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      A Test of Multi-Session Automatic Action Tendency Retraining to Reduce Alcohol Consumption among Young Adults in the Context of a Human Laboratory Paradigm

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          Abstract

          Background

          Young adult heavy drinking is an important public health concern. Current interventions have efficacy but with only modest effects, thus novel interventions are needed. In prior studies, heavy drinkers, including young adults, have demonstrated stronger automatically triggered approach tendencies to alcohol-related stimuli than lighter drinkers. Automatic action tendency retraining has been developed to correct this tendency and consequently reduce alcohol consumption. The current study is the first to test multiple iterations of automatic action tendency retraining, followed by laboratory alcohol self-administration.

          Methods

          A total of 72 non-treatment-seeking, heavy drinking young adults ages 21–25 were randomized to automatic action tendency retraining or a control condition (i.e., “sham training”). Of these, 69 (54% male) completed 4 iterations of retraining or the control condition over 5 days with an alcohol drinking session on Day 5. Self-administration was conducted according to a human laboratory paradigm designed to model individual differences in impaired control (i.e., difficulty adhering to limits on alcohol consumption).

          Results

          Automatic action tendency retraining was not associated with greater reduction in alcohol approach tendency or less alcohol self-administration than the control condition. The laboratory paradigm was probably sufficiently sensitive to detect an effect of an experimental manipulation given the range of self-administration behavior observed, both in terms of number of alcoholic and non-alcoholic drinks and measures of drinking topography.

          Conclusions

          Automatic action tendency retraining was ineffective among heavy drinking young adults without motivation to change their drinking. Details of the retraining procedure may have contributed to the lack of a significant effect. Despite null primary findings, the impaired control laboratory paradigm is a valid laboratory-based measure of young adult alcohol consumption that provides the opportunity to observe drinking topography and self-administration of non-alcoholic beverages (i.e., protective behavioral strategies directly related to alcohol use).

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          Most cited references41

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          Assessment of Alcohol Withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar)

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            Consequences of Automatic Evaluation: Immediate Behavioral Predispositions to Approach or Avoid the Stimulus

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              Retraining automatic action tendencies changes alcoholic patients' approach bias for alcohol and improves treatment outcome.

              This study tested the effects of a new cognitive-bias modification (CBM) intervention that targeted an approach bias for alcohol in 214 alcoholic inpatients. Patients were assigned to one of two experimental conditions, in which they were explicitly or implicitly trained to make avoidance movements (pushing a joystick) in response to alcohol pictures, or to one of two control conditions, in which they received no training or sham training. Four brief sessions of experimental CBM preceded regular inpatient treatment. In the experimental conditions only, patients' approach bias changed into an avoidance bias for alcohol. This effect generalized to untrained pictures in the task used in the CBM and to an Implicit Association Test, in which alcohol and soft-drink words were categorized with approach and avoidance words. Patients in the experimental conditions showed better treatment outcomes a year later. These findings indicate that a short intervention can change alcoholics' automatic approach bias for alcohol and may improve treatment outcome.
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                Author and article information

                Journal
                7707242
                365
                Alcohol Clin Exp Res
                Alcohol. Clin. Exp. Res.
                Alcoholism, clinical and experimental research
                0145-6008
                1530-0277
                3 March 2018
                12 March 2018
                April 2018
                01 April 2019
                : 42
                : 4
                : 803-814
                Affiliations
                [1 ]University of Florida
                [2 ]Yale School of Medicine
                [3 ]University of Amsterdam
                [4 ]Swedish Medical Center
                [5 ]Yale University
                Author notes
                Correspondence to: Robert Leeman, Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Box 118210, Gainesville, FL 32611 Tel: (352) 294-1808; Fax: (352) 392-1909; robert.leeman@ 123456ufl.edu

                DR. ROBERT F. LEEMAN (Orcid ID: 0000-0002-7003-8907)

                DR. KELLY S. DEMARTINI (Orcid ID: 0000-0003-0943-2507)

                Article
                PMC5995797 PMC5995797 5995797 nihpa942940
                10.1111/acer.13613
                5995797
                29450895
                2f794b8c-c2bd-499e-beca-2233eaca06d2
                History
                Categories
                Article

                alcohol self-administration,cognitive bias retraining,automatic action tendency retraining,young adult,impaired control over alcohol use

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