Cognitive Bias Modification (CBM) to Promote Neuroplasticity and Reduce Alcohol Use in Problematic Drinkers

Sun, 13 Sep 2026 01:00:00 +0100

Project Overview

This project investigates whether Cognitive Bias Modification (CBM) can promote functional neuroplasticity in neural systems involved in reward processing and craving among individuals with problematic alcohol use. Combining electroencephalography (EEG), joystick-based approach–avoidance training, and daily ecological momentary assessment (EMA), the study will examine whether a multi-session CBM intervention can reduce automatic approach tendencies towards alcohol, modulate underlying neural responses related to reward processing, and translate into reductions in daily craving and alcohol consumption.

Background

Problematic alcohol use and alcohol use disorder (AUD) are partly maintained by automatic cognitive and motivational biases. Alcohol-related cues can preferentially capture attention and trigger approach tendencies, often at the expense of responses to natural rewards. These processes are associated with dysregulation in prefrontal–striatal circuits and with altered electrophysiological markers of cue reactivity, reward processing, and executive control. Cognitive Bias Modification delivered through an Approach–Avoidance Task (AAT) is a promising, non-invasive intervention designed to retrain these automatic motivational tendencies. During training, alcohol-related stimuli are repeatedly paired with avoidance movements, whereas natural reward cues are paired with approach movements. Although CBM has shown potential to reduce alcohol-related approach bias, its neurophysiological mechanisms remain poorly understood. This study will test whether joystick-based CBM produces measurable changes in EEG/ERP markers of reward processing and cognitive control, and whether these changes are associated with improvements in craving and alcohol use in daily life. Establishing these links would support a scalable, mechanistically informed behavioral intervention for problematic alcohol use and relapse prevention.

Research Aims

Evaluate whether multi-session CBM reduces automatic approach bias towards alcohol-related cues
Examine functional neuroplasticity through pre- to post-intervention changes in EEG/ERP markers of reward processing
Assess whether CBM-related neural changes are associated with reductions in daily craving and alcohol use, measured through smartphone-based EMA
Determine the feasibility and acceptability of combining laboratory EEG assessments, multi-session joystick-based training, and longitudinal daily app-based monitoring

Methods

Experimental Paradigm and Laboratory EEG

Participants will complete laboratory assessments before and after the intervention, including EEG recording during passive and active computer-based tasks. These tasks will assess neural responses to alcohol-related cues relative to alternative or natural reward stimuli. Participants will also complete standardized clinical and psychological measures of alcohol-use severity, craving, and behavioral tendencies.

CBM Intervention Protocol

Participants will complete five targeted CBM sessions using a joystick-based AAT. The training will implicitly pair alcohol-related cues with avoidance movements, requiring participants to push the joystick away, and pair natural reward cues with approach movements, requiring participants to pull the joystick towards themselves. Sessions are scheduled flexibly to support adherence.

Ecological and Behavioral Measures

Participants will complete daily EMA assessments via a smartphone application for 15 consecutive days. These assessments will capture momentary craving, alcohol use, contextual triggers, and relevant environmental or emotional factors in participants' everyday lives.

Sample and Design

The study will use a longitudinal design involving non-treatment-seeking adults aged 18 to 50 years with frequent or problematic alcohol consumption patterns.

Significance

This project addresses a central neurocognitive mechanism in addiction: the interaction between automatic alcohol-approach bias and dysregulated reward processing. By directly testing CBM as a potential driver of functional neuroplasticity, the study will clarify whether changes in automatic behaviour are accompanied by measurable changes in brain function and alcohol use behavior. The integration of high-temporal-resolution EEG measures with real-world EMA data will bridge laboratory neuroscience and daily-life behavior. If successful, the findings will provide neurophysiological evidence for CBM as an accessible, non-pharmacological approach to reducing craving and supporting relapse prevention in individuals with problematic alcohol use.

Approach-Avoidance Task | NeuroAdx Lab