Prospective Thinking for Alcoholism

(NERF Trial)

Overseen By Colton Lind, BS

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Indiana University

Disqualifiers: Unstable medical, Habitual substance, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 1 day

98 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, it does exclude people with unstable medical disorders, which might imply that stable medication use could be allowed. It's best to check with the trial organizers for specific guidance.

What data supports the effectiveness of the treatment Enhancing Prospective Thinking, Episodic Future-Thinking (EFT) Cues for alcoholism?

Research shows that episodic future thinking (EFT) can reduce impulsive decision-making and the desire for addictive substances. In a study with individuals receiving treatment for alcohol use disorder, EFT led to reductions in alcohol demand and improved mindfulness, suggesting it may help in managing alcohol use. ^{1 2 3 4 5}

Is Prospective Thinking for Alcoholism safe for humans?

The studies on Episodic Future Thinking (EFT) suggest it is generally safe for humans, as it has been tested in various settings without reported safety concerns. Participants found the interventions enjoyable and relevant, indicating good acceptability. ^{1 2 4 5 6}

How is the treatment 'Enhancing Prospective Thinking' different from other treatments for alcoholism?

Enhancing Prospective Thinking (EFT) is unique because it involves imagining positive future events to help reduce impulsive decisions and the desire for alcohol, unlike traditional treatments that may focus on immediate behavior change or medication. This approach helps individuals expand their ability to think about the future, which can support long-term sobriety. ^{1 2 4 5 7}

What is the purpose of this trial?

The goal of this clinical trial is to test the prosocial effects of personally-relevant, high-intensity episodic future-thinking (EFT) cues in alcohol use disorder persons and related brain mechanisms. The main question\[s\] this trial aims to answer are: Will high-intensity EFT cues will produce greater delayed reward preference than low-intensity cues? Will high-intensity EFT cues effect greater treatment-seeking interest? Will high-intensity EFT cues elicit greater response in regions for prospective thinking during delay discounting (vs. low-intensity) Will nucleus accumbens-precuneus resting connectivity correlate with behavioral SS? Will the novel behavioral SS decision-making task activate the nucleus accumbens? Researchers will compare the experimental (high-intensity group) and control (low-intensity) groups to see if there are differences in the results for the questions outlined above.

Research Team

Brandon G Oberlin, PhD

Principal Investigator

Indiana University

Eligibility Criteria

This trial is for individuals with alcohol use disorder. The study aims to understand if certain mental exercises involving thinking about the future can influence their preference for delayed rewards and interest in seeking treatment.

Inclusion Criteria

English comprehension

Abstinence between 30 days and 1 year

Verbal endorsement of commitment to recovery

Exclusion Criteria

Unstable medical disorders

Habitual substance or alcohol use

Unstable psychiatric conditions

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive high-intensity or low-intensity episodic future-thinking cue images during an MRI decision-making task

1 day

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Enhancing Prospective Thinking

Trial Overview Researchers are testing two types of mental cues: 'Low-Intensity Cue' as a control, and 'High-Intensity Cue' as an experimental intervention. They want to see which one better encourages people with alcoholism to prefer long-term benefits over immediate pleasures.

Participant Groups

Group I: High-Intensity Experimental Treatment 1 Intervention

Participants will receive high-intensity episodic future-thinking cue images, and high-intensity episodic recent-thinking cue images during an MRI decision-making task.

Group II: Low-Intensity (Control) Active Control 1 Intervention

Participants will receive low-intensity episodic future-thinking cue images, and low-intensity episodic recent-thinking cue images during an MRI decision-making task.

Who Is Running the Clinical Trial?

Indiana University

Lead Sponsor

Trials

1,063

Recruited

1,182,000+

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Collaborator

Trials

865

Recruited

1,091,000+

Findings from Research

A 1-week episodic future thinking (EFT) protocol was tested on 28 individuals in treatment for alcohol use disorder, showing promise in reducing impulsive decision-making and alcohol motivation.

Participants exhibited decreased alcohol demand and delay discounting rates, along with increased mindfulness, suggesting that EFT could be a beneficial supplement to traditional addiction treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acute and extended exposure to episodic future thinking in a treatment seeking addiction sample: A pilot study. Patel, H., Amlung, M.[2022]

In a study of 360 college students, those who engaged in episodic future thinking (EFT) focused on nonalcoholic scenarios showed a significantly lower tendency to discount future rewards compared to those who thought about alcohol-related scenarios.

The content of the EFT, particularly when centered around professional goals, was linked to a greater preference for delayed rewards, suggesting that focusing on future professional aspirations can help individuals value long-term outcomes over immediate gratification.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of content and valence of episodic future thinking on delay discounting and alcohol demand. Chang, YC., Ladd, BO.[2023]

Individuals with alcohol dependence demonstrated significantly better episodic future thinking abilities compared to those with opiate use disorders, based on a study involving 31 opiate users, 21 alcohol-dependent individuals, and 23 healthy controls.

These findings suggest that rehabilitation programs for substance use disorders may need to be customized to address the varying capabilities of self-projection and future thinking among different substance use groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Not all drugs are created equal: impaired future thinking in opiate, but not alcohol, users. Moustafa, AA., Morris, AN., Nandrino, JL., et al.[2019]

Individuals with alcohol dependence showed significantly impaired prospective memory (PM) performance compared to social drinkers, indicating that alcohol use may negatively affect memory functions.

Using an imagery technique improved time-based PM in social drinkers but did not enhance PM performance in individuals with alcohol dependence, suggesting that these individuals may struggle with applying effective memory strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prospective memory and future event simulation in individuals with alcohol dependence. Griffiths, A., Hill, R., Morgan, C., et al.[2012]

The academic goal-relevant episodic future thinking (A-EFT) intervention was found to be feasible and acceptable for heavy drinking college students, with over 80% recruitment and retention rates, and participants rated it positively.

Participants in the A-EFT group showed a significant increase in study time and moderate reductions in alcohol consumption, suggesting that this intervention may help improve academic behaviors while also reducing drinking.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Episodic future thinking as a brief alcohol intervention for heavy drinking college students: A pilot feasibility study. Voss, AT., Jorgensen, MK., Murphy, JG.[2022]

In a study involving 45 individuals with substance use disorders and 59 university students, time-based prospective memory (PM) was found to predict increased risky decision-making behaviors, such as risky sexual practices and criminal activities, even after accounting for other factors.

The results suggest that deficits in PM could negatively impact everyday functioning and highlight the potential for cognitive rehabilitation to enhance traditional substance use treatments by addressing these memory deficits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Time-based prospective memory predicts engagement in risk behaviors among substance users: results from clinical and nonclinical samples. Weinborn, M., Moyle, J., Bucks, RS., et al.[2021]

Engaging alcohol-dependent individuals in episodic future thinking (EFT) significantly increased their valuation of future rewards and reduced their initial desire to consume alcohol, indicating a potential therapeutic benefit in reducing alcohol demand.

The effectiveness of EFT appeared to be greater in individuals with lower alcohol dependence, suggesting that this technique could be tailored for specific groups in rehabilitation programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Episodic Future Thinking: Expansion of the Temporal Window in Individuals with Alcohol Dependence. Snider, SE., LaConte, SM., Bickel, WK.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Acute and extended exposure to episodic future thinking in a treatment seeking addiction sample: A pilot study. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Effects of content and valence of episodic future thinking on delay discounting and alcohol demand. [2023]

3. Germany pubmed.ncbi.nlm.nih.gov

Not all drugs are created equal: impaired future thinking in opiate, but not alcohol, users. [2019]

4. England pubmed.ncbi.nlm.nih.gov

Prospective memory and future event simulation in individuals with alcohol dependence. [2012]

5. United States pubmed.ncbi.nlm.nih.gov

Episodic future thinking as a brief alcohol intervention for heavy drinking college students: A pilot feasibility study. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Time-based prospective memory predicts engagement in risk behaviors among substance users: results from clinical and nonclinical samples. [2021]

7. England pubmed.ncbi.nlm.nih.gov

Episodic Future Thinking: Expansion of the Temporal Window in Individuals with Alcohol Dependence. [2022]