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Citation
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Stein M, Soravia LM, Tschuemperlin RM, Batschelet HM, Jaeger J, Roesner S, Keller A, Gomez Penedo JM, Wiers RW, Moggi F. Addiction 2022; ePub(ePub): ePub. |
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Abstract
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AIMS: For the first time in a clinical sample with alcohol use disorder (AUD), this study compared the effects of two versions of alcohol-specific inhibition training (Alc-IT) on drinking outcomes and on experimental parameters assessing two possible working mechanisms: stimulus devaluation and inhibitory enhancement.
DESIGN: Multicentre, double-blind, three-arm, clinical RCT with 3-, 6- and 12-month follow-up comparing standard Alc-IT, improved Alc-IT, and an active control condition. SETTING: Three specialized AUD treatment centres in Switzerland.
PARTICIPANTS: N = 242 detoxified, recently abstinent patients with severe AUD (18-60 years; 29.8% female). Intervention and Comparator Both interventions (standard Alc-IT (n=84), improved Alc-IT (n=79)) and the comparator (unspecific inhibition training (n=79)) consisted of six sessions of a modified inhibitory task (Go-NoGo-task) with alcohol-related and neutral stimuli. Both versions of Alc-IT required response inhibition in alcohol-related trials but differed in Go/NoGo-ratios (standard: 50/50; improved: 75/25), with improved Alc-IT posing higher inhibitory demands. The control condition, an unspecific inhibition training, featured alcohol-related pictures in Go- as well as NoGo-trials.
MEASUREMENTS: The primary outcome, percentage of days abstinent, was assessed at 3-month follow-up with a timeline follow-back interview.
FINDINGS: The group receiving improved Alc-IT showed a significantly higher percentage of days abstinent at 3-month follow-up compared with the control group (γ(control) = 74.30 ; γ(improved) = 85.78 ; β = 11.48, 95% confidence interval (CI) [2.57, 20.40] p =.012, adjusted r(2) =.062), while for standard Alc-IT no effect significantly different from zero was detected (γ(standard) = 70.95 ; β = -3.35 , 95%-CI [-12.20, 5.50], p =.457, adjusted r(2) = -.04).
CONCLUSIONS: Alcohol-specific inhibition training with high inhibitory demands increased days abstinent at 3-month follow-up in patients with severe alcohol use disorder. Such an improved, inhibitory-demanding, alcohol-specific inhibition training outperformed the standard version of alcohol-specific inhibition training, suggesting an inhibitory working mechanism.
Language: en |