Cincy Science: Local researchers are testing a computer program for people who drink to ease anxiety

CINCINNATI - You have a problem. Social situations make you nervous, invariably leading you to drink too much. Don’t decide to take a pass on that party just yet, the solution may be as simple as accessing your computer, tablet or smart phone.

Grant recipients Miami University and University of Cincinnati will conduct a clinical trial to evaluate a new computer program designed to help people develop healthy mental habits related to alcohol and social anxiety.

The Attention Modification Program (AMP) attempts to change what individual’s focus their attention on in daily circumstances.

Joshua Magee, principle investigator for the UC trial, explained the how the program retrains the subconscious to better react to both issues.

LEARN MORE: What is social anxiety disorder?

Q&A with Joshua Magee, Ph.D.

What are the links between social anxiety and problem drinking?

We think that attention functions in a very similar way for both problems. One of the reasons we chose to do both of them together is that, we do end up seeing a lot of interconnection among the two problems.

For example, a lot of people may drink to deal with their anxiety about social situations. They may drink so that they more comfortably may enter those social situations or afterwards when they are worrying about what they said or how they were perceived. 

So one of the questions we’re also interested in is whether receiving training for both types of problems could have positive effects above and beyond either training, given that the problems can be interrelated.

How did the idea for AMP come about?

During the last two decades, we’ve really come to focus on the way people pay attention to their environment and how it matters in terms of mental health problems. For example, if someone is walking down the street, their brain is absorbing all this information, it’s just a flood – people going by, cars, stores, things like that. And your brain is selecting things to pay attention to for you to focus on that it thinks are important.

So in our study, we’re linking this to social anxiety and problems alcohol in that both of types of mental health problems have particular attention styles where for social anxiety, those people are really likely to have their brain zero in on negative social information, like somebody walking by with a threatening expression on their face.

Is it the same premise with alcohol?

For alcohol, it’s a similar issue where this person’s brain is really going to zero in on that liquor store that they walk by and have trouble pulling their attention away from it. Both of these attention patterns are things that we think put people with these problems at further risk. So what the trial is doing is we’re trying to directly shift these attention styles using a relatively simple computer program and based on a lot of evidence in the research literature, you can shift these attention styles.

We basically just train people to learn to have their attention start to go away from these things instead of towards it. And I think one of the coolest aspects of this is that it the way attention works is it’s largely outside of our awareness to what we can control. So we are retraining things that people might not even be able to control if they want to.

How many treatments do people receive?

The actual training takes place over four weeks. We have people come in twice a week for half an hour training sessions. So they do a total of eight half an hour training sessions. When you think about it, that’s a pretty minimal commitment for problems that have been long-standing for years or decades.

Will this be considered a cure or will people need to come back for additional treatments?

We’re not sure. It is a psychological treatment and ideally psychological treatments work so that people don’t have to keep revisiting it significantly in the future. However since this type of intervention that shifts attention is relatively new, we don’t know yet if those effects do maintain for the long term or if people might need what we call booster sessions every now and then.

Usually alcoholics only succeed if they’re "ready to quit." Do people need to be at that stage?

Everyone who comes into the trial is at a point where they’re willing to consider cutting down on their drinking. So they may not be sold on the fact that they want to quit, but they’re at least willing to consider it. So we think that this type of treatment is going to be more palatable for people who are going to be at least partially willing to consider it.

However, it does have a lot of potential for other applications for people who do not feel ready, but may do a program like this. Because again, we’re treating things that are outside of people’s awareness and outside of their control, so even if they feel like they don’t really want to quit yet, it may be that we can help them along that path through a program like this.

For people who just want to drink less, could this program help them as well?

This type of program should have applicability across whatever spectrum of the problem you’re studying exists. With some of the recent shifts of our understanding about alcohol, people have moved a little bit away from either you have alcohol dependence or not in a real categorical way of thinking about it and more about thinking of it as a continuum. We think that attention exists on a continuum, so by shifting attention we’re likely to have effects for people whether they have the higher level of problems on that continuum or moderate levels like you’re suggesting.

What types of social anxiety issues does AMP treat?

It’s about feeling a lot discomfort and avoiding a variety of social situations and this could range from talking in small groups with friends or at work, eating or drinking in public where people are able to observe you. Things like calling a stranger, meeting new people, going to a party – a lot of situations like these.

The goal with this treatment is that we hope to help their attentions style so that instead of talking to the group and zeroing in on that one person that has the negative facial expression, they can pay attention instead to the other six people who look positively and are giving a lot of positive social feedback. So by adjusting their attention style we can start to a change where they can feel better about their interaction and less anxious.

If successful, will you be able to treat other disorders?

There’s lot of applicability. So on the substance side, attention plays a role in a lot of other substance problems too, whether it’s smoking or other different types of stimulant abuse. With anxiety, I think there already is a lot of research about the way that attention plays a role in a variety of anxiety disorders. One way to expand this is to look at different problem areas.

Another way to expand it is we’re really interested in the technology part. You can imagine with a program like this, if it is successful it would be extremely easy to roll out into the community in way that your doctor or your counselor could just give you the program. You could take it home and do it whenever you want, whenever or wherever you are. I think it has a ton of potential for inexpensively helping people with these problems. Say you’re getting ready to go into a big meeting you’re anxious about and you dial this up and do it for a few minutes.

What’s the next step after the trial?

We’ll be running the trial for awhile. We are following up with people after the treatment ends, one week and one month later to see how they’re doing. We’ll be working until the end of March, so about nine more months. At that point we’ll be looking at the nuances of how it works and whether it works and hopefully taking some next steps at extending it. So if it works, looking into some ways we can start educating physicians and community members about this program and how it can be used in their setting.

Are you still looking for participants?

We are still looking. We have currently worked with about 50 individuals and we’re aiming for a total of 80 by the end of the project. With any type of problem, if you already knew the answer you wouldn’t have to do the research, but there are a lot of reasons to be excited about it.

For more information about the trial, call 866-267-5165 or email blockssn@uc.edu.

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