The aim of this study was to evaluate the effectiveness of a mobile game application targeting attentional bias modification for alcohol stimuli in patients with Alcohol Use Disorder. Attentional bias is the tendency for individuals to pay more attention to some environmental stimuli than others. Previous evidence suggests that attentional bias for alcohol stimuli is associated with severity of drinking and craving. The research questions are as follows; * Does the developed mobile game application reduce the attentional bias related to alcohol? * Does the developed mobile game application reduce alcohol craving severity? * Does the developed mobile game application reduce the severity of alcohol drinking? The researchers will evaluate the effectiveness of the mobile game, which aims to reduce attentional bias to alcohol stimuli, as standard treatment for Alcohol Use Disorder (medical treatment) versus standard treatment + mobile game application group. Participants, * Comply with the medical treatment prescribed by the doctor * Use the mobile gaming app every other day for one month * Come back in a month for an evaluation * Be available for a telephone interview three months after the first interview
Alcohol Use Disorder (AUD) is a significant public health problem that has far-reaching consequences for the well-being of individuals, families, and society. Recent studies have demonstrated that attentional bias for alcohol-related stimuli is associated with several variables, including alcohol craving, alcohol consumption behavior, and relapse following treatment. Therefore, interventions aimed at modifying attentional bias for alcohol cues have been a subject of scholarly interest. The literature shows that, in addition to psychotherapeutic strategies, computerized versions of conventional attentional bias assessment instruments-referred to as Attentional Bias Modification (ABM)-have been utilized to decrease alcohol-related attentional bias. Some research indicates that ABM training produces results similar to psychotherapeutic treatments. ABM has the benefits of fewer interaction demands, time, and geographical limitations. Gamified ABM methods have displayed encouraging impacts in decreasing craving, substance use, and relapse in different types of addiction. Nevertheless, research assessing gamified ABM treatments in people specifically diagnosed with AUD is still limited. Due to this shortage, an investigation of the effectiveness of gamified ABM treatments for AUD is deemed both timely and essential. Notably, most current ABM games for AUD have been created for desktop and laptop computers. Considering the extensive availability of mobile devices, providing such treatments through mobile devices will likely boost reach and user acceptance. To meet these requirements, the current study created a gamified mobile ABM treatment to decrease attentional bias for alcohol cues in patients diagnosed with AUD. In the first phase, qualitative content analysis was gathered, and expert and patient feedback on the game was analyzed. The game was adjusted, and its final version was prepared according to this feedback. The game's efficacy was tested in a tertiary care hospital in a northwestern province of Türkiye. Sixty subjects were enrolled-30 in the intervention group and 30 in the control group. All the subjects were given standard medical therapy as prescribed by a physician. Besides, the intervention group was also asked to use the mobile game developed for altering alcohol-related attentional bias. They were told to play the game every other day for a month. The participants filled out the Penn Alcohol Craving Scale (PACS), the Alcohol Use Disorders Identification Test (AUDIT), and the Dot-Probe Task as pre- and post-tests. Three months following the post-test, follow-up data were gathered through phone interviews. Statistical analysis through chi-square tests, independent samples t-tests, and linear mixed models will be used to assess intervention efficacy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
60
The mobile game designed to modify attentional bias toward alcohol-related cues was developed by integrating game elements into a modified version of the dot-probe task. This gamified intervention was installed on the smartphones of participants assigned to the experimental group, and each participant was provided with a unique username and password for access. Participants were instructed to engage with the mobile game every other day over one month.
Medicines prescribed by a doctor for the treatment of Alcohol Use Disorder (Akamprosat or Naltrekson or combined medical treatment (Akamprosat and Naltrekson))
Erenköy Ruh Ve Sinir Hastaliklari Eğitim Ve Araştirma Hastanesi
Istanbul, Turkey (Türkiye)
Dot-Probe Task
The Dot-Probe Task was used to assess attentional bias toward alcohol cues. The procedure was built using E-Prime 3.0 and conducted via laptop. Each trial began with a fixation cross (1000 ms), followed by alcohol-neutral image pairs for another 500 ms, displayed on opposite sides of the screen. Ninety-two culturally relevant beverage images (46 alcohol, 46 non-alcohol) were used, including beer, wine, rakı, whiskey, water, soda, cola, and iced coffee. The experiment consisted of three blocks of 46 trials. Participants were instructed to identify the location of a probe, appearing where one image had been, by pressing the left or right arrow key as quickly as possible. A four-trial practice block preceded the task. Reaction time differences between probes replacing alcohol vs. neutral cues were used to calculate attentional bias scores. Higher bias scores indicated increased attention toward alcohol-related stimuli.
Time frame: Average 30 days: measurement before intervention (Time 1), 4 weeks after intervention, immediately after intervention measurement (Time 2)
The Penn Alcohol Craving Scale (PACS)
The Penn Alcohol Craving Scale (PACS) is a self-report instrument to assess the intensity of alcohol craving during the past week. It evaluates five dimensions of craving: frequency, intensity, duration, resistance, and overall craving. The scale consists of five items under a single subdimension. Each item is scored on a scale from 0 to 6, yielding a maximum total score of 30. Higher scores indicate greater levels of alcohol craving.
Time frame: Average 30 days: pre-intervention measurement (Time 1), 4 weeks intervention, immediately after the intervention measurement (Time 2), Three months after Time 2 (Time 3)
The Alcohol Use Disorders Identification Test (AUDIT)
The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item questionnaire designed to gather information on alcohol consumption, dependency, and related consequences over the past year. Each question offers 3 to 5 response options that categorize the frequency and amount of alcohol use. The total score is calculated by summing the numerical values assigned to each selected response. A total score of 8 or above indicates harmful use, while a score of 16 or above reflects a high-risk level. At the start of the study, this scale was used to include participants who scored 8 or higher. The AUDIT-C, comprising the first three items of the original AUDIT scale, was utilized as a pre-test, post-test, and follow-up assessment tool.
Time frame: Average 30 days: pre-intervention measurement (Time 1), 4 weeks intervention, immediately after the intervention measurement (Time 2), Three months after Time 2 (Time 3)
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