Approach bias modification in inpatient psychiatric smokers

Machulska, Alla; Zlomuzica, Armin; Rinck, Mike; Assion, Hans‐Jörg

doi:10.1016/j.jpsychires.2015.11.015

Cited by 59 publications

(78 citation statements)

References 35 publications

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“…Such a criterion shift could also happen when an entire category is more salient than another. Given the previously reported increased risk of substance-related disorders in carriers of low-expressing DRD2 alleles (Morton et al, 2006; Doehring et al, 2009; Swagell et al, 2012; Voisey et al, 2012; also underpinned by a nominal TaqIA genotype effect on the smoking status in our cohort, see Table 1 ), the higher false alarm rate could also be considered a tendency to generalize reward-associated stimuli and to show a reduced ability to inhibit a response to such stimuli (see, for example, Machulska et al, 2016). This interpretation is also compatible with our previous observation in a motivated Go/Nogo learning task, in which TaqIA A1 carriers showed a selective deficit in learning the “NoGo-to-win” condition, i.e., the suppression of a motor response to obtain a reward (Richter et al, 2014).…”

Section: Discussionmentioning

confidence: 84%

Behavioral and Neural Manifestations of Reward Memory in Carriers of Low-Expressing versus High-Expressing Genetic Variants of the Dopamine D2 Receptor

et al. 2017

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Dopamine is critically important in the neural manifestation of motivated behavior, and alterations in the human dopaminergic system have been implicated in the etiology of motivation-related psychiatric disorders, most prominently addiction. Patients with chronic addiction exhibit reduced dopamine D2 receptor (DRD2) availability in the striatum, and the DRD2 TaqIA (rs1800497) and C957T (rs6277) genetic polymorphisms have previously been linked to individual differences in striatal dopamine metabolism and clinical risk for alcohol and nicotine dependence. Here, we investigated the hypothesis that the variants of these polymorphisms would show increased rewardrelated memory formation, which has previously been shown to jointly engage the mesolimbic dopaminergic system and the hippocampus, as a potential intermediate phenotype for addiction memory. To this end, we performed functional magnetic resonance imaging (fMRI) in 62 young, healthy individuals genotyped for DRD2 TaqIA and C957T variants. Participants performed an incentive delay task, followed by a recognition memory task 24 h later. We observed effects of both genotypes on the overall recognition performance with carriers of low-expressing variants, namely TaqIA A1 carriers and C957T C homozygotes, showing better performance than the other genotype groups. In addition to the better memory performance, C957T C homozygotes also exhibited a response bias for cues predicting monetary reward. At the neural level, the C957T polymorphism was associated with a genotype-related modulation of right hippocampal and striatal fMRI responses predictive of subsequent recognition confidence for reward-predicting items. Our results indicate that genetic variations associated with DRD2 expression affect explicit memory, specifically for rewarded stimuli. We suggest that the relatively better memory for rewarded stimuli in carriers of low-expressing DRD2 variants may reflect an intermediate phenotype of addiction memory.

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Section: Discussionmentioning

confidence: 84%

Behavioral and Neural Manifestations of Reward Memory in Carriers of Low-Expressing versus High-Expressing Genetic Variants of the Dopamine D2 Receptor

et al. 2017

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“…Recent research shows that it is not only possible to measure cognitive biases using computer-based tasks, but that such tasks have also merit in modifying existing cognitive biases to promote healthier behavior or abstinence from drug use [12]. In this instance, the Approach-Avoidance Task (AAT; [20]) has proven particularly valuable in both measuring and modifying a drug-related approach bias [18,21]. During the task, different pictures are consecutively presented on a computer screen and participants are instructed to ignore image content and to pull or push a joystick attached to the computer depending on a content-irrelevant feature of the task (i.e., pull all images rotated to the left and push all images rotated to the right).…”

Section: Introductionmentioning

confidence: 99%

“…Lately, the AAT has been adapted to a training variant by changing the contingency between picture content and arm movements, namely by presenting all drug-related pictures in push-away format and all neutral pictures in pull-closer format, thus training automatic avoidance in response to drug-related stimuli. Recently, we applied four sessions of AATtraining as an add-on to a brief smoking cessation intervention to a sample of inpatient psychiatric smokers [21]. Compared to sham training where smoking-related pictures had to be pulled and pushed equally often, the AAT-training led to a larger reduction of nicotine consumption at a threemonth follow-up.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, participants are required to keep multiple training appointments, which begs the question of whether individuals are able to maintain adherence to a daily or weekly training prescription. Indeed, preliminary evidence suggests that high dropout rates are an issue of concern in CBM studies (e.g., [28,21,29]. The second reason for rather small training effects concerns the ecological validity of the training tasks.…”

Section: Introductionmentioning

confidence: 99%

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Retraining automatic action tendencies for smoking using mobile phone-based approach-avoidance bias training: Study protocol for a randomized controlled study

Machulska

Kleinke

Eiler

et al. 2019

Preprint

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Background: Automatic tendencies to approach drug-related cues have been linked to the development and maintainance of harmful drug taking behavior. Recent studies have demonstrated that these automatic approach tendencies can be targeted directly by means of Cognitive Bias Modification (CBM) approaches. Moreover, changing those approach tendencies may enhance treatment outcomes. However, training and therapy effects tend to be rather small and adherence to the training might be impaired by time-consuming multiple lab-training sessions. Here, we present a protocol for a randomized control design to improve CBM training efficiency and facilitate access to the training by providing mobile phone-based training sessions at home to current smokers motivated to quit smoking. Methods: Participants (n = 100) are current smokers who smoke at least 6 cigarettes per day for at least 6 months and are willing to quit smoking. All participants attend a brief behavioral smoking cessation intervention (TAU) and are randomly assigned either to an experimental (TAU + training) or a control group. Participants in the experimental condition are given access to a training app aimed at retraining automatic approach biases for smoking cues. Participants are instructed to perform the app-training outside the laboratory context on a daily basis for 14 consecutive days. Participants in the control group do not receive the training. Primary outcome measures are changes in smoking-related approach biases and reductions in daily nicotine consumption as assessed at baseline, post-training and at a six-week follow-up. Secondary outcome measures include approach biases for alternative stimuli or smoking stimuli to which participants were not exposed during training, attentional and association biases, biochemical outcomes, and self-reported smoking behavior, also measured at three different time points (baseline, post-training, follow-up). After completion of the study, smokers in the control condition will receive access to the training app. Discussion: This RCT is the first to test the effectiveness of an app-based CBM intervention as an adjunct to a brief smoking cessation intervention in smokers motivated to quit smoking. The results of this study can inform future research in the optimisation and advancement of CBM treatment for addiction. Trial registration: Registered with Current Controlled Trials: study ID ISRCTN15690771. Registered on 20 November 2018; http://www.isrctn.com/ISRCTN15690771 Key words: Approach Bias, Cogitive Bias Modification, cigarette smoking, nicotine addiction, Randomized Control Trial, smartphone apps

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“…Cognitive bias modification (CBM) aims at changing these automatic tendencies towards problematic stimuli, subsequently improving maladaptive behavior. Promising effects have been shown in alcohol-dependent subjects and smokers 8,15,16 , where a CBM intervention decreased approach bias towards problematic stimuli while reducing consumption thereof. Regarding eating behavior, research has produced mixed findings 17 .…”

Section: Introductionmentioning

confidence: 99%

Unhealthy Yet Avoidable – How Cognitive Bias Modification Alters Behavioral And Brain Responses To Food Cues In Obesity

Mehl

Morys

Villringer

et al. 2018

Preprint

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ObjectiveObesity is associated with automatically approaching problematic stimuli, such as unhealthy food. Cognitive bias modification (CBM) could beneficially impact on problematic approach behavior. However, it is unclear which mechanisms are targeted by CBM in obesity: Candidate mechanisms include (1) altering reward value of food stimuli or (2) strengthening inhibitory abilities.Methods33 obese people completed either CBM or sham training during fMRI scanning. CBM consisted of an implicit training to approach healthy and avoid unhealthy foods.ResultsAt baseline, approach tendencies towards food were present in all participants. Avoiding vs. approaching food was associated with higher activity in the right angular gyrus (rAG). CBM resulted in a diminished approach bias towards unhealthy food, decreased activation in the rAG, and increased activation in the anterior cingulate cortex. Relatedly, functional connectivity between the rAG and right superior frontal gyrus increased. Analysis of brain connectivity during rest revealed training-related connectivity changes of the inferior frontal gyrus and bilateral middle frontal gyri.ConclusionTaken together, CBM strengthens avoidance tendencies when faced with unhealthy foods and alters activity in brain regions underpinning behavioral inhibition.

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Approach bias modification in inpatient psychiatric smokers

Cited by 59 publications

References 35 publications

Behavioral and Neural Manifestations of Reward Memory in Carriers of Low-Expressing versus High-Expressing Genetic Variants of the Dopamine D2 Receptor

Behavioral and Neural Manifestations of Reward Memory in Carriers of Low-Expressing versus High-Expressing Genetic Variants of the Dopamine D2 Receptor

Retraining automatic action tendencies for smoking using mobile phone-based approach-avoidance bias training: Study protocol for a randomized controlled study

Unhealthy Yet Avoidable – How Cognitive Bias Modification Alters Behavioral And Brain Responses To Food Cues In Obesity

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