Development and standardization of Indian Alcohol Photo Stimuli (IAPS) for cue‑reactivity paradigms in patients with alcohol use disorder

Abstract

Background: The availability of appropriate alcohol-related stimuli is a crucial concern for the evaluation and treatment of patients with alcohol dependence syndrome. The study aimed to standardize alcohol-related images with cultural relevance to the Indian setting. Methods: We produced an extensive database of 203 pictures, the Indian Alcohol Photo Stimuli (IAPS), portraying different categories and types of alcoholic beverages, after removing the confounding effects of low‑level stimulus parameters (e.g. brightness and blurriness). Thirty patients with alcohol dependence syndrome, currently abstinent, rated each image on visual analog scale (VAS) ranging from 0 (no craving) to 10 (extreme), to determine how typical the stimuli served as craving-relevant stimuli. Results: The mean VAS scores across beverages (ordered from highest to lowest) were whiskey >rum >beer >wine >vodka. Repeated‑measuresanalysisofvariance(ANOVA)showedasignificantdifferenceinmeanVASscoresacrossbeverages(F=2.93, df = 2.9/86.3, P = 0.039, Greenhouse–Geisser corrected); the effect size for the difference was small (ηp2 = 0.092). A post hoc Bonferroni shows significantly higher VAS scores with whiskey compared with vodka (P = 0.029), whereas the scores were similar across other beverages. A two-way repeated-measures ANOVA for interaction between type of alcoholic beverages and activity was not significant (F = 2.67, df = 2.6/76.6, P = 0.061, Greenhouse–Geisser corrected). Conclusions: We created a standardized alcohol-related image database for studying cue-reactivity paradigms in individuals with alcohol use disorder (AUD). Further research is needed to validate the impact of image features on cue reactivity.