News di Alcologia

Psychologists develop cognitive-bias modification to help alcoholics stay sober
Alcoholism is a tough addiction to kick. Eventually, most people return to drinking. But some Dutch and German psychological

scientists have tested a short-term regime that promises to help alcoholics stay sober. Their study is published in

Psychological Science, a journal of the Association of Psychological Science.
Heavy drinkers tend to behave impulsively in response to temptation. Meanwhile, their "reflective," or controlled, responses

-the thoughts that would help them resist drinking-are often weak. Most therapies, including Cognitive Behavior Therapy,

primarily address the reflective responses. "They deal with the reasons and strategies" for sobriety, said University of

Amsterdam experimental psychologist Reinout W. Wiers, the study's lead author. To boost treatment success, his team developed

cognitive-bias modification, or CBM, which, for the first time, "tries to turn around those impulsive responses."
This newly developed CBM variety employs video-game-like "approach-avoidance tasks": pushing or pulling a joystick in

response to images on a screen. Pulling zooms in on the image, as if the participant were "approaching" it. Pushing zooms

out, in "avoidance." The team's earlier studies found that heavier drinkers, shown images of alcoholic beverages or soft

drinks, are faster to "pull" the alcohol than lighter drinkers-but CBM can turn this "approach bias" into an "avoidance

bias."
Could CBM help serious alcoholics? In this study Wiers and his collaborators-Carolin Eberl and Johannes Lindenmeyer of the

Salus Clinic in Lindow, Germany, and Mike Rinck and Eni S. Becker of Radboud University-recruited 214 inpatients at the Salus

Clinic. Three weeks after detoxification, the patients were assessed for their craving for alcohol, as well as their

attraction to it, indicated by joystick and word-association tasks.
One group of patients then received CBM: they were trained to push away pictures of alcoholic drinks. The control groups

either received "sham" training or none at all. Four 15-minute sessions were conducted on four consecutive days.
When retested a week later, the CBM participants' "approach bias for alcohol had changed to an avoidance bias, on a variety

of tests," said Wiers. The control groups showed no such changes.
Then the patients began abstinence-based cognitive behavior therapy, a structured method that helps people identify and

challenge the thinking patterns that perpetuate their self-destructive behaviors. Treatment lasted about three months. A year

later, the researchers assessed the patients' success in staying sober.
As is typical, many patients had relapsed-but only 46 percent of the CBM trained group, compared with 59 percent of the

others. Although the researchers cannot be absolutely sure that CBM made the difference, joystick and word tests left them

"strongly confident," said Wiers, that "adding this intervention to regular treatment helps people stay abstinent."
One still-abstinent patient told a story illustrating this point. At a party, looking for a Coke, the man opened the

refrigerator, but found it full of beer. "Immediately, he made the push movement"-he closed the door. "In the heat of the

moment, when temptations is high, you have to take that immediate first step in the right direction or it becomes very

difficult," commented Wiers. "CBM helps people take this step, before they have time to consciously think, 'Should I take a

drink?'"
Source: Association for Psychological Science