Predictors of Changes in Alcohol Craving Levels during a Virtual Reality Cue Exposure Treatment among Patients with Alcohol Use Disorder

Olga Hernández-Serrano; Alexandra Ghiţă; Natàlia Figueras-Puigderrajols; Jolanda Fernández-Ruiz; Miquel Monras; Lluïsa Ortega; Silvia Mondon; Lidia Teixidor; Antoni Gual; Lidia Ugas-Ballester; Maribel Fernández; Roger Montserrat; Bruno Porras-Garcia; Marta Ferrer-Garcia; José Gutiérrez-Maldonado

doi:10.3390/jcm9093018

Predictors of Changes in Alcohol Craving Levels during a Virtual Reality Cue Exposure Treatment among Patients with Alcohol Use Disorder

J Clin Med. 2020 Sep 18;9(9):3018. doi: 10.3390/jcm9093018.

Authors

Olga Hernández-Serrano¹, Alexandra Ghiţă², Natàlia Figueras-Puigderrajols², Jolanda Fernández-Ruiz², Miquel Monras³, Lluïsa Ortega³, Silvia Mondon³, Lidia Teixidor³, Antoni Gual³, Lidia Ugas-Ballester², Maribel Fernández², Roger Montserrat², Bruno Porras-Garcia², Marta Ferrer-Garcia², José Gutiérrez-Maldonado²

Affiliations

¹ Department of Physical Therapy, Escola Universitària de la Salut i l'Esport (EUSES)-University of Girona, Carrer Francesc Macià, 65, Campus of Salt, 17190 Girona PC, Spain.
² Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de Vall d'Hebron, 175, 08035 Barcelona PC, Spain.
³ Addictive Behaviors Unit, Hospital Clinic of Barcelona, Carrer de Villarroel, 170, 08036 Barcelona PC, Spain.

Abstract

Background/objective: Determining the predictive variables associated with levels of alcohol craving can ease the identification of patients who can benefit from treatments. This study aimed to describe changes (improvement or no change/deterioration) in alcohol craving levels and explore the predictors of these changes from admission to discharge in outpatients with alcohol use disorder (AUD) undergoing treatment-as-usual (TAU), or treatment-as-usual supplemented with virtual reality cue-exposure therapy (TAU + VR-CET).

Method: A prospective cohort study was conducted amongst 42 outpatients with AUD (n = 15 TAU + VR-CET and n = 27 TAU) from a clinical setting. Changes in the levels of alcohol craving between admission and discharge were assessed with the Multidimensional Alcohol Craving Scale. Sociodemographic characteristics (age, gender, education, and socioeconomic and civil status), cognitive-affective behavioral patterns (AUD severity, abstinence duration, psychiatric comorbidity, state anxiety, attentional bias, and substance use), and type of treatment (TAU + VR-CET and only TAU) were also evaluated.

Results: The TAU + VR-CET group showed greater changes of improvement in the levels of alcohol craving than the TAU group (χ² = 10.996; p = 0.001). Intragroup changes in alcohol craving from pre to post-treatment were significant in the TAU + VR-CET group (χ² = 13.818; p = 0.003) but not within the TAU group (χ² = 2.349; p = 0.503). The odds of an improvement in any of the craving levels between pre- and post-test was 18.18 (1/0.055) times higher in the TAU + VR-CET group with respect to the TAU group. The use of illicit drugs in the month prior to the test increased the odds of having a positive change by 18.18 (1/0.055) with respect to not having consumed.

Conclusions: Including VR-CET in TAU programs may provide benefits in the treatment of AUDs mainly among patients with intense alcohol craving and individuals having used illicit substances prior to treatment.

Keywords: alcohol use disorder; craving; cue exposure therapy; treatment-as-usual; virtual reality.

Abstract

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