Batschelet Hallie M, Stein Maria, Tschuemperlin Raphaela M, Soravia Leila M, Moggi Franz
University Hospital of Psychiatry, Translational Research Center, Division of Clinical Research, University of Bern, Bern, Switzerland.
Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland.
Front Psychiatry. 2020 Jan 9;10:871. doi: 10.3389/fpsyt.2019.00871. eCollection 2019.
In patients with alcohol use disorder, novel interventions to increase abstinence have attracted growing attention. Interventions aimed at modifying cognitive biases linked to alcohol use [i.e. cognitive bias modification (CBM)] may serve as an add-on to standard therapy. This systematic review thoroughly aggregates existing data on the effects of three alcohol-specific computerized interventions, namely attentional bias modification (AtBM), approach bias modification (ApBM), and inhibition training (IT). In doing so, each CBM's effects on experimental tasks assessing the relevant biases, drinking behavior, and neurophysiology are summarized. Also, the influence of drinking behavior severity and motivation to change drinking behavior are discussed. A literature search was conducted in four databases for original research articles published between 2000 and May 2019. Studies were eligible if investigating the effects of alcohol-specific computerized interventions (AtBM, ApBM, IT) on drinking behavior, bias change, and/or neurophysiology. Forty eligible articles were classified as being either a non-clinical experimental lab study (ELS) or clinical randomized-controlled trial (RCT) and summarized. While AtBM seems to influence attentional bias, its effects on drinking behavior are inconsistent. As for ApBM, the best effects on drinking behavior are obtained in clinical samples. Effects of ApBM on approach bias are mixed. Interestingly, those clinical RCTs which investigated ApBM effects on bias change as well as on drinking outcome, reported consistent effects in both measures (i.e. either effects on bias drinking or no effects). Studies on IT are limited to non-clinical samples and show inconsistent effects on drinking behavior. Considering ITs effects on implicit semantic associations, most studies do not support the conceptualization of IT as a form of memory bias modification, while reports on IT's effects on inhibitory control are still incomplete. Conclusions about the overall influence of drinking behavior severity are hampered by the non-uniform use of sample descriptions. In clinical samples, ApBM has shown more consistent beneficial effects, while evidence on AtBM is more inconsistent, and data on IT still lacks important information. Conclusions about the influence of drinking behavior severity would be facilitated by a uniform use of clearly defined sample descriptions.
在酒精使用障碍患者中，旨在提高戒酒率的新型干预措施已引起越来越多的关注。旨在改变与酒精使用相关的认知偏差的干预措施（即认知偏差矫正，CBM）可作为标准治疗的补充。本系统评价全面汇总了关于三种特定于酒精的计算机化干预措施效果的现有数据，即注意力偏差矫正（AtBM）、趋近偏差矫正（ApBM）和抑制训练（IT）。在此过程中，总结了每种CBM对评估相关偏差、饮酒行为和神经生理学的实验任务的影响。此外，还讨论了饮酒行为严重程度和改变饮酒行为动机的影响。在四个数据库中进行了文献检索，以查找2000年至2019年5月发表的原始研究文章。如果研究特定于酒精的计算机化干预措施（AtBM、ApBM、IT）对饮酒行为、偏差改变和/或神经生理学的影响，则这些研究符合条件。40篇符合条件的文章被归类为非临床实验实验室研究（ELS）或临床随机对照试验（RCT）并进行了总结。虽然AtBM似乎会影响注意力偏差，但其对饮酒行为的影响并不一致。至于ApBM，在临床样本中对饮酒行为的效果最佳。ApBM对趋近偏差的影响好坏参半。有趣的是，那些研究ApBM对偏差改变以及饮酒结果影响的临床RCT在两种测量中都报告了一致的效果（即要么对偏差有影响，要么对饮酒有影响，要么两者都无影响）。关于IT的研究仅限于非临床样本，并且对饮酒行为的影响不一致。考虑到IT对内隐语义联想的影响，大多数研究不支持将IT概念化为一种记忆偏差矫正形式，而关于IT对抑制控制影响的报告仍然不完整。样本描述使用不统一妨碍了对饮酒行为严重程度总体影响的结论。在临床样本中，ApBM显示出更一致的有益效果，而关于AtBM的证据则更不一致，并且关于IT的数据仍然缺乏重要信息。统一使用明确定义的样本描述将有助于得出关于饮酒行为严重程度影响的结论。
