Imaginal retraining reduces alcohol craving in problem drinkers: A randomized controlled trial.
Alcohol use disorder
Craving
Imagery
Retraining
Journal
Journal of behavior therapy and experimental psychiatry
ISSN: 1873-7943
Titre abrégé: J Behav Ther Exp Psychiatry
Pays: Netherlands
ID NLM: 0245075
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
25
11
2018
revised:
26
03
2019
accepted:
02
04
2019
pubmed:
10
5
2019
medline:
1
8
2020
entrez:
10
5
2019
Statut:
ppublish
Résumé
Retraining, a psychological intervention derived from the approach-avoidance paradigm, has yielded mixed results for the treatment of alcohol use disorder as well as other forms of addiction. The present study investigated the efficacy of an imaginal variant of retraining that allowed greater personalization of the content. Within the framework of a randomized controlled trial (RCT), 84 individuals with self-reported alcohol-related problems were recruited over the Internet and allocated to either imaginal retraining (treatment manual dispatched as a pdf-file via email) or a wait-list control group (with care-as-usual). The intervention period was four weeks. Alcohol craving, as measured with a visual analogue scale (VAS), served as the primary outcome. Other emotional (e.g. self-esteem) and drinking-related variables served as secondary outcomes. Both per-protocol (PP) and intention-to-treat (ITT) analyses showed that imaginal retraining led to a significant reduction in alcohol craving compared to the control group at a large effect size. Self-esteem improved in the retraining condition relative to controls in the PP and one of the ITT analyses; 75% of the individuals in the treatment group reported less alcohol consumption in the treatment period, whereas drinking behavior remained essentially unchanged in the control group (p < .001) (the trial was registered at the German Clinical Trials Register, DRKS00015319). Whether the effects of imaginal retraining are sustained over time needs to be established. Attrition was significantly higher in the retraining group (40.5%) than in the control group (16.7%). Designs with an active control condition are needed as well as dismantling studies to explore which of the treatment's multiple components best predicts improvement. Future studies should verify participants' alcohol consumption levels using objective measures. Imaginal retraining led to significant effects on the reduction of alcohol craving.
Sections du résumé
BACKGROUND AND OBJECTIVES
Retraining, a psychological intervention derived from the approach-avoidance paradigm, has yielded mixed results for the treatment of alcohol use disorder as well as other forms of addiction. The present study investigated the efficacy of an imaginal variant of retraining that allowed greater personalization of the content.
METHODS
Within the framework of a randomized controlled trial (RCT), 84 individuals with self-reported alcohol-related problems were recruited over the Internet and allocated to either imaginal retraining (treatment manual dispatched as a pdf-file via email) or a wait-list control group (with care-as-usual). The intervention period was four weeks. Alcohol craving, as measured with a visual analogue scale (VAS), served as the primary outcome. Other emotional (e.g. self-esteem) and drinking-related variables served as secondary outcomes.
RESULTS
Both per-protocol (PP) and intention-to-treat (ITT) analyses showed that imaginal retraining led to a significant reduction in alcohol craving compared to the control group at a large effect size. Self-esteem improved in the retraining condition relative to controls in the PP and one of the ITT analyses; 75% of the individuals in the treatment group reported less alcohol consumption in the treatment period, whereas drinking behavior remained essentially unchanged in the control group (p < .001) (the trial was registered at the German Clinical Trials Register, DRKS00015319).
LIMITATIONS
Whether the effects of imaginal retraining are sustained over time needs to be established. Attrition was significantly higher in the retraining group (40.5%) than in the control group (16.7%). Designs with an active control condition are needed as well as dismantling studies to explore which of the treatment's multiple components best predicts improvement. Future studies should verify participants' alcohol consumption levels using objective measures.
CONCLUSION
Imaginal retraining led to significant effects on the reduction of alcohol craving.
Identifiants
pubmed: 31071483
pii: S0005-7916(18)30318-5
doi: 10.1016/j.jbtep.2019.04.001
pii:
doi:
Banques de données
DRKS
['DRKS00015319']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
158-166Informations de copyright
Copyright © 2019. Published by Elsevier Ltd.