A Review of Computer-Based Interventions Used in the Assessment, Treatment, and Research of Drug Addiction

Abstract

Computer-based interventions are cost-efficient methods that may result in greater access to drug addiction treatment. We review recent findings from our laboratory where computer-based interventions have produced outcomes that are comparable to therapist-delivered interventions. We also examine how computer-based interventions targeting substance abuse disorders relate to cognitive functioning. This review will suggest that not only are computer-based interventions cost-efficient and accessible but that they are also effective methods for the motivation, engagement, and treatment of drug-dependent individuals. Moreover, computer-based interventions are compatible with a recently proposed biological mechanism implicated as the basis for drug addiction.

Keywords :

• drug dependence
• discounting
• temporal discounting
• computer-based programs
• technologies
• neuroimaging
• functional magnetic resonance imaging (fMRI)
• substance abuse

THE AUTHORS

Warren K. Bickel, Ph.D., is the Wilbur D. Mills Chair of Alcoholism and Drug Abuse Prevention, Professor of psychiatry, and Director of the Center for Addiction Research, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas. Dr. Bickel also serves as Director of College of Public Health's Center for the Study of Tobacco Addiction at the UAMS. He has been continuously funded as Principal Investigator with several concurrent grants since 1988. His recent research includes the application of behavioral economics and neuroeconomics to drug dependence with an emphasis on the discounting of the future and the use of information technologies to deliver science-based prevention and treatment. He is the recipient of numerous awards and honors including the Joseph Cochin Young Investigator Award from the College on Problems of Drug Dependence, the Young Psychopharmacologist Award from the Division of Psychopharmacology and Substance Abuse of the American Psychological Association, a National Institutes of Health MERIT Award from the National Institute on Drug Abuse, and Researcher of the Year from the Arkansas Psychological Association's Honors for Outstanding Contribution. He served as President of the Division of Psychopharmacology and Substance Abuse, American Psychological Association, and as President of the College on Problems of Drug Dependence. He was editor of the journal Experimental and Clinical Psychopharmacology, has coedited five books, and has published over 250 papers.

Darren R. Christensen, Ph.D., Postdoctoral Research Fellow, Center for Addiction Research, UAMS. Dr. Christensen completed his Ph.D. in psychology at the University of Canterbury, New Zealand, where he studied quantitative models of choice and decision-making under Associate Professor Dr. Randolph Grace. His Ph.D. thesis culminated in an extended model of decision-making that describes both the acquisition and the steady state of nonhuman choice behavior and found a hitherto unknown phenomenon when the initial-link duration is increased and terminal-link delays are constant. Moreover, the extended model exhibited parameter invariance qualities when an archival data set was examined. His research interests are, broadly speaking, the quantification of decision-making and choice behavior including drug addiction and the neurological bases of behavior.

Lisa A. Marsch, Ph.D., is the Director of the Center for Technology and Health at National Development and Research Institutes, Inc., New York, New York. She has conducted numerous research studies focused on examining how technology can be used to enhance the reach of science-based prevention and treatment interventions. She has directed several projects focused on developing and evaluating interactive, computer-based systems that deliver evidence-based interventions using effective learning and informational technologies, including computer-based behavioral therapy for individuals with substance use disorders, HIV prevention for injection drug users, HIV and STI prevention for young drug users, and substance abuse prevention for children and adolescents. This research has provided novel empirical information regarding the role that technology may play in improving substance abuse prevention and treatment in a manner that is cost-effective, ensures fidelity, and enables the rapid diffusion and widespread adoption of science-based interventions. She serves as a scientific reviewer for the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, and the National Institute on Mental Health. Dr. Marsch is also on the editorial boards for the Journal of Child and Adolescent Substance Abuse, Substance Use and Misuse, and Experimental and Clinical Psychopharmacology.

GLOSSARY

• Computer-delivered therapy: Computer-delivered therapy is a computer-based media that provides users with information designed to supply therapeutic treatment.

• The executive system: The executive system is a theorized cognitive system that controls and manages other cognitive processes. It is thought to be involved in processes such as planning, cognitive flexibility, abstract thinking, rule acquisition, initiating appropriate actions and inhibiting inappropriate actions, and selecting relevant sensory information.

• Functional magnetic resonance imaging (fMRI): Functional magnetic resonance imaging is a type of specialized magnetic resonance imaging scan. It measures the haemodynamic response related to neural activity in the brain or spinal cord of humans or other animals.

• Information technology: Information technology is computer-based information systems, particularly software applications and computer hardware.

• Neurocognitive rehabilitation: Neurocognitive rehabilitation is a therapeutic effort to achieve functional changes by (1) reinforcing, strengthening, or reestablishing patterns of behavior or (2) establishing new patterns of cognitive activity or compensatory mechanisms for impaired neurological systems.

• Neuroscience: Neuroscience is the field devoted to the scientific study of the nervous system. This ranges from the biochemical and genetic analysis of dynamics of individual nerve cells and their molecular constituents to imaging representations of perceptual and motor tasks in the brain.

• Prefrontal cortex: The prefrontal cortex is the anterior part of the frontal lobes of the brain found in humans and higher mammals.

Notes

1 The journal's style utilizes the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused. Editor's note.