title: Approach bias modification in inpatient psychiatric smokers.
abstract: Drug-related automatic approach tendencies contribute to the development and maintenance of addictive behavior. The present study investigated whether a nicotine-related approach bias can be modified in smokers undergoing inpatient psychiatric treatment by using a novel training variant of the nicotine Approach-Avoidance-Task (AAT). Additionally, we assessed whether the AAT-training would affect smoking behavior. Inpatient smokers were randomly assigned to either an AAT-training or a sham-training condition. In the AAT-training condition, smokers were indirectly instructed to make avoidance movements in response to nicotine-related pictures and to make approach movements in response to tooth-cleaning pictures. In the sham-training condition, no contingency between picture content und arm movements existed. Trainings were administered in four sessions, accompanied by a brief smoking-cessation intervention. Smoking-related self-report measures and automatic approach biases toward smoking cues were measured before and after training. Three months after training, daily nicotine consumption was obtained. A total of 205 participants were recruited, and data from 139 participants were considered in the final analysis. Prior to the trainings, smokers in both conditions exhibited a stronger approach bias for nicotine-related pictures than for tooth-cleaning pictures. After both trainings, this difference was no longer evident. Although reduced smoking behavior at posttest was observed after both trainings, only the AAT-training led to a larger reduction of nicotine consumption at a three-month follow-up. Our preliminary data partially support the conclusion that the AAT might be a feasible tool to reduce smoking in the long-term in psychiatric patients, albeit its effect on other smoking-related measures remains to be explored.
authors.affiliation: Ruhr-Universität Bochum, Germany.
authors.forename: Alla
authors.initials: A
authors.lastname: Machulska
authors.affiliation: Ruhr-Universität Bochum, Germany.
authors.forename: Armin
authors.initials: A
authors.lastname: Zlomuzica
authors.affiliation: Ruhr-Universität Bochum, Germany; Behavioral Science Institute, Radboud University Nijmegen, The Netherlands.
authors.forename: Mike
authors.initials: M
authors.lastname: Rinck
authors.affiliation: LWL-Klinik Dortmund, Germany.
authors.forename: Hans-Jörg
authors.initials: HJ
authors.lastname: Assion
authors.affiliation: Ruhr-Universität Bochum, Germany. Electronic address: juergen.margraf@rub.de.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Margraf
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001362:Avoidance Learning; D001521:Behavior Therapy / Q000379:methods*; D015982:Bias; D003463:Cues; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000627:therapeutic use; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D018722:Nicotinic Agonists; D009538:Nicotine
keywords: Addiction; Approach; Avoidance; Cognitive bias modification; Nicotine dependence; Smoking cessation