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CUE EXPOSURE

 

 

 

Professor, MD, PhD, Chief Consultant, Head of Research Unit Bent Nielsen, Department of Psychiatry, OUH Odense University Hospital, Region of Southern Denmark / Research Unit of Psychiatry, University of Southern Denmark

Description of the cohort

It is well documented that individuals with alcohol dependence respond well during Cognitive Behavioural Therapy, but that a large proportion of individuals relapse after treatment when confronted with alcohol in real life. Therefore, future treatment interventions for long-term prevention of relapse should aim to teach how to apply coping strategies and regain control over their alcohol cravings in their daily confrontations with alcohol and associated stimuli.

Cue Exposure Treatment (CET) is a behavioural psychological approach that focuses on confronting alcohol cues in order to reduce cravings as well as the likelihood of relapse. During CET individuals are exposed to alcohol related stimuli whilst their usual drink responses are hindered. Thus, they are given the opportunity to practice coping strategies during exposure to alcohol. In this way, it is predicted that individual’s learned automatic responses will extinguish over time and that their cognitive control over cue reactivity strengthens.

The objective of the study is two-fold:

  1. To investigate whether manual-based CET delivered via a smartphone or in group sessions increases the efficiency of outpatient treatment in groups of alcohol dependent individuals.
  2. To investigate whether CET as a smartphone application is as or more effective than CET group therapy.

The study is implemented as a single-blind randomized controlled trial. A total of 300 consecutively enrolled alcohol dependent individuals, recruited from an alcohol outpatient clinic will be randomized to one of the three following aftercare treatment groups: (1) CET as a smartphone application; (2) CET as group therapy, and (3) Standard aftercare treatment. Individuals in group 1 are required to use the smartphone application five times a week for eight weeks. Individuals in group 2 are required to have CET group therapy every other week for eight weeks. Individuals in group 3 will receive one individual follow-up session eight weeks after the primary treatment has ended.

It is hypothesized that the two experimental groups will achieve better treatment outcomes as compared to the control group (3).

 

Data

The groups will be compared pre- and post-aftercare treatment, according to the following parameters:

  1. Relapse and alcohol intake, as measured with Addiction Severity Index (ASI), and Time-Line-Follow-Back (TLFB); as measured with Addiction Severity Index (ASI), and Time-Line-Follow-Back (TLFB);
  2. Cravings, measured with Desires for Alcohol Questionnaire (DAQ), Obsessive-Compulsive Drinking Scale (OCDS), and Visual Analogue Scale for Craving (VAS); measured with Desires for Alcohol Questionnaire (DAQ), Obsessive-Compulsive Drinking Scale (OCDS), and Visual Analogue Scale for Craving (VAS);
  3. Coping skills and self-efficacy, operationalized with Urge-Specific Strategies Questionnaire (USS), Craving Beliefs Questionnaire (CBQ), Alcohol Abstinence Self-Efficacy Scale (AASE), and Profile of Mood States (POMS). operationalized with Urge-Specific Strategies Questionnaire (USS), Craving Beliefs Questionnaire (CBQ),(AASE), and Profile of Mood States (POMS).
  4. as measured with Addiction Severity Index (ASI), and Time-Line-Follow-Back (TLFB); measured with Desires for Alcohol Questionnaire (DAQ), Obsessive-Compulsive Drinking Scale (OCDS), and Visual Analogue Scale for Craving (VAS); operationalized with Urge-Specific Strategies Questionnaire (USS), Craving Beliefs Questionnaire (CBQ),(AASE), and Profile of Mood States (POMS).

Data will be collected at three different time-points: before entering aftercare treatment (baseline), after eight weeks (follow-up), and again after six month (follow-up). Intention-to-treat analyses (ITT) will be carried out for all outpatients.

OPEN's data manager develops electronic schemes for data entry. Data will be imported and stored in OPEN Projects.

Data from registers: The National Patient Register, The National Health Service Register, The National Prescription Registry and The Psychiatric Central Research Register.

Collaborating researchers and departments

  • Department of Psychiatry, OUH Odense University Hospital / Research Unit of Psychiatry, University of Southern Denmark
    • Alcohol Treatment Center, Odense Municipal
      • Department of Biostatistics, University of Southern Denmark
        • Faculty of Health, Aalborg University/Institute of Organization and Industrial Sociology, Copenhagen Business School
          • The Mads Clausen Institute, University of Southern Denmark
            • Institute of Regional Health Services Research, University of Southern Denmark

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