Attentional retraining with alcohol dependent patients

Previous research has shown that alcoholics and heavy drinkers have an
attentional bias (AB) toward alcohol stimuli. AB increases over time with
increasing alcohol use. There is evidence that AB increases craving for
alcohol, which increases drinking behavior. Recent investigations have shown
that AB decreases after attention training. Attention training decreases AB in
a direct way, and it is assumed that this will decrease craving for alcohol.

Decreasing AB and subsequent craving through attention training in alcohol
dependent patients. Further, we will investigate whether the risk for relapse
diminishes after the training. Long term goal is to investigate the effect of
attention training during regular treatment in order to see whether attention
training is a useful extra tool in treating alcohol dependent patients.

Experimental research. Participants in the experimental group perform the
attention training for five times on separate days. Participants in the control
group perform a control task for five times on separate days. Before and after
each training/control task, craving will be measured. AB will be measured
during the first, third, fifth and sixth session. Up to three months after
participation, therapists will inform us about whether patients are still
abstinent or have relapsed.

Participants in the experimental group perform attention training five times,
with 3 days in between each session. The training is a reaction time task, in
which alcohol related and neutral stimuli are presented on a computer screen;
goal is to avoid the alcohol stimuli and attend to the neutral stimuli.
Participants in the control condition will perform a control task for five
times; the control task does not influence attentional bias.

For every participant, there are six sessions. The first one takes about one
and a half hour, the others about half an hour. Sessions are spread over a
three-week period. During each session, participants perform computerized
reaction time tasks of about 20 minutes. During the first session, the
researcher will fill out some questionnaires with the participant on his or her
former alcohol use, alcohol problems and use of other drugs (DSM-IV criteria).

There is no considerable risk in participating. The only negative consequence
we can think of is that the training and control task will increase craving
during these task, because alcohol related stimuli are presented in these
tasks. However, there is no evidence of such an effect in the literature on
attention training. Even more, the trainings we know of so far from our lab and
other labs (see Wiers et al., 2006) have shown that craving does not increase
after attention training.