Does Cognitive Bias Modification help in the treatment of addictive behaviours?
Despite the range of available, evidence-based treatments for substance use disorders, relapse rates remain high suggesting that current treatments may not yet target all relevant aspects of the disorders. One explanation lies in the dual process models of addiction (and more recent iterative processing varieties), which suggest that the development and maintenance of substance use disorders derives from an interplay of explicit and implicit processes. Current treatments, such as cognitive behavioural therapy, however, focus on techniques that are meant to strengthen explicit processes, for example patterns of decision-making. As a consequence, implicit processes that have been found to play a role in addiction may not be sufficiently targeted during these treatments. In line, recent studies have shown that these implicit processes seem to remain unchanged throughout current treatments. In order to directly address implicit processes, Cognitive Bias Modification (CBM) procedures have been developed. These procedures have first been tested in non-clinical samples investigating the capacity of modifying the targeted process. Several lab-based studies have shown that the modification of different implicit processes, such as approach and attentional biases, is possible using computerized procedures. CBM procedures, however, would only be a valuable addition to current treatments if they are not only able to modify the targeted processes but also able to transfer this modification into positive symptomatical changes of substance use. Therefore, more recent studies have investigated the effectiveness of CBM procedures in heavy using samples and clinical samples, to test whether these procedures can also help improving substance use symptoms.
The current symposium provides an overview of the current knowledge and developments on CBM in addiction. The first speaker of the symposium provides the audience with general information on different implicit processes and summaries the developments of the last years, especially focusing on studies in heavy using and clinical samples. Thereafter, three other speakers present recent studies investigating the effectiveness of CBM procedures on substance use symptoms. The first of these speakers present a study that tested the effects of an Attentional Bias Modification procedure, termed the Drug Attention Control Training Program, on substance use symptoms in in-treatment detoxified drug abusers (N = 87). Participants were randomly assigned to the training condition in which they completed three sessions of the training or a control group. The subsequent speaker presents the results of an RCT testing the effects of three different Inhibitory Control Trainings (i.e., Associative No-Go, Associative Stop Signal, General Inhibition) in reducing alcohol consumption in problem drinkers who were motivated to change their drinking behaviour (N = 246). The effects on alcohol consumption of the three training groups were compared with an active control group. Participants who were randomized to one of the training conditions completed up to 14 sessions of the training. The final and fourth speaker presents a study that examined the effectiveness of a home-delivered multisession Attentional Bias Modification training, called the Bouncing Image Training Task, as an add-on to regular treatment of alcohol and cannabis dependent outpatients (N = 169). The study was designed as an RCT in which participants were randomly allocated to the ABM training condition, a placebo condition, or a no training condition (only receiving treatment as usual). The results of the three studies, clinical applications, and future research directions will be discussed.