Learning to Resist the Urge: Inhibition Training in Abstinent Patients With Alcohol Use Disorders
Condition: Alcohol Dependence
MeSH terms: Alcoholism; Alcohol Drinking
Study type: Interventional

Summary: 
      The study aims to investigate the effects of a short computerized training as a therapeutic
      add-on to standard therapy in patients with alcohol-use disorder.
    

Detailed description: 
      Therapeutic interventions to treat alcohol use disorders (AUD) still need to be improved. A
      novel alcohol-specific inhibition-training seems to be a promising new intervention. In this
      study, recently abstinent patients with AUD attending an inpatient treatment program will be
      randomly assigned to one of two alcohol-specific inhibition-training groups (varying in
      Go/NoGo-ratio) or to a control condition. Besides the effects on drinking behavior,
      inhibition and implicit attitudes, the investigators expect the training to influence
      neurophysiological reactivity to alcohol related stimuli. A subgroup of patients will
      therefore additionally undergo EEG recording so that the neurophysiological effects of the
      training can be assessed and related to clinical outcome. Furthermore, since training effects
      rely on learning processes, the influence of endogenous cortisol level (a
      consolidation-enhancer which peaks in the morning) on training outcome will be examined by
      the variation of daytime of the training. All patients' inhibitory control and implicit
      associations towards alcohol will be measured before and after training. The training effects
      will be examined on proximal outcome variables (e.g. implicit associations, inhibitory
      control, abstinence related self-efficacy, craving) and on distal outcome variables at 3-, 6-
      and 12- months follow-up (e.g. percent abstinent days (primary outcome)).
    

Intervention name(s): Alc-IT (50/50) (morning); Alc-IT (75/25) (morning); Control-training (morning); Alc-IT (50/50) (afternoon); Alc-IT (75/25) (afternoon); Control-training (afternoon)
Intervention type(s): Behavioral; Behavioral; Behavioral; Behavioral; Behavioral; Behavioral
Intervention description(s): This alcohol-specific inhibition-training (Alc-IT) training group will operate with a Go/NoGo ratio of 50/50 (Houben et al. 2011; 2012): This original version of the Alc-inhibition-training will include 80 alcoholic NoGo trials as well as 80 non-alcoholic Go trials. In order to arrive at the same training length while keeping the number of Alc-NoGo-pairings constant and the Go/NoGo-ratio at 50/50, it will additionally include 80 neutral Go-trials as well as 80 neutral NoGo-trials. It will thus consist of 320 trials and take about 10.5 minutes to be completed. In the morning group, this training will be administered within the first 2 hours after awakening.; This version of the alcohol-specific inhibition-training (Alc-IT) will operate with a Go/NoGo-ratio of 75/25. It will equally include 80 Alcoholic NoGo-trials and 80 non-alcoholic Go-trials, but now 160 neutral Go-trials will complete the set. This training will also consist of 320 trials and take about 10.5 minutes. In the morning group, this training will be administered within the first 2 hours after awakening.; This group will receive an unspecific inhibition training. this training is of the same length and difficulty as the two Alc-inhibition-trainings. In the morning group, this training will be administered within the first 2 hours after awakening.; As in the arm "Alc-IT (50/50) (morning)", this alcohol-specific inhibition-training (Alc-IT) group will operate with a Go/NoGo ratio of 50/50 (Houben et al. 2011; 2012): This original version of the Alc-inhibition-training will include 80 alcoholic NoGo trials as well as 80 non-alcoholic Go trials. In order to arrive at the same training length while keeping the number of Alc-NoGo-pairings constant and the Go/NoGo-ratio at 50/50, it will additionally include 80 neutral Go-trials as well as 80 neutral NoGo-trials. It will thus consist of 320 trials and take about 10.5 minutes to be completed. In contrast to the In the morning group, this afternoon group will receive the training in the afternoon.; As in the arm "Alc-IT (75/25) (morning)", this version of the alcohol-specific inhibition-training (Alc-IT) will operate with a Go/NoGo-ratio of 75/25. It will equally include 80 Alcoholic NoGo-trials and 80 non-alcoholic Go-trials, but now 160 neutral Go-trials will complete the set. This training will also consist of 320 trials and take about 10.5 minutes. In contrast to the In the morning group, this afternoon group will receive the training in the afternoon.; As in the arm "Control-training (morning), this group will receive an unspecific inhibition training. This training is of the same length and difficulty as the two Alc-inhibition-trainings. In contrast to the In the morning group, this afternoon group will receive the training in the afternoon.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Alcohol use disorders; inhibition; EEG; cortisol; Training; clinical outcome measures