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.

scholarly journals A Smartphone Attention Bias App for Individuals With Addictive Disorders: Feasibility and Acceptability Study

10.2196/15465 ◽  
2019 ◽  
Vol 7 (9) ◽  
pp. e15465 ◽  
Author(s):  
Melvyn Zhang ◽  
Jiangbo Ying ◽  
Syidda B Amron ◽  
Zaakira Mahreen ◽  
Guo Song ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Participatory Design ◽  
Attention Bias ◽  
Acceptance Rate ◽  
Management Service ◽  
Qualitative Synthesis ◽  
Attention Bias Modification ◽  
Addictive Disorders ◽  
Health Technologies ◽  
Bias Modification

Background Conventional psychology therapies are unable to address automatic biases that result in individuals relapsing into their substance use disorder. Advances in experimental psychology have led to a better understanding of attention and approach biases and methods to modify these biases. Several studies have demonstrated the effectiveness of bias modification among clinical cohorts. The advances in mobile health technologies have allowed remote delivery of these interventions. To date, there is a lack of studies examining bias modification in a substance-using non-Western sample. Objective This study was designed to determine the feasibility of an attention bias modification intervention and an attention bias modification smartphone app for the reduction of attention biases among treatment-seeking individuals. The secondary aim is to determine the acceptability of the intervention. Methods A feasibility study was conducted among inpatients who were in their rehabilitation phase at the National Addictions Management Service. Participants were to complete a set of baseline questionnaires, and on each day that they are in the study, undertake an attention bias assessment and modification task while completing a visual analogue scale to assess their craving. Feasibility was determined by the acceptance rate of participation and participants’ adherence to the interventions. Acceptability was assessed by a perception questionnaire. Descriptive statistical analyses were performed using SPSS version 22. A thematic analysis approach was used in the qualitative synthesis of users’ perceptions. Results Of the 40 participants invited to participate in the feasibility study, 10 declined, yielding an acceptance rate of 75%. Of the recruited participants, 6 participants were diagnosed with alcohol dependence; 17, with opioid dependence; 2, with cannabis dependence; and 5, with stimulant dependence. In addition, of the final 30 participants, 11 (37%) failed to complete all the planned interventions and 22 (73%) completed the perspective questionnaires; of these 22 participants, 100% rated the app as extremely and very easy, 77% rated it as extremely or very interactive, 54% rated it as extremely or very motivating, and 33% reported a change in their confidence levels. Conclusions Our results highlight the feasibility of recruiting participants to undertake attention bias modification interventions. Participants generally accept use of a mobile version of such an intervention. Nevertheless, our acceptability data indicate that there could be improvements in the existing app, and a participatory design approach might be helpful in its future conceptualization. International Registered Report Identifier (IRRID) RR2-10.2196/11822

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 A Smartphone Attention Bias App for Individuals With Addictive Disorders: Feasibility and Acceptability Study (Preprint)

2019 ◽  
Author(s):  
Melvyn Zhang ◽  
Jiangbo Ying ◽  
Syidda B Amron ◽  
Zaakira Mahreen ◽  
Guo Song ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Participatory Design ◽  
Attention Bias ◽  
Acceptance Rate ◽  
Management Service ◽  
Qualitative Synthesis ◽  
Attention Bias Modification ◽  
Addictive Disorders ◽  
Health Technologies ◽  
Bias Modification

BACKGROUND Conventional psychology therapies are unable to address automatic biases that result in individuals relapsing into their substance use disorder. Advances in experimental psychology have led to a better understanding of attention and approach biases and methods to modify these biases. Several studies have demonstrated the effectiveness of bias modification among clinical cohorts. The advances in mobile health technologies have allowed remote delivery of these interventions. To date, there is a lack of studies examining bias modification in a substance-using non-Western sample. OBJECTIVE This study was designed to determine the feasibility of an attention bias modification intervention and an attention bias modification smartphone app for the reduction of attention biases among treatment-seeking individuals. The secondary aim is to determine the acceptability of the intervention. METHODS A feasibility study was conducted among inpatients who were in their rehabilitation phase at the National Addictions Management Service. Participants were to complete a set of baseline questionnaires, and on each day that they are in the study, undertake an attention bias assessment and modification task while completing a visual analogue scale to assess their craving. Feasibility was determined by the acceptance rate of participation and participants’ adherence to the interventions. Acceptability was assessed by a perception questionnaire. Descriptive statistical analyses were performed using SPSS version 22. A thematic analysis approach was used in the qualitative synthesis of users’ perceptions. RESULTS Of the 40 participants invited to participate in the feasibility study, 10 declined, yielding an acceptance rate of 75%. Of the recruited participants, 6 participants were diagnosed with alcohol dependence; 17, with opioid dependence; 2, with cannabis dependence; and 5, with stimulant dependence. In addition, of the final 30 participants, 11 (37%) failed to complete all the planned interventions and 22 (73%) completed the perspective questionnaires; of these 22 participants, 100% rated the app as extremely and very easy, 77% rated it as extremely or very interactive, 54% rated it as extremely or very motivating, and 33% reported a change in their confidence levels. CONCLUSIONS Our results highlight the feasibility of recruiting participants to undertake attention bias modification interventions. Participants generally accept use of a mobile version of such an intervention. Nevertheless, our acceptability data indicate that there could be improvements in the existing app, and a participatory design approach might be helpful in its future conceptualization. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/11822

scholarly journals Efficacy of Attention Bias Modification Training for Depressed Adults: A Randomized Clinical Trial

2020 ◽  
Author(s):  
Kean J. Hsu ◽  
Jason Shumake ◽  
Kayla D. Caffey ◽  
Semeon Risom ◽  
Jocelyn Labrada ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Attention Bias ◽  
Attention Bias Modification ◽  
Secondary Outcomes ◽  
Intent To Treat ◽  
Anhedonic Depression ◽  
Bias Modification

Background: This study examined the efficacy Attention Bias Modification Training (ABMT) for the treatment of depression. Methods: In this randomized clinical trial, 145 adults (77% female, 62% white) with at least moderate depression severity (i.e., self-reported Quick Inventory of Depressive Symptomatology (QIDS-SR) ≥ 13) and a negative attention bias were randomized to active ABMT, sham ABMT, or assessments only. Training consisted of two in-clinic and three (brief) at-home ABMT sessions per week for four weeks (2,224 training trials total). The pre-registered primary outcome was change in QIDS-SR. Secondary outcomes were the 17-item Hamilton Depression Rating Scale (HRSD) and anhedonic depression and anxious arousal from the Mood and Anxiety Symptom Questionnaire (MASQ). Primary and secondary outcomes were administered at baseline and four weekly assessments during ABMT. Results: Intent-to-treat analyses indicated that, relative to assessment only, active ABMT significantly reduced QIDS-SR and HRSD scores by an additional 0.62 ± 0.23 (p = .008, d = -0.57) and 0.74 ± 0.31 (p = .021, d = -0.49) points per week. Similar results were observed for active vs sham ABMT: a greater symptom reduction of 0.44 ± 0.24 QIDS-SR (p = .067, d = -0.41) and 0.69 ± 0.32 HRSD (p = .033, d = -0.42) points per week. Sham ABMT did not significantly differ from the assessment-only condition. No significant differences were observed for the MASQ scales.Conclusion: Depressed individuals with at least modest negative attentional bias benefitted from active ABMT.

scholarly journals Efficacy of attention bias modification training for depressed adults: a randomized clinical trial

2021 ◽  
pp. 1-9
Author(s):  
Kean J. Hsu ◽  
Jason Shumake ◽  
Kayla Caffey ◽  
Semeon Risom ◽  
Jocelyn Labrada ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Attention Bias ◽  
Attention Bias Modification ◽  
Secondary Outcomes ◽  
Intent To Treat ◽  
Anhedonic Depression ◽  
Bias Modification

Abstract Background This study examined the efficacy of attention bias modification training (ABMT) for the treatment of depression. Methods In this randomized clinical trial, 145 adults (77% female, 62% white) with at least moderate depression severity [i.e. self-reported Quick Inventory of Depressive Symptomatology (QIDS-SR) ⩾13] and a negative attention bias were randomized to active ABMT, sham ABMT, or assessments only. The training consisted of two in-clinic and three (brief) at-home ABMT sessions per week for 4 weeks (2224 training trials total). The pre-registered primary outcome was change in QIDS-SR. Secondary outcomes were the 17-item Hamilton Depression Rating Scale (HRSD) and anhedonic depression and anxious arousal from the Mood and Anxiety Symptom Questionnaire (MASQ). Primary and secondary outcomes were administered at baseline and four weekly assessments during ABMT. Results Intent-to-treat analyses indicated that, relative to assessment-only, active ABMT significantly reduced QIDS-SR and HRSD scores by an additional 0.62 ± 0.23 (p = 0.008, d = −0.57) and 0.74 ± 0.31 (p = 0.021, d = −0.49) points per week. Similar results were observed for active v. sham ABMT: a greater symptom reduction of 0.44 ± 0.24 QIDS-SR (p = 0.067, d = −0.41) and 0.69 ± 0.32 HRSD (p = 0.033, d = −0.42) points per week. Sham ABMT did not significantly differ from the assessment-only condition. No significant differences were observed for the MASQ scales. Conclusion Depressed individuals with at least modest negative attentional bias benefitted from active ABMT.

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 Neural changes with attention bias modification for anxiety: a randomized trial

2014 ◽  
Vol 10 (7) ◽  
pp. 913-920 ◽  
Author(s):  
Jennifer C. Britton ◽  
Jenna G. Suway ◽  
Michelle A. Clementi ◽  
Nathan A. Fox ◽  
Daniel S. Pine ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Attention Bias ◽  
Attention Bias Modification ◽  
Bias Modification

scholarly journals A Smartphone Attention Bias Intervention for Individuals With Addictive Disorders: Protocol for a Feasibility Study (Preprint)

2018 ◽  
Author(s):  
Melvyn Zhang ◽  
Jiangbo Ying ◽  
Syidda B Amron ◽  
Zaakira Mahreen ◽  
Guo Song ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Feasibility Study ◽  
Attention Bias ◽  
Mobile Technologies ◽  
Attentional Biases ◽  
Attention Bias Modification ◽  
Addictive Disorders ◽  
Bias Modification ◽  
Modification Intervention

BACKGROUND Substance use disorders are highly prevalent globally. Relapse rates following conventional psychological interventions for substance use disorders remain high. Recent reviews have highlighted attentional and approach or avoidance biases to be responsible for multiple relapses. Other studies have reported the efficacy of interventions to modify biases. With advances in technologies, there are now mobile versions of conventional bias modification interventions. However, to date, no study has evaluated bias modification in a substance-using, non-Western sample. Existing evaluations of mobile technologies for the delivery of bias interventions are also limited to alcohol or tobacco use disorders. OBJECTIVE This study aims to examine the feasibility of mobile-based attention bias modification intervention among treatment-seeking individuals with substance use and alcohol use disorders. METHODS This is a feasibility study, in which inpatients who are in their rehabilitation phase of clinical management will be recruited. On each day that they are in the study, they will be required to complete a craving visual analogue scale and undertake both a visual probe-based assessment and and modification task in a smartphone app . Reaction time data will be collated for the computation of baseline attentional biases and to determine whether there is a reduction of attentional bias across the interventions. Feasibility will be determined by the number of participants recruited and participants’ adherence to the planned interventions up until the completion of their rehabilitation program and by the ability of the app in detecting baseline biases and changes in biases. Acceptability of the intervention will be assessed by a short questionnaire of users’ perceptions of the intervention. Statistical analyses will be performed using SPSS version 22.0, while qualitative analysis of the perspectives will be performed using NVivo version 10.0. RESULTS This study was approved by the National Healthcare Group Domain Specific Research Board, with approval number (2018/00316). Results will be disseminated by means of conferences and publications.Currently, we are in the process of recruitment for this study. CONCLUSIONS To the best of our knowledge, this is the first study to evaluate the feasibility and acceptability of a mobile attention bias modification intervention for individuals with substance use disorders. The data pertaining to the feasibility and acceptability are undoubtedly crucial because they imply the potential use of mobile technologies in retraining attentional biases among inpatients admitted for medical-assisted detoxification and rehabilitation. Participants’ feedback pertaining to the ease of use, interactivity, and motivation to continue using the app is crucial because it will determine whether a codesign approach might be warranted to design an app that is acceptable for participants and that participants themselves would be motivated to use. INTERNATIONAL REGISTERED REPOR PRR1-10.2196/11822

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