Department of Psychology, University of Amsterdam, PB 15916, 1001 NK, Amsterdam, the Netherlands; Department of Pedagogical Sciences, Utrecht University, PB 15916, 1001 NK, Amsterdam, the Netherlands.
Department of Psychology, University of Amsterdam, PB 15916, 1001 NK, Amsterdam, the Netherlands.
J Behav Ther Exp Psychiatry. 2024 Mar;82:101916. doi: 10.1016/j.jbtep.2023.101916. Epub 2023 Oct 5.
Young offenders show high levels of substance use. Treatment programs within detention settings are less effective. Cognitive bias modification (CBM) is a promising supplement to substance use treatment. This study tests the effectiveness of CBM in young offenders to reduce cannabis and alcohol use, and delinquent recidivism.
A randomized controlled trial added CBM to treatment as usual (TAU), among 181 youth in juvenile detention centers. In a factorial design, participants were randomly assigned to either active- or sham-training for two varieties of CBM, targeting attentional-bias (AtB) and approach-bias (ApB) for their most used substance. Substance use was measured with the Alcohol and Cannabis Use Disorder Identification Tests. Delinquent recidivism was measured with the International Self-Report Delinquency (ISRD) survey.
At pretest, participants showed AtB but no ApB for both substances. For alcohol, a decrease was found in AtB in the active-training group. For cannabis, a decrease was found in AtB for both active- and sham-training groups. Regardless of condition, no effects were found on substance use or ISRD scores at follow-up.
The sample is judicial, not clinical, as is the setting. TAU and participant goals are not necessarily substance related.
Young offenders show a significant attentional-bias towards substance cues. CBM changed attentional-biases but not substance use. Combining CBM with a motivational intervention is advised. Follow-up research should better integrate CBM with running treatment programs. New developments regarding CBM task design could be used that link training better to treatment.
青少年罪犯表现出较高的物质使用水平。拘留环境中的治疗方案效果较差。认知偏差修正（CBM）是物质使用治疗的一种有前途的补充方法。本研究测试 CBM 在减少青少年罪犯的大麻和酒精使用以及犯罪复发方面的有效性。
一项随机对照试验在青少年拘留中心的 181 名青少年中，在常规治疗（TAU）的基础上增加了 CBM。采用析因设计，参与者随机分配到 CBM 的主动或假训练组，针对他们最常使用的两种物质进行注意力偏差（AtB）和接近偏差（ApB）的训练。物质使用情况通过酒精和大麻使用障碍识别测试进行测量。犯罪复发通过国际自我报告犯罪（ISRD）调查进行测量。
在预测试中，参与者对两种物质均表现出 AtB，但没有 ApB。对于酒精，在主动训练组中发现 AtB 减少。对于大麻，在主动和假训练组中均发现 AtB 减少。无论条件如何，在随访时，均未发现对物质使用或 ISRD 评分有影响。
样本是司法性的，而不是临床性的，所处环境也是如此。TAU 和参与者的目标不一定与物质有关。
青少年罪犯对物质线索表现出明显的注意力偏差。CBM 改变了注意力偏差，但没有改变物质使用。建议将 CBM 与动机干预相结合。后续研究应更好地将 CBM 与正在进行的治疗方案结合起来。可以使用新的 CBM 任务设计，将训练与治疗更好地联系起来。
