Relapse is a major risk in substance abuse disorders, which is closely related to craving for a substance, describing a strong urge for consumption. Cue-exposure therapy is an intervention aiming at the reduction of perceived craving by repeated confrontation. It is based on the assumption that craving drops after repeated exposure without the reinforcing experience elicited by consumption. In the present study, patients with alcohol dependency take part in nine cue-exposure training sessions. Each session consists of mood induction reflecting a high risk situation with subsequent in vivo confrontation with one's preferred alcoholic beverage followed by the training of coping strategies. During the cue-exposure, patients focus on perceiving automatic responses to alcohol-related cues. We hypothesize that especially patients exhibiting initially high reactions to such cues should profit from this intervention the most. The reactions are measured on a subjective (craving) and physiological level (hemodynamics of the prefrontal cortex, heart rate variability, electrodermal activity). Furthermore, we want to strengthen the expected training effects during the cue-exposure by an activating transcranial direct current stimulation of the dorsolateral prefrontal cortex, which has been shown to be hypoactive in substance abuse disorders. We investigate how the cue-exposure training affects the processing of alcoholic cues (cue-reactivity) and its relation to clinical symptoms of alcohol dependency.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
48
2 mA (verum group) over the left dorsolateral prefrontal cortex (F3, anodal), 15 min; 10 seconds ramp in verum and sham group (see also above)
5 weeks (9 sessions) of cue-exposure therapy with preferred alcoholic beverage (see also above)
Department of Psychiatry and Psychotherapy, University Hospital Tuebingen
Tübingen, Baden-Wurttemberg, Germany
RECRUITINGalcohol consumption days
Time frame: six months
Maximum subjective alcohol craving during alcohol cue-exposure (10-point scale)
During alcohol cue-exposure, subjects rate the subjective craving regularly on a scale from 0 to 10.
Time frame: 5 weeks
subjective rating of self-efficacy (score on a 10 item-scale)
questionnaire (General Self-Efficacy Scale, Schwarzer \& Jerusalem, 1995)
Time frame: 6 months
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