Modification of Automatic Alcohol‐Approach Tendencies in Alcohol‐Dependent Patients with Mild or Major Neurocognitive Disorder

• Published in: Alcoholism, clinical and experimental research clinical and experimental research, 2018-01, Vol.42 (1), p.153-161
• Main Authors: Loijen, Anke, Rinck, Mike, Walvoort, Serge J. W., Kessels, Roy P. C., Becker, Eni S., Egger, Jos I. M.
• Format: Article
• Language: English
• Subjects: Alcohol; Alcohol use; Alcohols; Approach‐Avoidance; Avoidance; Cognition; Cognitive ability; Cognitive bias modification; Cognitive tasks; Drug dependence; Korsakoff; Learning; Memory
• ISSN: 0145-6008; 1530-0277
• DOI: 10.1111/acer.13529

Background To examine the applicability of an alcohol‐avoidance training procedure in patients with alcohol dependence and alcohol‐induced neurocognitive disorders (NDs), we trained 2 groups that differed in the degree of cognitive impairment: One group fulfilled the DSM‐5 criteria for alcohol‐induced mild ND, and 1 group was diagnosed with Korsakoff's syndrome (KS) (alcohol‐induced major ND, confabulatory/amnesic subtype; DSM‐5). The intervention is assumed to match the preserved cognitive capacity for implicit learning in both groups. Methods Fifty‐one inpatients with a mild ND and 54 inpatients with KS were trained. Six training sessions (including pre‐ and posttests) of a computerized implicit alcohol approach‐avoidance task were applied. Neurocognitive variables were available from the standard assessment procedure of the clinic. Results Training of alcohol‐avoidance tendencies is feasible in a population with alcohol‐related NDs. The alcohol‐approach bias decreased for both groups in each session. Better learning results over time were obtained in participants with a larger baseline alcohol‐approach tendency. Learning effects were positively related to age and implicit (nondeclarative) memory functioning. No relation between training effects and executive or explicit memory functions was found. Conclusions Training of an alcohol‐avoidance tendency can be successfully applied in patients with alcohol dependence including those with alcohol‐induced NDs. Our results show that alcohol‐avoidance training indeed depends on more implicit processes: Learning effects are related to implicit and not to explicit memory functioning, and not to executive functioning. Session‐to‐session training effects indicate that patients with alcohol‐related neurocognitive disorders (including Korsakoff's syndrome) can also be trained, opening up the research field of cognitive bias modification procedures to patient populations with psychopathology‐related neurocognitive disorders.