scholarly journals Challenges When Evaluating Cognitive Bias Modification Interventions for Substance Use Disorder

2020 ◽  
Vol 17 (21) ◽  
pp. 7821
Author(s):  
Melvyn W. B. Zhang ◽  
Helen E. Smith
Keyword(s):  
Substance Use ◽  
Cognitive Bias ◽  
Cognitive Biases ◽  
Cognitive Bias Modification ◽  
Bias Assessment ◽  
Unconscious Processes ◽  
Negative Findings ◽  
Bias Modification ◽  
Modification Intervention ◽  
Selection Of

In recent years, advances in experimental psychology have led to a better understanding in automatic, unconscious processes, referred to as attentional and approach biases amongst individuals with substance use disorders. Attentional biases refer to the relatively automatic tendencies for attention to be preferentially allocated towards substance-related cues. Whereas, approach bias refers to the relatively automatic behavioral tendencies of individuals to reach out to substance-related cues in their natural environment. While, several reviews confirm the existence of these biases, and the effectiveness of bias modification, the conduct of cognitive bias modification amongst substance-using individuals is not without its challenges. One of these is that cognitive biases, both attentional and approach biases, are not universally present; and several individual differences factors modulate the magnitude of the biases. Another challenge that investigators faced in their conduct of cognitive bias modification relates to the selection of the appropriate task for bias assessment and modification. Other challenges intrinsic to cognitive bias modification intervention relates to that of participant attrition, much like conventional psychotherapies. Negative findings, of the absence of biases at baseline, or the lack of effectiveness of bias modification have been reported in studies of cognitive bias modification. All these challenges could have an impact on bias assessment and modification. In this perspective paper, we will explore the literature surrounding each of these challenges and discuss potential measures that could be undertaken to mitigate these clinical and research challenges.

scholarly journals A dismantling study on imaginal retraining in smokers

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Steffen Moritz ◽  
Josefine Gehlenborg ◽  
Janina Wirtz ◽  
Leonie Ascone ◽  
Simone Kühn
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Cognitive Bias ◽  
Mood Induction ◽  
Cognitive Bias Modification ◽  
Significant Decline ◽  
Behavioral Addictions ◽  
Multiple Components ◽  
Before And After ◽  
Bias Modification

AbstractImaginal retraining is a noncomputerized variant of cognitive bias modification, an intervention aimed at reducing craving in substance use disorders and behavioral addictions. We conducted a dismantling study to elucidate which of its multiple components are effective and hence essential ingredients of the training and which are ineffective (and hence perhaps dispensable) in reducing craving. We randomized 187 smokers to one out of six conditions that instructed participants to perform a brief intervention. In four of these, participants were instructed to perform isolated components of the imaginal retraining protocol, and in the two other conditions participants either suppressed or simply observed (control condition) the image of a cigarette. Before and after the intervention, participants were asked to rate their level of craving and how pleasant they found three smoking-related images. We examined within-group changes by means of paired t-tests separately across conditions (trial registration: DRKS00021044). Mental distancing from cigarettes (without a corresponding actual physical movement; non-motor retraining) led to a significant decline in craving (paired t-test), which remained significant when compared to the control condition. The effects of other components of the retraining were less consistent. The present study shows that a single therapeutic “dose” of distinct components involved in imaginal retraining can reduce craving for cigarettes. Future trials should investigate the effectiveness of components of imaginal retraining not yet tested (e.g., mood induction) and whether combinations and repetition of single components strengthen or dilute efficacy.

scholarly journals A Question of Control? Examining the Role of Control Conditions in Experimental Psychopathology using the Example of Cognitive Bias Modification Research

2017 ◽  
Vol 20 ◽  
Author(s):  
Simon E. Blackwell ◽  
Marcella L. Woud ◽  
Colin MacLeod
Keyword(s):  
Cognitive Bias ◽  
Clinical Utility ◽  
Cognitive Biases ◽  
Cognitive Bias Modification ◽  
Experimental Psychopathology ◽  
And Control ◽  
Bias Modification ◽  
Experimental Modification ◽  
Translational Process

AbstractWhile control conditions are vitally important in research, selecting the optimal control condition can be challenging. Problems are likely to arise when the choice of control condition is not tightly guided by the specific question that a given study aims to address. Such problems have become increasingly apparent in experimental psychopathology research investigating the experimental modification of cognitive biases, particularly as the focus of this research has shifted from theoretical questions concerning mechanistic aspects of the association between cognitive bias and emotional vulnerability, to questions that instead concern the clinical efficacy of ‘cognitive bias modification’ (CBM) procedures. We discuss the kinds of control conditions that have typically been employed in CBM research, illustrating how difficulties can arise when changes in the types of research questions asked are not accompanied by changes in the control conditions employed. Crucially, claims made on the basis of comparing active and control conditions within CBM studies should be restricted to those conclusions allowed by the specific control condition employed. CBM studies aiming to establish clinical utility are likely to require quite different control conditions from CBM studies aiming to illuminate mechanisms. Further, conclusions concerning the clinical utility of CBM interventions cannot necessarily be drawn from studies in which the control condition has been chosen to answer questions concerning mechanisms. Appreciating the need to appropriately alter control conditions in the transition from basic mechanisms-focussed investigations to applied clinical research could greatly facilitate the translational process.

scholarly journals Design of a Cognitive Bias Modification eHealth app to improve implicit vitality in breast cancer patients: a co-creation process (Preprint)

2020 ◽  
Author(s):  
Roos Wolbers ◽  
Christina Bode ◽  
Ester Siemerink ◽  
Sabine Siesling ◽  
Marcel Pieterse
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cognitive Bias ◽  
Cognitive Biases ◽  
Cognitive Bias Modification ◽  
Self Control ◽  
Breast Cancer Patients ◽  
Structured Interviews ◽  
Cancer Related Fatigue ◽  
Bias Modification

BACKGROUND More than 50% of all breast cancer patients experience fatigue symptoms during and after their treatment course. Recent evidence shows that fatigue is partly driven by cognitive biases, such as the self-as-fatigued identity bias, which may be corrected with computer-based Cognitive Bias Modification (CBM) techniques. OBJECTIVE The aim of the current study was to design such a CBM-training by adopting a co-creation approach. METHODS Semi-structured interviews were conducted with seven health professionals, three breast cancer patients and two patient advocates. Aim of the interviews was to collect input for the design of the CBM-training, taking the values and preferences of the stakeholders into account and to determine the timing and implementation of the training in the treatment course. RESULTS Overall, the interviews showed that the concept of CBM was accepted among all stakeholders. Important requirements were revealed, such as that the training needs to be simple, undemanding, yet engaging and persuasive. Based on the results, eHealth app IVY (Implicit VitalitY) was created. Interviews suggested that IVY should be offered early in the treatment course and should be carefully aligned with clinical treatment. CONCLUSIONS Using CBM to target cancer-related fatigue in a preventive approach is an innovative technique, which is embraced by breast cancer stakeholders. The current study suggests CBM has several benefits, such as being easy to use, and potentially increasing perceived self-control in patients. CLINICALTRIAL

scholarly journals Emotional Bias Modification in Youths with Attention Deficit Hyperactivity Disorder (ADHD): New Research Vista

2020 ◽  
Vol 17 (11) ◽  
pp. 4028
Author(s):  
Zhang Melvyn ◽  
Aloysius Chow ◽  
Ranganath Vallabhajosyula ◽  
Daniel SS Fung
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Cognitive Bias ◽  
Attention Deficit ◽  
Cognitive Biases ◽  
Preliminary Evidence ◽  
Cognitive Bias Modification ◽  
Emotional Dysregulation ◽  
Future Research ◽  
Hyperactivity Disorder ◽  
Bias Modification

Whilst cognitive bias modification was initially used in the treatment of anxiety disorders, it is also currently being used for the treatment of other psychopathologies. In fact, cognitive bias modification has been especially well-investigated amongst children and adolescents. A recent review suggests some evidence for the modification of interpretative biases amongst children with neurodevelopment disorders. There have since been other studies reporting of the existence of other cognitive biases, such as emotional biases, amongst individuals with attention deficit hyperactivity disorder (ADHD). This perspective article will discuss the epidemiology of ADHD and the nature of emotional biases that are present amongst individuals with ADHD. This perspective article also reviewed some of the studies that have assessed and modified emotional biases in individuals with ADHD. A total of three studies have been identified from the published literature that provide evidence for targeting emotional biases amongst individuals with ADHD. These studies provide us with preliminary evidence for the effectiveness of modifying emotional biases and how it could help in ameliorating symptoms related to emotional dysregulation. There needs to be future research in this area with further evidence supporting the effectiveness of modifying emotional biases. It is also crucial for future research to determine which of these tools is best at detecting such biases, and which of these tools are versatile enough and non-invasive that they could safely be implemented for both research and clinical needs.

scholarly journals Cognitive Bias Modification for Interpretation in Major Depression

2015 ◽  
Vol 3 (1) ◽  
pp. 126-139 ◽  
Author(s):  
Jutta Joormann ◽  
Christian E. Waugh ◽  
Ian H. Gotlib
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Cognitive Bias ◽  
Cognitive Biases ◽  
Stress Reactivity ◽  
Physiological Stress ◽  
Cognitive Bias Modification ◽  
Major Depressive ◽  
Physiological Stress Response ◽  
Bias Modification

Interpreting ambiguous stimuli in a negative manner is a core bias associated with depression. Investigators have used cognitive bias modification for interpretation (CBM-I) to demonstrate that it is possible to experimentally induce and modify these biases. In this study, we extend previous research by examining whether CBM-I affects not only interpretation but also memory and physiological stress response in individuals diagnosed with major depressive disorder. We found that CBM-I was effective in inducing an interpretive bias. Participants also exhibited memory biases that corresponded to their training condition and demonstrated differential physiological responding in a stress task. These results suggest that interpretation biases in depression can be modified and that this training can lead to corresponding changes in memory and to decreases in stress reactivity. Findings from this study highlight the importance of examining the relations among different cognitive biases in major depressive disorder and the possibility of modifying cognitive biases.

Applying the ‘Cognitive Bias Modification’ concept to smoking cessation – A Systematic Review

2016 ◽  
Vol 62 (6) ◽  
pp. 333-354 ◽  
Author(s):  
Stephan Mühlig ◽  
Jeanine Paulick ◽  
Johannes Lindenmeyer ◽  
Mike Rinck ◽  
Reto Cina ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Substance Use ◽  
Cognitive Bias ◽  
Routine Care ◽  
Cognitive Bias Modification ◽  
Smoking Behaviour ◽  
Cochrane Library ◽  
Approach Bias ◽  
Clinical Databases ◽  
Bias Modification

Abstract. Background: In recent years, new neurocognitive explanatory approaches such as dual-process theories offer significant progress in understanding long-term relapse in substance use disorders. Based on such explanatory concepts stemming from basic research, novel methods of intervention have been deduced which focus on directly changing cognitive biases. The efficacy of these Cognitive Bias Modification (CBM) concepts has been evaluated in a growing number of studies in the context of different substance use and addictive disorders. By now, there are also first findings for using CBM in the context of smoking. Objectives: To evaluate the empirical evidence, whether CBM qualifies i) for reducing attentional or approach bias towards smoking-related cues, ii) for effectively reducing the high relapse rates in smoking cessation, iii) for the reduction of smoking behaviour and iv) craving. Methods: The systematic evidence search has been carried out in clinical databases (Cochrane Library, PsycArticles, PSYNDEX, PsycINFO, Medline) as well as via manual reverse search. Finally, 12 studies have been identified which met the inclusion criteria (RCT, CBM interventions for smokers; outcomes: change in attentional or approach bias, craving, number of cigarettes smoked, abstinence). Results: Despite the heterogeneity of the studies in terms of sample selection, realisation of interventions and methodological aspects, the findings collectively indicate that different forms and ‘dosages’ of CBM interventions can influence attentional or approach bias in smokers. Also, positive effects on craving and motivation to quit could be detected. Effects on smoking behaviour are inconsistent and often statistically non-significant. First online applications showed encouraging results. Discussion: The results concerning the efficacy of CBM in smoking cessation are still rudimentary and inconsistent. However, a large portion of the studies was not conducted under naturalistic conditions, but rather in laboratories with non-treatment seekers or participants partially motivated to quit. Despite these limitations, the findings can be evaluated as encouraging. The results suggest that CBM will be implemented in routine care as an adjunct intervention within a behavioural therapy-oriented cessation programme. However, specific studies which assess the efficacy of CBM as a component for relapse prevention in smoking cessation intervention in routine care are still lacking.

Development of a co-designed gamified attention bias modification app for individuals with opioid use disorder

2020 ◽  
pp. 1-6
Author(s):  
Melvyn W.B. Zhang ◽  
Sandor Heng ◽  
Guo Song ◽  
Daniel S.S. Fung ◽  
Helen E. Smith
Keyword(s):  
Cognitive Bias ◽  
Therapeutic Option ◽  
Attention Bias ◽  
Cognitive Bias Modification ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Attention Bias Modification ◽  
Prior Review ◽  
Bias Modification ◽  
Modification Intervention

BACKGROUND: The advances in experimental psychology in the last decade have led to a greater understanding of cognitive bias, and the investigation of cognitive bias modifications as a therapeutic option. Whilst conventionally such interventions are delivered in a laboratory, technological advances are changing the potential modes of delivery of these interventions. Whereas mobile delivery of interventions might seem to increase accessibility and encourage compliance, this might not be the case for cognitive bias modification interventions. To reduce boredom, researchers have investigated whether gamification of the task could help reduce repetitiveness, and the diminished motivation that participants had over time. In a prior review of cognitive bias modification interventions, a collaboration between academics and developers was recommended to ensure that the developed product is evidence-based. With the increased recognition of the importance of participatory action research, participants could better help conventional intervention to meet their needs. OBJECTIVE: The aim of this article was to describe the iterative steps in the conceptualization of the co-designed gamified cognitive bias modification intervention for individuals with opioid use disorders. METHODS AND RESULTS: A multidisciplinary team worked through the differences in the perspectives offered by healthcare professionals and patient participants, and jointly worked with a developer to conceptualize a new co-designed gamified attention bias modification intervention. The methods shared in this article could be considered and applied to future conceptualization of co-designed interventions.

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