Confusion, Blues but Marchin’ on: what is the state of Cognitive Bias Modification in addiction?

Abstract

Cognitive Bias Modification (CBM) is a family of add-on interventions that has opened up new ways of addiction treatment by retraining maladaptive, automatic cognitive processes underlying addictive behaviours. Seminal applications of CBM in alcohol inpatients demonstrated beneficial effects and many studies in different types of addictions and populations have been published in the past two decades. In spite of being a promising low-threshold treatment and the accumulating empirical evidence, CBM has recently been subject of debates and critiques. Recent meta-analyses reported contradicting results regarding its clinical effectiveness. CBM effects are inconsistent across studies and seem to vary for different patient groups and addiction disorders, complicating the corroboration of its effectiveness. Furthermore, when participants are not intrinsically motivated to change, CBM interventions seem to fail in stimulating behaviour change. This symposium will present original CBM studies challenging existing limitations, testing novel training and research approaches and exploring new contexts of applicability. The main goal is twofold: critically highlighting how some of the issues affecting CBM may be addressed and stimulating innovative thinking on ways forward. The symposium will initially target problems in the systematic review of empirical evidence on CBM effectiveness, by also comparing frequentist and Bayesian meta-analytical approaches. The focus will shift to the fine-tuning of training paradigms for excessive drinking, with a talk bringing CBM research back to the lab to investigate how evaluative conditioning differentially affects explicit and implicit attitudes, followed by the presentation of the results from a large scale RCT investigating varieties of automatic inhibitory control training. The last two presentations include two CBM studies with diverse populations and methodologies: one factorially combining two CBM interventions for cannabis and alcohol use amongst youths within juvenile detention centres, and one adopting a single-case experimental approach evaluating the changing effects of combining CBM with motivational interviewing in smokers.