酒精使用障碍退伍军人的趋近回避训练与假 Sham 治疗比较：一项随机对照试验方案。

Approach avoidance training versus Sham in veterans with alcohol use disorder: protocol for a randomized controlled trial.

机构信息

San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, University of California, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120, USA.

Department of Veteran Affairs Medical Center, 3350 La Jolla Village Dr, San Diego, CA, 92161, USA.

出版信息

BMC Psychiatry. 2023 Jul 12;23(1):499. doi: 10.1186/s12888-023-04961-z.

DOI:10.1186/s12888-023-04961-z

PMID:37438722

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10337098/

Abstract

BACKGROUND

Alcohol use disorder (AUD) is highly prevalent and commonly co-occurs with other psychiatric disorders among Veterans. Provisional evidence supports the use of Approach Avoidance Training (AAT) - a form of computer-delivered cognitive bias modification designed to target implicit approach bias for alcohol-related cues - as an adjunctive program to treat AUD. However, the extent to which AAT is effective for improving AUD recovery outcomes in outpatient Veteran samples and those with psychiatric comorbidities has been understudied to date. Here we describe a double-blind randomized controlled trial of AAT versus a comparison condition (Sham) being conducted in Veterans with comorbid psychiatric conditions completing outpatient standard care.

METHODS

One hundred thirty-six Veterans currently receiving outpatient treatment for AUD will be recruited for this randomized controlled trial with parallel group assignment. Participants will be randomized to either 6 weeks of AAT (n = 68) or Sham (n = 68) training in conjunction with usual care. Assessments will occur at baseline and 6 weeks, 3 months, and 6 months post-baseline. Primary outcome variables will include functional consequences of drinking. Secondary outcome variables will include alcohol consumption, and behavioral indicators of alcohol approach bias. A subset of participants (n = 51) will also complete functional magnetic resonance imaging (fMRI) to assess neural response during an alcohol approach bias assessment.

DISCUSSION

This study is the first randomized controlled trial of AAT administered as an adjunctive treatment to standard care in Veterans with AUD and comorbid psychiatric disorders. Additionally, behavioral and neuroimaging data will be used to determine the extent to which AAT targets approach bias for alcohol cues. If effective, AAT may be a promising low-cost adjunctive treatment option for individuals with AUD.

REGISTRY NAME

AAT for Alcohol Use Disorder in Veterans.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT05372029; Date of Registration: 5/9/2022.

摘要

背景

酒精使用障碍（AUD）在退伍军人中非常普遍，并且通常与其他精神障碍同时发生。初步证据支持使用接近回避训练（AAT）-一种旨在针对与酒精相关线索的内隐接近偏见的计算机传递认知偏见修正形式-作为治疗 AUD 的辅助程序。然而，迄今为止，AAT 在外科退伍军人样本和伴有精神共病的人群中对改善 AUD 康复结果的有效性尚未得到充分研究。在这里，我们描述了一项针对伴有精神共病的退伍军人在接受门诊标准护理的同时接受 AAT 与对照条件（假）的双盲随机对照试验。

方法

将招募 136 名目前正在接受 AUD 门诊治疗的退伍军人参加这项随机对照试验，采用平行分组分配。参与者将被随机分配到 6 周的 AAT（n=68）或 Sham（n=68）训练中，并结合常规护理。评估将在基线和 6 周、3 个月和 6 个月后进行。主要结果变量将包括饮酒的功能后果。次要结果变量将包括酒精摄入量和酒精接近偏见的行为指标。一部分参与者（n=51）还将完成功能磁共振成像（fMRI），以评估在酒精接近偏见评估期间的神经反应。