The effect of approach bias modification on cue-reactivity in individuals with cannabis use disorder (CUD)

Abstract

Background: Evidence suggests that biases in cognitive processing of drug-related stimuli are central to the development and maintenance of addiction. The current study examines the effect of approach bias modification (ABM) on approach bias and cannabis cue-reactivity, and seeks to advance novel interventions for CUD. Methods: A randomized, double-blind, sham-controlled pilot study investigated the effect of a 4-session computerized ABM paradigm on cue-reactivity (N=33) in non-treatment seeking adults with CUD. ABM procedures utilized a cannabis adaptation of the Alcohol Approach-Avoidance Task, which requires subjects to push or pull a joystick in response to a non-content related stimulus feature (i.e. border color) and uses a zoom feature to simulate approach or avoidance behavior. Generalized linear mixed models were used to examine the effect of ABM on approach bias, cue-reactivity, and cannabis use. Findings: Participants receiving ABM showed a trend for blunted cannabis cue-induced craving at the end of treatment compared to controls (p = 0.065). A gender effect on cannabis use was also found; men receiving ABM reported fewer sessions per day at the end of treatment compared to women (p = 0.022), while there were no differences in the control group. Approach bias did not differ between groups at end of treatment or follow-up. Discussion: This pilot data indicates that ABM may be efficacious in reducing cue-reactivity and improving cannabis use outcomes, and that gender may moderate this effect. The efficacy of ABM as an adjunct to psychosocial interventions warrants investigation in larger clinical trials in treatment-seeking adults with CUD.