Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany.
Department of Occupational and Consumer Psychology, University of Freiburg, Freiburg, Germany.
Eur Addict Res. 2022;28(1):68-79. doi: 10.1159/000518678. Epub 2021 Sep 17.
Imaginal retraining is a self-help technique that adapts the principles of approach bias modification to the imagination. Imaginal retraining has been shown to reduce craving and addictive behaviours in 3 randomized controlled trials (RCTs) on problematic alcohol consumption, overweight, and tobacco use. To date, there have been no studies evaluating the long-term efficacy of the intervention. The aim of the present study was to generate first hypotheses on the long-term efficacy of imaginal retraining in smokers in a controlled 1-year follow-up study.
We recontacted the 345 participants who had taken part in an RCT on imaginal retraining for smokers 1 year later. The survey was carried out online and assessed craving for tobacco (primary outcome), smoking behaviour, well-being, and subjective appraisal. Individuals who applied the technique at least once during the previous year were categorized as the training group, whereas participants who never performed the training were categorized as the no-training group. Data were analysed using linear mixed models (LMMs). The study was preregistered as DRKS00021044.
The completion rate was 45.5%. Less than 40% used the intervention at least once in the previous 12 months. LMM analyses showed a significant reduction in craving for tobacco for the training compared to the no-training group after 1 year. No significant group differences emerged in smoking behaviour, depressive symptoms, or quality of life. Subjective appraisal of the intervention was favorable, similar to the initial study.
The present study provides preliminary support for the long-term efficacy of imaginal retraining on craving for tobacco but not on smoking behaviour, highlighting the importance of multimodal treatment concepts in smoking cessation that target a variety of maintaining factors. Future studies need to investigate the long-term efficacy of the intervention in prospective RCTs that test alternative ways of conveying the technique to improve adherence.
表象重训是一种自助技术，它将趋近偏差修正的原则应用于想象。有三项随机对照试验（RCT）表明，表象重训可减少酗酒、超重和吸烟等问题行为中的渴望和成瘾行为。迄今为止，还没有研究评估该干预措施的长期疗效。本研究旨在通过一项为期 1 年的对照随访研究，为吸烟者的表象重训长期疗效生成初步假设。
我们在 1 年后联系了曾参加过吸烟者表象重训 RCT 的 345 名参与者。该调查是通过在线进行的，评估了对烟草的渴望（主要结果）、吸烟行为、幸福感和主观评价。在过去的一年中至少进行过一次训练的个体被归类为训练组，而从未进行过训练的个体被归类为无训练组。使用线性混合模型（LMMs）分析数据。该研究已在 DRKS00021044 上预先注册。
完成率为 45.5%。在过去的 12 个月中，不到 40%的人至少使用过一次干预措施。LMM 分析表明，与无训练组相比，训练组在 1 年后对烟草的渴望显著降低。在吸烟行为、抑郁症状或生活质量方面，两组之间没有出现显著差异。对干预的主观评价是有利的，与初始研究相似。
本研究为表象重训对烟草渴望的长期疗效提供了初步支持，但对吸烟行为没有显著影响，这突出了针对多种维持因素的戒烟多模式治疗概念的重要性。未来的研究需要在前瞻性 RCT 中检验该干预措施的长期疗效，这些 RCT 可以测试不同的方法来传递该技术，以提高依从性。
