AABM to Decrease Problem Drinking and Impulsivity in Veterans With AUD: A Pilot Study
Condition: Alcohol Use Disorder
MeSH terms: Alcoholism; Impulsive Behavior
Study type: Interventional

Summary: 
      The proposed study is a pilot prospective, parallel groups, randomized, double blind, sham
      training-controlled, 9-session (over 3 weeks) clinical trial of AABM in 32 male and female
      veterans entering treatment for AUD at the VA Medical Center at San Francisco, California,
      between ages 18-65. The study consists of screening, 3-week AABM training, Week-4 post-test,
      and Week-12 follow-up. Assessment of inhibitory control, alcohol approach bias and craving
      will be administered at baseline and Week-4. Immediately following screening, patients will
      be randomly assigned to receive 9 sessions of real or sham AABM training (16 subjects each)
      taking place over three weeks. Following the 3 weeks of training, patients will complete a
      Week-4 post-test which includes assessment of alcohol approach bias, inhibitory control, and
      craving and a Week-12 follow-up assessing drinking behavior.
    

Detailed description: 
      The overall goal of the proposed project is to improve the treatment of veterans who consume
      alcohol at hazardous or harmful levels. We will conduct a pilot controlled clinical trial to
      assess the feasibility and acceptability of implementing an Alcohol Approach Bias
      Modification (AABM) task in veterans seeking outpatient treatment for alcohol use disorder
      (AUD). The investigators will also explore the efficacy of AABM to reduce alcohol use and
      enhance executive function. The proposed study is designed to test AABM as a novel,
      acceptable, safe, low-cost intervention to augment and boost the efficacy of standard
      outpatient treatment for reducing alcohol use and simultaneously improving executive function
      in veterans with AUD.

      The proposed project will pursue three primary aims in veterans with an AUD who are drinking
      alcohol at hazardous or harmful levels: 1) Establish the feasibility of enrolling and
      retaining veterans with AUD for a 3-week randomized trial of AABM; 2) Obtain preliminary
      assessment of the efficacy of AABM treatment to decrease alcohol approach bias and alcohol
      use; 3) Obtain preliminary assessment of the efficacy of AABM treatment to improve
      neurocognitive functioning domains that typically show deficits in AUD populations. To
      achieve these aims, we will conduct pilot prospective, parallel groups, randomized, double
      blind, sham training-controlled, 9-session (over 3 weeks) clinical trial of AABM in 32 male
      and female veterans entering treatment for AUD at the San Francisco VA Medical Center. We
      expect that this study will provide empirical data for recruitment, attrition and effect size
      estimation for a future randomized trial to definitively test that AABM reduces alcohol use
      and improves executive function in veterans with AUD. Moreover, findings from the proposed
      project are expected to improve the care of veterans with AUD, and by extension, to aid
      families and communities affected by the sequelae of these problems.
    

Intervention name(s): AABM Training; Sham Training
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The investigators will use a training version of the Alcohol Approach-Avoidance Task (AAT), in which patients are asked to respond to the format of presented pictures, irrespective of the pictures' content. Pushing a presented picture away will decrease picture size, whereas pulling a picture closer will increase size. There are 2 categories of pictures; 20 different alcoholic and 20 different non-alcoholic beverages. Training effect is achieved by presenting alcohol pictures in push format only and non-alcoholic drinks in pull format only. Two hundred training trials are presented per session.; Sham training is identical to AABM training, except pictures are presented randomly in both formats.
Other intervention name(s): AABM
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment