An experimental test of integrating imagery with approach bias modification for alcohol: A cautionary tale.

Objectives: In terms of dual process models, behaviour can be conceived of as the outcome of an interplay between reflective, top‐down and impulsive, bottom‐up processes. Behaviour change interventions may benefit from targeting both types of processes in a coherent way. One approach to this, in the context of reducing hazardous drinking, is to combine imagery involving real‐life situations involving alcohol with the simple actions involved in Approach Bias Modification (ApBM), a form of Cognitive Bias Modification. Design: We developed and tested a version of this Imagery‐enhanced Approach Bias Modification (IApBM) in an experimental design, with two independent factors: imagery versus control and ApBM versus control training components (N = 139). Methods: An effect of integrating the training factors was hypothesized on the alcohol‐approach bias of an alcohol Approach‐Avoidance Task. Further exploratory analyses were performed for the bias on alcohol‐related Single Attribute Implicit Association Tests and on alcohol‐related questionnaires. Finally, the psychometric properties of an imagery interference effect during training were explored. Results: Results showed no benefit of the training and in fact suggested a negative interaction in which combining the training components appeared to block reductions in craving effected by each in isolation. The reliability of the imagery‐related interference effect was high and the effect was correlated with alcohol‐related scales. Conclusions: In conclusion, it appears that interference between training components decreases their individual effects when combining imagery and ApBM in the current way. The imagery‐related interference effects that could be measured during training conditions may be useful as an implicit measure of automatic processes underlying hazardous drinking. [ABSTRACT FROM AUTHOR]