Cocaine craving and attentional bias in cocaine-dependent schizophrenic patients

Department of Psychiatry, Columbia University, New York, New York, United States
Psychiatry Research (Impact Factor: 2.47). 11/2004; 128(3):209-18. DOI: 10.1016/j.psychres.2004.07.006
Source: PubMed


Cocaine craving has been implicated as a major factor underlying addiction and drug relapse. From a cognitive viewpoint, craving may reflect, in part, attentional processing biased in favor of drug-related cues and stimuli. Schizophrenic individuals (SZ), however, abuse cocaine in high numbers but typically manifest baseline cognitive deficits that impair their ability to selectively allocate their attentional resources. In this study, we examined the relationship between attentional bias and craving in patients with cocaine dependence (COC; n=20), schizophrenic patients comorbid for cocaine dependence (COC+SZ; n=23), as well as two other comparison groups using a modified version of the Stroop test to include cocaine-relevant words. Results revealed that only the COC patients demonstrated Stroop interference on the cocaine-related words. Moreover, COC patients' attentional processing biases were significantly associated with their cocaine craving severity ratings. COC+SZ patients, in contrast, did not demonstrate Stroop interference and manifested significantly fewer craving symptoms than their COC counterparts. These results suggest that COC+SZ patients' inability to selectively encode their drug-use experience may limit and shape their subjective experience of craving cocaine and motivation for cocaine use.

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    • "Franken (2003, 2007) suggests attentional bias towards drug-related cues influences drug-seeking and increases craving, prompting relapse. Numerous studies report associations between attentional bias and craving intensity for several drug substances (Copersino et al., 2004; Field et al., 2005). Attentional bias has been associated with an increased risk of relapse in smokers (Powell et al., 2010), alcohol users (Cox et al., 2002) and heroin users (Marissen et al., 2006). "
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    ABSTRACT: Observational studies have shown that attentional bias for smoking-related cues is associated with increased craving and relapse. Laboratory experiments have shown that manipulating attentional bias may change craving. Interventions to reduce attentional bias could reduce relapse in smokers seeking to quit. We report a clinical trial of attentional retraining in treatment-seeking smokers. This was a double-blind randomised controlled trial that took place in UK smoking cessation clinics. Smokers interested in quitting were randomised to five weekly sessions of attentional retraining (N=60) or placebo training (N=58) using a modified visual probe task from one week prior to quit day. Both groups received 21mg nicotine patches (from quit day onwards) and behavioural support. Primary outcomes included change in attentional bias reaction times four weeks after quit day on the visual probe task and craving measured weekly using the Mood and Physical Symptoms Scale. Secondary outcomes were changes in withdrawal symptoms, time to first lapse and prolonged abstinence. No attentional bias towards smoking cues was found in the sample at baseline (mean difference=3ms, 95% CI=-2, 9). Post-training bias was not significantly lower in the retraining group compared with the placebo group (mean difference=-9ms, 95% CI=-20, 2). There was no difference between groups in change in craving (p=0.89) and prolonged abstinence at four weeks (risk ratio=1.00, 95% CI=0.70, 1.43). Taken with one other trial, there appears to be no effect from clinic-based attentional retraining using the visual probe task. Attentional retraining conducted out of clinic may prove more effective. UK Clinical Trials ISRCTN 54375405. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Full-text · Article · Feb 2015 · Drug and Alcohol Dependence
    • "Contingency Management (CM) protocol COC AB associated with 1treatment outcomes after CM vouchers ended Copersino et al. (2004) "
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    ABSTRACT: Cocaine use disorder (CUD) continues to be an important public health problem, and novel approaches are needed to improve the effectiveness of treatments for CUD. Recently, there has been increased interest in the role of automatic cognition such as attentional bias (AB) in addictive behaviors, and AB has been proposed to be a cognitive marker for addictions. Automatic cognition may be particularly relevant to CUD, as there is evidence for particularly robust AB to cocaine cues and strong relationships to craving for cocaine and other illicit drugs. Further, the wide-ranging cognitive deficits (e.g., in response inhibition and working memory) evinced by many cocaine users enhance the potential importance of interventions targeting automatic cognition in this population. In the current article, we discuss relevant addiction theories, followed by a review of studies that examined AB in CUD. We then consider the neural substrates of AB, including human neuroimaging, neurobiological, and pharmacological studies. We conclude with a discussion of research gaps and future directions for AB in CUD. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    No preview · Article · Sep 2014 · Experimental and Clinical Psychopharmacology
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    • "This may interfere with pathological gamblers' ability to apply attentional resources to learn cognitive and behavioral avoidance strategies aimed to prevent relapse. Numerous studies have documented the existence of attentional bias for cues associated with opioids (Lubman, Peters, Mogg, Bradley, & Deakin, 2000), nicotine (Bradley, & Lang, 1994; Ehrman et al., 2002), alcohol (Townshend & Duka, 2001), caffeine (Yeomans, Javaherian, Tovey, & Stafford, 2005), cannabis (Field, Mogg, & Bradley, 2004), and cocaine (Copersino et al., 2004) using the Stroop test, the visual probe task, the attentional blink task, and the dual task among others (Robinson & Berridge, 1993). By contrast, only five studies have investigated attentional bias in individuals with PG or problem gambling. "
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    ABSTRACT: In the study of addiction, attentional bias refers to the observation that substance-related cues tend to capture the attention of experienced substance users. Attentional bias is a cognitive intermediate in the conditioned association between drug-related cues, craving, and relapse. Numerous studies have documented the existence of attentional bias for cues associated with substances. By contrast, few studies have investigated attentional bias in individuals with pathological gambling (PG) or problematic gambling. In this study, we sought to assess attentional bias at the level of maintenance of attention in a sample of pathological gamblers. Twenty-three pathological gamblers and 21 healthy volunteers performed the Visual Probe Task to compare attentional bias with gambling-related cues between individuals with PG and healthy volunteers. The measured of attentional bias was based on their reaction times (RTs) to probes replacing neutral and gambling-related cues (images). Second, we examined the correlation between PG severity and degree of attentional bias among individuals with PG. Results show that pathological gamblers, but not healthy volunteers, had attentional bias for gambling-related cues with exposure times that assess maintenance of attention. There was no correlation between PG severity and degree of attentional bias. Theoretical and clinical implications of these results are discussed. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
    Full-text · Article · May 2013 · Psychology of Addictive Behaviors
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