Subjects: Psychology >> Social Psychology submitted time 2023-03-27 Cooperative journals: 《心理学报》
Abstract： Under relevant cues, people who are addicted tend to use drugs with little attention, purpose or cognitive effort, conforming to an automated “habitual” response behavior. When the substance is not available, this habitual response behavior will be transformed into psychological craving. A common goal of addiction treatment is to reduce cue-induced reactivity that has automatic and unconscious features. Based on previous research, this study used a self-report questionnaire, two behavioral experiments, and measures of Event-Related Potentials (ERPs) to explore the characteristics and neural mechanisms of cue-induced reactivity in heroin addicts under drug-related cues. On this basis, a training program using Virtual Reality (VR) technology and an Approach-Avoidance task (AAT) was designed to weaken the association between drug-related cues and automatic drug use behavior. In Study 1, the participants (N= 38) were men who were addicted to heroin (n=19) and a matched sample of healthy controls (n = 19). The Visual Analog Craving Scale (VAS) was used to investigate cue-induced reactivity by self-report. We then assessed ERPs to explore the nature and neural mechanism of cue-induced reactivity. We hypothesized that compared to the healthy controls, the participants who were addicted to heroin would show more cue-induced reactivity in the form of automatic response outside of awareness. Corroborating our hypotheses in Study 1, we proceeded to Study 2. N= 60 men who were addicted to heroin were equally divided into a treatment group (n= 30) and a no-treatment group (n= 30). The treatment was VR-AAT training for 10 sessions over the course of two months, with the goal of reducing or eliminating cue-induced reactivity. Before and after the treatment, VR-AAT and the Craving Automatized Scale-Substances (CAS-S) questionnaire were used to test the difference between the two groups. The results showed that 1) In between-group comparisons, VAS scores were higher in the addicts than in the control group. And in Study 2, the within-group analyses showed that self-reports of drug use behavior being “unconscious” and “involuntary” were significantly correlated with the duration of addiction. 2) In within-group analyses, N1 amplitude was smaller, latency was shorter, and reaction time was longer in response to drug-related cues versus neutral cues. Other between-group analyses of the ERP data, addicts demonstrated smaller N1 amplitude and longer reaction time in response to drug-related cues compared to the healthy controls, and these differences were concentrated in the central regions of the brain (i.e., the parietal lobe). 3) After the VR-AAT training, the physiological index (based on temperature, diastolic pressure and systolic pressure) decreased significantly, and the coefficient of approach bias of AAT [(Avoid behavior RTs drug-related- Approach behavior RTs drug-related) - (Avoid behavior RTs neutral- Approach behavior RTs neutral)] was significantly smaller than before training. The results were the same at a two-month follow-up. Our findings revealed that cue-induced reactivity showed characteristics of being automatic and unconscious, with greater N1 reactivity in sensorimotor and related brain areas. The VR-AAT training was effective in reducing cue-induced reactions among men addicted to heroin, suggesting that this method has potential applied value in treating heroin addiction and in designing relapse prevention programs. This research contributes to the addiction literature in two ways. First, AAT training has been used in the treatment of alcohol addiction, but not for other forms of addiction. This is the first research to use AAT training to treat heroin addiction. Second, the treatment in the current study is the first one to combine AAT with virtual reality technology. The VR-AAT method might also be a feasible approach for other substance abuse treatments, although more experimental evidence would be needed to support this. One limitation of this study was that the basis of automatic drug use behavior and automatic refusing drug use behavior cannot be distinguished. This issue can be investigated in future research.
Subjects: Psychology >> Applied Psychology submitted time 2022-04-13
Abstract：
Under relevant cues, people who are addicted tend to use drugs with little attention, purpose or cognitive effort, conforming to an automated "habitual" response behavior. When the substance is not available, this habitual response behavior will be transformed into psychological craving.
A common goal of addiction treatment is to reduce cue-induced reactivity that has automatic and unconscious features. Based on previous research, this study used a self-report questionnaire, two behavioral experiments, and measures of Event-Related Potentials (ERPs) to explore the characteristics and neural mechanisms of cue-induced reactivity in heroin addicts under drug-related cues. On this basis, a training program using Virtual Reality (VR) technology and an Approach-Avoidance task (AAT) was designed to weaken the association between drug-related cues and automatic drug use behavior.
In Study 1, the participants (N = 38) were men who were addicted to heroin (n =19) and a matched sample of healthy controls (n = 19). The Visual Analog Craving Scale (VAS) was used to investigate cue-induced reactivity by self-report. We then assessed ERPs to explore the nature and neural mechanism of cue-induced reactivity. We hypothesized that compared to the healthy controls, the participants who were addicted to heroin would show more cue-induced reactivity in the form of automatic response outside of awareness.
Corroborating our hypotheses in Study 1, we proceeded to Study 2. N = 60 men who were addicted to heroin were equally divided into a treatment group (n = 30) and a no-treatment group (n = 30). The treatment was VR-AAT training for 10 sessions over the course of two months, with the goal of reducing or eliminating cue-induced reactivity. Before and after the treatment, VR-AAT and the Craving Automatized Scale-Substances (CAS-S) questionnaire were used to test the difference between the two groups.
The results showed that 1) In between-group comparisons, VAS scores were higher in the addicts than in the control group. And in Study 2, the within-group analyses showed that self-reports of drug use behavior being "unconscious" and "involuntary" were significantly correlated with the duration of addiction. 2) In within-group analyses, N1 amplitude was smaller, latency was shorter, and reaction time was longer in response to drug-related cues versus neutral cues. Other between-group analyses of the ERP data, addicts demonstrated smaller N1 amplitude and longer reaction time in response to drug-related cues compared to the healthy controls, and these differences were concentrated in the central regions of the brain (i.e., the parietal lobe). 3) After the VR-AAT training, the physiological index (based on temperature, diastolic pressure and systolic pressure) decreased significantly, and the coefficient of approach bias of AAT [(Avoid behavior RTs drug-related -Approach behavior RTs drug-related) - (Avoid behavior RTs neutral - Approach behavior RTs neutral)] was significantly smaller than before training. The results were the same at a two-month follow-up.
Our findings revealed that cue-induced reactivity showed characteristics of being automatic and unconscious, with greater N1 reactivity in sensorimotor and related brain areas. The VR-AAT training was effective in reducing cue-induced reactions among men addicted to heroin, suggesting that this method has potential applied value in treating heroin addiction and in designing relapse prevention programs. This research contributes to the addiction literature in two ways. First, AAT training has been used in the treatment of alcohol addiction, but not for other forms of addiction. This is the first research to use AAT training to treat heroin addiction. Second, the treatment in the current study is the first one to combine AAT with virtual reality technology. The VR-AAT method might also be a feasible approach for other substance abuse treatments, although more experimental evidence would be needed to support this. One limitation of this study was that the basis of automatic drug use behavior and automatic refusing drug use behavior cannot be distinguished. This issue can be investigated in future research.
Peer Review Status:
Awaiting Review
Subjects: Psychology >> Clinical and Counseling Psychology submitted time 2021-11-19
Abstract： " Substance addicts show significant impulsivity, which manifests as substance abuse and difficulty in withdrawing. In addition to the problems of inhibition and executive control, driving force from multiple psychological dimensions is also an important reason for impulsive substance use. This drive stems from a variety of sources, including reward effect, S-R related cue response through conditioning and sensation-seeking personality trait. Low levels of inhibition are insufficient to resist the effects of the drive. Consequently, this unbalanced state will lead to a habitual tendency in behaviour or compulsion to use substances under addicts’ craving. These two types of behavior are the manifestation of addictive impulsivity. "
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