Schenkel Edwin J, Schöneck Robert, Becker Eni S, Wiers Reinout W, Lindenmeyer Johannes, Rinck Mike
Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Germany.
Salus Clinic Lindow, Lindow, Germany.
Alcohol Clin Exp Res (Hoboken). 2024 Oct;48(10):1979-1990. doi: 10.1111/acer.15431. Epub 2024 Aug 27.
Patients with alcohol use disorder (AUD) tend to selectively approach alcohol cues in the environment, demonstrating an alcohol-approach bias. Alcohol-approach-bias modification (Alcohol-ApBM) effectively increases abstinence rates in patients with AUD when added to abstinence-focused treatment, but the evidence for its proposed working mechanism (reduction of the alcohol-approach bias) is limited. Moreover, not all patients benefit from Alcohol-ApBM, and previous research did not identify reliable pretreatment predictors of Alcohol-ApBM effectiveness. Therefore, the current study focused on learning processes during the Alcohol-ApBM training itself. Specifically, we examined whether changes in approach-avoidance tendencies over the course of Alcohol-ApBM would predict abstinence after inpatient treatment.
The training data of 543 AUD patients in Germany (70% male, M = 47.96, SD = 9.08), receiving Alcohol-ApBM training during inpatient treatment, were used to examine whether various aspects of learning during training predicted abstinence 1 year after treatment discharge, both separately and in interaction with potential sociodemographic and clinical moderators of Alcohol-ApBM effectiveness.
Overall, successful learning across six Alcohol-ApBM training sessions was observed; that is, the approach tendency toward alcoholic stimuli was reduced over time. However, none of the examined learning parameters were predictive of abstinence, neither separately nor in combination with clinical or sociodemographic variables.
Previous studies have shown that Alcohol-ApBM is an effective add-on to abstinence-focused treatment for AUD, and this study showed that learning took place during Alcohol-ApBM training. However, specific learning parameters during training did not predict abstinence 1 year after treatment discharge. Therefore, we cannot specify which patients are most likely to benefit from ApBM with regard to abstinence after 1 year.
酒精使用障碍（AUD）患者倾向于在环境中选择性地接近酒精线索，表现出酒精接近偏向。当酒精接近偏向修正（Alcohol-ApBM）添加到以戒酒为重点的治疗中时，能有效提高AUD患者的戒酒率，但其提出的作用机制（减少酒精接近偏向）的证据有限。此外，并非所有患者都能从Alcohol-ApBM中获益，先前的研究也未确定Alcohol-ApBM有效性的可靠治疗前预测因素。因此，本研究聚焦于Alcohol-ApBM训练本身的学习过程。具体而言，我们研究了在Alcohol-ApBM训练过程中回避倾向的变化是否能预测住院治疗后的戒酒情况。
德国543名AUD患者（70%为男性，M = 47.96，SD = 9.08）的训练数据被用于研究，这些患者在住院治疗期间接受了Alcohol-ApBM训练，以检验训练期间学习的各个方面是否能预测出院后1年的戒酒情况，包括单独预测以及与Alcohol-ApBM有效性的潜在社会人口统计学和临床调节因素相互作用时的预测情况。
总体而言，观察到在六个Alcohol-ApBM训练环节中学习成功；也就是说，随着时间推移，对酒精刺激的接近倾向降低。然而，所考察的学习参数均不能预测戒酒情况，无论是单独预测还是与临床或社会人口统计学变量联合预测。
先前的研究表明，Alcohol-ApBM是AUD以戒酒为重点治疗的有效补充，本研究表明在Alcohol-ApBM训练过程中发生了学习行为。然而，训练期间的特定学习参数并不能预测出院后1年的戒酒情况。因此，我们无法确定哪些患者在1年后的戒酒方面最有可能从ApBM中获益。
