Assessment of Tobacco-Related Approach and Attentional Biases in Smokers, Cravers, Ex-Smokers, and Non-Smokers.

Marcella L Woud,Joyce Maas,Reinout W Wiers,Eni S Becker,Mike Rinck

doi:10.3389/fpsyg.2016.00172

Abstract

According to theories of addictive behaviors, approach and attentional biases toward smoking-related cues play a crucial role in tobacco dependence. Several studies have investigated these biases by using various paradigms in different sample types. However, this heterogeneity makes it difficult to compare and evaluate the results. The present study aimed to address this problem, via (i) a structural comparison of different measures of approach-avoidance and a measure of smoking-related attentional biases, and (ii) using within one study different representative samples in the context of tobacco dependence. Three measures of approach-avoidance were employed: an Approach Avoidance Task (AAT), a Stimulus Response Compatibility Task (SRC), and a Single Target Implicit Association Test (ST-IAT). To assess attentional biases, a modified Stroop task including smoking-related words was administered. The study included four groups: n = 58 smokers, n = 57 non-smokers, n = 52 cravers, and n = 54 ex-smokers. We expected to find strong tobacco-related approach biases and attentional biases in smokers and cravers. However, the general pattern of results did not confirm these expectations. Approach responses assessed during the AAT and SRC did not differ between groups. Moreover, the Stroop did not show the expected interference effect. For the ST-IAT, cravers had stronger approach associations toward smoking-related cues, whereas non-smokers showed stronger avoidance associations. However, no such differences in approach-avoidance associations were found in smokers and ex-smokers. To conclude, these data do not provide evidence for a strong role of implicit approach and attentional biases toward smoking-related cues in tobacco dependency.

Highlights

I need more cigarettes Give me more cigarettes, I need Gotta get more cigarettes I want more cigarettes Cigarettes Cigarettes (More Cigarettes–Replacements–2012)Tobacco-Related Approach BiasesThe inability to control drug use is a hallmark symptom of a drug addiction (Diagnostic Statistical Manual of Mental Disorders; DSM-5; 2013)
The present study aimed to address this problem via (i) a structural comparison of different measures of approach-avoidance and the most commonly used paradigm to assess attentional biases, and (ii) using within one study different representative samples in the context of tobacco dependence
These outcomes were treated as follows: For age, we repeated the main analyses including age as a covariate. This did not change the results, and for clarity and given the lack of specific hypotheses regarding age, we report unadjusted analyses without this covariate, and did not analyse this baseline imbalance further

Summary

Introduction

I need more cigarettes Give me more cigarettes, I need Gotta get more cigarettes I want more cigarettes Cigarettes Cigarettes (More Cigarettes–Replacements–2012)Tobacco-Related Approach BiasesThe inability to control drug use is a hallmark symptom of a drug addiction (Diagnostic Statistical Manual of Mental Disorders; DSM-5; 2013). It has been suggested that the latter processes are involved in emotional and motivational aspects of behavior. Such dual process models of addiction posit that addictive behaviors are the result of an imbalance between these two processes, i.e., there is no cooperative interplay: There are activated, drugoriented impulsive processes, in combination with relatively slow reflective processes that are not strong enough to control or regulate the impulsive process. In line with the incentive-sensitization-theory of Robinson and Berridge (1993, 2003, 2008), dual process models of addiction hypothesize that the impulsive processes become sensitized with repeated drug use. From an information processing perspective, this explains behavioral phenomena such as attentional and approach biases for drug-related cues: Due to the incentive salience of these cues, they automatically capture an individual’s attention and activate approach-related behaviors

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Conclusion