Online training to decrease alcohol consumption

There is a need for effective alcohol interventions. The aims of this intervention study are to examine the effectiveness of an online cognitive bias training (approach-avoidance bias and attentional bias) in reducing approach and attentional bias for alcohol-related cues, as well as increasing clinical alcohol outcomes (i.e., lower drinking rates, quitting drinking).
Participants are randomly assigned to one of four conditions:
(1) both attentional bias + approach bias training;
(2) attentional bias + placebo approach bias training,
(3) approach bias + placebo attentional bias training,
(4) placebo attentional bias + placebo approach bias training. The online cognitive training is supplemented with online tailored advice (using motivational interviewing techniques) to enhance behavioural change. Main study parameters and outcomes are: alcohol use, alcohol problems, craving, cognitive biases, personality- and impulsivity-related constructs, executive functioning and motivation.

1. After completing real approach bias re-training, participants will show a stronger reduction in approach bias for alcohol than after placebo training (main effect 1);

2. After completing real attentional bias re-training, participants will show a stronger reduction in attentional bias for alcohol than after placebo training (main effect 2);

3. Improvement in alcohol outcomes (decrease in use) in participants in CBM training conditions compared to those in placebo conditions: Strongest reduction in double real re-training; medium reduction in mixed conditions (one real re-training, one placebo) and weakest reduction in double placebo condition .

3. The effect of the CBM training is moderated by level of bias at baseline (both for attentional bias and for approach bias re-training)

4. The effect of CBM training is moderated by impulsivity

5. The effect of CBM training is moderated by motivation

6. The effect of CBM training is moderated by alcohol use and alcohol problems

Pre-session:

-Alcohol Use Disorder Identification Test (AUDIT)

-Tailored advice – Alcohol

-Beck’s Depression Inventory (BDI; 7-question short version)

-CORE (full version)

-Timeline Follow-back (TLFB; full version)

-Substance-Use Risk Profile Scale (SURPS)

-Desire for Alcohol Questionnaire (DAQ)

-Readiness for Change Questionnaire – Alcohol(RCQ)

-Drinking Motives Questionnaire (DMQ)



Training sessions (11 in total):

-Visual Analogue Scales (VAS; craving & motivation)

-Timeline Follow-back (TLFB; alcohol-specific version; since previous session)

-Credibility Expectancy Questionnaire (CEQ; only after the first training session)

-Client Satisfaction Questionnaire (CSQ; only after last training session)

Half-way & Post-training assessment:
-Beck’s Depression Inventory (BDI; 7-question short version)
-CORE (only last month)
-Timeline Follow-back (TLFB; alcohol-specific version; since previous session)
-Desire for Alcohol Questionnaire (DAQ)

Follow-up (1/2/3 months) assessment:
-Beck’s Depression Inventory (BDI; 7-question short version)
-CORE (only last month)
-Timeline Follow-back (TLFB; full version)
-Desire for Alcohol Questionnaire (DAQ)

The online sessions start out with an automatized motivational interview (tailored advice) followed by Cognitive bias modification (CBM) to reduce attentional bias (AB) and approach-avoidance bias (AAT) toward alcohol-related cues and to decrease drinking levels.

Condition 1: Both AB + AAT training

Condition 2: AB training + placebo AAT

Condition 3: AAT training + placebo AB

Condition 4: placebo AB + placebo AAT