The Alcohol Cue Exposure and Virtual Reality Project

All participants (even those in the active control group) complete a single 2-2.5 hour assessment session with a provisionally registered psychologist. This involves completing an online Qualtrics survey containing self-report questionnaires and a gamified battery of neuropsychological tests designed to assess expert-endorsed executive functions most relevant to addictions. The Qualtrics survey, which is completed at baseline / the beginning of the neuropsychological assessment, contains questions regarding the individual's demographic and clinical characteristics, such as age, sex, age of first full serve of alcohol, etc. It also contains clinical and drinking-related questionnaires such as those used to evaluate intervention outcomes, such as the Penn Alcohol Craving Scale to measure craving; Depression, Anxiety, and Stress Scale to measure psychological distress; and the Brief Situational Confidence Questionnaire to measure alcohol-related self-efficacy. Participants also complete the Test of Premorbid Functioning at baseline, which provides an estimate of their premorbid functioning (i.e., overall level of cognitive functioning before the onset of any illness or injury). The gamified cognitive assessment battery (Lee et al., 2023) features gamified versions of the following tasks: Stop Signal Task (SST) to measure response inhibition; Value-Modulated Attentional Capture Task (VMAC) to measure reward-related attentional bias, and the additional reversal component of the task (VMAC-R) measures persistence of reward-related attentional bias or cognitive inflexibility; Sequential Decision-Making Task (SDT) to measure habitual decision-making; Balloon Analogue Risk Task (BART) to measure risky decision-making; and the Delay Discounting Task (DDT) to measure delay discounting, that is, the extent to which the value of a reward decreases as the delay to obtaining that reward increases. These tasks are completed on a computer in the assessment room under the observation of the provisionally registered psychologist. Fifteen participants will be randomly selected to receive personalised neuropsychological feedback two weeks following the assessment. Feedback is provided both verbally (i.e., a 30-minute telephone session) and in written format (i.e., in the form of a short two-page letter/report) emailed to the participant at the beginning of their telephone feedback session. Individuals in the intervention group receive feedback on their levels of drinking, coping, craving, and drinking motives, as well as on their cognitive profile (i.e., their neurocognitive test performances). The feedback involves both normative and within-individual/premorbid comparisons. Individuals also receive psychoeducation regarding how their current cognitive functioning impacts their specific drinking patterns and vice versa. Alcohol harm reduction strategies are also provided during the telephone call and listed on the feedback letter, accompanied by follow-up, Australian alcohol and other drug (AOD) and crisis hotlines. Alcohol harm reduction strategies included those commonly listed on Australian government websites, such as "Drink water or other non-alcohol beverages between alcoholic drinks".