Short summary

The current study examines the effectiveness of virtual-reality-based approach-avoidance training program (AATP) delivered to patients with alcohol use disorder (AUD).

Rationale

The approach-avoidance training program (AATP) has shown preliminary promise as an add-on to standard treatment for alcohol dependence. However, knowledge is lacking as to whether the effectiveness of AATP can be enhanced further when performed in a typical drinking situation. The main aim of this study is to investigate whether approach-avoidance training implemented in a virtual-reality bar environment is superior to the classical joystick PC-version of the AATP.

Description of the cohort

The study will be implemented as a multi-site, randomized controlled trial. A total of 204 consecutively enrolled alcohol use disorder (AUD) patients, recruited from alcohol inpatient clinics across Germany (n = 68), Poland (n = 68), and Denmark (n = 68), will be allocated into one of three groups at the start of standard alcohol treatment: group A) stimulus-relevant AATP delivered on a PC; group B) stimulus-relevant AATP delivered in a virtual reality environment; and group C) treatment as usual (TAU; control group). Treatment outcomes will be assessed at pre-treatment, post-treatment and 3-month follow-up. Generalized mixed-models will be applied to compare the trajectories of the groups over time on drinking, craving and impulsiveness outcomes. It is hypothesized that the two experimental groups will achieve better treatment outcomes compared to group C, and it is also hypothesised that group B will achieve better outcomes than group A.

Data and biological material

The following data will be collected: Sociodemographic variables, alcohol consumption, psychiatric symptoms, comorbid disorders, behavioural inhibition, approach bias, cue-induced cravings, and response inhibition.

Collaborating researchers and departments

Neuroplasticity Research Group, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

• Dr. Leonie Ascone, clinical psychologist, neuroscientist
• Janina Wirtz, doctoral research fellow, M.Sc. neuropsychologist
• Friedrich Schadow, game designer & UX researcher
• Dr. Simone Kühn, professor of neural plasticity

Department of Psychiatry Pomeranian Medical University in Szczecin Poland, Szczecin, Poland

• Dr. Jerzy Samochowiec, professor of psychiatry
• Dr. Jolanta Kucharska-Mazur, professor of psychiatry

Research Unit of Psychiatry, Department of Clinical Research, University of Southern Denmark

• Anette Søgaard Nielsen, associate professor
• Nicolaj Mistarz, PhD student, psychologist

Publications associated with the project

Mellentin, A.I., Nielsen, A.S., Ascone, L. et al. A randomized controlled trial of a virtual reality based, approach-avoidance training program for alcohol use disorder: a study protocol. BMC Psychiatry 20, 340 (2020).