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Attentional bias toward alcohol-related stimuli in heavy drinkers: evidence from dynamic eye movement recording
The American Journal of Drug and Alcohol Abuse
Abstract
Background:
It has been proposed that attentional biases toward alcohol stimuli are contributing factors maintaining problematic drinking behavior.
Objective:
The main goal of the present set of studies was to provide an examination of dynamic attentional mechanisms associated with alcohol consumption derived from eye movement monitoring.
Method:
Undergraduate students were recruited for two studies. In Experiment 1, 80 students were exposed to complex scenes (containing alcohol-related cues or not) viewed at a self-determined presentation rate. In Experiment 2, 80 students were exposed to the stimuli for a fixed presentation time and asked to memorize the photographs. In both studies, participants completed the Khavari Alcohol Test (KAT) to measure their drinking behaviors.
Results:
Experiment 1 revealed that alcohol consumption was unrelated to eye movement measures on alcohol-related objects within pictures. However, results of Experiment 2 indicated that saccades into and out of the alcohol-related zones were more frequent as alcohol consumption increased. The time spent and the speed of the first fixation in the alcohol-related zone did not explain the variance in alcohol consumption.
Conclusion:
Attentional biases associated with alcohol consumption might be better understood in terms of dynamic attention mechanisms. More precisely, heavy drinker's attention seems to be constantly drawn back to alcohol-related objects once they are first fixated and when attention is enforced through other cognitive demands. From a clinical viewpoint, dynamic attentional biases might contribute to the development or maintenance of alcohol-related problems and this observation might help guide attention-based interventions.
... Therefore, it seems necessary for participants to be fully engaged in a cognitive task for these more automatic mechanisms to emerge. The fixation time and the speed of the first fixation in alcoholrelated regions, however, did not differentiate heavy drinking individuals from occasional drinkers (Roy-Charland et al., 2017). In a similar vein, Pennington et al. (2019) developed a "conjunction search eye tracking task" where participants detected an alcoholic or non-alcoholic target picture in a set of matched and unmatched distractors. ...
... Attentional focus was assessed using the dwell time and the number of fixations for these alcohol-related cues as well as for predefined "neutral" cues unrelated to alcohol consumption. In order to confirm the validity of the device, we expected to find positive correlations between these measures of attentional focus for alcohol-related cues and the participants' levels of alcohol craving and consumption (Roy-Charland et al., 2017;Soleymani et al., 2020), whereas no such relationship would be observed for neutral cues. Alcohol craving and consumption were selected as criteria to test for concurrent validity because they are predictive of alcohol-related attentional biases. ...
... Another limitation intrinsically related to the naturalness of the paradigm is the fact that participants were free to blink during the whole experiment, which might have reduced the number and duration of fixations. Finally, as Roy-Charland et al. (2017) study showed, in order to most effectively measure attentional biases in complex scenes, it is important to ensure full attention to the scene. As the main benefit of VR is to allow participants to freely explore an immersive environment, we chose to minimize the instructions given to the participants about their task in the Frontiers in Virtual Reality frontiersin.org ...
Several experimental paradigms were developed to measure attentional biases towards alcohol-related cues. However, most of them are based on reaction times to two-dimensional stimuli displayed on a computer screen, such that their ecological validity has been questioned. To address this, we integrated an eye tracking system into a virtual reality headset (ET-VR) and measured attentional biases in a subclinical population of alcohol users. In this exploratory study, forty social drinkers were recruited and immersed in a virtual bar including alcohol-related stimuli. Attentional focus was assessed using dwell time and number of fixations for these alcohol-related stimuli as well as for neutral stimuli unrelated to alcohol consumption. The results show that the number of fixations and, to a lesser extent, the dwell time for alcohol-related cues were positively correlated with the drinking motivation of the participants. In contrast, no significant correlation was found for neutral stimuli. In conclusion, the present study shows that alcohol-induced attentional biases can be studied using an ET-VR device in a subclinical population of alcohol users.
... Dovetailing with results in clinical samples, cue reactivity studies with social drinkers have also reported increases in attentional bias [223,224], heart rate variability [225], and craving [226][227][228] in response to alcohol cues in heavy drinkers. Interestingly, Roy-Charland et al. [223] observed that participants who consumed more alcohol performed more frequent saccades into and out of alcohol-related image parts, a behavior reminiscent of sign-tracking. ...
... Dovetailing with results in clinical samples, cue reactivity studies with social drinkers have also reported increases in attentional bias [223,224], heart rate variability [225], and craving [226][227][228] in response to alcohol cues in heavy drinkers. Interestingly, Roy-Charland et al. [223] observed that participants who consumed more alcohol performed more frequent saccades into and out of alcohol-related image parts, a behavior reminiscent of sign-tracking. Neuroimaging studies have further highlighted the relevance of fronto-striatal circuits, showing how heavy and light alcohol use modulate PFC, ACC, and ventral and dorsal striatal responses to alcohol-related cues [229][230][231]. ...
... Translation of animal research to humans remains, however, challenging, with less clear-cut findings than animal studies due, at least in part, to heterogeneity in the paradigms used, employed measures of conditioning (implicit physiological, explicit self-report or neuronal), level of awareness about the conditioning procedure and modifying factors, such as comorbidities, AUD severity and duration, or context (e.g., enrollment in treatment programs or recent detoxification). This notwithstanding, alcohol cues have been extensively proven to induce attentional and psychophysiological changes and increase craving in individuals with AUD [202][203][204][206][207][208][209][210][211][212][213][214][215], as well as social drinkers [223][224][225][226][227][228]. However, in contrast to animal research, conditioning of alcohol cues in human studies has usually taken place outside of the experimenter's control and is thus subject to an indeterminate number of potential confounders. ...
Purpose of Review
Current theories of alcohol use disorders (AUD) highlight the importance of Pavlovian and instrumental learning processes mainly based on preclinical animal studies. Here, we summarize available evidence for alterations of those processes in human participants with AUD with a focus on habitual versus goal-directed instrumental learning, Pavlovian conditioning, and Pavlovian-to-instrumental transfer (PIT) paradigms.
Recent Findings
The balance between habitual and goal-directed control in AUD participants has been studied using outcome devaluation or sequential decision-making procedures, which have found some evidence of reduced goal-directed/model-based control, but little evidence for stronger habitual responding. The employed Pavlovian learning and PIT paradigms have shown considerable differences regarding experimental procedures, e.g., alcohol-related or conventional reinforcers or stimuli.
Summary
While studies of basic learning processes in human participants with AUD support a role of Pavlovian and instrumental learning mechanisms in the development and maintenance of drug addiction, current studies are characterized by large variability regarding methodology, sample characteristics, and results, and translation from animal paradigms to human research remains challenging. Longitudinal approaches with reliable and ecologically valid paradigms of Pavlovian and instrumental processes, including alcohol-related cues and outcomes, are warranted and should be combined with state-of-the-art imaging techniques, computational approaches, and ecological momentary assessment methods.
... Two other studies recently developed more ecological procedures to measure attentional bias. Roy-Charland et al. (2017) proposed a dynamic exploration of eye movements, by analyzing the global pattern of saccadic movements produced by drinkers when seeing complex visual scenes (with or without alcohol cues). A first experiment showed an absence of alcohol-related bias during the free visual exploration of the scenes, no correlation between eye tracking indexes and alcohol consumption being reported. ...
... Conversely, young adult drinkers present a robust attentional bias (better indexed by eye tracking than behavioral measures) for simple (but not complex) alcohol pictures (Ceballos et al., 2009;Miller and Fillmore, 2010), which appears mostly related to modifications of the high-level attentional processes (Monem and Fillmore, 2017) and to reduced inhibitory control on saccadic movements (Wilcockson and Pothos, 2015). The evaluation of the attentional bias presents increased reliability when using eye tracking indexes (compared to behavioral performance measures) and personalized stimuli (Christiansen et al., 2015a), and the attentional bias is better evidenced by dynamic eye tracking measures (Roy-Charland et al., 2017). It might be increased by reward expectancy (Jones et al., 2012), craving (Hobson et al., 2013) and low alcohol ambivalence (Lee et al., 2014), but other studies have suggested that it is independent of craving, positive alcohol expectancies (Field et al., 2011), consumption intention , as well as actual consumption and mental disabilities (Van Duijvenbode et al., 2017). ...
... Indeed, despite the use of the same paradigm, some methodological choices differ across studies (e.g., using an arrow, a crosshair, or a dot as targets, leading to discrepancies in participant's task), which could decrease inter-studies comparability. More centrally, the eye tracking indexes measured strongly vary across studies, attentional bias having been assessed by: (1) averaging the mean fixation time on each stimulus (e.g., Monem and Fillmore, 2017); (2) calculating the proportion of fixation time or of numbers of fixations made on each stimuli category (e.g., Lee et al., 2014); (3) calculating a bias score by subtracting the average dwell time on neutral stimuli from the average dwell time on alcoholstimuli (e.g., Marks et al., 2015); and (4) counting the number of fixations made on each stimuli (e.g., Roy-Charland et al., 2017). These different methods for calculating a seemingly identical construct can explain incongruences across results, and methodology could thus be optimized to unravel the mechanisms sustaining this attentional bias: first saccade direction or first saccade latency can inform on the initial orientation of attention; first fixation duration on early attentional engagement; total dwell time on attentional maintenance; number of fixations on attentional reengagement. ...
Acute alcohol intoxication and alcohol use disorders are characterized by a wide range of psychological and cerebral impairments, which have been widely explored using neuropsychological and neuroscientific techniques. Eye tracking has recently emerged as an innovative tool to renew this exploration, as eye movements offer complementary information on the processes underlying perceptive, attentional, memory or executive abilities. Building on this, the present systematic and critical literature review provides a comprehensive overview of eye-tracking studies exploring cognitive and affective processes among alcohol drinkers. Using PRISMA guidelines, 36 papers that measured eye movements among alcohol drinkers were extracted from three databases (PsycINFO, PubMed, Scopus). They were assessed for methodological quality using a standardized procedure, and categorized based on the main cognitive function measured, namely perceptive abilities, attentional bias, executive function, emotion and prevention/intervention. Eye tracking indexes showed that alcohol-related disorders are related to: (1) a stable pattern of basic eye movement impairments, particularly during alcohol intoxication; (2) a robust attentional bias, indexed by increased dwell times for alcohol-related stimuli; (3) a reduced inhibitory control on saccadic movements; (4) an increased pupillary reactivity to visual stimuli, regardless of their emotional content; (5) a limited visual attention to prevention messages. Perspectives for future research are proposed, notably encouraging the exploration of eye movements in severe alcohol use disorders and the establishment of methodological gold standards for eye tracking measures in this field.
... Concerning occasional social drinkers' patterns, our results are in line with previous literature depicting AB at a maintenance stage of attention but not at an early-stage attention processing [31]. In contrast, individuals with heavy drinking patterns have an implicit tendency to detect alcoholrelated stimuli at early-stage attention as indicated elsewhere [47]. Such pattern is also emphasized in the second experiment of the current research, in which a certain degree of bias is stated at early but not maintenance stage of attention processing in heavy drinkers. ...
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.
... Attentional focus was assessed using the dwell time and the number of fixations for a set of previously identified stimuli. We hypothesized a positive correlation between AB measures for alcohol-related cues and level of alcohol craving and consumption (5,6). Materials & procedure ...
... Alcohol use disorder often shows attention bias to alcohol images, as revealed by eye-tracking tasks (67). The seek for alcohol significantly develops an attention bias, which has been demonstrated in previous studies (68). ...
It has been widely shown that chronic alcohol use leads to cognitive dysfunctions, especially inhibitory control. In an extension of the traditional approach, this research field has benefited from the emergence of innovative measures, among which is an anti-saccade, allowing direct and sensitive measure of the eye movements indexing attention bias to alcohol-related cues and the capability of inhibiting the reflexive saccades to the cues. During the past decade, there are numerous reports showing that drinkers make more unwanted reflexive saccades and longer latency in the anti-saccade task. These increased errors are usually explained by the deficits in inhibitory control. It has been demonstrated that inhibitory control on eye movement may be one of the earliest biomarkers of the onset of alcohol-related cognitive impairments. This review summarizes how an anti-saccade task can be used as a tool to investigate and assess the cognitive dysfunctions and the early detection of relapsing risk of alcohol dependence.
... Excessive drinking sensitizes alcohol abusers' attentional responsiveness to alcohol-related stimuli [4,5]. Increasing evidence has shown that AD have significant attentional bias to alcohol [6][7][8][9][10] and that attentional bias may play a crucial role in the formation of AD and the return to drinking after abstinence. Even though AD has been the focus of multiple studies, there are many aspects of the condition, such as the relationship between attention bias and abstinence of AD, that remain unclear. ...
... AB is described as an implicit selective attention when processing visual information in favor of desired cues [5]. It has been suggested that this implicit cognitive processing may elicit craving for alcohol or an intense desire to consume it [6] and may further facilitate drinkingrelated behaviors [7]. A growing body of literature emphasizes that AB has clinical implications in substance craving and should be addressed in the assessment [8], treatment [3] and relapse prevention [9] of addictive behaviors. ...
Introduction: Alcohol use disorder (AUD) represents a major general health concern with important consequences for individuals' psycho-social functioning. Many studies suggest that cognitive processes such as attentional bias (AB) are heavily involved in the phases of acquisition, maintenance and relapse precipitation in AUD. AB is described as an implicit selective attention when processing visual information in favor of desired cues, which may elicit craving for alcohol and facilitate drinking-related behaviors. In line with recent studies of the applications of human-computer interaction in the field of psychology, the current study aimed to assess attentional bias towards alcohol-related images using eye-tracking technology. Specifically, we explored the first gaze towards alcohol-related images versus neutral images in patients with short-term and long-term abstinence. Method: 24 outpatients (Mage = 53, SD = 11.65) from the Addictive Behavior Unit of the Hospital Clinic of Barcelona participated in the study. The inclusion criteria were diagnoses of AUD and normal or corrected-to-normal visual acuity. Participants were divided according to their abstinence period, with the cutoff point being set at four months. Fourteen patients had been abstinent for less than four months (M = 1, SD = 0.96), and 10 for longer than this period (M = 14, SD = 8.17). The self-reported abstinence period was supported by the results of urine analyses performed in all patients. Participants completed the Alcohol Use Disorder Identification Test (M = 19.75, SD = 9.34) and the Visual Attention Task (VAT). The VAT consisted of images related to alcohol consumption versus neutral images such as office objects. The EyeTribe eye-tracking technology was used to record eye movement activity during the VAT. Results: Our data indicated a statistically significant difference between patients with short-term and long-term abstinence regarding their first fixation towards alcohol-related and neutral images. Patients abstinent for less than four months had a tendency to look first at images related to alcohol consumption, whereas patients abstinent for more than four months were more likely to look first at neutral images, regardless of their AUDIT score. Conclusions: Patients with short-term abstinence had a greater AB than patients with long-term abstinence. The first gaze seems to be a sensitive parameter for differentiating between patients with low and high AB. The use of eye-tracking technology suggests that AB is important in clinical assessment and should be addressed in treatment as well as in relapse prevention. We consider that the eye-tracking technology is a promising instrument for assessing current addictive behavior.
... A low test-retest reliability is especially problematic when the task is used to measure changes in AB. To account for the low reliability of the visual probe task and other indirect measures of AB, several studies have tested whether more direct measures of attention by the use of eye-tracking can serve as an alternative [10,11]. However, although eyetracking can measure overt attention shifts (responding by directly moving and focussing the gaze on a target), it does not measure covert attention shifts (responding by seeing something peripherally without directly focussing the gaze on a target). ...
Cognitive models emphasise the importance of attentional bias in addiction. However, many attentional bias tasks have been criticised for questionable psychometric properties and inability to differentiate between engagement and disengagement processes. This study therefore examined the suitability of two alternative tasks for assessing attentional bias within the context of alcohol use. Participants were undergraduate students (N = 169) who completed the Visual Search Task and Odd-One-Out Task, the latter of which is designed to differentiate between engagement and disengagement processes of attention, at baseline and one week later. Participants also completed baseline measures of alcohol consumption, craving, and alcohol use problems. Internal consistency was adequate for the Visual Search Task index, and weak for the Odd-One-Out Task indices. Test-retest reliability was weak for both tasks. The Visual Search Task index and the disengagement (but not the engagement) index of the Odd-One-Out Task showed a positive association with alcohol consumption. This study was restricted to a non-clinical student sample. The relatively high error rate of the Odd-One-Out Task might have reduced its sensitivity as an index of attentional bias. Both tasks showed some merit as attentional bias measures, and results suggested that attentional disengagement might be particularly related to alcohol use. However, the reliability of the current measures was inadequate. One potential explanation for the low reliability is that non-clinical samples may have weak and unstable attentional biases to alcohol. Future efforts should be made to improve the psychometric qualities of both tasks and to administer them in a clinical sample.
... Monem and Fillmore (2016) also found that withinperson differences in gaze duration between alcoholic and non-alcoholic beverages in both sessions were positively related to typical alcohol use levels. Similarly, inside complex visual scenes presented on a computer screen, alcoholic beverages can elicit a greater number of cue-directed eye movements and the extent to which they do appears to be relate to alcohol use levels (Roy-Charland et al., 2017). More eye movements tend to be directed toward alcohol use scenes when they are presented alongside other scenes and gaze duration tends to be longer (Vincke and Vyncke, 2017). ...
Cofresí, R. C., B. D. Bartholow and T. M. Piasecki. Evidence for incentive salience sensitization as a pathway to alcohol use disorder. NEUROSCI BIOBEHAV REV 21(1) XXX-XXX, 1998. - The incentive salience sensitization (ISS) theory of addiction holds that addictive behavior stems from the ability of drugs to progressively sensitize the brain circuitry that mediates attribution of incentive salience (IS) to reward-predictive cues and its behavioral manifestations. In this article, we establish the plausibility of ISS as an etiological pathway to alcohol use disorder (AUD). We provide a comprehensive and critical review of evidence for: (1) the ability of alcohol to sensitize the brain circuitry of IS attribution and expression; and (2) attribution of IS to alcohol-predictive cues and its sensitization in humans and non-human animals. We point out gaps in the literature and how these might be addressed. We also highlight how individuals with different alcohol subjective response phenotypes may differ in susceptibility to ISS as a pathway to AUD. Finally, we discuss important implications of this neuropsychological mechanism in AUD for psychological and pharmacological interventions attempting to attenuate alcohol craving and cue reactivity.
... For those foods that are also perceived as being 'unhealthy' (i.e., high in sugar/fat/carbohydrates), consumers seem to expect a better taste, as well as reporting enjoying the actual consumption more (Raghunathan, Naylor, & Hoyer, 2006). Neurological evidence supports these findings: specifically, functional magnetic resonance imaging (fMRI; a technique 2 As a potential fourth nutritional value identified, note also that foods high in alcohol content seem to elicit an attentional bias wherein more attention is paid to alcohol-related, vs. neutral visual stimuli by those who drink (Roy-Charland et al., 2017; for a review, see Field & Cox, 2008). Specifically, an associated effect of increased visual (over auditory) sensory dominance has been identified when alcohol-related stimuli are shown (Monem & Fillmore, 2016). ...
The sight of food has a profound effect on us, from making us feel hungry/increasing our appetite, through to encouraging us to imagine what it would be like to eat that which we see. Indeed, using enticing visual imagery has been a common and effective tactic in the marketing of food and drink products for many decades now. Such imagery has been common in advertising, on menus, product packaging, and increasingly, on social media as well. However, despite its prevalence, any effect of being able to see the product itself on (or through) the packaging remains relatively poorly understood. Only over the past two decades has this research theme started to receive empirical scrutiny, with a growing body of findings now helping to highlight how the sight of a product influences the evaluations and behaviours of consumers. This chapter covers three main themes: the impact of product imagery printed on the pack; the impact of transparent packaging (thus allowing direct sight of the product itself); and a synthesis of these findings, paired with a number of concrete recommendations for academics, designers, and public health practitioners. We conclude by considering the future for product imagery and transparent packaging.
... When the general population is split into heavy and light social drinkers, it is only for light social drinkers that the distractibility of the biased item when task-irrelevant is found. This shows sub-group differences in attentional bias between heavy and light social drinkers, clarifying previous inconsistent findings (Cox et al. 2003;Cox et al. 1999;Sharma et al. 2001), while supporting more recent examinations of attentional bias via eye movements (McAteer et al. 2015;Roy-Charland et al. 2017). Put together, these stress the value of using more direct (eye movement data) and sensitive (signal detection theory) measurements to measure subtle changes in attentional state. ...
It is well established that alcoholics and heavy social drinkers show a bias of attention towards alcohol-related items. Previous research suggests that there is a shared foundation of attentional bias, which is linked to attentional control settings. Specifically, attentional bias relates to a persistent selection of a Feature Search Mode which prioritises attentional bias-related information for selection and processing. However, no research has yet examined the effect of pre-existing biases on the development of an additional attentional bias. This paper seeks to discover how pre-existing biases affect the formation of a new, additional attentional bias. Twenty-five heavy and 25 light social drinkers, with and without a pre-existing bias to alcohol-related items, respectively, had an attentional bias towards the colour green induced via an information sheet. They then completed a series of one-shot change detection tasks. In the critical task, green items were present but task-irrelevant. Irrelevant green items caused significantly more interference for light than heavy social drinkers. This somewhat counter intuitive result is likely due to heavy drinkers having more experience in exerting cognitive control over attentional biases, something not previously observed in investigations of the effects of holding an attentional bias. Our findings demonstrate for the first time that an established attentional bias significantly modulates future behaviour.
... Unlike other attention tasks (e.g., the Stroop task, dot-probe tasks), tracking eye movements allows for a moment-to-moment assessment of attention while participants view a display of competing gambling imagery. The issue of assessing individual variability as well as fluctuations in attention during attentional bias tasks has been recently highlighted as an important research direction in the alcohol literature (e.g., [47][48]). In our study, eye-gaze tracking permitted a nuanced comparison of attentional bias for specific types of gambling in real-time. ...
A growing body of research indicates that gamblers develop an attentional bias for gambling-related stimuli. Compared to research on substance use, however, few studies have examined attentional biases in gamblers using eye-gaze tracking, which has many advantages over other measures of attention. In addition, previous studies of attentional biases in gamblers have not directly matched type of gambler with personally-relevant gambling cues. The present study investigated the specificity of attentional biases for individual types of gambling using an eye-gaze tracking paradigm. Three groups of participants (poker players, video lottery terminal/slot machine players, and non-gambling controls) took part in one test session in which they viewed 25 sets of four images (poker, VLTs/slot machines, bingo, and board games). Participants' eye fixations were recorded throughout each 8-second presentation of the four images. The results indicated that, as predicted, the two gambling groups preferentially attended to their primary form of gambling, whereas control participants attended to board games more than gambling images. The findings have clinical implications for the treatment of individuals with gambling disorder. Understanding the importance of personally-salient gambling cues will inform the development of effective attentional bias modification treatments for problem gamblers.
... Attentional bias in substance dependency can be defined as an automatic tendency to focus attention on substance-related cues in the environment [5,6], such as alcohol advertisement or a used joint on the street. Attentional bias for substance-related cues has repeatedly been found in different substance use disorders, such as alcohol, tobacco, and opioids dependency [7][8][9]; for a critical review on the role of attentional bias in addiction see [10]. ...
Background
The automatic tendency to attend to and focus on substance-related cues in the environment (attentional bias), has been found to contribute to the persistence of addiction. Attentional bias modification (ABM) interventions might, therefore, contribute to treatment outcome and the reduction of relapse rates. Based on some promising research findings, we designed a study to test the clinical relevance of ABM as an add-on component of regular intervention for alcohol and cannabis patients.
Design/Methods
The current protocol describes a study which will investigate the effectiveness and cost-effectiveness of a newly developed home-delivered, multi-session, internet-based ABM (iABM) intervention as an add-on to treatment as usual (TAU). TAU consists of cognitive behavioural therapy-based treatment according to the Dutch guidelines for the treatment of addiction. Participants (N = 213) will be outpatients from specialized addiction care institutions diagnosed with alcohol or cannabis dependency who will be randomly assigned to one of three conditions: TAU + iABM; TAU + placebo condition; TAU-only. Primary outcome measures are substance use, craving, and rates of relapse. Changes in attentional bias will be measured to investigate whether changes in primary outcome measures can be attributed to the modification of attentional bias. Indices of cost-effectiveness and secondary physical and psychological complaints (depression, anxiety, and stress) are assessed as secondary outcome measures.
Discussion
This randomized control trial will be the first to investigate whether a home-delivered, multi-session iABM intervention is (cost-) effective in reducing relapse rates in alcohol and cannabis dependency as an add-on to TAU, compared with an active and a waiting list control group. If proven effective, this ABM intervention could be easily implemented as a home-delivered component of current TAU.
Trial registration
Netherlands Trial Register, NTR5497, registered on 18th September 2015.
Les effets toxiques de l’alcool sur le cerveau peuvent être mis en évidence par imagerie médicale. Ainsi, une diminution de la substance grise a été observée chez des personnes alcoolo-dépendantes. Plus la consommation d’alcool commence à un âge précoce, plus l’altération de la matière grise est importante. En Côte d’Ivoire, des travaux antérieures indiquent la présence de perturbations de l’attention sélective et de la mémoire de travail chez des adolescents et jeunes adultes non alcoolo-dépendants, mais consommateurs réguliers de koutoukou (eau-de-vie locale de fabrication artisanale, issue de la sève de palmier à huile ̏ Elaeis guineensis Jacq.̋). Cette étude a pour objectif d’étudier les effets de l’alcool sur les facultés attentionnelles des patients alcoolo-dépendants. A cet effet, un test neuropsychologique (test de Stroop) a été utilisé afin de comparer les performances attentionnelles des patients avant et après traitement (sevrage). Il en ressort que l’alcool altère significativement l’attention sélective chez les alcoolo-dépendants. Cependant, il a été constaté après traitement (sevrage), une récupération progressive de cette fonction cognitive. Cependant les performances des sujets traités n’égalent pas celle des témoins. (préciser le type de l’approche / étude ; ressortir les principaux résultats pour le lecteur). The toxic effects of alcohol on the brain can be demonstrated by medical imaging. Thus, a decrease in the gray matter has been observed in alcohol-dependent people. The earlier alcohol consumption begins, the greater the impairment of gray matter. In Côte d'Ivoire, previous work indicates the presence of disturbances in selective attention and working memory in non-alcohol-dependent adolescents and young adults, but regular consumers of koutoukou (local brandy made artisanal, made from oil palm sap ̏ Elaeis guineensis Jacq.̋). This study aims to study the effects of alcohol on the attentional faculties of alcohol-dependent patients. To this end, a neuropsychological test (Stroop test) was used to compare the attentional performance of patients before and after treatment (withdrawal). It appears that alcohol significantly alters selective attention in alcohol-dependent people. However, it was observed after treatment (withdrawal), a gradual recovery of these cognitive functions. However, the performance of the treated subjects did not equal that of the controls.
Les effets toxiques de l’alcool sur le cerveau peuvent être mis en évidence par imagerie médicale. Ainsi, une diminution de la substance grise a été observée chez des personnes alcoolo-dépendantes. Plus la consommation d’alcool commence à un âge précoce, plus l’altération de la matière grise est importante. En Côte d’Ivoire, des travaux antérieures indiquent la présence de perturbations de l’attention sélective et de la mémoire de travail chez des adolescents et jeunes adultes non alcoolo-dépendants, mais consommateurs réguliers de koutoukou (eau-de-vie locale de fabrication artisanale, issue de la sève de palmier à huile ̏ Elaeis guineensis Jacq.̋). Cette étude a pour objectif d’étudier les effets de l’alcool sur les facultés attentionnelles des patients alcoolo-dépendants. A cet effet, un test neuropsychologique a été utilisé afin de comparer les performances des patients avant et après traitement (sevrage). Il en ressort que l’alcool altère significativement l’attention sélective chez les alcoolo-dépendants. Cependant, il a été constaté après traitement (sevrage), une récupération progressive de ces fonctions cognitives.
Les effets toxiques de l’alcool sur le cerveau peuvent être mis en évidence par imagerie médicale. Ainsi, une diminution de la substance grise a été observée chez des personnes alcoolo-dépendantes. Plus la consommation d’alcool commence à un âge précoce, plus l’altération de la matière grise est importante. En Côte d’Ivoire, des travaux antérieures indiquent la présence de perturbations de l’attention sélective et de la mémoire de travail chez des adolescents et jeunes adultes non alcoolo-dépendants, mais consommateurs réguliers de koutoukou (eau-de-vie locale de fabrication artisanale, issue de la sève de palmier à huile ̏ Elaeis guineensis Jacq.̋). Cette étude a pour objectif d’étudier les effets de l’alcool sur les facultés attentionnelles des patients alcoolo-dépendants. A cet effet, un test neuropsychologique a été utilisé afin de comparer les performances des patients avant et après traitement (sevrage). Il en ressort que l’alcool altère significativement l’attention sélective chez les alcoolo-dépendants. Cependant, il a été constaté après traitement (sevrage), une récupération progressive de ces fonctions cognitives.
In severe alcohol use disorder (SAUD), attentional bias refers to the preferential allocation of attentional resources toward alcohol-related cues. Dominant models consider that this bias plays a key role in the emergence and maintenance of SAUD. We evaluate the available experimental support for this assumption through a systematic literature review, providing a critical synthesis of studies exploring the links between alcohol consumption and attentional bias. Using PRISMA guidelines, we explored three databases (PsycINFO, PubMed, Scopus) and extracted 95 papers. We assessed their methodological quality and categorized them based on the population targeted, namely patients with SAUD or subclinical populations with various drinking patterns. We also classified papers according to the measures used (i.e., behavioral or eye-tracking measures). Overall, subclinical populations present an alcohol-related bias, but many studies in SAUD did not find such bias, nor approach/avoidance patterns. Moreover, attentional bias fluctuates alongside motivational states rather than according to alcohol use severity, which questions its stability. We provide recommendations to develop further theoretical knowledge and overcome methodological shortcomings.
Background and objectives
Premenstrual Syndrome (PMS) refers to a group of symptoms linked to the menstrual cycle. Women with PMS have cognitive mode of rumination, which leads to their attention bias to emotional stimuli. This study investigated the biases for emotional information in women with high premenstrual symptoms (HPMS) compared with women with low premenstrual symptoms (LPMS).
Methods
A total of 38 women with HPMS and 44 women with LPMS completed self-report questionnaires and a free viewing task with eye-tracking technology.
Results
The questionnaire results indicate that women in the HPMS group had higher levels of rumination than those in the LPMS group. The eye-tracking results show that women in the HPMS group had an orientation bias towards negative emotional stimuli in the early cognitive process. In the late cognitive process, women in the HPMS group had accelerated attentional disengagement to positive emotional stimuli and difficult attentional disengagement to negative emotional stimuli. Further correlation analysis revealed positive relationships between the scores of initial fixation latency bias of positive pictures in premenstrual phase and the scores of symptom rumination in both groups and between the scores of initial fixation latency bias of positive pictures in premenstrual phase and the scores of brooding in HPMS group.
Limitations
This study used a retrospective questionnaire to assess the symptoms of PMS.
Conclusions
Women with HPMS had impaired attentional engagement and disengagement to emotional stimuli compared with women with LPMS, and it may be related to their cognitive mode of rumination.
Tinder has become a popular online dating tool for people looking for either short- or long-term relationships. In this study we build on existing research on gender differences in the motivations of Tinder users, by analyzing gender differences in self-presentation. We predicted that women would try to attract men to right-swipe (i.e., potentially match) their profiles through largely visual means; while men would put more emphasis on showing off their skills and interests. In a sample of 300 randomly obtained Tinder profiles (150 heterosexual females and 150 heterosexual males), half from Colombia and half from the USA, we found mixed support for our hypotheses. There was no significant difference between numbers of photos uploaded by women and men, but certain types of photos were unique to one gender. Links to other social networks did not differ much between genders; however, men tended to include more textual information in their profiles.
Annual Review of CyberTherapy and Telemedicine (ARCTT – ISSN: 1554-8716) is published annually (once per year) by the Interactive Media Institute (IMI), a 501c3 non-profit organization, dedicated to incorporating interdisciplinary researchers from around the world to create, test, and develop clinical protocols for the medical and psychological community. IMI realizes that the mind and body work in concert to affect quality of life in individuals and works to develop technology
Certain people are at risk for using alcohol or other drugs excessively and for developing problems with their use. Their susceptibility might arise from a variety of factors, including their genetic make-up, brain chemistry, family background, personality and other psychological variables, and environmental and sociocultural variables. Moreover, after substance use has become established, there are additional cognitive-motivational variables (e.g., substance-related attentional bias) that contribute to enacting behaviors consistent with the person's motivation to acquire and use the substance. People who are at such risk are likely to choose to use addictive substances even though doing so entails negative consequences. In the sense of complete freedom from being determined by causal factors, we believe that there is no such thing as free will, but defined as ability to make choices from among multiple options, even though the choices are ultimately governed by natural processes, addicted individuals are free to choose. Although they might appear unable to exercise this kind of free will in decisions about their substance use, addictive behaviors are ultimately always goal-directed and voluntary. Such goal pursuits manifest considerable flexibility. Even some severely addicted individuals can cease their use when the value of continuing the use abruptly declines or when the subjective cost of continuing the use is too great with respect to the incentives in other areas of their lives. Formal treatment strategies (e.g., contingency management, Systematic Motivational Counseling, cognitive training) can also be used to facilitate this reversal.
the aim of this study was to analyze alcohol consumption by university students and psychosocial problems related.
descriptive correlational study that included 396 university students. The "Alcohol Use Disorders Identification Test" - (AUDIT) - and an "ad hoc" questionnaire were used as instruments to assess the associated problems.
of the total sample, 88.6% drank, 20.5% had harmful consumption and 14.9% were at risk of dependence according to AUDIT. The study showed important results related to harmful alcohol consumption and dependence, with damage to the academic performance, social relationships, psychological status and sexual condition.
complications caused by problematic alcohol consumption by university students, which is high in this group due to the high prevalence of their alcohol consumption, highlights the importance of promoting programs to prevent the abuse and dependence of this substance in universities.
We used the theory of planned behaviour (TPB) to investigate factors associated with alcohol consumption among university students, and to examine whether general or alcohol-specific health knowledge acts as a moderator in the relationship between elements of the theory and drinking behaviour. Participants were 258 Australian undergraduate university students (79% female) who completed an online questionnaire, assessing the constructs of interest. The hypothesis that intentions and behaviour would be successfully predicted using the theory was generally supported. Little evidence for the moderating effect of knowledge on the TPB variables was observed, although both general and alcohol-specific health knowledge moderated the relationship between intentions and behaviours. Contrary to expectation, more accurate knowledge strengthened this relationship. Further work is necessary to investigate the role of knowledge in limiting alcohol-related harms.
Heavy episodic drinking in college is an issue of major concern in our society. In the college setting, where alcohol misuse is prevalent, alcohol-related perceptions and automatic attentional biases may be important determinants in students' decisions to engage in risking drinking behaviors. The current study examined college students' attention to alcohol-related beverages in real time using ocular-imaging techniques. The authors hypothesized that alcohol-consumption characteristics such as quantity-frequency of alcohol consumption would predict ocular-imaging indices of attentional bias to alcohol-related images.
Twenty-six college students successfully completed questionnaires assessing basic demographics and alcohol-consumption characteristics, followed by an eye-tracking task in which they viewed pictorial stimuli consisting of photographs of alcohol-related scenes, household objects, or a combination of these items.
Quantity-frequency index (QFI) of alcohol consumption was positively related to the percentage of initial ocular fixations on the alcohol-related items (r = .62, p = .001), whereas QFI negatively predicted the percentage of initial ocular fixations on the control images (r = -.60, p = .002). In addition, QFI positively predicted participants' dwell time on alcohol-related images (r = .57, p = .005), and negatively predicted dwell time on control images (r = -.41, p = .05). Age at first drink and days since last alcohol consumption were not related to eye-tracking metrics.
Ocular-imaging methods are a valuable tool for use in the study of attentional bias to alcohol-related images in college drinkers. Further research is needed to determine the potential application of these methods to the prevention and treatment of alcohol misuse on college campuses.
In highly controlled cuing experiments, conspecific gaze direction has powerful effects on an observer's attention. We explored the generality of this effect by using paintings in which the gaze direction of a key character had been carefully manipulated. Our observers looked at these paintings in one of three instructional states (neutral, social, or spatial) while we monitored their eye movements. Overt orienting was much less influenced by the critical gaze direction than what the cuing literature might suggest: An analysis of the direction of saccades following the first fixation of the critical gaze showed that observers were weakly biased to orient in the direction of the gaze. Over longer periods of viewing, however, this effect disappeared for all but the social condition. This restriction of gaze as an attentional cue to a social context is consistent with the idea that the evolution of gaze direction detection is rooted in social communication. The picture stimuli from this experiment can be downloaded from the Psychonomic Society's Archive of Norms, Stimuli, and Data, www.psychonomic.org/archive.
Recent research has suggested that anxiety may be associated with processing biases that favor the encoding of emotionally threatening information. However, the available data can be accommodated by alternative explanations, including response bias accounts. The current study introduces a novel paradigm that circumvents such interpretative problems by requiring subjects to make a neutral response (button press) to a neutral stimulus (visual dot probe). The position of this dot probe was manipulted on a VDU (visual display unit) screen relative to visually displayed words, which could either be threat related or neutral in content. Probe detection latency data were then used to determine the impact of threat-related stimuli on the distribution of visual attention. Clinically anxious (but not clinically depressed) subjects consistently shifted attention toward threat words, resulting in reduced detection latencies for probes appearing in the vicinity of such stimuli. Normal control subjects, on the other hand, tended to shift attention away from such material. The results were interpreted as supporting the existence of anxiety-related encoding bias, and it is suggested that this cognitive mechanism may contribute to the maintenance of such mood disorders.
Bartlett viewed thinking as a high level skill exhibiting ballistic properties that he called its “point of no return”. This paper explores one aspect of cognition through the use of a simple model task in which human subjects are asked to commit attention to a position in visual space other than fixation. This instruction is executed by orienting a covert (attentional) mechanism that seems sufficiently time locked to external events that its trajectory can be traced across the visual field in terms of momentary changes in the efficiency of detecting stimuli. A comparison of results obtained with alert monkeys, brain injured and normal human subjects shows the relationship of this covert system to saccadic eye movements and to various brain systems controlling perception and motion. In accordance with Bartlett's insight, the possibility is explored that similar principles apply to orienting of attention toward sensory input and orienting to the semantic structures used in thinking.
Previous research has shown an attentional bias toward drug-related stimuli in opiate addicts and toward emotionally threatening words in anxiety patients.
The primary aim of this study was to investigate whether non-dependent heavy social drinkers would differ in their selective attention towards alcohol-related stimuli in comparison with a group of occasional social drinkers.
Attentional bias was assessed using alcohol-related pictures and words in a dot probe detection task. Picture and word pairs were visually presented, followed by a dot probe that replaced one of the items. Attentional bias was determined from latencies in responding to the dot probe. Questionnaires were used to examine the relationships among attention, outcome expectancies after alcohol consumption, and personality traits. Higher-order executive function was also measured with two cognitive tasks, recognition memory and attentional shift.
The heavy social drinkers showed an attentional bias towards the alcohol-related stimuli when compared to the occasional social drinkers. The heavy social drinkers also scored more highly on expectancy factors of sociability and sexuality and lower on the personality traits of self-directedness and persistence. Conclusion: The results support cognitive theories of addictive behaviour in which the ability of drug-related stimuli to capture attention is suggested to play a part in drug dependence, craving and relapse.
The effects of university students' habitual drinking practices and experimental alcohol cue exposure on their attentional bias for alcohol-related stimuli were assessed.
Participants were exposed in vivo to either an alcoholic or non-alcoholic beverage immediately prior to completing a cognitively demanding emotional Stroop task that uses alcohol-related and control words as potential distractors.
Regression analyses indicated that, for participants who were low consumers of alcohol, neither level of habitual drinking, type of cue exposure, nor their interaction predicted attentional bias for the alcohol-related stimuli. For high consumers of alcohol who were exposed to the alcoholic beverage (but not those exposed to the non-alcoholic beverage), the amount of alcohol that participants habitually drank significantly predicted the degree of attentional bias.
The results indicate that, among non-dependent drinkers (unlike alcohol-dependent participants), alcohol-related attentional bias is not a generalized phenomenon, but occurs only under a specific set of circumstances.
Examinations of gender differences in alcohol expectancies among college drinkers typically have used self-report measures to assess single expectancy dimensions and often have been confounded by drinking level. This study examined gender differences in alcohol expectancies using 2 assessment methods. College students (N = 88) completed self-report questionnaires, including expectancy likelihood and subjective evaluation endorsements of expectancies, and a computerized expectancy accessibility task. Expectancy accessibility and endorsement were modestly correlated, with higher alcohol consumption and female gender linked to greater accessibility and endorsement of social enhancement expectancies. Gender moderated the relation between consumption and sociability expectancy accessibility; among men, heavier drinking was associated with more rapid activation of expectancies. Findings suggest complexity in associations among these variables and underscore the need to capture the multidimensionality of the expectancy construct and its relationship to alcohol use.
To examine the hypothesis that patients who present in the UK to detoxification services differ from patients who present with severe alcohol-induced liver disease (ALD) with respect to severity of dependence on alcohol and other features of their drinking history.
Levels of alcohol dependence were assessed in 34 patients with severe ALD, all of whom were cirrhotic, and 34 subjects from a residential alcohol detox centre in Southampton using the Severity of Alcohol Dependence Questionnaire (SADQ). During interview, various aspects of participants' alcohol consumption were recorded, including total monthly consumption, whom they usually drank with and where, and, if applicable, what caused them to start drinking heavily. Social circumstances were also noted, including participants' employment and marital status.
Among ALD patients, 58% scored none/mild on the SADQ, 32% moderate and 9% severe. In contrast, 76% of the detox group were graded severe and 34% moderate (P < 0.001). ALD patients were also significantly older, had lower scores on the Alcohol Use Disorders Identification Test, tended to drink less alcohol, were more likely to be in a stable relationship, were less likely to be unemployed and gave different reasons for starting to drink heavily. The ALD group were most likely to have started drinking heavily for social reasons, whereas subjects in the detox group were most likely to have started drinking heavily as a result of relationship or money problems.
Patients attending a liver unit and patients admitted to a detoxification unit were separate but overlapping populations of alcohol misusers. Perhaps these two populations of alcohol misusers are likely to require different approaches for effective detection, intervention and treatment.
The authors used a flicker paradigm for inducing change blindness as a more direct method of measuring attentional bias in problem drinkers in treatment than the previously used, modified Stroop, Posner, and dual-task paradigms. First, in an artificially constructed visual scene comprising digitized photographs of real alcohol-related and neutral objects, problem drinkers detected a change made to an alcohol-related object more quickly than to a neutral object. Age- and gender-matched social drinkers showed no such difference. Second, problem drinkers given the alcohol-related change to detect showed a negative correlation between the speed with which the change was detected and the problem severity as measured by the number of times previously treated. Coupled with other data from heavy and light social drinkers, the data support a graded continuity of attentional bias underpinning the length of the consumption continuum.
The chapter considers the use of individualized versus generalized stimuli to assess implicit cognitive processes in addictive behaviors. Most studies have used generalized stimuli that were not specifically selected for each participant. A major advantage of doing so is that compiling the stimuli is straightforward. A uniform set of addiction-related stimuli, however, might not apply to all participants, who vary in their addiction-related habits and preferences. A limited number of studies have used individualized stimuli, which were selected to represent each participant's current concerns. The individualized approach offers promise for better understanding people's individual motives for using addictive substances. It also has therapeutic implications for helping problematic users to control their use.
The findings obtained with the textual Stroop paradigm, testing for an attentional bias towards alcohol stimuli in heavier compared to lighter social drinkers, are limited in number and inconsistent in outcome. Using a pictorial rather than textual Stroop paradigm for the first time in alcohol research, a significant alcohol attentional bias is reported in heavier social drinkers compared to lighter social drinking controls. According to Cohen's scheme, the significant effect size is classified as ‘large'. The presence of an alcohol attentional bias helps to explain the perpetuation of abusive/dependent consumption and the frequency of post-treatment relapse. In a similar vein, these results add to the evidence that a differential alcohol attentional bias might also be present between two levels of social drinking and, in heavier social drinkers, has the potential to impact on the contents of awareness and the flow of thought towards alcohol. In this respect, it extends the small group of other perceptual-cognitive effects measured in social drinkers (alcohol cue reactions, alcohol associations and alcohol expectancies) that can influence the initiation of consumption in some social drinkers.
In the present review, an integrated approach to craving and addiction is discussed, which is based on recent insights from psychology and neuropsychopharmacology. An integrated model explains craving and relapse in humans by the psychological mechanism of "attentional bias" and provides neuropsychopharmacological mechanisms for this bias. According to this model, cognitive processes mediate between drug stimulus and the subject's response to this stimulus and subsequent behavioral response (e.g., drug use, relapse). According to the model, a conditioned drug stimulus produces an increase in dopamine levels in the corticostriatal circuit, in particular the anterior cingulate gyrus, amygdala, and nucleus accumbens, which in turn serves to draw the subject's attention towards a perceived drug stimulus. This process results in motor preparation and a hyperattentive state towards drug-related stimuli that, ultimately, promotes further craving and relapse. Evidence for this attentional bias hypothesis is reviewed from both the psychopharmacological and the neuroanatomical viewpoints. The attentional bias hypothesis raises several suggestions for clinical approaches and further research.
This study sets out to investigate the possible association between alcohol consumption and eight types of problem behaviour in the lives of a sample of 2027 British adults. It also examines gender differences in the prevalence of these problems. The problems considered were related to working, eating, shopping, use of the Internet, sexual activity, exercise, gambling and dieting. Last occasion's alcohol consumption was significantly associated with having experienced problems related to work, gambling, dieting and sexual activity. Total previous week's drinking was only associated with two of these problems—gambling and sexual activity. There were a number of distinct gender differences in the levels of specific problems reported. Females were significantly more likely than males to report having experienced problems related to eating and dieting. Conversely, males were more likely than females to report having had problems related to work, use of the Internet, sexual activity and gambling. These findings do indicate that adult drinking was associated with several forms of “‘problem behaviour”. Even so, they do not support the conclusion that all such behaviours are necessarily interconnected. The gender differences that emerged were not unexpected in view of prevailing social norms and stereotypes concerning the behaviour of the sexes.
Evidence from a number of substance abuse populations suggests that substance abuse is associated with a cluster of differences in cognitive processes. However, investigations of this kind in non-clinical samples are relatively few. The present study examined the ability of alcohol-attentional bias (an alcohol Stroop task), impulsive decision-making (a delay discounting task), and impaired inhibitory control (a GO-NOGO task) to: (a) discriminate problem from non-problem drinkers among a sample of college students; (b) predict scores on the Alcohol Use Disorders Identification Test (AUDIT; a measure of alcohol consumption, drinking behaviour, and alcohol-related problems) across all of the student drinkers; (c) predict AUDIT scores within the subgroups of problem and non-problem student drinkers. In logistic regression controlling for gender and age, student drinkers with elevated alcohol-attentional bias and impulsive decision-making were over twice as likely to be a problem than a non-problem drinker. Multiple regression analysis of the entire sample revealed that all three cognitive measures were significant predictors of AUDIT scores after gender and age had been controlled; the cognitive variables together accounted for 48% of the variance. Moreover, subsequent multiple regressions revealed that impaired inhibitory control was the only significant predictor of AUDIT scores for the group of non-problem drinkers, and alcohol-attentional bias and impulsive decision-making were the only significant predictors of AUDIT scores for the group of problem drinkers. Finally, both impulsive decision-making and impaired inhibitory control were significantly correlated with alcohol-attentional bias across the whole sample. Implications are discussed relating to the development of problematic drinking.
Visual probe tasks are often used to measure attentional bias (AB) towards alcohol-related images in drinkers, but little is known about the effect of the properties of the images used in this task: specifically, image complexity.
AB was examined in a group of adult drinkers (n = 25). Two measures of attentional bias were obtained from a modified visual probe task. First, a traditional dot probe detection task measured attentional bias in drinkers based on their reaction times to probes replacing neutral and alcohol-related images. Secondly, an eye-tracking measure was applied to this task to directly assess the drinkers' eye gazes to the alcohol-related and neutral images. The effect of image complexity was examined by comparing AB towards images classified as simple and complex.
Results showed that drinkers displayed AB only towards simple alcohol-related images as measured by both probe RT and fixation times.
These findings suggest that complex alcohol-related images might be less effective at capturing drinkers' attention and could result in less attentional bias when used in visual probe tasks.
The construction of a profile instrument for the quantification of beer, wine and distilled spirits consumption, based on the reported use of 2303 men and women, is presented.
It was postulated that generalized anxiety states are associated with selective processing of threat cues arising from the activity of cognitive structures concerned with processing information related to personal danger (danger schemata). Selective processing was investigated using a modification of the Stroop Colour-naming Task, in which some of the target words were related to physical or social threat, while others were completely unrelated to danger. Anxious Ss were generally slower than controls in colour-naming all words, but were particularly slow with threat words. In the case of physical (but not social) threat words, there was also evidence that interference was most marked in those Ss reporting worries within the relevant domain. Taken together with correlational findings that degree of slowing was associated with mood state, the results were interpreted as evidence that the individual content of danger schemata determine the type of material that is selectively processed, while the extent of interference observed depends on current anxiety level.
The issues explored in this study were whether a patient group of problem drinkers selectively attend to alcohol-related stimuli and the time course of any interference from alcohol-related stimuli in comparison with two control groups of non-problem drinkers.
A 3 x 2 x 2 x 5 factorial design was used. Drinking group (low, high and problem) and word order (alcohol-neutral, neutral-alcohol) were between-participant factors, and word type (alcohol, neutral) and presentation block (1-5) were within participant factors.
Three groups were used, 20 participants from a local community alcohol Service (CAS) and 40 participants (student volunteers) in two control groups. The two control groups were differentiated as scoring high or low on the Alcohol Use Disorders Identification Test (AUDIT).
A modified computerized Stroop colour naming test was used to measure response latencies. Anxiety was measured using the State-Trait Anxiety Inventory.
The CAS group showed significantly longer reaction times to respond to the colour of alcohol-related words than to neutral category words. Although the interference was smaller for the high AUDIT group it was significant. No significant interference was found in the low AUDIT group. There was no statistical evidence that the interference habituated in the three groups.
The present study showed it is possible to use a modified Stroop task as a measure of implicit processing of alcohol stimuli. Despite the fact that all participants were asked to ignore the words, they were unable to do so. Alcohol-related words produced more interference than neutral category words in a group of problem drinkers and a control group of high alcohol drinkers.
The study investigated biases in selective attention to emotional face stimuli in generalized anxiety disorder (GAD) and depressive disorder, using a modified probe detection task. There were 4 face types: threatening, sad, happy, and neutral. Measures of attentional bias included (a) the direction and latency of the initial eye movement in response to the faces and (b) manual reaction time (RT) to probes replacing the face stimuli 1,000 ms after their onset. Results showed that individuals with GAD (without depressive disorder) were more likely to look first toward threat faces rather than neutral faces compared with normal controls and those with depressive disorder. They also shifted their gaze more quickly toward threat faces, rather than away from them, relative to the other two groups. There were no significant findings from the manual RT data. Implications of the results for recent theories of clinical anxiety and depression are discussed.
To assess relationships between alcohol consumption and two dimensions of drinking restraint (temptation and restriction), American and German college students were given the Khavari Alcohol Test (KAT) and the Temptation and Restraint Inventory (TRI). As hypothesized, drinking temptation was a positive predictor of students' alcohol consumption in both countries, but there was no main effect for drinking restriction. Also as hypothesized, American students who were high on drinking temptation drank greater (not smaller) quantities of alcohol if they were also high on drinking restriction. Conversely, German students who were high on drinking temptation drank more alcohol if they were also low on drinking restriction. The results point to cross-cultural similarities and differences in relationships between drinking temptation and restriction and actual alcohol consumption.
Detoxified clients at an alcohol treatment centre (n = 34) were administered a modified Stroop test, an index of attentional bias or distraction. Their performance was compared to controls (n = 33) who were staff recruited from specialist substance misuse clinics based on the presumption of familiarity with the alcohol and addiction related terms of the Stroop task. The card-format Stroop test contained words such as "alcohol" and "relapse" and neutral, semantically homogenous words such as "table" and "chair." Analysis of variance (ANOVA) revealed significant main effects for word type with both the clinic attendees and controls taking longer to colour-name alcohol-related words. Predicted interactions between word type and subject status were not observed. These findings suggest that both problem drinkers and clinic staff did not differ significantly in the degree of Stroop interference displayed, although a trend towards greater distraction by clinic attendees with alcohol-related terms was noted. The statistically significant results were nonetheless consistent with findings that expertise or familiarity can be influential factors in Stroop performance. Multiple regression analyses with the entire sample (n = 65) showed that psychometric and self-reported indices of alcohol dependence and consumption were predictive of Stroop interference. This is consistent with the existence of a acquired information processing bias related to escalating alcohol use and dependence such as that proposed by Tiffany [Psychol. Rev. 97 (1990) 147.].
This study examined whether alcohol abuse patients are characterized either by enhanced schematic processing of alcohol related cues or by an attentional bias towards the processing of alcohol cues.
Abstinent alcohol abusers (N = 25) and non-clinical control participants (N = 24) performed a dual task paradigm in which they had to make an odd/even decision to a centrally presented number while performing a peripherally presented lexical decision task. Stimuli on the lexical decision task comprised alcohol words, neutral words and non-words. In addition, participants completed an incidental recall task for the words presented in the lexical decision task.
It was found that, in the presence of alcohol related words, the performance of patients on the odd/even decision task was poorer than in the presence of other stimului. In addition, patients displayed slower lexical decision times for alcohol related words. Both groups displayed better recall for alcohol words than for other stimuli.
These results are interpreted as supporting neither model of drug cravings. Rather, it is proposed that, in the presence of alcohol stimuli, alcohol abuse patients display a breakdown in the ability to focus attention.
To investigate biases in overt orienting of attention to smoking-related cues in cigarette smokers, and to examine the relationship between measures of visual orienting and the affective and motivational valence of smoking cues.
Smokers and non-smokers took part in a single session in which their attentional and evaluative responses to smoking-related and matched control pictures were recorded.
Twenty smokers and 25 non-smokers.
Direction and duration of gaze was measured while participants completed a visual probe task. Subjective and cognitive-experimental measures of the motivational and affective valence of the stimuli were recorded.
Smokers, but not non-smokers, maintained their gaze for longer on smoking-related pictures than control pictures. They were also faster to detect probes that replaced smoking-related than control pictures, consistent with an attentional bias for smoking-related cues. Furthermore, smokers showed greater preferences for smoking-related than control pictures, compared with non-smokers, on both the subjective (explicit) and cognitive-experimental (implicit) indices of stimulus valence. Within smokers, longer initial fixations of gaze on smoking-related pictures were associated with a bias to rate the smoking pictures more positively, with greater approach tendencies for smoking pictures on the cognitive-experimental task, and with a greater urge to smoke.
These results demonstrate that smokers show biased attentional orientating to smoking cues, which is related to craving and the affective and motivational valence of the stimuli.
Background:
Epidemiological research examining health consequences of alcohol consumption generally relies on average volume consumed, yet examinations of drinking patterns show different dimensions of use associated with different health outcomes. Gender differences in metabolism and body composition may lead to gender-specific consequences of drinking frequency, quantity consumed per occasion, average amount consumed, and drinking pattern. Inconsistent results suggest gender differences are not well understood.
Methods:
Participants were 3069 male and 2600 female health maintenance organization survey respondents. Gender differences in relationships between alcohol consumption and health were examined using analyses of covariance adjusting for age alone and for age, ethnicity, marital status, body water index, and smoking. Past-year alcohol consumption (frequency, quantity per occasion, average drinks per month, and drinking pattern) and health measures (Short Form-36 general health, physical functioning, mental health subscales) were examined.
Results:
Gender x drinking frequency and drinking quantity interactions were significant in age-adjusted and fully adjusted models of general health and physical functioning. Gender interactions for drinking pattern were significant in the age-adjusted model and marginally significant in the fully adjusted model. No gender x drinking measure interactions were found for mental health. Fully adjusted models attenuated but did not eliminate gender differences for health and magnified relationships for functioning, the latter after adjusting for body water. For both genders, light to moderate consumption and more frequent drinking were associated with better health and functioning; relationships were stronger among women than men.
Conclusions:
Gender x drinking measure interactions in health outcomes suggest analyses should include such interactions except, possibly, for mental health. Adjusting for potential confounders can attenuate (general health) or magnify (physical functioning) gender differences. Functional status appears a sensitive measure for evaluating gender differences in alcohol's health effects, adjusting for body water. Women's health may benefit proportionally more from moderate drinking than men's.
The findings obtained with the textual Stroop paradigm, testing for an attentional bias towards alcohol stimuli in heavier compared to lighter social drinkers, are limited in number and inconsistent in outcome. Using a pictorial rather than textual Stroop paradigm for the first time in alcohol research, a significant alcohol attentional bias is reported in heavier social drinkers compared to lighter social drinking controls. According to Cohen's scheme, the signifant effect size is classified as 'large'. The presence of an alcohol attentional bias helps to explain the perpetuation of abusive/dependent consumption and the frequency of post-treatment relapse. In a similar vein, these results add to the evidence that a differential alcohol attentional bias might also be present between two levels of social drinking and, in heavier social drinkers, has the potential to impact on the contents of awareness and the flow of thought towards alcohol. In this respect, it extends the small group of other perceptual-cognitive effects measured in social drinkers (alcohol cue reactions, alcohol associations and alcohol expectancies) that can influence the initiation of consumption in some social drinkers.
Attentional bias for alcohol-related cues is associated with the motivation to drink alcohol, possibly because attentional bias increases craving.
We examined whether an experimentally induced attentional bias would influence subjective and behavioural indices of the motivation to drink.
Heavy social drinkers (N=40) completed an attentional training procedure, in which half of the participants were trained to direct their attention towards alcohol-related cues ('attend alcohol'), and half of the participants were trained to direct their attention away from alcohol-related cues ('avoid alcohol'). After attentional training, participants rated their urge to drink alcohol, and the amount of beer consumed during a taste test was measured.
The attentional training procedure produced significant changes in attentional bias in the predicted direction in both experimental groups. Attentional training produced an increase in the urge to drink alcohol in the attend alcohol group, and the attend alcohol group consumed more beer than the avoid alcohol group during the taste test.
These results suggest that a potentiated attentional bias for alcohol-related cues can increase the motivation to drink alcohol. Theoretical and clinical implications are discussed.
Progress in dealing with the alcohol-impaired driving problem in the United States during the past 25 years is addressed.
Trends in various measures of the problem were tracked and a thorough review of the relevant literature conducted.
In the 1980s and continuing into the early 1990s, major decreases occurred in alcohol-impaired driving and its consequences. The contribution of alcohol to fatal crashes dropped by 35-40% during this period. Two primary reasons for the decline appear to be the emergence of citizen activist groups that mobilized public support and attention to the problem, and the proliferation of effective laws. Since about 1995 the alcohol-impaired driving problem has stabilized at a reduced but still quite high level.
Highway safety organizations and citizen activist groups have continued to highlight the problem, but its status as a social issue has diminished. We basically know what the primary target groups are, and we know measures that would work to reduce the problem if implemented more fully. We know that political leadership, state task forces, and media advocacy are important ingredients in addressing the problem. It is likely that a resurgence in citizen activism will be necessary to foster these elements and refocus the nation on the unfinished battle against alcohol-impaired driving.
Alcohol-impaired driving is still a major problem that needs continuing attention.
This paper presents a review and a model of the development of addictive behaviors in (human) adolescents, with a focus on alcohol. The model proposes that addictive behaviors develop as the result of an imbalance between two systems: an appetitive, approach-oriented system that becomes sensitized with repeated alcohol use and a regulatory executive system that is not fully developed and that is compromised by exposure to alcohol. Self-regulation critically depends on two factors: ability and motivation to regulate the appetitive response tendency. The motivational aspect is often still weak in heavy drinking adolescents, who typically do not recognize their drinking as problematic. Motivation to regulate use often develops only years later, after the individual has encountered serious alcohol-related problems. Unfortunately, at that point behavioral change becomes harder due to several neurocognitive adaptations that result from heavy drinking. As we document, there is preliminary support for the central elements of the model (appetitive motivation vs. self-regulation), but there is a paucity of research directly addressing these mechanisms in human adolescents. Further, we emphasize that adolescent alcohol use primarily takes place in a social context, and that therefore studies should not solely focus on intra-individual factors predicting substance use and misuse but also on interpersonal social factors. Finally, we discuss implications of the model for interventions.
Smokers have attentional biases towards smoking-related cues, and such cues elicit cravings. Smokers also feel anxious during nicotine deprivation, and anxiety may exacerbate attentional biases toward aversive cues. We examined the attentional bias of smokers (n = 14) and a control group of nonsmokers (n = 16) towards smoking-related and aversive cues. Using an eye-tracking device, we measured eye movement when smoking-related, aversive, and control cues were presented simultaneously. We analyzed the number of initial fixations, and gaze duration, to identify the attentional bias. Smokers initially fixed their gaze on aversive cues, and maintained their gaze longer on smoking-related cues, in comparison to the control group. These results suggest that smokers show biased attentional orientation to smoking-related and aversive cues.
Results from two experiments suggest that observers selectively attend to male, but not female, targets displaying signs of social dominance. Participants overestimated the frequency of dominant men in rapidly presented stimulus arrays (Study 1) and visually fixated on dominant men in an eyetracking experiment (Study 2). When viewing female targets, participants attended to signs of physical attractiveness rather than social dominance. Findings fit with evolutionary models of mating, which imply that dominance and physical attractiveness sometimes tend to be prioritized preferentially in judgments of men versus women, respectively. Findings suggest that sex differences in human mating are observed not only at the level of overt mating preferences and choices but also at early stages of interpersonal perception. This research demonstrates the utility of examining early-in-the-stream social cognition through the functionalist lens of adaptive thinking.
A wealth of research from the past two decades shows that addictive behaviors are characterized by attentional biases for substance-related stimuli. We review the relevant evidence and present an integration of existing theoretical models to explain the development, causes, and consequences of addiction-related attentional biases. We suggest that through classical conditioning, substance-related stimuli elicit the expectancy of substance availability, and this expectancy causes both attentional bias for substance-related stimuli and subjective craving. Furthermore, attentional bias and craving have a mutual excitatory relationship such that increases in one lead to increases in the other, a process that is likely to result in substance self-administration. Cognitive avoidance strategies, impulsivity, and impaired inhibitory control appear to influence the strength of attentional biases and subjective craving. However, some measures of attentional bias, particularly the addiction Stroop, might reflect multiple underlying processes, so results need to be interpreted cautiously. We make several predictions that require testing in future research, and we discuss implications for the treatment of addictive behaviors.
Using inhibition of return to illustrate the psychological scientist's challenge to avoid unreality and uncontrol
- R M Klein
- M D Hilchey
Klein RM, Hilchey MD. Using inhibition of return to
illustrate the psychological scientist's challenge to avoid
unreality and uncontrol. Can J Exp Psychol
2010;64:302-302.