Hahn Austin M, Corcoran Erin, Danielson Carla Kmett
Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
Contemp Clin Trials Commun. 2025 Jan 25;44:101435. doi: 10.1016/j.conctc.2025.101435. eCollection 2025 Apr.
Alcohol and cannabis are the first and second most used substances among adolescents. Adolescence is a period of considerable development, making the adolescent brain particularly vulnerable to negative effects of alcohol and cannabis use. Developing and testing interventions that target both alcohol and cannabis use during adolescence are vital to decreasing costly consequences. Biases in cognitive processing of drug-related stimuli play an important role in the development and maintenance of problematic substance use. The Approach-Avoidance Task (AAT) is a computerized program, effective in assessing implicit approach biases for both alcohol and cannabis, in which participants make approach or avoidance movements in response to an irrelevant feature of an image presented on a screen (e.g., push when in portrait, pull when in landscape). A modified version of the AAT is also used as an approach bias modification (ApBM) intervention, to retrain participants' implicit biases toward or away from stimuli by presenting the target stimuli predominantly in one format (e.g., push or pull). Despite research demonstrating the effectiveness of AAT interventions to reduce problematic alcohol and cannabis use, there is a dearth of research examining this intervention among adolescents. This protocol paper describes a NIDA-funded randomized control trial (RCT) to evaluate an integrated mobile ApBM intervention to target co-occurring alcohol and cannabis use among treatment-seeking adolescents. Outcomes will be measured from pre-treatment through a three-month follow-up. The sampling procedures, assessment protocol, description of the intervention, and planned statistical approaches to evaluating outcomes are detailed. Clinical and research implications of this work are also discussed.
酒精和大麻是青少年中使用最为频繁的第一和第二大物质。青春期是一个经历显著发育的时期，这使得青少年大脑特别容易受到酒精和大麻使用所带来的负面影响。研发并测试针对青少年时期酒精和大麻使用的干预措施对于减少高昂的后果至关重要。对与毒品相关刺激的认知加工偏差在问题性物质使用的发展和维持中起着重要作用。趋近-回避任务（AAT）是一个计算机化程序，在评估对酒精和大麻的内隐趋近偏差方面很有效，参与者根据屏幕上呈现图像的无关特征做出趋近或回避动作（例如，纵向时按，横向时拉）。AAT的一个修改版本也被用作一种趋近偏差修正（ApBM）干预措施，通过主要以一种形式（例如，按或拉）呈现目标刺激来重新训练参与者对刺激的内隐偏差。尽管有研究表明AAT干预措施在减少问题性酒精和大麻使用方面有效，但在青少年中研究这种干预措施的却很少。本方案文件描述了一项由美国国家药物滥用研究所资助的随机对照试验（RCT），以评估一种综合移动ApBM干预措施，针对寻求治疗的青少年中同时存在的酒精和大麻使用问题。结果将在治疗前到三个月的随访期间进行测量。详细介绍了抽样程序、评估方案、干预措施描述以及评估结果的计划统计方法。还讨论了这项工作的临床和研究意义。
