Cognitive Bias Modification for Addictive Disorders: Emerging Knowledge and Persistent Gaps

Melvyn Wb Zhang,Helen E Smith

doi:10.3390/psychiatryint1020009

Melvyn Wb Zhang, Helen E Smith

Open Access

https://doi.org/10.3390/psychiatryint1020009

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Abstract

The advances in experimental psychology have led to the discovery of unconscious, automatic biases (attentional and approach biases) that account for the lapse and relapses amongst individuals with addictive disorders. To date, there has been extensive investigation into the assessment and modification of attention biases amongst individuals with the highly prevalent substance use disorders. Alternative modalities, such as technology, has also been evaluated for the delivery of these interventions. Given this, the specific objectives of this perspective article are in highlighting the emerging knowledge that has accrued over the last three years, and in addressing several of the research gaps in the previous article. Firstly, this perspective article will examine the evidence for biases and bias modification amongst the highly prevalent substance use disorders. This article will also examine how such bias modification has been utilized clinically. Secondly, this perspective article will also examine how technology has been applied to these bias modification interventions. Thirdly, this article will also examine the literature to highlight the biological underpinnings following bias modification. Fourthly, this article also examines the limitations of existing bias modification paradigms and methods taken to better these conventional interventions. The article concludes with highlighting the outstanding gaps in the current knowledge. To date, there remains mixed evidence for the modification of attention biases; and there are a paucity of studies examining the effectiveness of mobile delivery of bias intervention. Only one study has considered patients’ perspective in the development of an intervention. There remained several gaps in the knowledge, which future research could address.

Highlights

IntroductionThe advances in experimental psychology have led to the discovery of unconscious, automatic biases (attentional and approach biases) that account for the lapses and relapses amongst individuals with addictive disorders
The advances in experimental psychology have led to the discovery of unconscious, automatic biases that account for the lapses and relapses amongst individuals with addictive disorders
Zhang et al (2018) [6], in their previous perspective article, have highlighted the biological basis for attentional biases amongst substance users. They reported how electrophysiological measures had been used to characterize attentional biases, and reported that individuals in abstinence continue to have biases against substance-related cues, with electrophysiological data suggesting there is an overall shorter P1 latency, larger N1, N2 and P2 amplitudes [15]. They reported the findings of fMRI studies, which have demonstrated that attentional bias is associated with activations in the anterior cingulate cortex, dorsolateral prefrontal cortex, insula, nucleus accumbens and amygdala [13]

Summary

Introduction

The advances in experimental psychology have led to the discovery of unconscious, automatic biases (attentional and approach biases) that account for the lapses and relapses amongst individuals with addictive disorders. With regards to the evidence for the existence of these biases, several meta-analytical reviews have provided evidence, such as that of MacLean R.R. et al (2018) [1], who reported that individuals diagnosed with opioid use disorder have a greater magnitude of attentional biases, as compared to controls; and that of O’Neill et al (2020) [2], which considered 14 independent studies comprising a total of 1271 participants with cannabis use disorders and reported that cannabis users have more significant attentional biases as compared to healthy controls [2] Other reviews, such as that by Cristea et al (2016) [3] have investigated the effectiveness of bias modification amongst individuals with addictive disorders. The specific objectives of this perspective article are in highlighting the emerging knowledge that has accrued over the last three years, and in addressing several of the research gaps in the previous article This perspective article will examine the evidence for biases and bias modification amongst the highly prevalent substance use disorders. The article concludes with highlighting the outstanding gaps in the current knowledge

Evidence for Bias Modification Amongst Highly Prevalent Substance Disorders

Main Findings

Technological Advances and Its Impact on Bias Modification

Outstanding Gaps in Our Knowledge

Conclusions