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Randomized Controlled Trial on Imaginal Retraining for Problematic Alcohol Use: A Dismantling Study.

Josefine Gehlenborg¹, Anja S Göritz², Joana Kempken¹

¹Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.

Clinical Psychology & Psychotherapy

|May 24, 2024

Summary

Imaginal retraining (IR) components were tested in a randomized controlled trial (RCT). While no significant differences were found overall, approach training with psychoeducation showed promise for reducing alcohol consumption.

Keywords:

addiction alcohol craving dismantling imaginal retraining

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Area of Science:

Psychology
Clinical Psychology
Behavioral Science

Background:

Imaginal retraining (IR) is an approach-avoidance procedure with demonstrated efficacy.
The current study aimed to dismantle the efficacy of individual IR components.

Purpose of the Study:

To conduct a randomized controlled trial (RCT) to evaluate the distinct components of imaginal retraining (IR).
To assess the impact of IR components, with or without psychoeducation (PE), on alcohol craving and consumption.

Main Methods:

A randomized controlled trial (RCT) with nine conditions, including eight intervention groups and a waitlist control group (WLC).
Intervention groups focused on mood induction, mental avoidance, motor avoidance, and approach to healthy stimuli, with or without prior psychoeducation (PE).
Outcomes including alcohol craving, consumption, depressive symptoms, and quality of life were assessed online at baseline, 6 weeks, and 12 weeks.

Main Results:

No significant group differences were observed for primary or secondary outcomes after Šidák correction.
Uncorrected analyses indicated decreased alcohol consumption for the approach + PE group and a merged motor avoidance group compared to WLC.
Exploratory analyses suggested that individuals with high visualization skills benefited most from the intervention.

Conclusions:

The study did not find significant differences between IR components, but highlighted potential benefits of approach training with psychoeducation.
Visualization training and motivational components may enhance the efficacy and adherence of imaginal retraining (IR).