Development of a co-designed gamified attention bias modification app for individuals with opioid use disorder

2020 ◽  
pp. 1-6
Author(s):  
Melvyn W.B. Zhang ◽  
Sandor Heng ◽  
Guo Song ◽  
Daniel S.S. Fung ◽  
Helen E. Smith
Keyword(s):  
Cognitive Bias ◽  
Therapeutic Option ◽  
Attention Bias ◽  
Cognitive Bias Modification ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Attention Bias Modification ◽  
Prior Review ◽  
Bias Modification ◽  
Modification Intervention

BACKGROUND: The advances in experimental psychology in the last decade have led to a greater understanding of cognitive bias, and the investigation of cognitive bias modifications as a therapeutic option. Whilst conventionally such interventions are delivered in a laboratory, technological advances are changing the potential modes of delivery of these interventions. Whereas mobile delivery of interventions might seem to increase accessibility and encourage compliance, this might not be the case for cognitive bias modification interventions. To reduce boredom, researchers have investigated whether gamification of the task could help reduce repetitiveness, and the diminished motivation that participants had over time. In a prior review of cognitive bias modification interventions, a collaboration between academics and developers was recommended to ensure that the developed product is evidence-based. With the increased recognition of the importance of participatory action research, participants could better help conventional intervention to meet their needs. OBJECTIVE: The aim of this article was to describe the iterative steps in the conceptualization of the co-designed gamified cognitive bias modification intervention for individuals with opioid use disorders. METHODS AND RESULTS: A multidisciplinary team worked through the differences in the perspectives offered by healthcare professionals and patient participants, and jointly worked with a developer to conceptualize a new co-designed gamified attention bias modification intervention. The methods shared in this article could be considered and applied to future conceptualization of co-designed interventions.

scholarly journals Gamified M-Health Attention Bias Modification Intervention for Individuals with Opioid Use Disorder: Protocol for a Pilot Randomised Study

2020 ◽  
Vol 17 (3) ◽  
pp. 752 ◽  
Author(s):  
Melvyn W. B. Zhang ◽  
Sandor Heng ◽  
Syidda B. Amron ◽  
Zaakira Mahreen ◽  
Guo Song ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Rating Scale ◽  
Attention Bias ◽  
Opioid Use Disorder ◽  
Management Service ◽  
Opioid Use ◽  
Attention Bias Modification ◽  
Addictive Disorders ◽  
Randomised Study ◽  
Bias Modification

Introduction: Globally, there is an epidemic of opioid use disorders. Locally, in Singapore, there is an increase in the number of individuals abusing opioids. The advances in experimental psychology have highlighted the need to modify unconscious, automatic biases. These automatic, unconscious biases result in individuals having preferential attention to substance-related cues in their natural environment, thus leading to a slip or relapse back into their underlying addictive disorders. Prior studies have demonstrated not only the presence of robust attentional biases amongst individuals with opioid use disorder, even when maintained on methadone; and the effectiveness of bias modification amongst these individuals. There remains limited evaluation of attention bias modification amongst a treatment-seeking cohort of Asian individuals. The objective of this pilot is to ensure that the methods of the planned definitive randomized trial could be conducted. Methods and Analysis: A non-blinded pilot randomized trial will be conducted. A total of 30 participants will be randomized to receive either the conventional application or the newly designed co-designed application. In order to identify these 30 participants, 60 participants will be recruited and screened to determine if they have baseline biases. Participants will be recruited from the inpatient unit at the National Addictions Management Service (NAMS) Singapore. All participants who are enrolled into the trial will complete a baseline assessment task, and a bias modification assessment and modification task daily. They will have to complete a baseline demographic and clinical information questionnaire, as well as a cravings rating scale before and after the intervention daily. Perspectives—that of self-reported experiences—will be sought from the participants following their completion of three intervention tasks. Descriptive statistical analyses will be performed, and chi-square and ANOVA analyses will be performed. Qualitative analyses will be undertaken for the perspectives shared. Ethics and Dissemination: Ethical approval has been obtained from the National Healthcare Group’s Domain Specific Research Board (DSRB) (approval number that of 2019/00934). The findings arising from this study will be disseminated by means of conferences and publications.

Codesigned Gamified Attention Bias Modification for Individuals with Opioid Use Disorder: Study Protocol of a Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Melvyn Zhang ◽  
Daniel SS Fung ◽  
Helen Elizabeth Smith
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Attention Bias ◽  
Attentional Biases ◽  
Opioid Use ◽  
Attention Bias Modification ◽  
Randomized Controlled ◽  
Opioid Use Disorders ◽  
Bias Modification ◽  
Modification Intervention

UNSTRUCTURED Introduction Substance use disorders are prevalent globally. In 2019, there has been a large increase in individuals abusing opioids; a 56% increment from previous estimates, and this led to the World Health Organization declaring there being an Opioid epidemic. Locally, in Singapore, Opioids are also highly abused. The recent advances in experimental psychology has led to there being better understanding of automatic, unconscious processes, such as that of attentional biases. Prior research has demonstrated there being robust attentional biases amongst individuals diagnosed with opioid use disorders; and even those who are maintained on methadone maintenance therapy. To date, there remains no prior studies that have evaluated the effectiveness of bias modification amongst Asian individuals, and amongst a cohort of participants with opioid use disorders. No prior evaluations have evaluated the effectiveness of a codesigned mobile attention bias modification intervention. Given this, this current study investigates the effectiveness of the codesigned intervention as compared to the conventional intervention in reducing the magnitude of the attentional biases, where effectiveness is defined as a substantial significant reduction in the magnitude of attentional biases (when comparing the magnitude at baseline and that at the end of the intervention). Methods and Analysis This proposed study is a non-blinded randomized controlled trial, comparing the codesigned attention bias modification intervention against the conventional intervention. Prior to randomization, all participants will be assessed to determine if they are eligible and if they have underlying positive baseline biases. This study uses a 2 (Intervention: codesigned versus conventional) x 2 (time: baseline, completion of intervention) design. Power computation reveals that 162 participants per arm are required, considering a 65% attrition rates (for participants without baseline biases). Participants enrolled into this trial are either randomized into receiving the conventional intervention or the codesigned intervention. Ethics and Dissemination We are in the process of seeking extramural funding. Once funding has been secured, we will apply for ethical approval from the National Healthcare Group’s Domain Specific Research Board. The results arising from the study will be disseminated by conferences and research publications.

scholarly journals Attention and Cognitive Bias Modification Apps: Review of the Literature and of Commercially Available Apps (Preprint)

2018 ◽  
Author(s):  
Melvyn Zhang ◽  
JiangBo Ying ◽  
Guo Song ◽  
Daniel SS Fung ◽  
Helen Smith
Keyword(s):  
Cognitive Bias ◽  
Personal Digital Assistant ◽  
Attention Bias ◽  
Smartphone Application ◽  
Cognitive Bias Modification ◽  
Mobile App ◽  
Cross Sectional ◽  
Manual Search ◽  
Search Terms ◽  
Bias Modification

BACKGROUND Automatic processes, such as attentional biases or interpretative biases, have been purported to be responsible for several psychiatric disorders. Recent reviews have highlighted that cognitive biases may be modifiable. Advances in eHealth and mHealth have been harnessed for the delivery of cognitive bias modification. While several studies have evaluated mHealth-based bias modification intervention, no review, to our knowledge, has synthesized the evidence for it. In addition, no review has looked at commercial apps and their functionalities and methods of bias modification. A review is essential in determining whether scientifically validated apps are available commercially and the proportion of commercial apps that have been evaluated scientifically. OBJECTIVE The objective of this review was primarily to determine the proportion of attention or cognitive bias modification apps that have been evaluated scientifically and secondarily to determine whether the scientifically evaluated apps were commercially available. We also sought to identify commercially available bias modification apps and determine the functionalities of these apps, the methods used for attention or cognitive bias modification, and whether these apps had been evaluated scientifically. METHODS To identify apps in the published literature, we searched PubMed, MEDLINE, PsycINFO, and Scopus for studies published from 2000 to April 17, 2018. The search terms used were “attention bias” OR “cognitive bias” AND “smartphone” OR “smartphone application” OR “smartphone app” OR “mobile phones” OR “mobile application” OR mobile app” OR “personal digital assistant.” To identify commercial apps, we conducted a manual cross-sectional search between September 15 and 25, 2017 in the Apple iTunes and Google Play app stores. The search terms used to identify the apps were “attention bias” and “cognitive bias.” We also conducted a manual search on the apps with published evaluations. RESULTS The effectiveness of bias modification was reported in 7 of 8 trials that we identified in the published literature. Only 1 of the 8 previously evaluated apps was commercially available. The 17 commercial apps we identified tended to use either an attention visual search or gamified task. Only 1 commercial app had been evaluated in the published literature. CONCLUSIONS This is perhaps the first review to synthesize the evidence for published mHealth attention bias apps. Our review demonstrated that evidence for mHealth attention bias apps is inconclusive, and quite a few commercial apps have not been validated scientifically.

scholarly journals Codesigning a mobile gamified attention bias modification intervention: research protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031897
Author(s):  
Melvyn WB Zhang ◽  
Sandor Heng ◽  
Guo Song ◽  
Daniel Shuen Sheng Fung ◽  
Helen Smith
Keyword(s):  
Participatory Design ◽  
Design Research ◽  
Healthcare Professionals ◽  
Cognitive Biases ◽  
Attention Bias ◽  
Second Phase ◽  
Attention Bias Modification ◽  
Ethical Approval ◽  
Bias Modification ◽  
Modification Intervention

IntroductionAdvances in experimental psychology has highlighted the need to modify underlying automatic cognitive biases, such as attentional biases. While prior research has documented the effectiveness of cognitive bias modification, such interventions tend to be highly repetitive and individuals lack motivation to train over time. Participatory action research methods have been more widely applied in psychiatry to help design interventions that are of relevant to key stakeholders and end users. This study aimed to involve both healthcare professionals and patients in the joint codesign of a gamified mobile attention bias modification intervention.Methods and analysisThe participatory design research method adopted is that of a use-oriented design approach, in the form of a future workshop. 20 participants, comprising 10 healthcare professionals, 5 inpatients and 5 outpatients will be recruited to participate in three separate codesign workshops. In the first phase of the workshop, the participants share their critique of an attention bias modification intervention. In the second phase of the workshop, participants are asked to brainstorm features. The participants are also shown gamification approaches and are asked to consider if gaming elements could enhance the existing application. In the last phase, the participants are asked to sketch a new prototype.Ethics and disseminationEthical approval has been obtained from the National Healthcare Group’s Domain Specific Research Board (approval number 2018/01363). The findings arising from this study will be disseminated by means of conferences and publications.

scholarly journals Challenges When Evaluating Cognitive Bias Modification Interventions for Substance Use Disorder

2020 ◽  
Vol 17 (21) ◽  
pp. 7821
Author(s):  
Melvyn W. B. Zhang ◽  
Helen E. Smith
Keyword(s):  
Substance Use ◽  
Cognitive Bias ◽  
Cognitive Biases ◽  
Cognitive Bias Modification ◽  
Bias Assessment ◽  
Unconscious Processes ◽  
Negative Findings ◽  
Bias Modification ◽  
Modification Intervention ◽  
Selection Of

In recent years, advances in experimental psychology have led to a better understanding in automatic, unconscious processes, referred to as attentional and approach biases amongst individuals with substance use disorders. Attentional biases refer to the relatively automatic tendencies for attention to be preferentially allocated towards substance-related cues. Whereas, approach bias refers to the relatively automatic behavioral tendencies of individuals to reach out to substance-related cues in their natural environment. While, several reviews confirm the existence of these biases, and the effectiveness of bias modification, the conduct of cognitive bias modification amongst substance-using individuals is not without its challenges. One of these is that cognitive biases, both attentional and approach biases, are not universally present; and several individual differences factors modulate the magnitude of the biases. Another challenge that investigators faced in their conduct of cognitive bias modification relates to the selection of the appropriate task for bias assessment and modification. Other challenges intrinsic to cognitive bias modification intervention relates to that of participant attrition, much like conventional psychotherapies. Negative findings, of the absence of biases at baseline, or the lack of effectiveness of bias modification have been reported in studies of cognitive bias modification. All these challenges could have an impact on bias assessment and modification. In this perspective paper, we will explore the literature surrounding each of these challenges and discuss potential measures that could be undertaken to mitigate these clinical and research challenges.

Sign in / Sign up

Export Citation Format

Share Document