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

Hollis C Karoly; Joseph P Schacht; Joanna Jacobus; Lindsay R Meredith; Charles T Taylor; Susan F Tapert; Kevin M Gray; Lindsay M Squeglia

doi:10.1016/j.drugalcdep.2019.04.007

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

Drug Alcohol Depend. 2019 Jul 1:200:145-152. doi: 10.1016/j.drugalcdep.2019.04.007. Epub 2019 May 14.

Authors

Hollis C Karoly¹, Joseph P Schacht², Joanna Jacobus³, Lindsay R Meredith⁴, Charles T Taylor³, Susan F Tapert³, Kevin M Gray², Lindsay M Squeglia²

Affiliations

¹ University of Colorado Boulder, Institute of Cognitive Science, Boulder, CO, USA. Electronic address: hollis.karoly@colorado.edu.
² Department of Psychiatry and Behavioral Sciences, Addiction Sciences Division, Medical University of South Carolina, Charleston, SC, USA.
³ Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
⁴ Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA.

Abstract

Background: Cognitive Bias Modification (CBM) has garnered interest as a potential addiction treatment. CBM interventions such as Approach Avoidance Training (AAT) are designed to alter automatic tendencies to approach drugs or drug-related cues. In our previous work, the cannabis AAT (CAAT) reduced cannabis approach bias, which was related to reduced cannabis use, among 80 non-treatment-seeking cannabis-using youth (Jacobus et al., 2018). In this preliminary examination, a subsample of these youth underwent neuroimaging to explore CAAT's effect on cannabis cue-related neural activation.

Methods: Sub-study participants were 41 cannabis-using youth ages 17-21 (mean age = 18.83; 47.5% female). Participants completed a cannabis cue-reactivity task during a functional MRI scan pre- and post CAAT-training or CAAT-sham to examine CAAT-related neural changes.

Results: Thirty-seven youth completed all six CAAT (n = 19) or CAAT-sham (n = 18) training sessions and had usable neuroimaging data. The group*time interaction on cannabis approach bias reached trend-level significance (p = .055). Change in approach bias slopes from pre-to post-treatment was positive for CAAT-sham (increased approach bias) and negative for CAAT-training (change to avoidance bias), consistent with the larger study. No significant changes emerged for cannabis cue-induced activation following CAAT-training or CAAT-sham in whole brain or region of interest analyses. However, active CAAT-training was associated with small-to-medium decreases in amygdala (Cohen's d_z = 0.36) and medial prefrontal cortex (Cohen's d_z = 0.48) activation to cannabis cues.

Conclusions: Despite reducing cannabis use in the larger sample, CAAT-training did not alter neural cannabis cue-reactivity in the sub-study compared to CAAT-sham. More research is needed to understand neural mechanisms underlying AAT-related changes in substance use.

Keywords: Adolescence; Cannabis; Cognitive bias modification; Cue-Reactivity; Neuroimaging.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adolescent
Adolescent Behavior / psychology*
Avoidance Learning* / physiology
Behavior, Addictive / diagnostic imaging
Behavior, Addictive / psychology
Brain / diagnostic imaging*
Cues
Double-Blind Method
Female
Humans
Magnetic Resonance Imaging / methods
Magnetic Resonance Imaging / trends*
Male
Marijuana Abuse / diagnostic imaging
Marijuana Abuse / psychology
Marijuana Abuse / therapy
Marijuana Smoking / psychology
Marijuana Smoking / therapy*
Photic Stimulation / methods
Pilot Projects
Therapy, Computer-Assisted / methods
Therapy, Computer-Assisted / trends*
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding