1. ABC-Training: A New Proposition-Based Variety of Cognitive Bias Modification. Theoretical Background and Initial Results.

Approach-bias modification (a variety of Cognitive Bias Modification or CBM), has consistently yielded positive effects as add-on to the treatment of AUD, with reduced relapse of approximately 10% (Wiers et al, 2011; Eberl et al, 2013; Rinck et al., 2018; Manning et al., 2021; Salemink et al., 2021). Meanwhile, proof-of-principle studies shed new light on underlying mechanisms. CBM was originally thought to target unconscious, associative processes (based on dual-process models), but recent studies demonstrated that awareness of consequences is needed, and that effects can be achieved through instructions (Van Dessel et al., 2019), in line with an inferential rather than an associative account. Based on these new insights into underlying mechanisms, ABC-training was developed (Wiers et al., 2020). It defines personalized Antecedents, personally-relevant Behavioral alternatives and Consequences (Cs) (of drinking or alternative).

ABC-training thus targets automatically activated (propositional) inferences about the contingencies between stimuli, responses, and outcomes that translate into behaviour. It aims to train goal-driven inferences about the instrumental relevance of actions to one's goals. We will outline the theory behind ABC-training and show results of first studies.

A first study compared ABC-training with sham-training in hazardously drinking volunteers, and found a stronger increase of (automatically activated and questionnaire-assessed) negative expectancies. In a second pilot study volunteers of an abstinence challenge were randomized over ABC-training, standard CBM and sham-CBM. Participants receiving ABC-training were more likely to remain abstinent during the challenge.

Participants receiving ABC-training were more likely to remain abstinent during the challenge. These initial results indicate that ABC-training could be a new valuable training-tool to test in a clinical context.