Alcohol Use Disorder
Conditions
Brief summary
This proposed R21, Effect of CBT Microinterventions on Mechanisms of Behavior Change among Adults with AUD: Using Eye Tracking to Measure Pre-Post Cognitive Control, uses a translational team science approach to isolate and examine the effect of three different Cognitive Behavioral Therapy (CBT) interventions (functional analysis (FA), cognitive restructuring for alcohol related thoughts (CR), and dealing with cravings (DC)) on specific hypothesized mechanisms (cognitive control, stimulus salience, or craving/arousal, respectively).
Detailed description
This R21 uses an innovative paradigm pairing a microintervention design with eye tracking laboratory tasks used successfully to show deficits of cognitive control over cocaine and nicotine cues, and to objectively measure stimulus salience and craving/arousal in response to alcohol cues. To achieve the study's two specific aims, participants with AUD will be assessed with antisaccade (to measure cognitive control) and attentional bias (to measure stimulus salience and pupil diameter) eye tracking tasks. Specific Aim 1. To isolate and preliminarily assess the impact of specific CBT microinterventions on potentially malleable hypothesized mechanisms of change in drinking using a novel laboratory paradigm and conducted by a translational science team. Specific Aim 2. To test specificity of CBT interventions' effect on particular Mechanisms of Behavioral Change, the investigators will test each microintervention's effects on all three purported mechanisms (as stated in Brief Summary.)
Interventions
BEHAVIORALControl
60 minute psycho-education on alcohol and drugs.
BEHAVIORALFunctional Analysis
Component of standard CBT that helps to break the chain of events (external and internal) that lead from cue (trigger) to alcohol use to consequences of use.
BEHAVIORALCognitive Restructuring
CR is used to to help identify and change automatic, habituated thoughts that occur in response to alcohol triggers.
BEHAVIORALDealing With Cravings
DC is used reduce cravings for alcohol by conjuring negative images associated with alcohol, teaching distraction techniques, and teaching breathing techniques to reduce physiological arousal.
Sponsors
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
University of Massachusetts, Worcester
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
4 arms: 3 CBT microinterventions + control condition
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18 or older * Current Alcohol Use Disorder (AUD) Diagnosis * Drank Alcohol within 60 days prior to telephone screen * Able to read and understand English at the 7th grade education level
Exclusion criteria
* Participant diagnosed with Schizophrenia or Schizoaffective Disorder * Participant has a head injury with symptoms in the last 30 days * Current inpatient or outpatient treatment for AUD or Drug use Disorder (DUD)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in Drinking Behavior | Weekly for up to 3 weeks | Changes in drinking behavior are measured by tracking eye movement patterns using antisaccade + attentional bias eyetracking tasks. Specifically, outcome mediators include changes in cognitive control (# of errors in antisaccade eye-tracking task), changes in stimulus salience (stimulus dwell time measurements), and changes in craving/arousal (pupil diameter changes in response to stimuli presentation.) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Alcohol Use Questionnaire (AUQ) | Weekly for up to 3 weeks | AUQ is an 8-item questionnaire that measures self-reported craving for alcohol. Item scores range from 1-7 and a total score, ranging from 8-56, is calculated by summing all values. Higher scores indicate greater craving. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Working Alliance Inventory Short Form | Week 2 appointment out of 3 week program | 12-item self-report measure of the therapeutic alliance. Total scales are calculated by summing all values. Values range from 1-7 with total scores ranging from 12 to 84. Higher scores indicate greater alliance. |
| Barratt Impulsivity Questionnaire | Weekly for up to 3 weeks | The Barratt is a 30-item questionnaire that measures self-reported general impulsivity. Item scores range from 1-4 and a total score, ranging from 30-120, is calculated by summing all values. There are three sub scales (Attentional, Motor, and Nonplanning) which are derived from individual items. Higher scores indicate greater attentional, motor, and nonplanning impulsivity and scores range from 8 to 32, 11 to 44, and 11 to 44, respectively. |
| Use of Treatment Skills (UTS) | Week 3 appointment out of 3 week program | UTS is an 18-item questionnaire that measures adherence to microintervention homework assigned at week 2 appointment. Item scores range from 0 to 4 and a total score, ranging from 0 to 72, is calculated by summing all values. Higher values indicate greater adherence to assigned homework. |
| Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) | Measurement taken at baseline | 19 item self-report questionnaire assessing client readiness for change. An additional item assesses the client's motivation for coming to therapy. Item scores range from 1 to 5 and a total score, ranging from 19 to 95, is calculated by summing all values. There are three sub scales (Recognition, Ambivalence, and Taking Steps) which are derived from individual items. Higher scores indicate greater recognition, ambivalence and taking steps and scores range from 7 to 35, 4 to 20, and 8 to 40, respectively. |
| Treatment Services Review | Given at Week 2 and Week 3 appointments out of 3 week program | Interview assessing quantity and type of services received (e.g., health, psychological) outside of study intervention. Total scores are calculated by summing the number of outside services used. Total scores have a minimum of 0 and no maximum value. |
Countries
United States
Outcome results
None listed