Behavioral Intervention for Impulsivity Related to Alcohol Consumption

Overseen By Shivani Doshi

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Icahn School of Medicine at Mount Sinai

Disqualifiers: Younger than 21, Left-handed

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 2

280 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of this study is to investigate the behavioral and neural correlates of stress exposure. Results from this study will enrich the understanding of how sociocultural, behavioral, and neural factors combine to influence alcohol use.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment for impulsivity related to alcohol consumption?

Research shows that brief interventions, which are part of the behavioral treatments, are effective in reducing alcohol consumption and preventing future alcohol-related injuries. Behavioral approaches, including cognitive-behavioral therapy, have a strong track record in treating alcohol problems by enhancing social skills and coping strategies. ^{1 2 3 4 5}

Is the behavioral intervention for impulsivity related to alcohol consumption safe for humans?

The research on brief interventions, which are similar to the behavioral intervention for impulsivity related to alcohol consumption, suggests they are generally safe for humans. These interventions are designed to be time-efficient and are often used by healthcare providers to help people reduce their alcohol consumption without causing harm. ^{2 3 6 7 8}

How is this behavioral intervention for impulsivity related to alcohol consumption different from other treatments?

This treatment is unique because it specifically targets impulsivity, a key factor in alcohol dependence, by using behavioral strategies rather than medication. It focuses on improving decision-making and reducing impulsive actions, which are often linked to alcohol misuse, making it different from traditional treatments that may not address these underlying behavioral issues. ^{9 10 11 12 13}

Research Team

Uraina Clark, PhD

Principal Investigator

Icahn School of Medicine at Mount Sinai

Eligibility Criteria

This trial is for right-handed, English-speaking African Americans aged between 21 and 35 who are interested in understanding how stress affects impulsivity and alcohol use. It's not suitable for those under 21 or left-handed individuals.

Inclusion Criteria

I am between 21 and 35 years old.

Right-handed

Fluent in English

Exclusion Criteria

I am under 21 years old.

Left-handed

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants undergo baseline fMRI scans to measure resting-state functional connectivity and BOLD signal

1 week

1 visit (in-person)

Stress Exposure

Participants are exposed to stress threat or no threat stress to assess behavioral and neural responses

1 week

1 visit (in-person)

Follow-up

Participants are monitored for any changes in behavior or neural activity post-exposure

4 weeks

Treatment Details

Interventions

• Task-based behavioral intervention

Trial Overview The study tests a task-based behavioral intervention to see how it impacts impulsivity when facing stereotype threats, using fMRI to track brain activity and its relation to alcohol consumption.

Participant Groups

Group I: stress exposure Active Control 1 Intervention

exposure to stress threat

Group II: no stress exposure Placebo Group 1 Intervention

no threat stress

Who Is Running the Clinical Trial?

Icahn School of Medicine at Mount Sinai

Lead Sponsor

Trials

933

Recruited

579,000+

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Collaborator

Trials

865

Recruited

1,091,000+

Findings from Research

A stepped care approach for addressing problem drinking, which starts with a brief intervention and intensifies if needed, was found to be as effective as a full-care approach while requiring significantly less intervention time.

Both the stepped care and full-care interventions showed small to medium improvements in drinking outcomes compared to an untreated control group, suggesting that even minimal interventions can be beneficial for at-risk drinkers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluation of a telephone-based stepped care intervention for alcohol-related disorders: a randomized controlled trial. Bischof, G., Grothues, JM., Reinhardt, S., et al.[2018]

Brief interventions for hazardous and harmful drinking are effective in encouraging individuals to change their alcohol use patterns, even when they do not meet the criteria for alcohol abuse or dependence.

Innovative delivery methods, like online platforms and interactive multimedia, can enhance the implementation of these interventions, making them more accessible and easier to disseminate to a wider audience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Brief interventions for alcohol problems: factors that facilitate implementation. Moyer, A., Finney, JW.[2021]

Brief intervention is an effective and efficient counseling method for nondependent drinkers, aimed at reducing alcohol consumption and preventing future alcohol-related injuries and health issues.

This intervention is particularly beneficial for patients who have recently experienced alcohol-related injuries, as they are more open to receiving help and making changes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Brief intervention after alcohol-related injuries. Dyehouse, JM., Sommers, MS.[2022]

Cognito-behavioral therapy for alcohol dependence emphasizes improving social integration and conditioning, which are crucial for effective treatment.

The therapy can be tailored to individual needs or conducted in groups, adapting to the patient's level of neuropsychological impairment and motivation, enhancing its efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Alcoholism: cognitive-behavioral therapy]. Uehlinger, C.[2019]

Behavioral approaches are effective and cost-efficient in treating alcohol problems, and they can enhance the effectiveness of medication-based treatments.

Cognitive-behavioral strategies are particularly useful for improving treatment motivation and retention, suggesting that similar methods could be beneficial for treating other substance use issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavioral treatments for drug problems: lessons from the alcohol treatment outcome literature. Miller, WR.[2007]

A single motivational interviewing-based brief intervention (BI) counseling session given to first-time DUI arrestees did not significantly reduce self-reported drinking behavior over 90 days compared to a control group, with both groups showing similar decreases in problematic drinking as measured by AUDIT scores.

The study involved 200 participants and found no significant differences in binge drinking, abstinence, or seeking treatment between those who received the BI and those who did not, suggesting that this intervention may not be effective in changing drinking behaviors in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect on problematic drinking behavior of a brief motivational interview shortly after a first arrest for driving under the influence of alcohol: a randomized trial. Utter, GH., Young, JB., Theard, LA., et al.[2014]

In a randomized trial involving 186 seriously injured individuals from alcohol-related crashes, brief counseling led to the lowest rate of binge drinking at 12 months, with an average of 1.97 binges per month compared to higher rates in other groups.

While the brief counseling intervention did not show a statistically significant difference compared to simple advice or control groups, it suggests that more intensive interventions may be beneficial in reducing binge drinking among this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Binge drinking, sensible drinking, and abstinence after alcohol-related vehicular crashes: the role of intervention versus screening. Sommers, MS., Dyehouse, JM., Howe, SR.[2016]

In a study involving 126 participants undergoing different therapies for alcohol use disorders, therapists who engaged in exploratory and connecting behaviors were more effective at encouraging clients to discuss positive changes in their drinking behavior.

Higher therapist skillfulness in exploring and connecting with clients significantly enhanced the effectiveness of these behaviors, leading to better client responses, while teaching behaviors were less effective in promoting discussions about change.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Therapist and client discussions of drinking and coping: a sequential analysis of therapy dialogues in three evidence-based alcohol use disorder treatments. Magill, M., Walthers, J., Mastroleo, NR., et al.[2019]

The Integrated Intervention Program for Alcoholism (IIPA) significantly reduced impulsivity and improved decision-making related to reward processing in 50 individuals with alcoholism over an 18-day period, compared to a treatment as usual (TAU) group that showed no significant changes.

These results suggest that IIPA may address core features of substance use disorders, potentially reducing the risk of relapse, and highlight the need for further research on its long-term effects on sobriety and relapse rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Integrated intervention program for alcoholism improves impulsiveness and disadvantageous reward processing/risk-taking. Kumar, R., Kumar, KJ., Benegal, V., et al.[2022]

In a study of 20 participants, including 10 nondependent alcohol bingers, it was found that binge drinkers did not exhibit higher impulsivity but were more concerned about their drinking control and experienced greater tolerance to alcohol's sedative effects.

Alcohol consumption led to a priming effect, increasing the urge to drink among participants, particularly in bingers, indicating that the risk of binge drinking is more closely related to the subjective effects of alcohol rather than impulsive behavior.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The subjective, rather than the disinhibiting, effects of alcohol are related to binge drinking. Rose, AK., Grunsell, L.[2022]

In a 4-year follow-up study of 471 heavy drinkers, those with alcohol use disorders showed significantly higher levels of behavioral impulsivity compared to healthy controls, indicating a strong link between impulsivity and alcohol dependence.

The Stop-Signal Task (SST) was identified as a significant predictor of developing alcohol dependence, suggesting that difficulties in inhibitory control may contribute to the progression of alcohol use disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The role of behavioral impulsivity in the development of alcohol dependence: a 4-year follow-up study. Rubio, G., Jiménez, M., Rodríguez-Jiménez, R., et al.[2022]

Impulsivity, particularly in the context of alcohol use, can be divided into two types: behavioral inhibition, which affects a person's ability to control their actions, and delay of reward, which influences how immediate rewards impact decision-making.

The review suggests that difficulties in delaying gratification may indicate early alcohol use or abuse, while impairments in behavioral inhibition could signal a progression towards alcohol dependence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Laboratory paradigms of impulsivity and alcohol dependence: a review. Aragues, M., Jurado, R., Quinto, R., et al.[2019]

Alcohol-dependent patients with borderline personality disorder (BPD) showed greater behavioral impulsivity, particularly in making omission errors, compared to those with antisocial personality disorder (AntPD), indicating different impulsivity patterns among these groups.

Overall, alcohol-dependent individuals with any Cluster-B personality disorder exhibited more impulsivity across various measures than those without personality disorders and healthy controls, suggesting that impulsivity may serve as a vulnerability marker for alcohol dependence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Varieties of impulsivity in males with alcohol dependence: the role of Cluster-B personality disorder. Rubio, G., Jiménez, M., Rodríguez-Jiménez, R., et al.[2022]

References

1. Ireland pubmed.ncbi.nlm.nih.gov

Evaluation of a telephone-based stepped care intervention for alcohol-related disorders: a randomized controlled trial. [2018]

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

Brief interventions for alcohol problems: factors that facilitate implementation. [2021]

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

Brief intervention after alcohol-related injuries. [2022]

4. Switzerland pubmed.ncbi.nlm.nih.gov

[Alcoholism: cognitive-behavioral therapy]. [2019]

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

Behavioral treatments for drug problems: lessons from the alcohol treatment outcome literature. [2007]

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

The effect on problematic drinking behavior of a brief motivational interview shortly after a first arrest for driving under the influence of alcohol: a randomized trial. [2014]

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

Binge drinking, sensible drinking, and abstinence after alcohol-related vehicular crashes: the role of intervention versus screening. [2016]

8. England pubmed.ncbi.nlm.nih.gov

Therapist and client discussions of drinking and coping: a sequential analysis of therapy dialogues in three evidence-based alcohol use disorder treatments. [2019]

9. India pubmed.ncbi.nlm.nih.gov

Integrated intervention program for alcoholism improves impulsiveness and disadvantageous reward processing/risk-taking. [2022]

10. England pubmed.ncbi.nlm.nih.gov

The subjective, rather than the disinhibiting, effects of alcohol are related to binge drinking. [2022]

11. England pubmed.ncbi.nlm.nih.gov

The role of behavioral impulsivity in the development of alcohol dependence: a 4-year follow-up study. [2022]

12. Switzerland pubmed.ncbi.nlm.nih.gov

Laboratory paradigms of impulsivity and alcohol dependence: a review. [2019]

13. England pubmed.ncbi.nlm.nih.gov

Varieties of impulsivity in males with alcohol dependence: the role of Cluster-B personality disorder. [2022]