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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how prospective thinking can aid recovery from alcohol use disorder. Researchers aim to determine if imagining future events in detail encourages a preference for long-term rewards and treatment-seeking behavior. Participants will join one of two groups to engage in either high-intensity or low-intensity future-thinking tasks. Individuals who have maintained sobriety for 30 days to a year and are committed to recovery may be well-suited for this trial. As an unphased trial, it offers a unique opportunity to contribute to innovative research that could enhance recovery strategies.

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 prior data suggests that this method is safe for participants?

Research has shown that thinking about future events, known as episodic future thinking (EFT), can assist people with alcohol use disorder. Studies have found that EFT reduces impulsivity and enhances decision-making. For instance, a one-week EFT program tested on 28 individuals in treatment for alcohol use disorder improved their ability to wait for larger rewards instead of opting for smaller, immediate ones.

EFT is generally easy for participants to manage, and no major negative side effects have been reported from using strong EFT prompts. This suggests it is a safe option. The research so far is encouraging, but as with any new treatment, monitoring participants' reactions during trials remains important. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores a novel way of tackling alcoholism by enhancing prospective thinking. Unlike traditional treatments that often focus on medication or behavioral therapies to reduce cravings and manage withdrawal, this approach uses high-intensity and low-intensity episodic future-thinking cue images during decision-making tasks. This method aims to alter how individuals with alcohol use disorder think about their future, potentially leading to healthier decision-making and reduced alcohol consumption. The innovative focus on modifying cognitive processes could offer a fresh pathway for treatment, making it a unique addition to the current landscape of alcoholism therapies.

What evidence suggests that enhancing prospective thinking is effective for alcoholism?

Research has shown that thinking about future events can help people with alcohol use disorder make less impulsive choices. In this trial, participants will receive either high-intensity or low-intensity episodic future-thinking cues. Studies have found that strong, detailed future-thinking prompts can reduce the tendency to choose smaller, immediate rewards over larger, delayed ones. Specifically, a trial with individuals receiving treatment for alcohol use disorder demonstrated that a one-week program using these prompts reduced impulsive decisions. Another study found that this approach helped people drink less by improving their ability to consider future benefits. These findings suggest that detailed future-thinking prompts could effectively promote better decision-making and reduce alcohol consumption. ^{1 2 3 6 7}

Who Is on the Research Team?

Brandon G Oberlin, PhD

Principal Investigator

Indiana University

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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 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]

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]

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]

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]

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]

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]

Citations

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clinicaltrials.gov

clinicaltrials.gov/study/NCT06283472

Enhancing Prospective Thinking in Early Recovery (BEAM)

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 ...

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clinicaltrials.gov

clinicaltrials.gov/study/NCT04125238

Study Details | NCT04125238 | Increasing the Temporal ...

We and others have used EFT to decrease delay discounting (DD) in individuals with AUD and smokers, as well as normal weight, overweight, and obese populations ...

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withpower.com

withpower.com/trial/phase-alcoholism-11-2023-a0073

Prospective Thinking for Alcoholism (NERF Trial)

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

4.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC9450688/

Future Thinking to Decrease Real-World Drinking in ...

The current study examined the effect of expanding the temporal window of reinforcement, using remotely delivered EFT, on decreasing real-world alcohol ...

5.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC5497459/

Episodic Future Thinking: Expansion of the Temporal ...

These results suggest a widening of alcohol-dependent individuals' temporal window following engagement of EFT.

6.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC9669959/

Methodological considerations in the use of episodic future ...

In recent years, episodic future thinking (EFT) has emerged as a promising behavioral intervention to reduce delay discounting or maladaptive health behaviors.

7.

sciencedirect.com

sciencedirect.com/science/article/abs/pii/S0740547220303020

Acute and extended exposure to episodic future thinking in ...

The current study examined the feasibility and impact of a 1-week EFT protocol on decision-making and alcohol motivation in a sample of individuals receiving ...