Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.
Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.
Alcohol Clin Exp Res. 2018 Jan;42(1):153-161. doi: 10.1111/acer.13529. Epub 2017 Nov 24.
To examine the applicability of an alcohol-avoidance training procedure in patients with alcohol dependence and alcohol-induced neurocognitive disorders (NDs), we trained 2 groups that differed in the degree of cognitive impairment: One group fulfilled the DSM-5 criteria for alcohol-induced mild ND, and 1 group was diagnosed with Korsakoff's syndrome (KS) (alcohol-induced major ND, confabulatory/amnesic subtype; DSM-5). The intervention is assumed to match the preserved cognitive capacity for implicit learning in both groups.
Fifty-one inpatients with a mild ND and 54 inpatients with KS were trained. Six training sessions (including pre- and posttests) of a computerized implicit alcohol approach-avoidance task were applied. Neurocognitive variables were available from the standard assessment procedure of the clinic.
Training of alcohol-avoidance tendencies is feasible in a population with alcohol-related NDs. The alcohol-approach bias decreased for both groups in each session. Better learning results over time were obtained in participants with a larger baseline alcohol-approach tendency. Learning effects were positively related to age and implicit (nondeclarative) memory functioning. No relation between training effects and executive or explicit memory functions was found.
Training of an alcohol-avoidance tendency can be successfully applied in patients with alcohol dependence including those with alcohol-induced NDs.
为了检验一种酒精回避训练程序在酒精依赖和酒精引起的神经认知障碍（NDs）患者中的适用性，我们对认知障碍程度不同的两组患者进行了训练：一组符合 DSM-5 酒精引起的轻度 ND 的标准，另一组被诊断为科萨科夫综合征（KS）（酒精引起的重度 ND，虚构/遗忘型；DSM-5）。该干预措施假定与两组患者的内隐学习保留认知能力相匹配。
对 51 名轻度 ND 住院患者和 54 名 KS 住院患者进行了训练。应用了六次计算机化的内隐酒精趋近回避任务的训练（包括前测和后测）。神经认知变量可从诊所的标准评估程序中获得。
在有酒精相关 NDs 的人群中，进行酒精回避倾向的训练是可行的。两组在每次训练中对酒精的趋近倾向都有所降低。在基线酒精趋近倾向较大的参与者中，随着时间的推移，学习效果更好。学习效果与年龄和内隐（非陈述性）记忆功能呈正相关。未发现训练效果与执行功能或外显记忆功能之间存在关系。
酒精回避倾向的训练可以成功应用于酒精依赖患者，包括那些有酒精引起的 NDs 的患者。
