{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T19:06:12Z","timestamp":1781636772808,"version":"3.54.5"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["2009851"],"award-info":[{"award-number":["2009851"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2026,1]]},"abstract":"Abstract<\/jats:title>\n \n Background and aims<\/jats:title>\n Several randomised controlled trials (RCTs) have demonstrated that delivering approach bias modification (ApBM) during residential alcohol use disorder (AUD) treatment helps prevent post\u2010treatment relapse. However, few studies have examined ApBM's efficacy for AUD in outpatients. We trialled a personalised ApBM smartphone app in individuals receiving outpatient AUD treatment.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n This double\u2010blind RCT randomised participants to receive ApBM or sham training, adjunctive to treatment as usual.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Participants were recruited from alcohol and other drug treatment services in Melbourne, Australia.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n 79 participants (mean age 46.6\u2009years; 45 male, 34 female) installed the app between May 2022 and January 2024.<\/jats:p>\n <\/jats:sec>\n \n Intervention and comparator<\/jats:title>\n \n In the ApBM condition, the app delivered personalised, gamified ApBM. Notifications prompted participants (\n n<\/jats:italic>\n \u2009=\u200939) to complete 2 ApBM sessions weekly for 4\u00a0weeks. The control version prompted participants (\n n<\/jats:italic>\n \u2009=\u200940) to complete a weekly sham\u2010training task for 4\u00a0weeks.\n <\/jats:p>\n <\/jats:sec>\n \n Measurements<\/jats:title>\n The primary outcome was number of standard drinks (10\u00a0g pure alcohol) consumed in week 4 of the intervention period, self\u2010reported in the app. Secondary outcomes included past\u2010week standard drinks at 8\u2010week and 16\u2010week follow\u2010ups, past\u2010week drinking days, past\u2010week heavy drinking days (HDDs; days when \u22655 standard drinks were consumed) and questionnaire measures of AUD severity, quality of life and alcohol craving. Primary analyses followed an intention\u2010to\u2010treat (ITT) approach, with secondary complete\u2010case sensitivity analyses also conducted for all outcomes.<\/jats:p>\n <\/jats:sec>\n \n Findings<\/jats:title>\n \n Groups did not statistically significantly differ in the primary outcome [values from ITT negative binomial model: ApBM\u2009=\u200975.49 standard drinks, control\u2009=\u200971.34 standard drinks, difference\u2009=\u20094.16, 95% confidence interval (CI) = \u221242.37 to 50.69,\n P<\/jats:italic>\n \u2009=\u20090.859]. Most analyses of secondary outcomes showed statistically non\u2010significant effects, with the only exception being past\u2010week standard drinks at the 16\u2010week follow\u2010up, where ApBM participants showed statistically significantly larger decreases than controls in past\u2010week standard drinks (reduction of 14.6, relative to baseline, versus 2.1 in controls; interaction \u03b2\u2009=\u2009\u221212.53, 95% CI = \u221223.85 to \u22121.22;\n P<\/jats:italic>\n \u2009=\u20090.030). Time x group interaction effects were statistically non\u2010significant for all other secondary outcomes (\n P<\/jats:italic>\n s\u2009>\u20090.069).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A smartphone app using approach bias modification showed no evidence for reducing alcohol use among alcohol use disorder outpatients after 4\u00a0weeks, or evidence for effects on most secondary outcomes, although 16\u2010week follow\u2010up results suggested that approach bias modification may have facilitated delayed\/longer\u2010term reductions in alcohol use.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/add.70184","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T09:10:23Z","timestamp":1756977023000},"page":"82-93","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy of a personalised alcohol approach bias modification smartphone app in people accessing outpatient alcohol use disorder treatment: A randomised controlled trial"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5076-6499","authenticated-orcid":false,"given":"Joshua B. B.","family":"Garfield","sequence":"first","affiliation":[{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University Melbourne Australia"},{"name":"Turning Point Eastern Health Richmond Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bosco","family":"Rowland","sequence":"additional","affiliation":[{"name":"Monash Addiction Research Centre, Eastern Health Clinical School Monash University Melbourne Australia"},{"name":"Turning Point Eastern Health Richmond Victoria Australia"},{"name":"Faculty of Health, School of Psychology Deakin University Burwood Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel K.","family":"Liu","sequence":"additional","affiliation":[{"name":"Turning Point Eastern Health Richmond Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugh","family":"Piercy","sequence":"additional","affiliation":[{"name":"Monash Addiction 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