Abstract
Objective: Abnormal selective attention to drug cues and negative affect is observed in patients with substance dependence, and it is closely associated with drug addiction and relapse. Methadone maintenance is an effective replacement therapy to treat heroin addiction, which significantly reduces the relapse rate. The present study examines whether the patients with opioid use disorder on chronic methadone maintenance therapy exhibit abnormal attentional bias to drug cues and negative-affective cues. Moreover, its relation to therapeutic and neuropsychological factors is also examined.Methods: Seventy-nine patients with opioid use disorder under chronic methadone maintenance therapy and 73 age-, sex-, and education-matched healthy controls were recruited and assessed for attentional bias to drug cues and negative affect using a dot-probe detection task. Correlational analysis was used to examine the relationships between the attentional bias and the demographic, therapeutic, and neuropsychological factors.Results: No significant overall patient-control group difference is observed in drug-related or negative-affective-related attentional bias scores. In the patient group, however, a significant negative correlation is found between the attentional bias scores to negative-affective cues and the duration of methadone treatment (p = 0.027), with the patients receiving longer methadone treatment showing less attentional avoidance to negative-affective cues. A significant positive correlation is found between the negative affect-induced bias and the impulsivity score (p = 0.006), with more impulsive patients showing higher attentional avoidance to negative affective cues than less impulsive patients. Additionally, the patients detect a smaller percentage of probe stimuli following the drug (p = 0.029) or negative-affective pictures (p = 0.009) than the healthy controls.Conclusion: The results of the present study indicate that the patients under chronic methadone maintenance therapy show normalized attentional bias to drug and negative-affective cues, confirming the involuntary attention of the patients is not abnormally captured by external drug or negative-affective clues. Our findings also highlight that the attentional avoidance of negative-affective cues is modulated by the duration of methadone treatment and the impulsivity level in the patients.
Highlights
The patients with drug use disorder allocate more attention to drug-related information in the environment, which may result in partial or full relapse back to addictive behavior [1]
From June 2018 to January 2019, we recruited 79 opioidaddicted patients from three methadone maintenance therapy (MMT) clinics located in Shanghai, along with 73 age, sex, and education-matched healthy control participants (HCs) who were recruited from the community through advertisements and assessed attentional bias to drug cues and negative affect using a dot-probe detection task
Age Sex (M/F) Education Tobacco use FTND score Alcohol use Alcohol Use Disorders Identification Test (AUDIT) score MMT duration Current methadone dosage Subjective Opiate Withdrawal Scale (SOWS) score Beck Depression Inventory (BDI) score State-Trait Anxiety Inventory (STAI)-S score STAI-T score UPPS-P1 score: positive urgency UPPS-P2 score: negative urgency UPPS-P3 score: sensation seeking UPPS-P4 score: lack of premeditation UPPS-P5 score: lack of perseverance Spatial Working Memory (SWM): number of errors Paired Associative Learning (PAL): number of patterns reached PAL: number of errors Stockings of Cambridge (SOC): number of moves SOC: Trials solved in minimum moves
Summary
The patients with drug use disorder allocate more attention to drug-related information in the environment, which may result in partial or full relapse back to addictive behavior [1]. A number of studies have provided evidence supporting the hypothesized role of drug-related attentional bias (AB) in drug addiction. Drug-related attentional bias is associated with the severity of the addiction [2, 3], drug craving [4], and relapse to drug use after a period of abstinence [5]. Successful abstinence may reduce the attentional bias in former drug-addicted patients [6]. Attentional bias to drug cues has been found in heroin addicts [3, 8], which may be mediated by enduring, perhaps permanent, changes within the brain’s reward system [9]
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