Developing digital interventions for a post-Covid world: A smartphone- based approach-avoidance training to reduce alcohol craving.

This article provided proof of concept and randomized control data for a novel smartphone version of the Approach Avoidance Task (AAT). Patients with addiction disorders show preferential bias towards drug stimuli (faster to approach, longer to avoid) in lab-based AAT. This bias towards stimuli that are associated with drug use is thought to increase craving and eventual drug use. One method of altering this bias is through cognitive bias modification (CBM). Here, the research team assessed their novel gamified CBM intervention to determine the possible efficacy of home-based training. In the proof of concept study, 62 UK-based adults who consumed 14+ units of alcohol per week were either waitlisted (n = 32) or received the training (n = 30). Image-induced craving decreased from baseline at a 1-day follow-up in the training group (p = 0.007) but not the waitlist group (p = 0.102). In the subsequent experiment, 118 individuals who consumed 20+ units of alcohol per week were randomly assigned to the novel training (n = 56) or active control (n = 62). Training effects at a 1-week follow-up revealed a decrease in prior week risky alcohol behavior  (p = 0.007) and alcohol craving (p = 0.003). However, training did not reduce image-induced craving (p = 0.108) or alter alcohol stimuli bias (all p > 0.05). This data provides support for the use of this novel smartphone-delivered training in reducing cravings for alcohol and weekly risk for use. However, the lack of impact on alcohol approach bias remains an open area of research. Due to the limitations in this population, a larger study is currently being conducted by the authors using individuals seeking treatment for alcohol use.