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Abstract

Extensive recent research has begun to unravel the more implicit or automatic cognitive mechanisms in addiction. This effort has increased our understanding of some of the perplexing characteristics of addictive behaviors. The problem, often, is not that substance abusers do not understand that the disadvantages of continued use outweigh the advantages; rather, they have difficulty resisting their automatically triggered impulses to use their substance of abuse. Existing interventions may help to moderate these impulses. In addition, new techniques aimed at directly modifying implicit cognitive processes in substance abuse are being developed.

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... Drug consumption is associated with various biases, potentially implied in maintaining drug use, such as automatic drug-positive associations (e.g., De Houwer et al., 2006), but also attentional (e.g., Bradley et al., 2004) and approach biases toward drug (e.g., . To account for the approach bias, models of addiction rely on the general idea that individuals acquire automatically activated cognitive biases for cues referring to previous use experiences (e.g., Di Chiara, 2000; Robinson & Berridge, 1993; R. W. Wiers & Stacy, 2006; for a review see Watson et al., 2012). ...
... One possibility is to turn to dual-process models of addiction (e.g., Stacy & Wiers, 2010;Strack & Deutsch, 2004). According to these models, drug consumption is the result of an imbalance between impulsive and deliberative processes (R. W. Wiers & Stacy, 2006). As a function of the increase in substance use, the impulsive system would predominate, giving less room for the influence of delib-erative processes. ...
... iers & Stacy, 2006). As a function of the increase in substance use, the impulsive system would predominate, giving less room for the influence of delib-erative processes. Importantly, however, the impulsive and deliberative systems can interact with each other so that motivational processes can moderate approach tendencies (Deutsch & Strack, 2006;R. W. Wiers & Stacy, 2006). In line with motivated behaviors and self-regulation processes (e.g., Köpetz et al., 2013;Stroebe et al., 2008), one can speculate that light smokers invest to a greater extent the goal of controlling smoking behaviors to maintain a low level of consumption (for a similar reasoning with alcohol see Spruyt et al., 2013;Townshend & Duka, ...
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The relationship between heaviness of use and the approach bias (i.e., stronger approach than avoidance tendencies) toward tobacco remains ambiguous at both theoretical and empirical levels. Indeed, some models of addition would formulate opposite predictions (i.e., positive vs. negative relationship) and, as it turns out, current evidence is mixed. In three studies, we investigated this relationship among smokers (relying on a continuous measure of heaviness) and compared approach/avoidance tendencies of light smokers and non-smokers (relying on group comparison). To measure approach/avoidance tendencies, we used the Visual Approach/Avoidance by the Self Task (VAAST) that visually simulates whole body movements. This task was used as irrelevant-feature version (i.e., instructions about another dimension). Heaviness of use was assessed continuously with daily cigarette use. Data were analyzed in two Integrative Data Analyses (IDAs; a kind of meta-analysis considering jointly the raw data of the three studies), thus taking into account both significant and non-significant effects (total N = 173). In our first integrative analysis (Studies 1-3), we observed an increase in the approach bias toward tobacco as a function of heaviness of use, as well as an avoidance bias among light smokers. In our second integrative analysis (Studies 2 and 3), we found that light smokers have a stronger avoidance bias than non-smokers. While the positive relationship between heaviness of use and approach tendencies toward tobacco is consistent with most addiction models, our finding on light smokers’ avoidance bias stands in sharp contrast. These findings, however, can be incorporated into general motivational models or single-process propositional models that consider the role of goal-oriented or propositional processes, respectively.
... Several prominent psychological models of addiction agree that substance use disorder (SUD) is characterized by automaticity [e.g., (1,2)]. Whereas these theories are not without their limitations [e.g., (3,4)], they have inspired many researchers, leading to an extensive literature on this topic [e.g., (1,2,5)]. ...
... Several prominent psychological models of addiction agree that substance use disorder (SUD) is characterized by automaticity [e.g., (1,2)]. Whereas these theories are not without their limitations [e.g., (3,4)], they have inspired many researchers, leading to an extensive literature on this topic [e.g., (1,2,5)]. For instance, habit theories of addiction suggest that drug cues automatically elicit a response that involves approaching and consuming the drug [e.g., (5)(6)(7)(8)]. ...
... When we search literature on automaticity and drug use, this yields thousands of papers. However, most of this research makes inferences regarding automaticity based on brain imaging or computer-based tasks [e.g., (2,(59)(60)(61)]. It is highly uncommon for automaticity researchers to directly ask patients about their experiences of automaticity and the way these experiences change during therapy. ...
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Automaticity is a hallmark of substance use disorder. In Schema Therapy (an evidence-based form of psychotherapy, that has also been applied to substance use disorders), automaticity appears to be a relevant variable. However, the role of automaticity in Schema Therapy has never been made explicit. In the present article, we investigate the role of automaticity in schema modes and its role in different phases in Schema Therapy for substance use disorders. In performing this investigation, we facilitate a better understanding of the working mechanisms of Schema Therapy, and, vice versa, suggest an alternative understanding of automaticity in substance use disorders. We suggest that the automatic use of substances is way of coping with schemas and, therefore, is the consequence of schema mode activity. In the article, four characteristics of automaticity (unconscious, uncontrollable/uncontrolled, efficient, fast) are translated to schema modes. Subsequently, a Schema Therapy case of a patient suffering from an alcohol use disorder and a narcissistic personality disorder is discussed, focusing on the four facets of automaticity. Last, implications for theory, clinical practice and future research are discussed.
... Ce manque d'efficacité des mesures explicites dans la prédiction et la prise en charge des comportements autodestructeurs pourrait également s'expliquer par le fait que ces comportements seraient régis par des processus implicites (Nock, 2009 ;Wiers & Stacy, 2006). Les processus implicites sont des processus inconscients qui influenceraient nos comportements de manière automatique. ...
... Les processus implicites et explicites peuvent interagir et s'influencer ; la réponse activée automatiquement par les processus implicites peut être modulée par les processus explicites, si la personne dispose des ressources nécessaires (Haeffel et al., 2007). En effet, les processus explicites nécessitent un effort, une motivation et des ressources cognitives (Fazio & Towles-Schwen, 1999 ;Gilbert, Pelham, & Krull, 1988 (Stacy, 1997 ;Wiers & Stacy, 2006 ;Wiers, Van Woerden, Smulders, & de Jong, 2002). Nous prendrons l'exemple dans les prochains paragraphes des deux psychopathologies qui nous intéressent dans cette thèse : les addictions et les comportements suicidaires. ...
... Le maintien du comportement de consommation malgré ses conséquences délétères est a priori paradoxal (Wiers & Stacy, 2006) ; pourtant, ce phénomène peut être expliqué grâce aux modèles duaux de la cognition. Bien que l'individu ait conscience du trouble et ait l'envie explicite de réduire ou d'arrêter les consommations, celles-ci peuvent être maintenues par des processus inconscients. ...
Thesis
Cette thèse a pour objectif de tester la fiabilité de résultats majeurs de psychologie montrant que des mesures implicites permettraient de prédire et de changer des comportements autodestructeurs. Cela semble particulièrement important dans le contexte de crise de confiance traversé actuellement par les sciences et plus particulièrement par la psychologie. À cette fin, nous avons mené trois études préenregistrées. Dans une première série d'études, nous avons répliqué les résultats de Houben, Havermans, et Wiers (2010) montrant qu'un conditionnement évaluatif permettrait de changer l'évaluation implicite de l'alcool ainsi que les consommations d'alcool (Houben, Havermans, et al., 2010). Notre première étude, une réplication conceptuelle, ne réplique que partiellement les effets originaux. Nous ne trouvons en effet pas de réduction des biais implicites envers l'alcool après un conditionnement évaluatif ; cependant, nous répliquons l'effet montrant une réduction des consommations d'alcool. Notre deuxième étude, une réplication exacte, ne réplique aucun des deux résultats originaux. Néanmoins, nous trouvons dans cette étude une réduction des consommations d'alcool, après un conditionnement évaluatif, chez les individus ayant une consommation à risque. Une deuxième série d'études visait ensuite à tester la fiabilité et le consensus de résultats montrant qu'un test d'association implicite permettrait de discriminer les individus suicidaires et de prédire les futures tentatives de suicide (Nock et al., 2010). Pour cela, nous avons réalisé une petite méta-analyse afin de tester s'il existe un consensus dans la littérature scientifique sur la validité prédictive des mesures implicites dans les comportements suicidaires. Cette méta-analyse montre une taille d'effet moyenne dans la discrimination et la prédiction des comportements suicidaires par les mesures implicites. Enfin, dans une dernière étude qui s'est étendue sur une période de trois ans, nous avons voulu réaliser une réplication exacte des effets de Nock et al. (2010). Les résultats répliquent partiellement ceux de l'étude originale. Dans notre étude, le test d'association implicite suicide ne discrimine pas les patients suicidaires des autres patients mais prédit bien les futures tentatives de suicide à six mois au-delà des facteurs de risque habituels. Les résultats présentés dans cette thèse démontrent que les mesures implicites joueraient un rôle dans la prédiction et la modification des comportements autodestructeurs. Les implications théoriques et cliniques sont discutées.
... Generalizing from definitions found in the extant literature regarding substance use(r) identities, substance use(r) identity broadly refers to the extent that individuals view or associate themselves with alcohol, tobacco, and/or marijuana (Lindgren, Ramirez, Olin, & Neighbors, 2016; for a more comprehensive definition of substance user identities, see Lindgren et al., 2017). Definitions of substance user identity have also been articulated based on a dual-process model of cognition and the examination of explicit and implicit cognition (Wiers et al., 2007;Wiers & Stacy, 2006). The assessment of explicit substance user identity typically occurs through the use of self-report measures such that individuals are asked to consider whether substance use plays an integral role to their self-concept and personality. ...
... In the alcohol field, a burgeoning area of identity research has been conducted based on a dual-process theory of cognition (Wiers et al., 2007;Wiers & Stacy, 2006). Both explicit and implicit drinking identity have been found to be predictive of unique variance in alcohol use quantity (Lindgren, Ramirez, Olin, & Neighbors, 2016). ...
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Objective: Research indicates that a substance user identity (i.e., drinking, smoking, and marijuana identity) is positively correlated with substance use-related outcomes (e.g., frequency, quantity, consequences, and disorder symptoms). The current study aimed to meta-analytically derive single, weighted effect size estimates of the identity–outcome association as well as to examine moderators (e.g., substance use type, explicit/implicit assessment, demographic characteristics, and research design) of this association. Method: Random effects meta-analysis was conducted on 70 unique samples that assessed substance user identity and at least one substance use-related outcome (frequency, quantity, consequences, and/or disorder symptoms), and provided the necessary information for effect size calculations. Results: Substance user identity was found to be a statistically significant moderate-to-large correlate of all substance use-related outcomes examined in the current study (rw = .365, p < .001, rw² = .133). The strongest associations were observed between identity and disorder symptoms (alcohol) and frequency of substance use (tobacco or marijuana). In terms of moderators of the identity–outcome association, the link between explicit drinking identity and alcohol use-related outcomes appeared to be stronger in magnitude than the relationship between implicit drinking identity and alcohol use-related outcomes; however, this difference appears to be largely due to the finding that implicit measures have lower reliability. The strongest identity–outcome association was observed among younger individuals. Conclusions: Substance user identity is clearly an important correlate of substance use-related outcomes and this association is stronger among younger individuals. Additional theoretical, empirical, and intervention research is needed to utilize knowledge gleaned from the current study on the identity–outcome association.
... Problematic Internet pornography users built up automated associations between online porn cues and positive outcomes, prompting cue-reactivity and craving (Snagowski, Wegmann, Pekal, Laier, & Brand, 2015). The internetrelated attentional biases and craving/approaching responses are consistent with the idea that attentional biases may play a fundamental role in guiding addictive behavior as well as the dual-mode theories of addictive behaviors (Stacy & Wiers, 2010;Wiers & Stacy, 2006). In addition, according to previous evidence attentional bias has been suggested to be associated with craving or flow experience in individuals with IGD , problematic pornography use (Allen, Kannis-Dymand, & Katsikitis, 2017;Brahim, Cruz, Courtois, May, & Khazaal, 2023;Marino et al., 2023), and social networking (Nikolaidou et al., 2019). ...
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Background and aims Uncontrollable gaming behavior is a core symptom of Internet Gaming Disorder (IGD). Attentional bias towards game-related cues may contribute to the difficulty in regulating online gaming behavior. However, the context-specific attentional bias and its cognitive mechanisms in individuals with IGD have not been systematically investigated. Methods We compared individuals with IGD to healthy controls (HC) using a rapid serial visual presentation (RSVP) task to measure temporal attentional bias. By applying game-related and neutral stimuli as targets, we specifically assessed how attentional resources were allocated to game-related stimuli compared to neutral stimuli. Results The IGD group showed enhanced attentional blink effect when a game-related stimulus was the first target and a neutral target was the next, reflecting IGD's difficulty in disengaging from game-related stimuli. Both IGD and HC individuals exhibited decreased accuracy in identifying a neutral first target followed by a game-related second target at shorter lags, indicating increased attentional engagement with game-related stimuli in general. Discussion The results provide a cognitive basis for recurrent and uncontrollable gaming behaviors in individuals with IGD. Game cues have priority in the allocation of attentional resources in individuals with IGD. The results shed new light on the development of specific treatments for IGD.
... Strong automatic reactions to cues related to the addictive behaviour have been identified as a hallmark of addictive use in other contexts, such as illicit drugs and alcohol (Wiers & Stacy, 2006). Thus, automatic reactions to exercise-related stimuli may serve as an indicator of the risk of exercise addiction. ...
Article
While physical activity (PA) has numerous health benefits, in rare cases it can become addictive and lead to adverse health effects. Automatic reactions to addiction-related cues are a hallmark of addiction, however, their association with exercise dependence (ED) remains unknown. This research examined the links between ED and automatic reactions to PA-related cues in physically active individuals with low-to-moderate levels of ED through two studies. Study 1 (N = 65) used a dot-probe task with eye-tracking to assess the association between attentional bias toward PA and ED scores measured by the Exercise Dependence Scale-Revised. Study 2 (N = 125) used a manikin task and a single-category implicit association test to examine the association of approach-avoidance tendencies and implicit affective attitudes toward PA with ED scores. Results revealed ED scores were positively associated with behavioral indicators of attentional bias (i.e., reaction times), but not with eye-tracking indicators (i.e., first-gaze localization, gaze duration). Similarly, ED scores were unrelated to approach-avoidance tendencies or implicit affective attitudes toward PA. Therefore, our research provides limited evidence supporting the hypothesis that automatic reactions to PA may reflect a “signature” of ED. Our findings do not robustly support the link between automatic processes and ED, raising questions about whether the psychological mechanisms involved in ED might differ from those observed in other addictive behaviors where automatic processes are key. However, due to our sample's low-to-moderate levels of ED, definitive conclusions cannot be drawn. Further research with individuals exhibiting addiction-related dependence, personalized stimuli, and neurophysiological methods is needed.
... In alcohol use disorder (AUD), the dual process model emphasizes the interplay between the "reflective system" (controlled, deliberate responses governed by emotion regulation and expected outcomes) and the "reflexive system" (implicit appraisal of appetitive/alcohol-related stimuli) [15,16]. Decision-making reflects an imbalance between the two systems and an enhanced reflexive system ("impulsive system") may facilitate implicit re-sponses that favor the approach of alcohol-related stimuli [5,9]. ...
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b> Introduction: Attentional bias (AB) is an implicit selective attention toward processing disorder-significant information while neglecting other environmental cues. Considerable empirical evidence highlights the clinical implication of AB in the onset and maintenance of substance use disorder. An innovative method to explore direct measures of AB relies on the eye-movement activity using technologies like eye-tracking (ET). Despite the growing interest regarding the clinical relevance of AB in the spectrum of alcohol consumption, more research is needed to fully determine the AB patterns and its transfer from experimental to clinical applications. The current study consisted of three consecutive experiments. The first experiment aimed to design an ad-hoc visual attention task (VAT) consisting of alcohol-related and neutral images using a nonclinical sample ( n = 15). The objective of the second and third experiments was to analyze whether the effect of type of image (alcohol-related vs. neutral images) on AB toward alcohol content using the VAT developed in the first experiment was different for type of drinker (light vs. heavy drinker in the second experiment [ n = 30], and occasional social drinkers versus alcohol use disorder (AUD) patients in the third experiment [ n = 48]). Methods: Areas of interest (AOIs) within each type of image (neutral and alcohol-related) were designed and raw ET-based data were subsequently extracted through specific software analyses. For experiment 1, attention maps were created and processed for each image. For experiments 2 and 3, data on ET variables were gathered and subsequently analyzed through a two-way ANOVA with the aim of examining the effects of the type of image and drinker on eye-movement activity. Results: There was a statistically significant interaction effect between type of image and type of drinker (light vs. heavy drinker in experiment 2, F (1, 56) = 13.578, p < 0.001, partial η2 = 0.195, and occasional social drinker versus AUD patients in the experiment 3, F (1, 92) = 35.806, p < 0.001, partial η2 = 0.280) for “first fixation” with large effect sizes, but not for “number of fixations” and “dwell time.” The simple main effect of type of image on mean “first fixation” score for AUD patients was not statistically significant. Conclusion: The data derived from the experiments indicated the importance of AB in sub-clinical populations: heavy drinkers displayed an implicit preference for alcohol-related images compared to light drinkers. Nevertheless, AB fluctuations in patients with AUD compared to the control group were found. AUD patients displayed an early interest in alcohol images, followed by an avoidance attentional processing of alcohol-related images. The results are discussed in light of recent literature in the field.
... Such decisions may over time lead to habitual behaviors and related motivations linked to predominance of reward system inputs in the setting of decreased top-down cognitive control (e.g., Brewer & Potenza, 2008;Everitt & Robbins, 2005;Koob & Volkow, 2010). With the experience of positive and/or negative reinforcement through the behavior, reward anticipation processes may become modified in that cognitive biases toward target-associated cues become more pronounced (Wiers & Stacy, 2006). These alterations may in turn mobilize attentional resources and therefore facilitate the perception of target-associated stimuli. ...
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Psychological core processes that underpin disorders due to addictive behaviors, including craving, inhibitory control, maladaptive decision-making, and cognitive biases, are important factors to target and modify in interventions. Mindfulness-based and neurofeedback techniques have been particularly promising interventions. The aim of the present systematic review (PROSPERO ID: CRD42020200113) was to evaluate the research evidence on their effectiveness for behavioral addictions. Empirical intervention studies in the realm of nonsubstance addictive behaviors fulfilled the inclusion criteria, which led to 15 studies and 297 participants being included in this review among PubMed, Scopus, and Web of Knowledge. Results suggest that mindfulness-based interventions are effective in reducing mental distress and craving reactions. Reductions in craving levels were reported in four of six studies with biggest effects for mindfulness-based cognitive therapy and mindfulness-enhanced cognitive behavioral therapy. Successful reductions in mental distress were identified in five of seven studies that used diverse mindfulness-based techniques. However, no more than one study on mindfulness-based interventions reporting improvements in self-control, inhibitory control, maladaptive decision-making, and cognitive biases could be identified. No research could be found on neurofeedback. This review highlights the potential of mindfulness interventions for these disorders, and the specific mechanisms of therapeutic change warrant further investigation.
... decisionmaking situations (Bechara, 2005;Wiers & Sta cy, 2006). Implicit associations are linked to the auto matic processing of a dominant impulsive system which overrides the controlled system by initiating goaldirect ed drugseeking behavior in the form of an implicit ap proach tendency that is further assumed to elicit drug consumption (Robinson & Berridge, 1993;Wiers & Stacy, 2006). Following the IPACE (Interaction of PersonAf fectCognitionExecution) model by , these implicit cognitions interact with use expectancies and the experience of gratification and compensation in the development and maintenance of behavioral addic tions (see Figure 1). ...
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Aims: The problematic use of social networks is discussed as a further specific type of Internet-use disorders. Our project aims to clarify whether social-networks-use disorder (SNUD) is marked by characteristics of addictive behaviors by tracking behavior and investigating the relevance of 1) implicit cognitions, 2) the experiences of gratification and compensation and 3) use expectancies in SNUD compared to tobacco-use disorder. Methodology: Four groups will be examined: individuals with 1) SNUD without tobacco use, 2) risky use patterns with regard to social networks without tobacco use, 3) tobacco use disorder and 4) healthy controls. All participants first complete a laboratory examination including the Implicit Association Test (IAT) and the Approach-Avoidance task (AAT). We will use smartphone-based data tracking for 14 days following laboratory testing to record smoking and social-networks-use patterns. During this period, we further measure use expectancies and the experience of gratification and compensation by means of a smartphone-based experience sampling method (ESM). Conclusions: This is the first study to examine relevant characteristics of addictive behaviors in individuals with SNUD compared to individuals with tobacco use, using a combination of experimental psychological methods and smartphone-based measurements. We expect that this investigative approach will contribute to a deeper understanding of the processes involved in SNUD.
... EC is a regulative dimension of temperament that involves attentional control, inhibitory control and activation control, and reflects self-regulation abilities that develop later in life parallel with the maturation of the prefrontal cortex and refers to top-down control [10]. According to the dual pathways model, psychopathology arises from an imbalance between two complementary neurobiological systems: (1) the impulsive system or the bottom-up reactivity in terms of behavioral inhibition (BIS) and behavioral activation (BAS) system and (2) the reflective system or top-down regulation in terms of EC [11][12][13]. Vulnerability theories of psychopathology emphasize the role of self-regulation or EC which may moderate the association between temperamental (BISBAS) reactivity and psychopathology [8,9,[14][15][16][17][18]. ...
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Temperament and personality traits are important factors underlying the vulnerability for both the initiation and continuation of addictive behaviors. We investigated the influence of reactive and regulative temperament and their interaction in relation to clinical symptomatology and personality disorders (PDs) in a sample of 841 inpatients (68.1% males) with a substance use disorder (SUD). To assess reactive temperament we used the Behavioral Inhibition and Behavioral Activation Scales (BISBAS) and to assess regulative temperament we used the Effortful Control Scale. Clinical symptomatology and personality traits were measured by means of the Symptom Checklist-90 (SCL-90) and the Assessment of ADP-IV Personality Disorders (ADP-IV). Hierarchical regression analyses showed that both, clinical symptomatology and PDs were related to low levels of effortful control (EC). None of the two-way interactions (BIS × EC, BAS × EC) however were significantly related to psychopathology. Current findings highlight the role of effortful control (EC) in the expression of psychopathology in an adult sample of inpatients with SUD. Therapeutic interventions aiming at strengthening EC can possibly result in better treatment outcomes for both the addiction and the comorbid psychopathology.
... Theoretical approaches such as the Reinstatement Model of Drug Relapse illustrate the importance of these mechanisms in drug-seeking behavior (Bossert et al., 2013). Various factors such as the frequency of drug use (Wiers & Stacy, 2006) or the search for treatment (Vadhan et al., 2007) may contribute to the differences in cognitive bias toward the drug shown by people with SUD. ...
Article
Background Implicit cognition has been linked to relapse in substance use disorder (SUD). Studies on attentional bias have found different outcomes related to the therapeutic context, finding an association with relapse in inpatients but not in outpatients. There are no similar studies that use associations in semantic memory as a measure of implicit cognition. Objectives (i) to analyze the relationship between a measure of associations in semantic memory and relapse in inpatients and outpatients; (ii) to compare the evolution of these associations between inpatients and outpatients after 3 months of treatment. Methods Eighty nine outpatients and 94 inpatients with SUD for cocaine and alcohol participated in this study. We employed a longitudinal design with a baseline evaluation and follow-up after three months, using the Word Association Task for Drug Use Disorder (WAT-DUD). Results The choice of drug-related words predicted relapse in cocaine (odds ratio = 1.97, z = 2.01, p = .045) and alcohol-cocaine (odds ratio = 2.39, z = 2.55, p = .011) use. Follow-up at 3 months revealed a reduction in the choice of drug-related words in inpatients (Z = 2.031, p = .042). Conclusions A greater choice of drug-associated words in the presence of ambiguous images was related to relapse in inpatients but not in outpatients. The inpatients group showed a reduction in the semantic association with drugs during the first three months of treatment.
... wherefore it may become more likely that specific behaviors are adapted as coping styles. Simultaneously, reinforcement mechanisms may facilitate the attentional allocation of activity-related internal and external triggers (i.e., cognitive biases [53,54]) which may again facilitate the experience of cue reactivity and craving. ...
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Purpose of Review This manuscript aims to propose an integration of desire thinking into the Interaction of Person-Affect-Cognition-Execution (I-PACE) model based on theoretical considerations within the Elaborated Intrusion Theory of Desire and Self-Regulatory Execution Function model and empirical evidence from the field of internet-use disorders. Recent Findings Theory and research on desire thinking in the context of internet-use disorders suggest considerable relations to craving, metacognitive beliefs, and emphasizes its nature when initiated as a reaction towards unpleasant triggers. Accordingly, we postulate that desire thinking may be located at the position for affective and cognitive reactions towards triggers within the I-PACE model. Summary The suggested integration of desire thinking into the I-PACE model specifically implies the assumption of a relief-oriented and pleasure-oriented entry pathway into desire thinking and a feedback loop between desire thinking and the experience of gratification and compensation. The model pathways proposed here may serve as a theoretical basis for future research and need further empirical verification.
... Physiological, emotional and cognitive responses to conditioned addictionrelated stimuli 7,11 Craving Intense and urgent desire, subjective experience of desiring drug intake, potentially a result of cue reactivity, and reward craving and relief craving 24 Attentional bias Automatic cognitive processes (including implicit associations) underlying the effect that drug abusers become easily aware of addiction-related stimuli in their environment [25][26][27] Approach-avoidancetendency ...
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In the eleventh International Classification of Diseases (ICD‐11) of the World Health Organization, gambling disorder and gaming disorder are included in the category ‘disorders due to addictive behaviours’, which can be specified further as occurring either predominantly offline or predominantly online. Other specific problematic behaviours may be considered for the category ‘other specified disorders due to addictive behaviours’. The Research Unit FOR 2974, funded by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG), focuses on the most prominent online addictive behaviours: gaming, pornography use, buying‐shopping and social‐networks use. The main goal of the Research Unit is to contribute to a better understanding of the common and differential psychological as well as neurobiological mechanisms involved in these specific types of Internet‐use disorders. We aim to investigate theoretically argued (bio)psychological processes with a focus on concepts coming from research of substance‐use disorders, for example, cue reactivity and craving, executive functions and specific inhibitory control, coping, implicit cognitions, and decision making. One central characteristic of the Research Unit is that we will investigate all participants using a comprehensive core battery of experimental paradigms, neuropsychological tasks, questionnaires, biomarkers, ambulatory assessment, and a 6‐month follow‐up survey. Beyond the anticipated contributions to the scientific understanding of the mechanisms involved in the development and maintenance of respective online addictive behaviours, we also expect contributions to clinical practice by showing which affective and cognitive mechanisms may be addressed more intensively to optimize treatment. New Research Unit on psychology and neurobiology of Internet‐use disorders. Seven projects address systematically common and differential processes involved in specific types of online‐related addictive behaviours.
... Directly emerging from the definition of addiction laid out above, two factors that are strongly involved in drug consumption are impulse control (X3) and craving strength (X4) [15,23,37]. The model will build on the rationale that when impulse control is higher than craving strength, drug consumption (X2) will decrease and vice versa. ...
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This study introduces an adaptive causal network model of the effects of treatment on drug consumption in the case of addiction. Different factors are included that have been found to affect drug consumption and are impacted by addiction treatments. To prove the validity of the model, a number of example scenarios are presented that simulate treatments of different lengths and comprehensiveness. In addition, validation was supported by parameter tuning, and verification was performed by mathematically verifying stationary points for simulations of the model.
... In recent years, implicit cognition of drug users has become a major research focus. Implicit cognition involves automatic appraisal of stimuli in terms of their emotional and motivational significance, and it differs from explicit cognition, which includes controlled processes related to conscious deliberations (Wiers and Stacy, 2006;Wiers et al., 2007). According to some theorists, addictive behaviors are a joint outcome of implicit and explicit cognitions (Wiers et al., 2007;Stacy and Wiers, 2010). ...
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Implicit and explicit self-identification as a drug user specific to the substance used (e.g., viewing oneself as a drinker) have been examined, as they relate to that drug use. However, studies have rarely explored whether identifying as a “drug user” differs implicitly and explicitly for people who use different drugs and how this identification relates to drug-use behaviors or abstinence. This study examined implicit and explicit self-identification as a “drug user” and their associations with drug-use behaviors and abstinence in people who used heroin (PWUH) and people who used methamphetamine (PWUM). Forty PWUH and 35 PWUM in a rehabilitation facility completed the single category implicit association test (SC-IAT), which evaluated implicit associations of a “drug user” with “self,” and a measure of explicit self-identification as a “drug user.” Prior drug-use behaviors and current abstinence duration of the participants were assessed. PWUH demonstrated stronger implicit “self + drug user” associations and higher levels of explicit self-identification as a “drug user” than PWUM. A higher frequency of drug use was associated with higher levels of explicit drug-user self-identity, and longer abstinence duration was positively related to stronger implicit “self + drug user” associations in PWUH. The drug type of heroin (vs. methamphetamine) participants used was associated with a higher frequency of use, which, in turn, predicted higher levels of explicit drug-user self-identity. Given that the PWUH group differs from the PWUM group in terms of implicit and explicit self-identification as “drug users,” it would be more appropriate to address drug-user self-identity of individuals according to the substance they use rather than as a collective group.
... As described above, dual process models provide both theoretical and measurement advances over previous theories of the relationship between attitudes and behaviors by incorporating interactive automatic and controlled processes (see Wicker, 1971). The application of a dual-process framework has consequently improved explanation and prediction in a number of areas involving mental health, including addiction (Wiers & Stacy, 2006), anxiety Dual-Processes in Suicidality, 15 (Teachman et al., 2012), and sexual assault (Widman & Olson, 2013). Much of this work incorporates advances in implicit measurement in clinical domains (Roefs et al., 2011). ...
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Dual-process models of cognition distinguish relatively automatic from relatively controlled processes in terms of their interactive impact on perception, judgment, and behavior. Such models have advanced explanation and prediction in a variety of domains across psychology but have yet to be comprehensively applied to the pressing societal and public health problem of suicide. We propose a model of suicide that integrates dual-process models of social cognition with ideation-to-action conceptualizations of suicide. The model specifies: (a) suicide-relevant automatic associations involving the self, others, the future, death, and bodily harm, (b) suicide-relevant motives involving the self, interpersonal relations, the future, and the desire to die, and (c) hypotheses regarding the conditions under which automatic associations and motives individually and interactively impact suicidal ideation and lethal action at various stages of an ideation-to-action framework. The model recasts a number of suicide-relevant variables in terms of the opportunity factor of dual-process theories of attitudes, which encompasses capacity-relevant variables (e.g., time, cognitive resources) that determine whether suicide-relevant judgments and behavior are the result of relatively automatic associations or more controlled, deliberative cognition. Accordingly, the model articulates a number of novel predictions regarding the sources of suicide-relevant automatic associations, motives, and opportunity factors, as well as their interactive influences on suicidal ideation and action. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... A separate dual-process model focuses specifically on implicit cognition as a critical driver of drug-related behaviors (Stacy and Wiers, 2010;Wiers and Stacy, 2006). The model proposes that several learnt associations, memories or implicit attitudes (collectively implicit cognitions) are spontaneously activated and influences the decision-output of an individual with a dependence towards drug-related behaviors; especially if there is weaker cognitive control over these implicit cognitions. ...
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... Alongside those more reflective thinking processes identified above, SIMCM argues that social identities also operate in a manner which is not open to conscious inspection by the individual; the process which an individual will have limited (if any) awareness of . That such dual processes, and specifically the interplay between reflective and intuitive systems, operate for the self-regulation of behavioural enactment has been the subject of contemporary work in the addictive behaviours field (see Friese & Hofmann, 2009;Moss & Albery, 2009;Wiers & Stacy, 2006) These accounts allow for predictions to follow for how and when identity-based systems, such as social identity and self-concept (self-identity) accounts, occur. The vast majority of work examining how implicit drinker identity predicts various measures of alcohol use and misuse has been concerned with personal (self) identities or those which concern how we think of ourselves in relation to others (Lindgren et al, 2016 for a review). ...
Chapter
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One area that is receiving growing interest among those exploring psychosocial aspects of addictive behaviors, and alcohol (mis)use in particular, and how such processes may be important for facilitating change, concerns conceptions of the self which are based on how similar one believes one is relative to “like minded” others in their group (in-group) and how their group differs to other groups (outgroups). This chapter utilizes this social-identity perspective to explore how and why social identities may be important for understanding drinking initiation, the misuse of alcohol and how people might transition between identities to change their related behavior. These include identity-related factors related to aspects of social isolation and loneliness, the need to form interpersonal social connections and to dissociate oneself from others in alternative groups, as well as the role in stigmatization for social identity function. We argue that social identity may also function in behavioral change and present a review of recent evidence which details potential mechanisms through which identity-based factors may have their effects. We also outline practical implications for treatment.
... Approach and avoidance toward food in individuals with high weight suppression may be different depending on the level of processing (i.e., explicit versus implicit level). According to the dual-process model of addictive behaviors (Wiers and Stacy, 2006), a reward response toward appetitive cues could emerge through two semi-independent systems, namely, the impulsive and reflective systems. The impulsive system (at the implicit level) comprises a quick, unintentional, and automatic reward response, whereas the reflective system (at the explicit level) involves a relatively deliberate, intentional, and consciously controlled reward response (Bargh, 1994). ...
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This study investigated the effects of psychobiological characteristics of non-obese women with a high level of weight suppression (H-WS) on explicit-implicit and approach-avoidance response toward food cues, depending on hunger-satiety states. The 634 participants were divided into two groups according to their weight history. If the difference between their highest weight over the last year and their current weight (a difference sustained at least for 1 year) was more than 5%, they were assigned to the “H-WS” group (N = 25). If the difference in weight was less than 5%, they were assigned to the “low level of weight suppression” (L-WS) group (N = 29). Explicit approach and avoidance toward food were measured by self-report questionnaires. Implicit approach and avoidance toward food cues were measured using an eye-tracker. Fasting blood samples were obtained to measure fasting serum leptin levels. After this, participants consumed a standard breakfast to control the satiety level. After breakfast, explicit-implicit approach-avoidance responses were repeatedly measured at the satiety states. Self-reported body shape concerns, drive for thinness, ambivalent food craving, and bulimic behavior were also assessed. The results showed that the H-WS group had lower leptin levels, and higher body shape concerns, drive for thinness, ambivalent food craving, and bulimic behaviors compared to the L-WS group. At the explicit level, the H-WS group reported lower approach and higher avoidance to food compared to the L-WS group, regardless of hunger-satiety state. Whereas, at the implicit level, the H-WS group showed higher approach during satiety rather than during hunger states. Regardless of the hunger-satiety state, there were no significant group differences with regard to implicit avoidance between the two groups. Thus, we confirmed that a high level of avoidance toward foods was observed in the H-WS group at the explicit level but not at the implicit level. Moreover, in contrast with a high level of explicit avoidance toward palatable foods, inhibition for implicit approach toward high-calorie foods seemed to be blunted after food consumption in the H-WS group. These inconsistencies may be associated with ambivalent food craving and vulnerability to bulimic behavior among H-WS individuals.
... This section describes what has been used from the relevant literature, which serves as the rationale behind the introduced model. To support coherence in the paper, in this section already references to states Xi can be found that will be used in the more detailed design of the network model, as presented in Section 4. Directly emerging from the definition of addiction laid out above, two factors that are strongly involved in drug consumption are impulse control (X3) and craving strength (X4) [15,23,37]. The model will build on the rationale that when impulse control is higher than craving strength, drug consumption (X2) will decrease and vice versa. ...
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This study introduces an adaptive causal network model of the effects of treatment on drug consumption in the case of addiction. Different factors are included that have been found to affect drug consumption and are impacted by addiction treatments. To prove the validity of the model, example scenarios are presented that simulate treatments of different lengths and comprehensiveness. In addition, validation was supported by parameter tuning, and verification was performed by mathematically verifying stationary points for simulations of the model.
... As argued by Hakulinen and Jokela (23), alcohol use has been associated with poorer goal-directed decision making. With impaired control, cognitive processes may be weakened and implicit impulsive processes may start to dominate (47), which is related to low conscientiousness or high sensation seeking. ...
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Objective: It is well known that certain personality traits are associated with alcohol use. Because less is known about it, we wished to investigate whether changes in alcohol use were longitudinally associated with changes in personality and in which direction the influence or causation might flow. Methods: Data came from the self-reported questionnaire answers of 5,125 young men at two time points during the Cohort study on Substance Use Risk Factors (C-SURF). Their average ages were 20.0 and 25.4 years old at the first and second wave assessments, respectively. Four personality traits were measured: (a) aggression–hostility; (b) sociability; (c) neuroticism–anxiety; and (d) sensation seeking. Alcohol use was measured by volume (drinks per week) and binge drinking (about 60+ grams per occasion). Cross-lagged panel models and two-wave latent change score models were used. Results: Aggression–hostility, sensation seeking, and sociability were significantly and positively cross-sectionally associated with both alcohol use variables. Drinking volume and these three personality traits bidirectionally predicted each other. Binge drinking was bidirectionally associated with sensation-seeking only, whereas aggression–hostility and sociability only predicted binge drinking, but not vice versa. Changes in alcohol use were significantly positively associated with changes in aggression–hostility, sensation seeking, and sociability. Associations reached small Cohen's effect sizes for sociability and sensation seeking, but not for aggression–hostility. Associations with neuroticism–anxiety were mostly not significant. Conclusion: The direction of effects confirmed findings from other studies, and the association between changes in personality and alcohol use support the idea that prevention programs should simultaneously target both.
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Gambling disorder is the only behavioral addiction recognized as a clinical disorder in DSM-5, and Internet gaming disorder is included as a condition requiring further research. ICD-11 categorizes gambling and gaming disorders as disorders due to addictive behaviors. Additional behavioral addictions may include compulsive sexual behavior disorder, compulsive buying-shopping disorder, and problematic use of social media. This narrative review summarizes the current state of knowledge regarding these five (potential) disorders due to addictive behaviors. All five (potential) disorders are clinically relevant and prevalent. Behavioral addictions frequently co-occur with other mental and behavioral problems, such as depression, anxiety, and attention deficit hyperactivity disorder. Validated diagnostic instruments exist, with empirical support varying across conditions. No medications have approved indications from regulatory bodies for behavioral addictions, and cognitive-behavioral therapy has the most empirical support for efficacious treatment. Given that behavioral addictions are prevalent, frequently co-occur with psychiatric disorders, may often go undiagnosed and untreated, and have been linked to poorer treatment outcomes, active screening and treatment are indicated. Public health considerations should be expanded, and impacts of modern technologies should be investigated more intensively. Treatment optimization involving pharmacotherapy, psychotherapy, neuromodulation, and their combination warrants additional investigation.
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Although the focus of research for decades, there is a surprising lack of consensus on what is (and what is not) self-control. We review some of the most prominent theoretical models of self-control, including those that highlight conflicts between smaller-sooner versus larger-later rewards, “hot” emotions versus “cool” cognitions, and efficient automatic versus resource-intensive controlled processes. After discussing some of their shortcomings, we propose an alternative approach based on tenets of construal level theory (Trope et al., 2021) that integrates these disparate models while also providing novel insights. Specifically, we model self-control as a problem of regulatory scope—the range of considerations one accounts for in any decision or behavior. Self-control conflicts occur when the pursuit of specific local opportunities threatens the ability to address motivational priorities that span a broader array of time, places, individuals, and possibilities. Whereas a more contractive consideration of relevant concerns may prompt indulgence in temptation, a more expansive consideration of concerns should not only help people identify the self-control conflict but also successfully resolve it. We review empirical evidence that supports this new framework and discuss implications and new directions. This regulatory framework not only clarifies what is and what is not self-control but also provides new insights that can be leveraged to enhance self-control in all its various forms.
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Objectives Posttraumatic stress disorder (PTSD) and cannabis use disorder (CUD) commonly co-occur. Conditioned associations between psychological trauma cues, distress, cannabis use, and desired relief outcomes may contribute to the comorbidity. These conditioned associations can be studied experimentally by manipulating trauma cue exposure in a cue-reactivity paradigm (CRP) and examining effects on affective and cognitive outcomes in participants with and without PTSD. However, traditional CRPs take place in-lab limiting recruitment/power. We aimed to examine the effects of CRP condition (trauma and neutral) and PTSD group (likely PTSD+ and PTSD−) on affective and craving outcomes using a stand-alone online expressive writing CRP. Methods Participants (n = 202; 43.6% male; Mage = 42.94 years, SD = 14.71) with psychological trauma histories and past-month cannabis use completed a measure of PTSD symptoms (PTSD Checklist-5 for DSM-5 [PCL-5]) and were randomized to complete either a trauma or neutral expressive writing task. Then they completed validated measures of affect (Positive and Negative Affect Schedule-Short Form [PANAS-SF]) and cannabis craving (Marijuana Craving Questionnaire-Short Form [MCQ-SF]). Results Linear mixed models tested the hypothesized main and interactive effects of CRP condition (trauma and neutral) and PTSD group (likely PTSD+ and PTSD−) on negative and positive affect (PANAS-SF) and cannabis craving dimensions (MCQ-SF). The hypothesized main effects of trauma versus neutral expressive writing were found for negative affect and the expectancy dimension of cannabis craving and of PTSD group for negative affect and all cannabis craving dimensions; no interactions were observed. Conclusions Expressive writing appears a useful online CRP. Interventions focused on reducing negative affect and expectancy craving to trauma cues may prevent/treat CUD among cannabis users with PTSD.
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Background: Many studies have found that smokers' attentional bias toward cigarette-related cues and cognitive control impairment significantly impacts their cigarette use. However, there is limited research on how the interaction between attentional bias and cognitive control may modulate smokers' cigarette-seeking behavior. Objectives: This study used a cigarette Stroop task to examine whether smokers with different attentional control ability had different levels of attentional bias toward cigarette-related cues. Methods: A total of 130 male smokers completed the Flanker task to measure their attentional control ability. The attentional control scores of all participants were ranked from low to high, with the top 27% placed in the high attentional control group and the bottom 27% in the low attentional control group. Subsequently, both groups completed the cigarette Stroop task to measure their attentional bias toward cigarette-related cues. Results: Smokers with low attentional control responded more slowly to cigarette-related cues than to neutral cues, while smokers with high attentional control showed no significant difference in their response time to either condition. Conclusions/Importance: Attentional control ability can regulate smokers' attentional bias toward cigarette-related cues. Smokers with low attentional control ability are more likely to have attentional bias toward cigarette-related cues, offering insights for targeted prevention of cigarette addiction.
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Rationale Attentional bias to drug-related stimuli is hypothesised to contribute towards addiction. However, the acute effects of Δ9-tetrahydrocannabinol (THC) on attentional bias to cannabis cues, the differential response in adults and adolescents, and the moderating effect of cannabidiol (CBD) are unknown. Objectives Our study investigated (1) the acute effects of vaporised cannabis on attentional bias to cannabis-related images in adults and adolescents and (2) the moderating influences of age and CBD. Methods We conducted a randomised, double-blind, placebo-controlled, cross-over study where three weight-adjusted vaporised cannabis preparations: ‘THC’ (8 mg THC for a 75-kg person), ‘THC + CBD’ (8 mg THC and 24 mg CBD for a 75-kg person) and PLA (matched placebo). Cannabis was administered on 3 separate days to 48 participants, who used cannabis 0.5–3 days/week: 24 adolescents (12 females, aged 16–17) and 24 adults (12 females, aged 26–29). Participants completed a visual probe task with cannabis cues. Our primary outcome was attentional bias to cannabis stimuli, measured using the differential reaction time to a cannabis vs. neutral probe, on 200-ms trials. Results In contrast to hypotheses, attention was directed away from cannabis cues on placebo, and there was a main effect of the drug (F(2,92) = 3.865, p = 0.024, η²p = 0.077), indicating THC administration eliminated this bias. There was no significant impact of CBD nor an age-by-drug interaction. Conclusions Acute THC intoxication eliminated attentional bias away from cannabis cues. There was no evidence of differential response in adolescents compared to adults and no evidence that a moderate vaporised dose of CBD altered the impact of cannabis on attentional bias. Trial registration This study was listed with the US National Library of Medicine and registered on ClinicalTrials.gov, URL: Do Adolescents and Adults Differ in Their Acute Response to Cannabis?—Full Text View—ClinicalTrials.gov, registration number: NCT04851392.
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Background: Despite high co-occurrence, chronic pain is often unaddressed in treatment for opioid use disorder (OUD) and little is known about mechanisms that may underlie associations between pain and opioid use. Using an attentional bias (AB) task with both pain and opioid cues, we evaluated a cognitive bias modification (CBM) task administered during regularly scheduled medications for OUD (mOUD) dosing visits. The current study evaluated the feasibility, acceptability, and preliminary efficacy of the CBM task. Outcomes for AB tasks used traditional mean-based score and trial-level bias scores (TLBS). Methods: In a double-blind, randomized controlled trial, 28 individuals with OUD and chronic pain engaged in mOUD were randomized to either CBM or an AB control condition and completed up to three tasks per week for four weeks. Standard AB task was completed at baseline and post-treatment. Participants completed feasibility and acceptability measures, and preliminary efficacy (i.e., change in AB) was assessed using ANOVA models. Results: Participants attended 83.3% of scheduled sessions and generally reported the task was enjoyable, credible, and easy to complete. Preliminary results demonstrated a condition by time interaction highlighting a reduction in AB in the CBM group but not the control group in opioid TLBS variability (F[1,26]=5.01, p = .034) and pain TLBS towards (F[1,26]=6.42, p = .018) and pain TLBS variability (F[1,26]=5.24, p = .03). Conclusions: The current study supports integrating brief, computer-based tasks designed to reduce AB into mOUD clinical care. The preliminary results suggest that TLBS outcomes may be more sensitive to capture changes in AB; however, larger studies are required.
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Individuals with substance use disorder (SUD) tend to have attention bias to drug and negative emotions, which leads to drug craving and relapse. This study examines attentional bias from the time dimension, and adopts the rapid sequence visual presentation (RSVP) paradigm to study the attentional blink effect of individuals with SUD towards different types of negative words. A total of 55 males with SUD were recruited from a compulsory drug rehabilitation center in Jiangxi Province. The results indicated that the following: (1) The accuracy of T2 recognition when T1 was correctly recognized (T2|T1) increased with the increase of the time interval, indicating that the attentional blink was successfully induced. (2) When T1 was addictive vocabulary, compared with the neutral vocabulary, the attentional blink effect of males with SUD was enhanced. When T2 was negative addiction vocabulary or negative vocabulary, compared with the neutral vocabulary, the attentional blink of males with SUD was weakened. The current research results not only find that males with SUD have an attention bias towards addiction clues from the time characteristics of the attention process, but also it is of great significance to guide the rehabilitation centers to improve the craving and relapse of males with SUD by reducing the appearance of negative addictive information.
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Alcohol use disorder (AUD) is a severe and widespread mental disorder with a huge negative impact on the social, economic and health dimensions. The identification of risk factors for the development of AUD and for relapse in existing AUD are crucial for prevention and treatment approaches. Alcohol‐related implicit associations have been shown to contribute to drinking and might partially explain sudden relapses. The aims of this study are to investigate implicit associations in abstinent AUD patients and to test whether cathodal transcranial direct current stimulation (tDCS) modulates implicit associations. We measured performance in two alcohol‐related implicit association tests (IATs) and two control tasks (flower‐insect IAT, Stroop task) in 27 abstinent AUD patients with 31.5 (SD = 36) days of abstinence on average. During the execution of the tasks, we applied 1 mA cathodal or sham tDCS over the left dorsolateral prefrontal cortex (dlPFC) in a sham‐controlled within‐subject design. Results show an implicit bias of alcohol avoidance and implicit nondrinking identity for abstinent AUD patients. Cathodal tDCS modulated neither alcohol‐related implicit associations nor the control tasks. This study complements knowledge about implicit alcohol‐related association in AUD patients and shows no effect of a neuromodulatory intervention to alter implicit associations with the present parameters. This preregistered double‐blind randomized clinical trial demonstrates implicit alcohol avoidance and nondrinking identity biases in abstinent patients with alcohol use disorder (AUD). Both biases were not susceptible to modulation by cathodal transcranial direct current stimulation to the left dorsolateral prefrontal cortex. These findings warrant further investigations regarding temporal stability of implicit associations and their relation to clinical paramteres like severity of AUD, duration of abstinence and relapse.
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Background Even after qualified detoxification, alcohol-dependent (AD) patients may relapse to drinking alcohol despite their decision to abstain. Two mechanisms may play important roles: first, the impact of environmental cues on instrumental behavior (i.e., Pavlovian-to-instrumental transfer (PIT) effect), which was found to be stronger in prospectively relapsing AD patients compared to abstaining patients. Second, an automatic approach bias towards alcohol stimuli was observed in AD patients, and interventions targeting this bias reduced the relapse risk in some studies. Previous findings suggest a potential behavioral and neurobiological overlap between these two mechanisms. Methods In the current study, we examined the association between the alcohol approach bias and both the behavioral and neural non-drug-related PIT effects in AD patients after detoxification. N = 100 AD patients (17 females) performed a PIT task and an alcohol approach/avoidance task (aAAT). Patients were followed up for 6 months. Results A stronger alcohol approach bias was associated with both a more pronounced behavioral PIT effect and a stronger PIT-related neural activity in the right nucleus accumbens (NAcc). Moreover, the association between the alcohol approach bias and the behavioral PIT increased with the severity of alcohol dependence and trait impulsivity, and was stronger in patients who relapsed during follow-up in the exploratory analysis. Conclusions These findings indicate partial behavioral and neurobiological overlap between the alcohol approach bias and the PIT effect assessed with our tasks. The association was stronger in patients with more severe alcohol dependence.
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Response inhibition, a crucial component of executive function, is closely related to personal impulse control, social adaption, and mental health. Previous studies have found response inhibition deficit in patients with major depressive disorder, but whether it also exists in individuals with subclinical depression (SD) remains unclear. This study aimed to identify the ability of response inhibition to emotional face stimuli both under explicit and implicit conditions in individuals with SD. Thirty‐six subclinical depressed college students and 39 healthy individuals were recruited and administered the non‐emotional, explicit, and implicit emotional stop‐signal tasks (SSTs). Mixed‐model analyses of variance were used to analyze the differences between and within groups. In implicit emotional SST, the results showed a significant longer stop‐signal response time, a shorter stop‐signal delay time, a shorter go reaction time, and a similar proportion of stop success in the SD group compared to healthy controls. However, the above indices showed no significant difference between the two groups in the non‐emotional SST and explicit emotional SST. These findings suggest a possible defect of response inhibition in implicit emotional processing in individuals with SD, which may potentially serve as a marker of susceptibility to depression and thus be applied to early screening and intervention for major depressive disorder.
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Despite growing concerns about the addictive potential of social networking sites (SNSs), little is known about the precise neural, cognitive, and emotional processes underpinning compulsive SNS behaviours, such as excessive checking of SNSs. Recent evidence points to the important role of reward in SNS behaviours and one avenue to examine reward processes related to SNSs is the use of behavioural paradigms that allow for the measurement of implicit motivational responses, such as the approach avoidance task (AAT). The AAT has been successfully utilised to capture changes in unconscious reward processes in substance use disorders and other behavioural addictions, with faster approach reactions to addiction-related stimuli reflecting increased wanting/urges to have/consume the reward. In the present study 411 young adults completed an online Visual Approach/Avoidance by the Self Task (VAAST) with social media and control logos as well as other subjective (explicit) measures of reward experience related to SNSs. Our results showed that across participants SNS logos elicited strong approach reactions (compared to control stimuli) and that stronger SNS approach tendencies predicted more frequent SNS checking. Importantly, increased approach motivation was not associated with more problematic use. However, both checking frequency and problematic use were related to alterations of explicit reward processing, including the subjective experience of SNS urges or wanting. We conclude that changes in automatic approach motivation towards SNS stimuli are common in most SNS users, which suggests that implicit imbuement of social media with reward has become pervasive among young adults. Problematic SNS use however may be more reliably indicated by changes in explicit reward processing, such as subjective wanting.
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Background and aims Pathological skin-picking (PSP) or excoriation disorder is a destructive behavior that affects 1-2% of the general population. The purpose of this pilot study was to evaluate the effect of a computerized behavior modification task on action-tendencies (i.e., approach or avoidance) in adults with PSP. We aimed to modify these action-tendencies by having participants with PSP complete the Approach-Avoidance Training (AAT) task, using a joystick to simulate an approach (=pull) or avoidance (=push) response. Method Forty-five participants diagnosed with PSP were randomized to one of three training conditions: (1) Avoidance Training (AvT; n = 15), (2) Approach Training (ApT; n = 15), or (3) Placebo Training (PT; n = 15). We hypothesized that after training, those in the AvT would have the greatest reduction in behavioral approach (i.e., their overall reaction time [RT] to approach pictures of irregular skin stimuli). Results Results of the pre-training assessment task revealed a positive correlation between behavioral approach to irregular skin stimuli and skin-picking severity as assessed by the Skin Picking Scale-Revised (SPS-R). After training, a lower behavioral approach and urges to pick were found in the AvT and PT groups, while those in the ApT reported higher behavioral approach and urges to pick. At two-week follow-up, no significant changes on the SPS-R were reported between groups. Discussion Our preliminary data suggest that the AAT is a promising avenue of research to develop as a cognitive intervention to address an excessive behavioral approach tendency that characterizes skin-picking problems.
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Background: Most people often consume alcohol cumulatively and gradually. Yet almost scientific knowledge about alcohol's acute effects on cognition, behavior, and affect stems from laboratory studies that employ a single beverage administration procedure. Objective: This study tests the hypothesis that alcohol's acute effects depend on both methods of administration and alcohol blood level. We introduce a new laboratory procedure for studying cumulative alcohol drinking and examine alcohol's effects on emotion recognition as a function of both alcohol administration method and alcohol blood level. Methods: Participants were recruited for one of two studies. One study employed a between-subject design using a single alcoholic dose. Participants were randomly assigned to drink either placebo (0.00%), low (0.03%), moderate (0.06%), or high (0.09%) alcohol levels. The second study employed a within-subject design using a cumulative alcoholic administration method, in which each participant drank four drinks (placebo, followed by three alcoholic drinks). Both groups reached similar breath alcohol concentrations. In both studies, participants attended a single study session, in which emotion recognition was examined following alcohol administration. Results: Single alcoholic beverage administration method caused greater impairment in emotion recognition ability, specifically for anger, happiness, and fear, as compared with cumulative administration method, even though breath alcohol levels were similar in both conditions. Conclusions: This paper presents questions concerning the internal validity of previous laboratory studies that use a single beverage administration procedure. Insights into the effects of alcohol on behavior, as well as regarding our knowledge about models of addiction are presented.
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Research on implicit processes has revealed problems with awareness categorizations based on nonsignificant results. Moreover, post hoc categorizations result in regression to the mean (RTM), by which aware participants are wrongly categorized as unaware. Using Bayes factors to obtain sensitive evidence for participants’ lack of knowledge may deal with nonsignificance being nonevidential, but also may prevent regression-to-the-mean effects. Here, we examine the reliability of a novel Bayesian awareness categorization procedure. Participants completed a reward learning task followed by a flanker task measuring attention towards conditioned stimuli. They were categorized as B_Aware and B_Unaware of stimulus–outcome contingencies, and those with insensitive Bayes factors were deemed B_Insensitive. We found that performance for B_Unaware participants was below chance level using unbiased tests. This was further confirmed using a resampling procedure with multiple iterations, contrary to the prediction of RTM effects. Conversely, when categorizing participants using t tests, t_Unaware participants showed RTM effects. We also propose a group boundary optimization procedure to determine the threshold at which regression to the mean is observed. Using Bayes factors instead of t tests as a post hoc categorization tool allows evaluating evidence of unawareness, which in turn helps avoid RTM. The reliability of the Bayesian awareness categorization procedure strengthens previous evidence for implicit reward conditioning. The toolbox used for the categorization procedure is detailed and made available. Post hoc group selection can provide evidence for implicit processes; the relevance of RTM needs to be considered for each study and cannot simply be assumed to be a problem.
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This special issue addresses the affective and cognitive processes and their interactions potentially reflecting mechanisms underlying the development, maintenance of, or recovery from behavioral addictions. Various specific types of behavioral addictions will be considered, including those already in ICD-11 (gambling disorder, gaming disorder), but also new phenomena that are not yet classified (e.g., buying-shopping disorder, social-network-disorder) and phenomena potentially belonging to behavioral addictions although they are currently classified elsewhere (e.g., compulsive sexual behavior disorder). The articles included in this special issue investigate directly affective processes (e.g., cue-reactivity, craving, mood, stress, social interactions) and/or cognitive processes (e.g., executive functions, attention, memory). The studies involve experimental paradigms, neuropsychological tasks, psychophysiological measures, and neuroimaging techniques. Specific articles also deal with the relationship between affective and cognitive processes. The special issue is complemented by articles covering current debates and reviewing current empirical findings in the field.
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The investigation of the characteristics and attributes that make a brand prominent for shoppers is known as salience research. This line of study concentrates on influencing buying behaviors via the manipulation of shopping environments and food products. Such promotional strategies successfully attract massive food sales and therefore have been associated with changes in dietary patterns and the epidemic expansion of non-communicable diseases, like obesity. Marketers have empirically proven that global buying patterns are influenced by their salience strategies and techniques. However, despite the significance of such methods, empirical salience investigations have rarely been extended beyond their primary business focus to the field of health promotion. Therefore, this study is presenting a way of transferring the salience knowledge to the health promotion field in order to track dietary choices and possibly gain information to identify buying and eating behaviors connected to obesity. The salience literature from various disciplines permits to hypothesize that consumers are more likely to have unhealthy diets when food-choices and conditions are saliently manipulated. A quasi-experimental method (combining salience measures with Bayesian analysis) was used to test this proposition. The results support the hypothesis and endorse the introduced research tool. As predicted, data reflect the latest national overweight and obesity statistics and suggest that habitual unhealthy diets are more likely when salience strategies link food products to taste, social and emotional attributes. These preliminary findings encourage further investigation to enhance the method as a possible epidemiological tool. https://academic.oup.com/heapro/advance-article-abstract/doi/10.1093/heapro/daaa123/6143529
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The studies described in this paper were supported by NIDA grants DA11779-02, DA12487-03, DA16708, and by NINDS grant NS19632-23.
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I argue that implicit measures are measurement outcomes that have certain functional properties. The expression "indirect measure," however, refers to an objective property of the measurement procedure, being that the researcher does not assess the attitude on the basis of a self-assessment by the participant but on the basis of another behavior. With regard to the question of why one should use implicit measures, research suggests that they do not allow one to register stable structures in memory. It is also doubtful that they provide an index of implicit attitudes. But to the extent that implicit measures reflect the automatic impact of attitudes and cognitions, they could provide a unique insight into the effects of automatic processing on real-life behavior.
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This study examined the utility of an implicit measure of cognitive associations, the Implicit Association Test (IAT; ), to assess alcohol-related approach dispositions. Forty-seven hazardous drinkers completed a modified IAT procedure that assessed the relation between alcohol and behavioral categories (i.e., approach and avoid). Participants completed a series of individual difference measures before an alcohol cue exposure task in which they anticipated alcohol consumption. Results indicate that the modified IAT is associated with binge drinking episodes, perceived difficulty controlling alcohol use, and appetitive responses to alcohol cues. Findings are discussed in terms of the potential value of this measure to assess alcohol-related memory associations among those whose alcohol use puts them at risk for harm.
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To test whether an expectancy challenge (EC) changes implicit and explicit alcohol-related cognitions and binge drinking in young heavy drinkers. This is important for theoretical and practical reasons: the EC presents a critical test for the hypothesized mediational role of alcohol cognitions and the EC has been presented as a promising intervention to counter alcohol problems in heavy drinking youth. SETTING, PARTICIPANTS AND INTERVENTION: Ninety-two heavy drinking college and university students (half women) were assigned randomly to the EC or control condition (a sham alcohol experiment in the same bar-laboratory). Explicit alcohol cognitions and alcohol use were assessed with paper-and-pencil measures. Alcohol use was assessed prior to the experiment and during a 1-month follow-up. Implicit alcohol-related cognitions were assessed with two versions of the Implicit Association Test (IAT), adapted to assess implicit valence and arousal associations with alcohol. The EC resulted in decreased explicit positive arousal expectancies in men and women alike. There was some evidence for a differential reduction in implicit arousal associations, but findings depended on the version of the IAT and on the scoring-algorithm used. In men (but not in women) there was a short-lived differential reduction in prospective alcohol use (significant in week 3 of the follow-up), and this reduction was partially mediated by the decrease in explicit positive arousal expectancies. These findings suggest that an EC successfully changes explicit alcohol cognitions and that this may have short-lived beneficial effects in heavy drinking young men.
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Studies using bipolar Implicit Association Tests (IATs) found that heavy drinkers have negative and arousal associations with alcohol relative to soda. Study 1 examined whether these results were due to the label 'alcohol' and the choice of the contrast category 'soda'. Four unipolar IATs assessed alcohol associations with positive and negative valence, arousal, and sedation, while varying the target dimension: alcohol or beer versus soda or animals. Results showed that drinkers had the strongest associations between alcohol and negative valence with the exact strength depending on the choice of the target categories. They also showed associations between alcohol and positive valence, arousal, and to a lesser extent sedation, which were uninfluenced by composition of the target dimension. These findings indicate ambivalence in both the valence and arousal-sedation dimension, underscoring the importance of using unipolar alcohol-IATs. Further, study 2 showed that "figure-ground" asymmetries could not account for these IAT results. These findings provide support that implicit alcohol associations are not merely IAT artifacts and that they can be assessed in a meaningful way with unipolar IATs.
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