# Neural Links of Approach Bias Modification in Heavy Drinking Veterans

> **NIH VA IK2** · VETERANS AFFAIRS MED CTR SAN FRANCISCO · 2021 · —

## Abstract

The overall goal of the proposed project is to improve the care of Veterans who consume alcohol at heavy and
unhealthy levels. Heavy alcohol use is highly prevalent among military Veterans, related to many other mental
health and chronic medical conditions, contributes to high-risk behaviors such as violence and suicide, and is a
leading preventable cause of morbidity and mortality. A tendency to automatically approach alcohol has been
identified in heavy drinking students and European in-patient populations. This alcohol approach-bias
contributes to continued alcohol use despite an explicit desire to quit. Alcohol approach-bias modification
(AABM), a cognitive training program has been shown to remediate alcohol approach-bias and reduce alcohol
relapse rates. However, we currently do not know the extent of alcohol approach-bias related neural activity in
heavy drinking Veterans with highly prevalent comorbid conditions (i.e., PTSD and mild traumatic brain injury),
or the extent to which these Veterans will respond to AABM training. Additionally, the mechanisms of functional
connectivity in alcohol approach-bias reward neural circuitry remain largely unknown.
Therefore, the proposed CSR&D CDA-2 seeks to fill these gaps by conducting a longitudinal observational
study designed to evaluate the neural associations of alcohol approach-bias and AABM training. The research
study has three overarching aims: Aim 1: To investigate neural activation and connectivity during an alcohol
approach-avoidance task and an alcohol cue-reactivity task; Aim 2: To investigate neural change following
AABM training; Aim 3: To measure and investigate neural, cognitive, and psychiatric predictors of behavioral
response to AABM training. To test these aims, 50 heavy drinking Veterans and 20 healthy light/non-drinking
Veteran controls will be recruited from the San Francisco Veterans Affairs Medical Center and affiliated clinics.
We will compare baseline neural and behavioral characteristics between these two groups. Heavy drinking
Veterans will then complete 3 weeks (9 sessions) of AABM training. Following training, heavy drinking
Veterans will repeat the neural and behavioral assessments completed at baseline. Heavy drinking Veterans
will also complete a follow-up assessment at 3 months post-baseline to evaluate sustained behavioral change
(e.g., reduced alcohol use). The proposed work will directly harness the neuroanatomical precision and spatial
resolution of functional magnetic resonance imaging (fMRI) data.
The proposed CDA-2 will be the first to: 1) investigate the underlying neural and cognitive mechanisms of
alcohol approach-bias in a population of heavy drinking Veterans, 2) examine functional connectivity during an
alcohol approach-avoidance task, 3) investigate the extent to which both fMRI activation and connectivity data
predict response to AABM, 4) investigate the extent to which neurocognitive and psychiatric symptoms
common in heavy drinking Veterans predi...

## Key facts

- **NIH application ID:** 10291809
- **Project number:** 5IK2CX001510-05
- **Recipient organization:** VETERANS AFFAIRS MED CTR SAN FRANCISCO
- **Principal Investigator:** David L Pennington
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-06-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10291809

## Citation

> US National Institutes of Health, RePORTER application 10291809, Neural Links of Approach Bias Modification in Heavy Drinking Veterans (5IK2CX001510-05). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10291809. Licensed CC0.

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