On the Efficacy of Cognitive-Bias-Modification Training in Alcohol-Dependent Inpatients: A Double-Blind, Multisite Randomized Control Trial

Several large randomized controlled trials (RCTs) have shown that adding alcohol-avoidance training to abstinence-oriented treatment for alcohol use disorders leads to reduced relapse rates. Given the consistently positive but relatively modest magnitude of these effects (i.e., an overall risk reduction of 7.1%, comparable with current medication for alcohol use disorders), we conducted a double-blind, multisite RCT ( N = 247) to examine the effect of combining alcohol-avoidance training with an intervention aimed at reducing the attentional bias toward alcohol-related stimuli. Using a 2 × 2 factorial design, we found that neither intervention resulted in a reduction in the number of relapses or alcohol-related problems (assessed at 3, 6, and 12 months after completion of the 6-week training regimen). In fact, alcohol-avoidance training even tended to increase (rather than decrease) relapse rates. Cognitive-bias indices were also unaffected by the two interventions. Possible explanations for these null findings are discussed.