Attentional bias predicts heroin relapse following treatment

Institute of Psychology (IOP), Erasmus Universiteit Rotterdam, Rotterdam, South Holland, Netherlands
Addiction (Impact Factor: 4.74). 10/2006; 101(9):1306-12. DOI: 10.1111/j.1360-0443.2006.01498.x
Source: PubMed


Previous studies have shown that abstinent heroin addicts exhibit an attentional bias to heroin-related stimuli. It has been suggested that attentional bias may represent a vulnerability to relapse into drug use. In the present study, the predictive value of pre-treatment attentional bias on relapse was examined in a population of abstinent heroin addicts. Further, the effect of cue exposure therapy (CET) on attentional bias was studied.
Participants were assigned randomly to receive nine sessions of CET or placebo psychotherapy.
An in-patient drug abuse treatment setting.
Abstinent heroin-dependent patients.
Participants completed the emotional Stroop task both before and after completing treatment.
Pre-treatment attentional bias predicted relapse at 3-month follow-up, even when controlling for self-reported cravings at the test session. Further, attentional bias was reduced in both groups after therapy, independent of treatment condition.
Attentional bias may tap an important component of drug dependence as it is a predictor of opiate relapse. However, CET does not specifically reduce attentional bias.

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    • "Field, Schoenmakers, & Wiers, 2008; Sharma, Albery, & Cook, 2001), cannabis use (Field, Eastwood, Bradley, & Mogg, 2006) and nicotine use (Mogg, Field, & Bradley, 2005). Longitudinal designs have also demonstrated the association between attentional bias and risk of subsequent relapse in alcohol abusers (Cox, Hogan, Kristian, & Race, 2002), tobacco smokers (Waters, Shiffman, Bradley, & Mogg, 2003), heroin users (Marissen et al., 2006) and cocaine users (Carpenter, Schreiber, Church, & McDowell, 2006). "
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    ABSTRACT: Background: Over the last twenty years metacognitive theory has provided a novel framework, in the form of the Self-Regulatory Executive Function (S-REF) model, for conceptualizing psychological distress (Wells & Matthews, 1994, 1996). The S-REF model proposes that psychological distress persists because of unhelpful coping styles (e.g. extended thinking and thought suppression) which are activated and maintained as a result of metacognitive beliefs. Objective: This paper describes the S-REF model and its application to addictive behaviors using a triphasic metacognitive formulation. Discussion: Evidence on the components of the triphasic metacognitive formulation is reviewed and the clinical implications for applying metacognitive therapy to addictive behaviors outlined.
    Addictive Behaviors 05/2015; 44:9-15. DOI:10.1016/j.addbeh.2014.08.002 · 2.76 Impact Factor
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    • "Attentional bias (AB) – where disorder-related stimuli become the focus of one's attention – has been consistently demonstrated for substance-related stimuli in substance users relative to non-users (Field & Cox, 2008; Wiers & Stacy, 2006). Furthermore, AB is associated with craving in addiction (Field, Eastwood, Bradley, & Mogg, 2006), is positively correlated with frequency of substance use (Morgan, Freeman, Schafer, & Curran, 2010; Morgan, Rees, & Curran, 2008) and has been linked to relapse in individuals abstaining from substance use (Cox, Hogan, Kristian, & Race, 2002; Marissen et al., 2006). Consequently, AB features as a key component of many recent theoretical models of addiction (Franken, 2003; Ryan, 2002; Wiers & Stacy, 2006), where it is awarded a central role in the development and maintenance of substance use. "
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    ABSTRACT: Attentional bias (AB) is implicated in the development and maintenance of substance dependence and in treatment outcome. We assessed the effects of attentional bias modification (ABM), and the relationship between AB and treatment adherence in opiate dependent patients. An independent groups design was used to compare 23 opiate dependent patients with 21 healthy controls. Participants completed an AB task before either a control or an ABM task designed to train attention away from substance-related stimuli. Pre- and post-ABM AB and craving were assessed to determine any changes. Relationships between treatment adherence ('using on top' of prescribed opiates or not) and AB, craving and psychopathology were also examined. There was no baseline difference in AB between patients and controls, and no significant effect of ABM on AB or substance craving. However, treatment adherent patients who did not use illicit opiates on top of their prescribed opiates had statistically significantly greater AB away from substance-related stimuli than both participants using on top and controls, and reported significantly lower levels of craving than non-treatment adherent patients. Whilst we did not find any significant effects of ABM on AB or craving, patients who were treatment adherent differed from both those who were not and from controls in their attentional functioning and substance craving. These findings are the first to suggest that AB may be a within-treatment factor predictive of adherence to pharmacological treatment and potentially of recovery in opiate users. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Addictive behaviors 03/2015; 46:100-105. DOI:10.1016/j.addbeh.2015.03.017 · 2.76 Impact Factor
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    • "Numerous studies report associations between attentional bias and craving intensity for several drug substances (Copersino et al., 2004; Field et al., 2005). Attentional bias has been associated with an increased risk of relapse in smokers (Powell et al., 2010), alcohol users (Cox et al., 2002) and heroin users (Marissen et al., 2006). Attentional bias is commonly measured with a visual probe task (Bradley et al., 2004; Hogarth et al., 2003). "
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    ABSTRACT: Observational studies have shown that attentional bias for smoking-related cues is associated with increased craving and relapse. Laboratory experiments have shown that manipulating attentional bias may change craving. Interventions to reduce attentional bias could reduce relapse in smokers seeking to quit. We report a clinical trial of attentional retraining in treatment-seeking smokers. This was a double-blind randomised controlled trial that took place in UK smoking cessation clinics. Smokers interested in quitting were randomised to five weekly sessions of attentional retraining (N=60) or placebo training (N=58) using a modified visual probe task from one week prior to quit day. Both groups received 21mg nicotine patches (from quit day onwards) and behavioural support. Primary outcomes included change in attentional bias reaction times four weeks after quit day on the visual probe task and craving measured weekly using the Mood and Physical Symptoms Scale. Secondary outcomes were changes in withdrawal symptoms, time to first lapse and prolonged abstinence. No attentional bias towards smoking cues was found in the sample at baseline (mean difference=3ms, 95% CI=-2, 9). Post-training bias was not significantly lower in the retraining group compared with the placebo group (mean difference=-9ms, 95% CI=-20, 2). There was no difference between groups in change in craving (p=0.89) and prolonged abstinence at four weeks (risk ratio=1.00, 95% CI=0.70, 1.43). Taken with one other trial, there appears to be no effect from clinic-based attentional retraining using the visual probe task. Attentional retraining conducted out of clinic may prove more effective. UK Clinical Trials ISRCTN 54375405. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Drug and Alcohol Dependence 02/2015; DOI:10.1016/j.drugalcdep.2015.01.041 · 3.42 Impact Factor
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