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一项用于治疗酒精使用障碍的注意力控制训练的随机对照试验。

A Randomized Controlled Trial of Attentional Control Training for Treating Alcohol Use Disorder.

作者信息

Mellentin Angelina Isabella, Cox W Miles, Fadardi Javad S, Martinussen Laila, Mistarz Nicolaj, Skøt Lotte, Rømer Thomsen Kristine, Mathiasen Kim, Lichtenstein Mia, Nielsen Anette Søgaard

机构信息

Unit for Psychiatric Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

Brain Research-Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

出版信息

Front Psychiatry. 2021 Nov 26;12:748848. doi: 10.3389/fpsyt.2021.748848. eCollection 2021.

Abstract

There is consistent evidence that community and clinical samples of individuals with an alcohol use disorder (AUD) have attentional biases toward alcohol cues. The alcohol attentional control training program (AACTP) has shown promise for retraining these biases and decreasing alcohol consumption in community samples of excessive drinkers. However, there is a lack of evidence regarding the effectiveness of ACTP in clinical AUD samples. The main aim of the present study is to investigate whether primary pharmacological and psychological, evidence-based alcohol treatment can be enhanced by the addition of a gamified AACTP smartphone application for patients with an AUD. The study will be implemented as a randomized controlled trial. A total of 317 consecutively enrolled patients with AUD will be recruited from alcohol outpatient clinics in Denmark. Patients will be randomized to one of three groups upon initiation of primary alcohol treatment: Group A: a gamified AACTP smartphone application + treatment as usual (TAU); Group B: a gamified AACTP sham-control application + TAU; or Group C: only TAU. Treatment outcomes will be assessed at baseline, post-treatment, and at 3- and 6-month follow-ups. Repeated measures MANOVA will be used to compare the trajectories of the groups over time on alcohol attentional bias, alcohol craving, and drinking reductions. It is hypothesized that Group A will achieve better treatment outcomes than either Group B or Group C. Because attentional bias for alcohol cues is proportional to the amount of alcohol consumed, and these biases are not addressed within current evidence-based treatment programs, this study is expected to provide new evidence regarding the effectiveness of the gamified AACTP in a clinical population. Furthermore, due to promising results found using AACTP in community samples of excessive drinkers, there is a high probability that the AACTP treatment in this study will also be effective, thereby allowing AACTP to be readily implemented in clinical settings. Finally, we expect that this study will increase the effectiveness of evidence-based AUD treatment and introduce a new, low-cost gamified treatment targeting patients with an AUD. Overall, this study is likely to have an impact at the scientific, clinical, and societal levels. https://clinicaltrials.gov/ct2/show/NCT05102942?term=NCT05102942&draw=2&rank=1, identifier: NCT05102942.

摘要

有一致的证据表明,患有酒精使用障碍(AUD)的个体的社区和临床样本对酒精线索存在注意力偏差。酒精注意力控制训练计划(AACTP)已显示出在重新训练这些偏差以及减少过度饮酒者社区样本中的酒精消费量方面具有前景。然而,关于ACTP在临床AUD样本中的有效性缺乏证据。本研究的主要目的是调查对于患有AUD的患者,通过添加一个游戏化的AACTP智能手机应用程序,是否可以增强主要的药物和心理循证酒精治疗。该研究将作为一项随机对照试验实施。总共317名连续招募的AUD患者将从丹麦的酒精门诊诊所招募。在开始主要酒精治疗时,患者将被随机分为三组:A组:一个游戏化的AACTP智能手机应用程序+常规治疗(TAU);B组:一个游戏化的AACTP假对照应用程序+TAU;或C组:仅TAU。将在基线、治疗后以及3个月和6个月随访时评估治疗结果。重复测量多元方差分析将用于比较各组在酒精注意力偏差、酒精渴望和饮酒减少方面随时间的轨迹。假设A组将比B组或C组取得更好的治疗结果。由于对酒精线索的注意力偏差与饮酒量成正比,并且这些偏差在当前的循证治疗计划中未得到解决,预计本研究将提供关于游戏化AACTP在临床人群中的有效性的新证据。此外,由于在过度饮酒者的社区样本中使用AACTP发现了有前景的结果,本研究中的AACTP治疗也很有可能有效,从而使AACTP能够在临床环境中轻松实施。最后,我们预计本研究将提高循证AUD治疗的有效性,并引入一种针对患有AUD的患者的新的低成本游戏化治疗方法。总体而言,本研究可能在科学、临床和社会层面产生影响。https://clinicaltrials.gov/ct2/show/NCT05102942?term=NCT05102942&draw=2&rank=1,标识符:NCT05102942

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dab/8661535/568779b1d99f/fpsyt-12-748848-g0001.jpg

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