Computerized Intervention for Teen Substance Abuse

(CARS Trial)

Overseen By Austin M Hahn, Ph.D.

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Medical University of South Carolina

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

Compensation: Varies

Number of Visits: Unknown

Duration: 1 week

52 Participants Needed

Trial Summary

What is the purpose of this trial?

The study will test a computerized treatment with subjects ages 13-17 years who are seeking treatment for alcohol and/or cannabis use. Follow-up assessments will be conducted at one- and three-months following treatment.

Will I have to stop taking my current medications?

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

What data supports the effectiveness of the treatment modified Approach-Avoidance Task (mAAT) for teen substance abuse?

The research does not provide direct evidence for the effectiveness of the modified Approach-Avoidance Task (mAAT) for teen substance abuse. However, Motivational Interviewing (MI), a similar approach used in addiction treatment, shows promise in promoting behavior change, although results are mixed and further investigation is needed. ^{1 2 3 4 5}

How is the modified Approach-Avoidance Task (mAAT) treatment for teen substance abuse different from other treatments?

The modified Approach-Avoidance Task (mAAT) is unique because it is a computerized intervention that aims to change automatic tendencies to approach substances, unlike traditional therapies that may focus on counseling or medication. This approach uses cognitive training to help teens avoid substance-related cues, potentially reducing cravings and use. ^{6 7 8 9 10}

Eligibility Criteria

This trial is for young people aged 13-17 who are looking for help with alcohol or cannabis use and have used both in the past three months. They must be willing to seek treatment and have a caregiver who can consent to their participation. Pregnant or breastfeeding individuals cannot join.

Inclusion Criteria

Patients must be seeking treatment for either cannabis or alcohol use

I am between 13 and 17 years old.

Patients must report co-occurring alcohol and cannabis use during the past three months

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a computerized intervention for reducing cannabis and alcohol use

1 week

Follow-up

Participants are monitored for safety and effectiveness after treatment

3 months

Follow-up assessments at one- and three-months

Treatment Details

Interventions

• modified Approach-Avoidance Task (mAAT) that does not aim to modify automatic approach bias.
• modified Approach-Avoidance Task (mAAT), which aims to modify automatic approach bias

Trial Overview The study tests a computerized task called modified Approach-Avoidance Task (mAAT) designed to change automatic tendencies towards substance use. Participants will either receive mAAT that aims to modify this bias or one that does not, assessing its effectiveness over time.

Participant Groups

Group I: Group A: Treatment Group Experimental Treatment 1 Intervention

Group II: Group B: Control Group Placebo Group 1 Intervention

Who Is Running the Clinical Trial?

Medical University of South Carolina

Lead Sponsor

Trials

994

Recruited

7,408,000+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials

2,658

Recruited

3,409,000+

Findings from Research

Motivational Interviewing is an effective, person-centered approach that helps individuals explore their ambivalence and activate their motivation for making positive lifestyle changes, particularly in managing conditions like diabetes and obesity.

The technique has been adapted for use in pediatric settings, addressing the unique challenges of engaging families with children at different developmental stages, showing its versatility across age groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The potential for motivational interviewing to improve outcomes in the management of diabetes and obesity in paediatric and adult populations: a clinical review. Christie, D., Channon, S.[2022]

This study will compare the effectiveness of a standard comprehensive intake assessment with a person-centered Motivational Interviewing (MI) intervention for adults seeking outpatient addiction treatment, involving 150 participants (75 in each group).

The trial aims to assess whether the MI approach can improve client engagement in treatment, as well as its feasibility and sustainability within addiction treatment programs, potentially reducing the high attrition rates seen during initial intakes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness and feasibility of a motivational interviewing intake (MII) intervention for increasing client engagement in outpatient addiction treatment: an effectiveness-implementation hybrid design protocol. Hurlocker, MC., Moyers, TB., Hatch, M., et al.[2023]

Motivational interviewing (MI) is a client-centered counseling approach that aims to promote behavior change, particularly in areas like diet and physical activity, and has its origins in addiction treatment.

While MI shows promise in helping patients make lifestyle changes, research results are mixed, indicating a need for further investigation into its implementation and effectiveness across different patient populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of motivational interviewing to improve chronic condition self-management: what does the research show us? Coyne, N., Correnti, D.[2019]

Motivational interviewing (MI) showed some effectiveness in reducing the number of cigarettes smoked per day among adolescents, with significant decreases reported at the 1-month follow-up, although overall abstinence rates were low and did not differ significantly from brief advice (BA).

MI was effective in changing adolescents' perceptions of peer and adult smoking norms, which could be beneficial for future smoking interventions, but it did not lead to higher motivation or self-efficacy to quit smoking compared to BA.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhanced motivational interviewing versus brief advice for adolescent smoking cessation: results from a randomized clinical trial. Colby, SM., Nargiso, J., Tevyaw, TO., et al.[2022]

Motivational Enhancement Therapy (MET), which incorporates Motivational Interviewing (MI), has been shown to effectively help adolescents consider and maintain changes to reduce harmful behaviors, such as smoking.

The structured approach of MET, which includes personalized feedback and follow-up, makes it a suitable brief intervention for adolescents, enhancing the likelihood of positive treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A motivational intervention for adolescent smokers. Lawendowski, LA.[2022]

Heavy cannabis users show a significant approach-bias towards cannabis-related images, indicating a tendency to seek out drug-related stimuli compared to non-users.

This approach-bias is predictive of increased cannabis use over a six-month period, suggesting it could be a useful indicator for identifying individuals at risk of escalating their cannabis consumption.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reaching out towards cannabis: approach-bias in heavy cannabis users predicts changes in cannabis use. Cousijn, J., Goudriaan, AE., Wiers, RW.[2021]

In a study involving 105 adult smokers, adding Approach-Avoidance Modification Training (AAMT) to standard treatment did not lead to a significant reduction in daily cigarette consumption compared to a sham training group.

The study found no consistent evidence that AAMT changed biases in information processing related to smoking, suggesting that future research should explore improved training methods for better outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Approach-avoidance modification as an add-on in smoking cessation: A randomized-controlled study. Wittekind, CE., Reibert, E., Takano, K., et al.[2020]

A pilot study involving 1082 participants using a mobile app for alcohol avoidance training showed a significant reduction in alcohol consumption, with an average decrease of 7.8 units per week after 3 weeks and an additional reduction of 6.2 units at 3 months.

The app was well-received, with 79% of participants completing the recommended sessions and positive feedback on its user-friendly design, indicating that mobile cognitive bias modification could be a promising tool for helping individuals reduce alcohol use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Alcohol Avoidance Training as a Mobile App for Problem Drinkers: Longitudinal Feasibility Study. Laurens, MC., Pieterse, ME., Brusse-Keizer, M., et al.[2021]

Cognitive Bias Modification through Approach Avoidance Training (CAAT) showed a trend towards reducing cannabis approach bias in a study of 41 cannabis-using youth, suggesting potential for altering automatic responses to drug cues.

While CAAT-training was associated with decreased activation in brain areas like the amygdala and medial prefrontal cortex in response to cannabis cues, it did not significantly change neural reactivity compared to a sham training, indicating the need for further research on the neural mechanisms involved.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Preliminary evidence that computerized approach avoidance training is not associated with changes in fMRI cannabis cue reactivity in non-treatment-seeking adolescent cannabis users. Karoly, HC., Schacht, JP., Jacobus, J., et al.[2020]

The study aims to evaluate the feasibility and acceptability of 'SWIPE,' a personalized and gamified smartphone app designed to help individuals with hazardous drinking habits reduce their alcohol consumption through approach bias modification (ABM).

By recruiting 500 participants who wish to reduce their drinking, the study will assess changes in alcohol consumption and cravings over four weeks, potentially providing a convenient and accessible intervention for those who may not seek traditional treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Personalized Approach Bias Modification Smartphone App ("SWIPE") to Reduce Alcohol Use Among People Drinking at Hazardous or Harmful Levels: Protocol for an Open-Label Feasibility Study. Manning, V., Piercy, H., Garfield, JBB., et al.[2020]

References

1. England pubmed.ncbi.nlm.nih.gov

The potential for motivational interviewing to improve outcomes in the management of diabetes and obesity in paediatric and adult populations: a clinical review. [2022]

2. England pubmed.ncbi.nlm.nih.gov

Effectiveness and feasibility of a motivational interviewing intake (MII) intervention for increasing client engagement in outpatient addiction treatment: an effectiveness-implementation hybrid design protocol. [2023]

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

Effectiveness of motivational interviewing to improve chronic condition self-management: what does the research show us? [2019]

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

Enhanced motivational interviewing versus brief advice for adolescent smoking cessation: results from a randomized clinical trial. [2022]

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

A motivational intervention for adolescent smokers. [2022]

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

Reaching out towards cannabis: approach-bias in heavy cannabis users predicts changes in cannabis use. [2021]

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

Approach-avoidance modification as an add-on in smoking cessation: A randomized-controlled study. [2020]

8. Canada pubmed.ncbi.nlm.nih.gov

Alcohol Avoidance Training as a Mobile App for Problem Drinkers: Longitudinal Feasibility Study. [2021]

9. Ireland pubmed.ncbi.nlm.nih.gov

Preliminary evidence that computerized approach avoidance training is not associated with changes in fMRI cannabis cue reactivity in non-treatment-seeking adolescent cannabis users. [2020]

10. Canada pubmed.ncbi.nlm.nih.gov

Personalized Approach Bias Modification Smartphone App ("SWIPE") to Reduce Alcohol Use Among People Drinking at Hazardous or Harmful Levels: Protocol for an Open-Label Feasibility Study. [2020]