Cognitive Bias Modification targeting the cannabis and alcohol consumption of youth in juvenile detention centers

Abstract

Background: Juvenile delinquents use more drugs compared to general population youth, and persist when detained. CBM may be particularly useful in treating drug-use in this population, as they are impulsive and show poor behavioural control. This study investigates the feasibility and effectiveness of CBM for this population, targeting two predominantly used substances. Methods: 173 Dutch youth admitted to 6 facilities since 2014 (91.4% male; M-age = 18.35). Participation was voluntary. Participants were selected on CUDIT-R and AUDIT scores and completed five sessions of genuine or placebo versions of either attention-bias or approach-bias CBM, targeting cannabis or alcohol (based on severity of use). Substance use was assessed via self-report of lifetime and past-year frequencies. CUDIT-R and AUDIT were re-administered after 12 months. Follow-up data collection finishes March 2017. Bias scores were tested with One-Sample T-tests. Next, groups were formed based on severity of use. Attention data was analysed using simple ANOVAs, approach data with Mixed ANOVAs. Findings: Attention-bias medians differed significantly from 0 for both total cannabis and alcohol users, and for at-risk cannabis users, but approach-bias medians did not. CUDIT-R scores of at-risk cannabis users correlated positively with both cannabis (.20) and control (.24) stimuli reaction times. Casual users’ usage correlated positively with control reaction times (.54). Discussion: Initial results indicate an attention-bias for cannabis but no approach-bias, particularly for at-risk users. Usage strongly correlated with control stimuli reaction times for casual users, suggesting that escalation of use impairs disengagement from cannabis cues. Insufficient severe alcohol users for significant effects.