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Study to assess preliminary efficacy of cognitive bias modification for alcohol use disorders

Dr Poppy Watson was awarded $40,000 in the 2019 round of UNSW Medicine Neuroscience, Mental Health and Addiction Theme and Maridulu Budyari Gumal – SPHERE Clinical Academic Group (CAG) Collaborative Research Seed Funding for the project, Cognitive bias modification for enhancing treatment efficacy in alcohol use disorder: pilot study of an adapted protocol aimed at reducing relapse rates.

image - Study to assess preliminary efficacy of cognitive bias modification for alcohol use disorders

Name: Dr Poppy Watson

Position/s: Postdoctoral researcher in the School of Psychology, UNSW

How has the Neuroscience, Mental Health and Addiction Theme and CAG enabled you to develop your research interests?

The Neuroscience, Mental Health and Addiction Theme and CAG research seed funding is allowing me to translate research knowledge into clinical practice. My research is focused on understanding how previous experience with rewards (such as food or addictive substances) shapes our attention and choice behaviour. I am increasingly directing this research towards understanding (and intervening with) unhealthy behaviours, such as those linked with compulsive overeating or addiction. The project funding allows me to take my current research interests outside of the lab and into the clinic which is an exciting development in my program of research. As an early career researcher I am also taking the important step of demonstrating my leadership capabilities as project lead - whilst receiving full support and mentoring from my postdoctoral supervisor (Associate Professor Mike Le Pelley, UNSW).

Your project, Cognitive bias modification for enhancing treatment efficacy in alcohol use disorder: pilot study of an adapted protocol aimed at reducing relapse rates was successful in the 2019 round of Theme and CAG collaborative research seed funding. Can you please tell us about the project?

Alcohol use disorders (AUD) are highly prevalent and debilitating, and standard treatment rates are poor. Cognitive biases, such as difficulty in ignoring cues in the environment that signal the availability of alcohol, are argued to contribute to relapse in AUD. In recent years, cognitive bias modification (CBM) protocols have been developed in order to re-train and reduce these cognitive biases towards alcohol. These protocols involve simple computer tasks where participants are repeatedly trained to turn their attention (or responding) away from alcohol and towards non-alcohol related drinks. A number of studies have now demonstrated that offering CBM alongside treatment as usual (approximately 4-6 sessions over the course of two weeks) can reduce the rate of relapse one year later, relative to patients in an active control group. Although promising, the effect sizes are small and there is scope to improve the current CBM protocols. We are planning to run a pilot study here in Sydney among alcohol-dependent patients to compare the preliminary efficacy of a revised protocol for CBM in reducing rate of relapse, compared to an active control.  In addition, all treatment providers will be interviewed in regards to implementation issues and future strategies that could improve delivery of CBM in the clinical context.

What impact do you imagine the project will have?

First and foremost we hope that relapse rates after individuals leave treatment facilities are significantly reduced as a result of the CBM training. CBM offers a simple yet effective way to improve treatment outcomes for the large numbers of Australians suffering from an AUD and the study will inform as to the feasibility of upscaling CBM across clinical groups within NSW. Notably, the CBM approach is not restricted to alcohol but can be modified for other drugs of abuse in addition to anxiety and disordered eating, so validation of the revised CBM protocol will have wider implications. In sum, the project has the potential to deliver significant health outcomes and opportunities for future development and roll-out.

How will the project support new collaborations?

Pulling together the proposal involved making new connections with many researchers and clinical-facing experts which has been fantastic. Dr Katrina Prior (Matilda Centre, University of Sydney) and Dr Janette Smith (NDARC, UNSW) were so generous in introducing me to potential collaborators in the clinical domain and the enthusiasm that everyone feels for the project has been really positive. Senior researchers who have pioneered this work in Europe and Australia have already provided so much input in terms of study design and providing materials, it truly is a collaborative effort. Everyone benefits from this project with those in more clinical roles excited at the potential of the project and having real input to ensure that translation to the clinical setting is optimised. Early and mid-career researchers are benefitting from mentoring by senior clinicians and academics. I am sure that this project is the start of many collaborations between this stellar team.