Drug-Specific Global Attentional Bias in Females with Drug Use Disorder: Response Slowing Under Short but Not Long Cue Exposure

Attentional bias toward drug-related cues is considered to be an indication of neurocognitive processes associated with drug dependence. While this phenomenon has been shown in other addictive substances, whether hypnotic medication would lead to similar processes remains an issue to be investigated. The present study examined attentional bias toward drug-related cues in long-term hypnotic users and the effect of negative affect on this process. Thirteen long-term hypnotic users participated in this study. They spent 2 nights in the sleep laboratory: a mood-induction night and a neutral night. Attentional bias was measured through the recording of event-related potentials using a cue-reactivity paradigm; subjective craving for hypnotics was assessed using a single-item rating scale, and negative affect was measured using the Positive and Negative Affect Schedule. The results showed that the amplitudes of P300 and slow positive wave for hypnotic-related and sleep-related photographs were significantly higher than those for neutral photographs in both conditions. Negative mood induction did not significantly increase attentional bias. The findings provide preliminary evidence that long-term hypnotic users do have attentional bias for hypnotic-related photos, suggesting the possibility of neurocognitive processes associated with drug dependence. However, the results did not show higher attentional bias under negative mood, suggesting that the use of hypnotics is not reinforced by the desire to eliminate negative affect. Because of the limited sample size and lack of a control group, the results should be considered as preliminary findings that call for future studies to further investigate this issue.

Theory and data suggest that attentional bias (AB) to drug-related cues should be associated with craving when smoking motivation is high, and that AB should be predictive of drug use when immediate use is possible. The current study is the first to test these propositions in smokers in a controlled laboratory environment. Ninety daily smokers were randomly assigned to a high smoking motivation (nicotine-deprived and/or smoking cue exposure) or low smoking motivation (non-deprived and/or control cue exposure) condition. Participants engaged in an AB task in which they viewed smoking and matched control pictures while their eye movements were continuously monitored. Participants were then given the option to smoke, and latency to first puff and number of puffs were coded. High motivation smokers had significantly higher urges to smoke (p < .001) and shorter latencies to smoke (p = .001) than low motivation smokers, but AB measures (ie, dwell time and initial fixation bias scores) and number of puffs did not differ across groups (ps > .45). As predicted, the association between dwell time bias scores and urge to smoke was stronger in the high (r = .47) than low (r = .18) smoking motivation condition, but this difference failed to reach significance (p = .068). Contrary to predictions, neither AB measure was significantly associated with smoking behavior (SB). Internal reliability was excellent for dwell time bias scores (alpha = .90) but very low for initial fixation bias scores (alpha = .20). Maintenance of attention on drug-related cues may be a valid index of incentive motivation. Importantly, however, these dwell time bias scores were not predictive of actual SB. This study tested key predictions made by theoretical accounts of addiction that emphasize AB to drug-related cues as fundamental components of the development and maintenance of drug use. Namely, this is the first experimental study in smokers to test whether AB to smoking-related cues is associated with craving when smoking motivation is high and whether AB predicts SB assessed immediately after the AB task. As predicted, the association between AB and craving was stronger in smokers randomly assigned to a high rather than a low smoking motivation condition. Contrary to predictions, AB did not predict SB.

Maintaining Clinical Relevance: Considerations for the Future of Research into D-Cycloserine and Cue Exposure Therapy for Addiction

Effects of chronic aerobic exercise on attentional bias among women with methamphetamine addiction

Although both drugs and negative emotions can trigger drug craving or relapse in individuals with methamphetamine-use disorder (MUD), it remains unclear whether individuals with MUD have attentional biases toward both drug and negative emotional cues and whether this bias involves attention orientation or difficulty in attention disengagement. This study aimed to measure different components of attentional bias toward drug-related and negative emotional cues in individuals with MUD. Two dot-probe tasks were used to investigate attentional bias toward drug (drug task) and negative emotional cues (emotion task) in individuals with MUD. Forty-three males with MUD (average age of 43.44 ± 11.91 years, average drug-use duration of 11.35 ± 8.39 years) participated in the study voluntarily. There was a significant interaction between the task type and location (p = .01). Specifically, for drug cues, participants showed significant difficulty in attention disengagement toward drug cues (p = .01); however, no attention orientation (p = .46). For negative emotional cues, neither significant attention orientation (p = .07) nor significant difficulty in attention disengagement (p = .50) was found. Attentional bias in individuals with MUD was highly selective for drug cues; thus, difficulty in attention disengagement from drug cues can be considered a potential mediating mechanism for attentional bias modification interventions for individuals with MUD. This study served to generate hypotheses or suggest future experiments on interventions for individuals with MUD.

Theories posit that the combination of external (e.g. cue exposure) and internal (e.g. attention biases) factors contributes to the development of game craving. Nevertheless, whether different components of attentional biases (namely, engagement bias and disengagement bias) play separate roles on game craving has not been fully elucidated. We aimed to examine the associations between two facets of attentional biases and game craving dynamics under a daily life setting. Participants (110 regular internet game players) accomplished the modified attentional assessment task in the laboratory, after which they entered a 10-day ecological momentary assessment (EMA) to collect data on their momentary game craving and occurrence of game-related events at five different time points per day. We found that occurrence of game-related events was significantly associated with increased game craving. Moreover, attentional disengagement bias, instead of engagement bias, bore on the occasional level variations of game craving as moderating variables. Specifically, attentional disengagement bias, not engagement bias, was associated with a greater increase in game craving immediately after encountering a game-related event; however, neither attentional engagement bias nor disengagement bias was associated with the craving maintenance after a relatively long period. The present study highlights the specific attentional processes involved ingame craving dynamics, which could be crucial for designing interventions for attentional bias modification (ABM) in Internet Gaming Disorder (IGD) populations.

Neuroscience models have much to offer the field of addiction, but they will be self-defeating if they lead to severe restrictions on the type of neuroscience research that can conducted in future. A major challenge for the addiction field is to integrate the insights that neuroscience research has provided on drug use and addiction with those provided about drug use and addiction by clinical, epidemiological, sociological and economic research. The challenge is (1) to develop theories of addiction that take seriously the neurobiological bases for drug effects and addictive phenomena; (2) without depicting addicts as automatons whose behaviour is under the control of the drugs acting on the receptors sites in their brains; and (3) while recognizing the opportunities for individual decision, interpersonal influence and social policy to affect the drug use and the behaviour of drug-dependent people.

With ecological momentary assessment (EMA) methods, research participants complete self-report and cognitive assessments on mobile devices as they go about their daily lives. EMA represents a valuable opportunity to investigate behaviour in the contexts in which it normally occurs, and it has become increasingly popular in recent years. In the addiction field, EMA studies have made important contributions to issues such as the prospective relationship between subjective craving and substance use 1, drug interactions 2 and the relationship between negative affect and alcohol consumption 3. Fatseas and colleagues’ paper 4 makes an important contribution to the literature on cue–reactivity, craving and drug use. Previous investigations of drug cue–reactivity tended to use standardized cues, and therefore neglected cues that were specific to the individual, such as being in a certain place or in the company of a specific person. Person-specific cues such as these cannot be studied in clinical and laboratory settings, and arguably EMA is the only viable method to investigate their influence. Study findings indicated that the number of general substance-related and person-specific cues that had been encountered in the previous hours was associated with concurrently assessed craving intensity. Regarding relationships over time, person-specific cues were predictive of subsequent craving but general substance-related cues were not. Other analyses revealed that craving intensity predicted substance use 4 hours later, confirming findings reported in a recent meta-analysis from the same group 1. Finally, a mediation analysis demonstrated that the relationship between exposure to drug cues and drug use 4 hours later was fully mediated by craving intensity. EMA research is not without its limitations, many of which were noted by the authors. Perhaps the most important limitation of this particular study is that participants were asked to recall their exposure to drug cues over the previous few hours immediately after they had rated their craving intensity during the corresponding period. It is possible that recall of an experience of strong craving may have prompted a (perhaps involuntary) search for the cause of that craving, and therefore more drug-related cues may have been remembered. Given that assessments occurred at predictable intervals, the converse could also be true (‘I encountered a lot of drug cues so I am probably craving now’). These explanations could be tested in future research by decoupling the assessment of craving and exposure to drug cues so that each assessment probes only one, and including assessments at random rather than fixed intervals. The study suggests opportunities to exploit this methodology to address other research questions. For example, the authors speculated that attentional bias to drug cues might have contributed to increased craving in response to those cues. Indeed, other EMA studies demonstrated that attentional bias can be measured on mobile devices, that increases in bias preceded increases in craving 5 and that attentional bias may predict relapse independently of craving 6. This may lead eventually to novel clinical interventions: trials of attentional bias modification (ABM) administered in clinical settings have generally yielded negative or ambiguous findings, perhaps because effects do not generalize outside the clinic 7. A recent trial demonstrated that ABM administered on mobile devices could prompt reductions in cigarette craving in tobacco smokers 8, and a priority for future research should be to investigate if this intervention can reduce the risk of relapse in drug users who are attempting to remain abstinent. None.

Individual Differences in Attentional Bias Associated with Cocaine Dependence Are Related to Varying Engagement of Neural Processing Networks

In the study of addiction, attentional bias refers to the observation that substance-related cues tend to capture the attention of experienced substance users. Attentional bias is a cognitive intermediate in the conditioned association between drug-related cues, craving, and relapse. Numerous studies have documented the existence of attentional bias for cues associated with substances. By contrast, few studies have investigated attentional bias in individuals with pathological gambling (PG) or problematic gambling. In this study, we sought to assess attentional bias at the level of maintenance of attention in a sample of pathological gamblers. Twenty-three pathological gamblers and 21 healthy volunteers performed the Visual Probe Task to compare attentional bias with gambling-related cues between individuals with PG and healthy volunteers. The measured of attentional bias was based on their reaction times (RTs) to probes replacing neutral and gambling-related cues (images). Second, we examined the correlation between PG severity and degree of attentional bias among individuals with PG. Results show that pathological gamblers, but not healthy volunteers, had attentional bias for gambling-related cues with exposure times that assess maintenance of attention. There was no correlation between PG severity and degree of attentional bias. Theoretical and clinical implications of these results are discussed.

Binging and purging are transdiagnostic features of eating disorders (EDs). Attentional biases (ABs) toward food and body shape cues and negative affect (NA) are associated with ED psychopathology. These ABs might also be present in people with subthreshold ED not meeting full diagnostic criteria. We investigated ABs to food and body shape cues and the interaction between ABs and NA in young people with binge/purge behavior (B/P group) and healthy controls (HC group). Our B/P sample consisted of individuals with threshold and subthreshold ED, including participants with BN, AN-R, and AN-B/P. We conducted two studies. Study 1 recruited n=54 HC and n=53 B/P participants aged 16-25, and Study 2 recruited n=73 HC and n=72 B/P participants. In Study 1, ABs toward food and body shape cues were compared between B/P versus HC participants using a pictorial dot-probe task. In Study 2, ABs were compared between B/P versus HC participants after NA induction using the Cyberball social exclusion task. Indexes of attentional engagement and disengagement were computed. There was a main effect of cue type on attentional engagement at 0.2s (p=0.006, =0.075) and 2s (p=0.040, =0.043), and attentional disengagement at 2s (p=0.006, =0.077) in Study 1. Findings were not replicated following NA induction in Study 2. No main effect of group or group × cue type interaction was found. Our results disagree with previous research supporting the importance of ABs toward food and body shape cues in young people with threshold and subthreshold EDs and suggest these might not constitute a relevant target in the treatment of ED behavior. However, due to a heterogeneous approach to measuring ABs and multiple types of AB being described in EDs, further research is needed to clarify whether ABs map onto transdiagnostic models of behavioral dysregulation.

1. Ximena Sanchez-Samper, MD* 2. John R. Knight, MD* 1. *Center for Adolescent Substance Abuse Research, Children's Hospital Boston, Boston, Mass After completing this article, readers should be able to: 1. Discuss current trends in adolescent substance use and the specific substances used most commonly among 8th, 10th, and 12th graders. 2. Identify risk and protective factors, including genetic and environmental correlates, for the initiation of substance use in adolescents. 3. Discuss the most common concomitant mental health disorders and how they can affect the course of diagnosis and treatment for substance abuse. 4. Delineate the variety of treatment options available. 5. Describe the role of the pediatrician in educating patients and families on substance abuse prevention; performing screening and initial assessments; and providing support, brief counseling, or referrals for in-depth treatment. Adolescence is a time of physical, emotional, and psychological maturation as well as a period of searching for independence and experimentation. One area of experimentation associated with adolescence is substance use. (1) Although many adolescents experiment with drugs and alcohol from time to time without enduring problems, those who develop the disorders of substance abuse and dependence make substance use a major public health concern. The Monitoring the Future Study (MTFS) is a nationwide survey measuring smoking, drinking, and illicit drug use among nearly 50,000 8th, 10th, and 12th graders in more than 400 secondary schools in the United States each year. (2)(3) According to the 2006 overview of findings from the MTFS, approximately one fifth (21%) of today's 8th graders, more than one third (36%) of 10th graders, and nearly half (48%) of all 12th graders reported using an illicit drug at least once during their lifetimes. Despite a minimum legal age requirement to purchase alcohol, 6% of 8th graders, 19% of the 10th graders, and 30% of the 12th graders self-reported drunkenness during the month prior to being interviewed. (2)(3) Among the problems experienced by adolescents who use alcohol and drugs are …

Anesthesiologists Recovering From Chemical Dependency: Can They Safely Return to the Operating Room?

Introduction:This study aims to investigate the attentional bias toward drug-related stimuli along with subjective craving after encountering such stimuli in methamphetamine users. Studies of cue reactivity have confirmed a bias in attention and gaze toward drug-related stimuli for most substances; however, methamphetamine drugs are less studied through a direct measure, such as eye tracking.Methods:A total of 30 male subjects in the case group (methamphetamine users) and 36 subjects in the control group (no prior drug use) participated in this study. The participant’s eye movement data were collected while they were viewing pairs of drug-related and non-drug images in a dot-probe paradigm. Craving was assessed via a self-report questionnaire on a scale of 0 to 10 before and after the psychophysical task.Results:The analysis of eye-movement data showed a meaningful gaze bias toward cue images (drug-related) in the case group. Additionally, the gaze duration on cue images was significantly higher in the case group, in contrast to the control group. The same effect was observed in analyzing the dot-probe task; that is, the mean reaction time to a probe that replaced a cue image was significantly lower. The mean of the first-fixation measure in the control group was not significantly higher than chance; however, the percentage of the first-fixation on cue images in the drug users was meaningfully biased. Reported craving was significantly greater after performing the task compared to before.Conclusion:Our results indicated an attentional bias toward drug-related cues in methamphetamine users as well as subjective craving after encountering such cues.HighlightsThe gaze duration on cue images was significantly higher in methamphetamine users.The mean reaction time to a probe that replaced a cue image was significantly lower in methamphetamine users compared to the control group.The mean of the first-fixation measure in the case group was significantly better than chance.Craving was reported to be significantly greater after performing the task.Plain Language SummarySubstance users tend to focus on the stimuli associated with substances. This is known as attention bias. Attention bias leads to increased craving. Attention bias for various substances has been previously reported; however, methamphetamine attention bias has not been evaluated so far. In this study, we measured the attention bias toward stimuli related to methamphetamine in methamphetamine users and control subjects with direct (eye tracking) and indirect (dot probe paradigm) methods. In addition, we measured the number of cravings in the case group. Our results confirmed the bias in attention toward methamphetamine-related stimuli in the case group compared to the control group.

Effects of chronic exercise on attentional bias among individuals with methamphetamine use disorder