the picture, we presented all pictures in this experimental condition in the same square format. Patients in the second experimental condition (implicit instruction) continued to
respond as in the pretest, but all alcohol pictures were presented in the format they were avoiding (i.e., landscape), and all soft-
drink pictures were presented in the format they were approaching (i.e., portrait). Patients were trained in four sessions.

Question 7

the 2 control groups

Answer 7

One control group received no training at all, and the other received four additional sessions of the assessment task (sham training), which required an equal number of approach and avoidance movements to both alcoholic and nonalcoholic drinks

Question 8

A similar generalization of training effects to a different assessment procedure was not found in attentional retraining in alcoholic patients, although closer generalization to untrained stimuli within the same task was found (Schoenmakers et al., 2010). Perhaps
retraining of action tendencies has stronger effects than retraining of attentional bias.

Answer 8

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