Attentional biases in drug abuse and addiction

Abstract

Drug abuse and addiction are associated with biases in selective attention for drug-associated stimuli. This chapter reviews this literature and discusses it within existing theoretical frameworks. Although the existence of attentional biases is well documented, a variety of different paradigms (that may tap different mechanisms) have been used, leaving the cognitive and attentional processes involved in attentional biases poorly understood and in need of clarification. Consistent with some theoretical predictions, the evidence suggests that attentional biases operate in early stages of attentional processing and thus they may be ‘automatic’. Attentional biases are closely associated with subjective drug craving, and recent research suggests that this relationship may be bidirectional in nature: elevated drug craving may make drug-related cues more salient, but pronounced attentional biases may promote further increases in craving. Theoretical predictions that attentional biases are ultimately caused by classical conditioning mechanisms, and the relationships between attentional biases and drug-use behaviours at different stages of addiction, are also discussed.