A new experimental method has proven effective in changing the drinking behaviour of alcoholics. ‘Cognitive Bias Modification-training’ may, in addition to conventional behavioural therapy, reduce the automatic action tendencies towards alcohol. These are the findings of research conducted by psychologists at the University of Amsterdam (UvA), the Salus Clinic in Lindow (Germany) and Radboud University published this week in the scientific journal Psychological Science.
Prof. Dr. Reinout Wiers, professor of Developmental Psychopathology at the UvA, has devised a new method of intervention, a retraining based on Cognitive Bias Modification (CBM). The basic idea of CBM is direct manipulation of a cognitive bias, which is thought to play a crucial role in mental disorders such as alcoholism. In collaboration with researchers at Radboud University and the Salus Clinic, Wiers tested the retraining of the approach response in a large group of alcoholic patients (214 in total).
The patients were randomly assigned to an experimental group or a control group. Prior to the regular treatment - conventional behavioural therapy - the patients in the experimental group followed four short training sessions with CBM. employing video-game-like ‘approach-avoidance tasks’: pushing or pulling a joystick in response to images on a screen. They pushed the joystick in reaction to images related to alcohol and pulled when seeing images of soft drinks and water. Pulling zooms in on the image, as if the participant were ‘approaching’ it. Pushing zooms out, in ‘avoidance.’ Patients in the control group, who did a ‘sham’ training, pulled and pushed the joystick equally in response to alcohol. Part of the control group did no training (which made no difference). The action tendency (the tendency to show certain behavior) only changed to an automatic avoidance response towards alcohol in the case of the experimental group. Before the training, the majority of the patients largely associated alcohol with ‘approaching’, and this only changed to associating alcohol with ‘avoidance’ in the case of the experimental group. These were the findings of, among other things, several tests with automatic associations. The group that received minimal experimental intervention in addition to the normal treatment, showed better treatment outcomes after one year (with less cases of relapse).
Effects of automatic cognitive processes
Neurocognitive models of psychopathology suggest that disturbances in information processing play an important role in the onset and maintenance of various psychiatric disorders. The development of alcohol addiction caused several known biases: an attention bias for alcohol (anything to do with alcohol, holds the attention of a heavy drinker), automatic memory associations and the action tendency to approach alcohol. Wiers and colleagues have now designed experimental methods to influence all these biases. These methods complement existing behavioural treatments, trying to make people aware of irrational thoughts and replacing them with functional thoughts. Although cognitive behavioral therapy has proven effective in treating drug addiction, it appears that this intervention is not always effective in influencing automatic cognitive processes. This makes people susceptible to relapse. The findings of Wier and colleagues suggest that a short-CBM intervention in addition to conventional treatment approach can change the automatic response to alcohol and may improve treatment outcome.
Reinout W. Wiers, Carolin Eberl, Mike Rinck, Eni S. Becker, Johannes Lindenmeyer: ‘Re-training automatic action tendencies changes alcoholic patient’s approach bias for alcohol and improves treatment outcome’, in Psychological Science, March 2011.
Note to editors
For more information, please contact Prof. Reinout Wiers, email: R.W.H.J.Wiers@uva.nl.