Development and standardization of Indian Alcohol Photo Stimuli (IAPS) for cue-reactivity paradigms in patients with alcohol use disorder

Indian J Psychiatry. 2024 Feb;66(2):135-141. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_233_23. Epub 2024 Feb 12.

Abstract

Background: The availability of appropriate alcohol-related stimuli is a crucial concern for the evaluation and treatment of patients with alcohol dependence syndrome. The study aimed to standardize alcohol-related images with cultural relevance to the Indian setting.

Methods: We produced an extensive database of 203 pictures, the Indian Alcohol Photo Stimuli (IAPS), portraying different categories and types of alcoholic beverages, after removing the confounding effects of low-level stimulus parameters (e.g. brightness and blurriness). Thirty patients with alcohol dependence syndrome, currently abstinent, rated each image on visual analog scale (VAS) ranging from 0 (no craving) to 10 (extreme), to determine how typical the stimuli served as craving-relevant stimuli.

Results: The mean VAS scores across beverages (ordered from highest to lowest) were whiskey >rum >beer >wine >vodka. Repeated-measures analysis of variance (ANOVA) showed a significant difference in mean VAS scores across beverages (F = 2.93, df = 2.9/86.3, P = 0.039, Greenhouse-Geisser corrected); the effect size for the difference was small (ηp2 = 0.092). A post hoc Bonferroni shows significantly higher VAS scores with whiskey compared with vodka (P = 0.029), whereas the scores were similar across other beverages. A two-way repeated-measures ANOVA for interaction between type of alcoholic beverages and activity was not significant (F = 2.67, df = 2.6/76.6, P = 0.061, Greenhouse-Geisser corrected).

Conclusions: We created a standardized alcohol-related image database for studying cue-reactivity paradigms in individuals with alcohol use disorder (AUD). Further research is needed to validate the impact of image features on cue reactivity.

Keywords: Alcohol; alcohol dependence; craving; cue reactivity.