Cocaine craving and attentional bias in cocaine-dependent schizophrenic patients

ArticleinPsychiatry Research 128(3):209-18 · November 2004with7 Reads
Impact Factor: 2.47 · DOI: 10.1016/j.psychres.2004.07.006 · Source: PubMed
Abstract

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.

    • "Attentional bias can be defined as an automatic and uncontrollable tendency to allocate attention towards stimuli related to the individual's area of concern (Robinson and Berridge, 2008). Studies that have examined the attentional biases in addictions to nicotine (Ehrman et al., 2002), alcohol (Townshend and Duka, 2001), cannabis (Field et al., 2004), cocaine (Copersino et al., 2004), and gambling (Hønsi et al., 2013) have shown that addiction-related stimuli are processed more efficiently by addicted individuals, further strengthening irrational cognitions and maladaptive behaviors (Field and Cox, 2008; Field et al., 2009). As proposed by Berridge's (1993, 2008) incentive-sensitization model, stimuli associated with reward, through a classical conditioning process (such as substance-related or gambling-related stimuli), induce sensitization in the mesocorticolimbic dopamine system in the brain. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: From a cognitive perspective, attentional biases are deemed as factors responsible in the onset and development of gambling disorder. However, knowledge relating to attentional processes in gambling is scarce and studies to date have reported contrasting results. Moreover, no study has ever examined which component and what type of bias are involved in attentional bias in gambling. Methods: In the present study, 108 Italian participants, equally divided into problem and non-problem gamblers, were administered a modified Posner Task, an attentional paradigm in which – through the manipulation of stimuli presentation time – it is possible to measure both initial orienting and maintenance of attention. In addition to the experimental task, participants completed self-report measures involving (i) craving (Gambling Craving Scale), (ii) depression, anxiety and stress (Depression Anxiety Stress Scale) and (iii) emotional dysregulation (Difficulties in Emotion Regulation Scale). Results: Analyses revealed facilitation in detecting gambling-related stimuli at the encoding level in problem gamblers but not in non-problem gamblers. Compared to non-problem gamblers, problem gamblers also reported higher levels of craving, emotional dysregulation, and negative mood states. Furthermore, all measures correlated with the gambling severity. Limitations: The use of indirect measure of attentional bias could be less accurate compared to direct measures. Conclusions: The facilitation in detecting gambling-related stimuli in problem gamblers and the correlation between subjective craving and facilitation bias suggests that attentional bias could not be due to a conditioning process but that motivational factors such as craving could induce addicted-related seeking behaviors.
    Full-text · Article · Mar 2016 · Journal of Affective Disorders
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    • "Franken (2003 Franken ( , 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;). 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). "
    [Show abstract] [Hide abstract] 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
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    • "Contingency Management (CM) protocol COC AB associated with 1treatment outcomes after CM vouchers ended Copersino et al. (2004) "
    [Show abstract] [Hide abstract] 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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