Gamified Adaptive Approach Bias Modification: a Pilot RCT in Individuals with Methamphetamine Use History

Abstract

AbstractIMPORTANCECognitive bias modification (CBM) programs have shown promise in treating psychiatric conditions, but they can be perceived as boring and repetitive. Incorporating gamified designs and adaptive algorithms in CBM training may address this issue and enhance engagement and effectiveness.OBJECTIVETo assess the efficacy of an adaptive approach bias modification (A-ApBM) paradigm with gamified designs and dynamic difficulty adjustments in reducing cue-induced craving in individuals with methamphetamine use history. DESIGN: Randomized controlled trial with three study groups: Adaptive ApBM (A-ApBM), Static ApBM (S-ApBM), and control.SETTINGTwelve community-based rehabilitation centers in Sichuan, China.PARTICIPANTSIndividuals aged 18-50 with methamphetamine dependence were randomized.INTERVENTIONA-ApBM and S-ApBM groups engaged in ApBM training using a smartphone application for four weeks. A-ApBM used an adaptive algorithm to dynamically adjust the difficulty level based on individual performance, while S-ApBM had a static difficulty level.MAIN OUTCOMES AND MEASURESCue-induced craving scores assessed using a visual analog scale at baseline, post-intervention, and at week-16 follow-up.RESULTSThe A-ApBM group showed a significant reduction in cue-induced craving scores at post-intervention compared to baseline (p = 0.02). The reduction remained significant at the week-16 follow-up (p = 0.01). No significant changes were observed in the S-ApBM and control groups.CONCLUSION AND RELEVANCEThe adaptive ApBM paradigm with gamified designs and dynamic difficulty adjustments may be an effective intervention for reducing cue-induced craving in individuals with methamphetamine use history. This approach improves engagement and personalization, potentially enhancing the effectiveness of CBM programs. Further research is needed to validate these findings and explore the application of adaptive ApBM in other psychiatric conditions.TRIAL REGISTRATIONRegistered atclinicaltrials.gov(IDNCT05794438).