Alcohol Dependency
Conditions
Brief summary
Relapse is a major risk in substance abuse disorders, which is closely related to craving for a substance, describing a strong urge for consumption. Cue-exposure therapy is an intervention aiming at the reduction of perceived craving by repeated confrontation. It is based on the assumption that craving drops after repeated exposure without the reinforcing experience elicited by consumption. In the present study, patients with alcohol dependency take part in nine cue-exposure training sessions. Each session consists of mood induction reflecting a high risk situation with subsequent in vivo confrontation with one's preferred alcoholic beverage followed by the training of coping strategies. During the cue-exposure, patients focus on perceiving automatic responses to alcohol-related cues. We hypothesize that especially patients exhibiting initially high reactions to such cues should profit from this intervention the most. The reactions are measured on a subjective (craving) and physiological level (hemodynamics of the prefrontal cortex, heart rate variability, electrodermal activity). Furthermore, we want to strengthen the expected training effects during the cue-exposure by an activating transcranial direct current stimulation of the dorsolateral prefrontal cortex, which has been shown to be hypoactive in substance abuse disorders. We investigate how the cue-exposure training affects the processing of alcoholic cues (cue-reactivity) and its relation to clinical symptoms of alcohol dependency.
Interventions
DEVICEtDCS
2 mA (verum group) over the left dorsolateral prefrontal cortex (F3, anodal), 15 min; 10 seconds ramp in verum and sham group (see also above)
BEHAVIORALCue Exposure Therapy
5 weeks (9 sessions) of cue-exposure therapy with preferred alcoholic beverage (see also above)
Sponsors
University Hospital Tuebingen
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Clinical diagnosis of an alcohol dependence (F10.2) * abstinence motivation
Exclusion criteria
* epileptic seizures * acute psychotic episode * another substance use disorder besides nicotine dependency (F17.2) * acute withdrawal symptoms
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| alcohol consumption days | six months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Maximum subjective alcohol craving during alcohol cue-exposure (10-point scale) | 5 weeks | During alcohol cue-exposure, subjects rate the subjective craving regularly on a scale from 0 to 10. |
| subjective rating of self-efficacy (score on a 10 item-scale) | 6 months | questionnaire (General Self-Efficacy Scale, Schwarzer & Jerusalem, 1995) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Hemodynamics in the orbitofrontal cortex and the dorsolateral prefrontal cortex during cue-exposure | 5 weeks | With near-infrared spectroscopy, changes in the concentrations of oxygenated (O2HB) and deoxygenated (HHb) haemoglobin are assessed (in mmol\*mm), peaks in those concentrations are evaluated |
| heart-rate variability during alcohol cue-exposure | 5 weeks | low frequency/ high frequency (LF/HF) power ratio and standard deviation of the duration between R-peaks (RR) during cue-exposure |
| Skin conductance level during alcohol cue exposure | 5 weeks | skin conductance level (SCL) in Mikrosiemens (μS) |
Countries
Germany
Contacts
Primary ContactAgnes Kroczek, Dipl.-Psych.
Outcome results
None listed