Persistence of attentional bias toward alcohol-related stimuli in intoxicated social drinkers

Attentional bias to alcohol-related cues: effects of menstrual cycle phase and sex differences

RATIONALE

A recent study by our group found that women displayed greater attentional bias to alcohol-related cues during the late versus early follicular phase in both sober and intoxicated states, suggesting a greater risk of excessive drinking among women during this phase. Changes in attentional bias as a function of menstrual cycle phase raise questions about potential sex differences in the relative consistency by which women and men display attentional bias to alcohol over time.

OBJECTIVES

The present study tested sex differences in attentional bias to alcohol by comparing the change in women's attentional bias from early to late follicular phase to that observed in men over the same period.

METHODS

Twenty-five men and 25 women aged 21-32 participated in a placebo-controlled study examining sex differences in the rewarding properties of alcohol. Participants completed measures of attentional bias to alcohol-related cues during two sessions following both 0.6 g/kg alcohol and placebo. Test sessions occurred one week apart, and for female participants coincided with the early and late follicular phases.

RESULTS

Men consistently displayed attentional bias to alcohol-related cues across sessions under both doses. By contrast, women showed attentional bias only during the late follicular phase, at a magnitude greater than that observed in men, and persistent under both doses.

CONCLUSIONS

These findings highlight the potential role of sex and menstrual cycle phase in sensitizing drinkers to rewarding properties of alcohol-related cues. Men's motivation to drink may remain relatively consistent, whereas women may be most motivated during the late follicular phase.

Attention bias and alcohol craving: Differential effects via biological sex and mood

BACKGROUND

Attentional bias (AB) has been linked to alcohol use, mood, and alcohol craving, with key differences across different types of mood and biological sex. However, further exploration of the role of AB across these alcohol variables is needed. The current study examined the relationship between mood and AB as predictors of alcohol craving using ecological momentary assessment (EMA). Exploratory analysis examined these effects as a function of biological sex.

METHODS

Participants (n = 69) from a Midwestern University carried a mobile device for 15 days and provided ratings of momentary mood (positive mood, anxious mood, and sad mood), alcohol craving, and AB. Data were analyzed using a two-level multilevel regression model, with associations between craving, mood, and AB examined at both the momentary and between-subjects levels.

RESULTS

Across assessments, positive and negative moods were positively associated with momentary craving, with AB found to operate differently between men and women. At the within-subjects level, increases in positive mood among men strengthened the AB-craving association, while women showed stronger AB-craving associations when positive mood decreased. At the between-subjects level, trait-like sadness led to positive AB-craving associations for men, however, this was the opposite for women. Similarly, AB-craving associations were positive and robust for men with trait-like positive mood but again the opposite was observed for women.

CONCLUSIONS

The findings highlight the importance and nuances of biological sex in the context of mood, AB, and craving. Interventions targeting AB and/or emotion regulation may yield different outcomes for men and women.

Raising the bar: improving methodological rigour in cognitive alcohol research

BACKGROUND AND AIMS

A range of experimental paradigms claim to measure the cognitive processes underpinning alcohol use, suggesting that heightened attentional bias, greater approach tendencies and reduced cue-specific inhibitory control are important drivers of consumption. This paper identifies methodological shortcomings within this broad domain of research and exemplifies them in studies focused specifically on alcohol-related attentional bias.

ARGUMENT AND ANALYSIS

We highlight five main methodological issues: (i) the use of inappropriately matched control stimuli; (ii) opacity of stimulus selection and validation procedures; (iii) a credence in noisy measures; (iv) a reliance on unreliable tasks; and (v) variability in design and analysis. This is evidenced through a review of alcohol-related attentional bias (64 empirical articles, 68 tasks), which reveals the following: only 53% of tasks use appropriately matched control stimuli; as few as 38% report their stimulus selection and 19% their validation procedures; less than 28% used indices capable of disambiguating attentional processes; 22% assess reliability; and under 2% of studies were pre-registered.

CONCLUSIONS

Well-matched and validated experimental stimuli, the development of reliable cognitive tasks and explicit assessment of their psychometric properties, and careful consideration of behavioural indices and their analysis will improve the methodological rigour of cognitive alcohol research. Open science principles can facilitate replication and reproducibility in alcohol research.

Alcohol attention bias in 14-16 year old adolescents: an eye tracking study

RATIONALE

Theoretical models regarding the automaticity of attentional processes highlight a progression of attentional bias style from controlled to automatic in drinking populations as alcohol use progresses. Previous research has focused on older adolescent and adult drinking populations at later stages in their drinking career.

OBJECTIVES

The aim of this study was to investigate alcohol attention bias in 14-16-year-old adolescent social drinkers and abstainers.

METHODS

Alcohol attention bias was measured in social drinking and abstaining groups in an eye-tracking paradigm. Questionnaires measured alcohol use, expectancies, exposure and socially desirable response styles.

RESULTS

Social drinkers fixated to alcohol stimuli more frequently and spent a larger proportion of their fixation time attending to alcohol stimuli compared to non-drinkers. Groups displayed differences in their style of attentional processing of alcohol-related information, with heavy drinkers fixating significantly longer to alcohol information across alcohol stimulus presentation and exhibiting a delayed disengagement style of alcohol attention bias that differentiated them from light drinking and abstaining peers. All social drinkers fixated significantly more than abstainers in the latter half of alcohol stimulus presentation.

CONCLUSION

Alcohol attention bias was present in this adolescent sample. Drinking subgroups are defined from abstaining peers by unique features of their attentional bias that are controlled in nature. These findings are comparable to those in other adolescent and adult social drinking populations. The identification of specific attentional bias features according to drinking subpopulations has implications for our theoretical understanding of developing alcohol attention bias and problematic drinking behaviours, as well as at-risk identification and early intervention.

Eye Tracking Studies Exploring Cognitive and Affective Processes among Alcohol Drinkers: a Systematic Review and Perspectives

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.

Craving is everything: An eye-tracking exploration of attentional bias in binge drinking

BACKGROUND

Attentional bias towards alcohol-related stimuli is a core characteristic of severe alcohol use disorders (AUD), directly linked to clinical variables (e.g. alcohol consumption, relapse). Nevertheless, the extent of this bias in subclinical populations remains poorly documented. This is particularly true for binge drinking, an alcohol consumption pattern highly prevalent in youth, characterised by an alternation between excessive intakes and withdrawal periods.

AIMS

We used eye-tracking to: (a) measure attentional bias in binge drinking, (b) determine its time course by dissociating early/late processing stages, (c) clarify its specificity for alcohol-related stimuli compared to other appetitive stimulations and (d) explore its modulation by current craving intensity.

METHODS

Binge drinkers (n=42) and matched controls (n=43) performed a visual probe task, requiring visual targets preceded by pairs of pictures to be processed, with three conditions (i.e. alcohol vs. soft drink, alcohol vs. high-calorie food, high-calorie food vs. low-calorie food).

RESULTS

No group difference was observed for early processing (i.e. first area of interest visited). Dwell times highlighted a bias towards soft drinks and healthy food among controls, without any global bias towards alcohol in binge drinkers. Centrally, a comparison of binge drinkers with low versus high current craving intensity indicated that binge drinking was associated with a bias towards alcohol and high-calorie food only in the presence of a high craving towards these stimuli.

CONCLUSION

Attentional bias towards alcohol reported in severe AUD is only found in binge drinkers in the presence of high craving and is generalised to other appetitive cues.

Evidence for incentive salience sensitization as a pathway to alcohol use disorder

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.

Alcohol administration reduces attentional bias to alcohol-related but not food-related cues: Evidence for a satiety hypothesis

Attentional bias to alcohol is a well-documented effect whereby drinkers allocate greater visual attention toward alcohol-related stimuli rather than nonappetitive, neutral stimuli. Some recent research has shown that acute administration of alcohol temporarily reduces attentional bias to alcohol cues, possibly because alcohol consumption satiates the motivation to drink. However, the specificity of this effect has not been tested, and so it is unclear whether reduced attentional bias following alcohol is specific to alcohol-related stimuli or whether attention to other appetitive stimuli is also reduced (e.g., food). This study tested the degree to which acute alcohol administration selectively reduced attentional bias to alcohol-related but not to food-related cues in a group of 23 healthy young adults who reported consuming alcohol roughly twice per week. Attentional bias to alcohol-related and food-related cues was tested using visual dot probe tasks following 2 active doses of alcohol, .30 g/kg and .65 g/kg, and a placebo. Results showed that attentional bias, measured as fixation time to stimuli on the visual probe tasks, to alcohol cues declined in a dose-dependent manner, whereas attentional bias to food cues was unaffected by the doses. The evidence suggests that alcohol consumption specifically reduces attentional bias to alcohol-related stimuli whereas bias to other appetitive stimuli remains intact. Evidence that alcohol consumption reduces attentional bias specifically to alcohol cues lends further credibility to the satiation theory and to the utility of attentional bias as an indicator of acute and transient changes in an individual's motivation to use alcohol. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Attentional bias to cannabis cues in cannabis users but not cocaine users

Attentional bias to drug cues has been associated with the problematic use of drugs, including cannabis. The cognitive mechanisms underlying this bias are not fully understood. The purpose of this study was to determine whether cannabis-cue attentional bias is associated with disruptions in attentional processing. To this end, a novel cannabis-cue visual probe task that incorporated eye tracking technology and attention-based metrics derived from signal detection theory was administered to seventeen individuals who reported daily/near-daily cannabis use. Seventeen individuals with cocaine use disorder were also enrolled as a clinical-control group. Cannabis and neutral images were briefly presented side-by-side on a computer screen, followed by the appearance of a "go" or "no-go" target upon offset of both images to permit assessment of attention-based performance. Cannabis users exhibited attentional bias to cannabis cues, as measured by fixation time and response time, but not cue-dependent disruptions on subsequent attentional performance. Cocaine users did not display an attentional bias to cannabis cues but did display poorer attentional performance relative to cannabis users. These results indicate that attentional bias to cannabis cues is selective to cannabis use history and not associated with impaired attentional processing.

Mobile Phone-Based Ecological Momentary Intervention to Reduce Young Adults' Alcohol Use in the Event: A Three-Armed Randomized Controlled Trial

Background

Real-time ecological momentary interventions have shown promising effects in domains other than alcohol use; however, only few studies regarding ecological momentary interventions for alcohol use have been conducted thus far. The increasing popularity of smartphones offers new avenues for intervention and innovation in data collection.

Objective

We aimed to test the efficacy of an ecological momentary intervention, comprising mobile Web-based ecological momentary assessments (EMAs) and text messaging (short message service, SMS) brief interventions, delivered during drinking events using participants’ mobile phones.

Methods

We conducted a three-armed randomized controlled trial to assess the effect of a mobile Web-based ecological momentary assessment with texting feedback on self-reported alcohol consumption and alcohol-related harms in young adults. Participants were enrolled from an existing observational cohort study of young adults screened for risky drinking behavior. The intervention group (ecological momentary intervention group) completed repeated ecological momentary assessments during 6 drinking events and received immediate texting-based feedback in response to each ecological momentary assessment. The second group (ecological momentary assessment group) completed ecological momentary assessments without the brief intervention, and the third did not receive any contact during the trial period. Recent peak risky single-occasion drinking was assessed at the baseline and follow-up using telephone interviews. We used a random effects mixed modeling approach using maximum likelihood estimation to provide estimates of differences in mean drinking levels between groups between baseline and 12-week follow-up.

Results

A total of 269 participants were randomized into the 3 groups. The ecological momentary intervention group exhibited a small and nonsignificant increase between baseline and follow-up in (geometric) the mean number of standard drinks consumed at the most recent heavy drinking occasion (mean 12.5 vs 12.7). Both ecological momentary assessment and control groups exhibited a nonsignificant decrease (ecological momentary assessment: mean 13.8 vs 11.8; control: mean 12.3 vs 11.6); these changes did not differ significantly between groups (Wald χ²₂ 1.6; P=.437) and the magnitude of the effects of the intervention were markedly small. No other significant differences between groups on measures of alcohol consumption or related harms were observed. The intervention acceptability was high despite the technical problems in delivery.

Conclusions

With a small number of participants, this study showed few effects of an SMS-based brief intervention on peak risky single-occasion drinking. Nevertheless, the study highlights areas for further investigation into the effects of EMI on young adults with heavy alcohol consumption.

Trial Registration

Australian New Zealand Clinical Trials Registry ACTRN12616001323415; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369534 (Archived by WebCite at http://www.webcitation.org/7074mqwcs)

Alcohol Administration Increases Cocaine Craving But Not Cocaine Cue Attentional Bias

BACKGROUND

Alcohol consumption is a known antecedent to cocaine relapse. Through associative conditioning, it is hypothesized that alcohol increases incentive motivation for cocaine and thus the salience of cocaine-related cues, which are important in maintaining drug-taking behavior. Cocaine-using individuals display a robust cocaine cue attentional bias as measured by fixation time during the visual probe task. The purpose of this study was to evaluate the influence of alcohol administration on cocaine cue attentional bias using eye-tracking technology to directly measure attentional allocation.

METHODS

Twenty current cocaine users completed a double-blind, placebo-controlled, within-subjects study that tested the effect of 3 doses of alcohol (0.00, 0.325, and 0.65 g/kg) on cocaine cue attentional bias using the visual probe task with eye-tracking technology. The participant-rated and physiological effects of alcohol were also assessed.

RESULTS

Participants displayed a robust cocaine cue attentional bias following both placebo and alcohol administration as measured by fixation time, but not response time. Alcohol administration did not influence cocaine cue attentional bias, but increased craving for cocaine in a dose-dependent manner. Alcohol produced prototypic psychomotor and participant-rated effects.

CONCLUSIONS

Alcohol administration increases cocaine craving but not cocaine cue attentional bias. Alcohol-induced cocaine craving suggests that alcohol increases incentive motivation for cocaine but not the salience of cocaine-related cues.

The sensitivity of laboratory tests assessing driving related skills to dose-related impairment of alcohol: A literature review

Laboratory tests assessing driving related skills can be useful as initial screening tools to assess potential drug induced impairment as part of a standardized behavioural assessment. Unfortunately, consensus about which laboratory tests should be included to reliably assess drug induced impairment has not yet been reached. The aim of the present review was to evaluate the sensitivity of laboratory tests to the dose dependent effects of alcohol, as a benchmark, on performance parameters. In total, 179 experimental studies were included. Results show that a cued go/no-go task and a divided attention test with primary tracking and secondary visual search were consistently sensitive to the impairing effects at medium and high blood alcohol concentrations. Driving performance assessed in a simulator was less sensitive to the effects of alcohol as compared to naturalistic, on-the-road driving. In conclusion, replicating results of several potentially useful tests and their predictive validity of actual driving impairment should deserve further research. In addition, driving simulators should be validated and compared head to head to naturalistic driving in order to increase construct validity.

Cognitive and behavioral preoccupation with alcohol in recidivist DUI offenders

OBJECTIVE

A high proportion of individuals convicted of driving under the influence (DUI) are repeat offenders. Efforts have sought to identify specific factors underlying DUI recidivism. Of particular interest is the role that alcohol-related cognitions might play in the development and escalation of alcohol use. The present study investigated the degree to which preoccupation with, and attentional bias to, alcohol are heightened among repeat DUI offenders.

METHOD

Three groups of participants (recidivist DUI offenders, first-time offenders, and controls; n = 20 per group) performed a visual probe task to measure attentional bias and completed questionnaires regarding their cognitive and emotional preoccupation with alcohol and drinking habits.

RESULTS

Recidivist offenders displayed a significantly heightened alcohol attentional bias and reported greater preoccupation with alcohol compared with both first-time offenders and controls. By contrast, none of the groups differed with regard to the self-reported quantity and frequency of their consumption.

CONCLUSIONS

Factors reflecting preoccupation with alcohol have utility for differentiating recidivist offenders from both first-time offenders and nonoffenders. These findings highlight the value of moving beyond self-reported assessments of drinking patterns toward assessing specific cognitive and behavioral characteristics that can improve our understanding, assessment, and treatment of the problem of DUI recidivism.

Alcohol attention bias in adolescent social drinkers: an eye tracking study

RATIONALE

Previous research on attention bias in nondependent social drinkers has focused on adult samples with limited focus on the presence of attention bias for alcohol cues in adolescent social drinkers.

OBJECTIVES

The aim of this study was to examine the presence of alcohol attention bias in adolescents and the relationship of this cognitive bias to alcohol use and alcohol-related expectancies.

METHODS

Attention bias in adolescent social drinkers and abstainers was measured using an eye tracker during exposure to alcohol and neutral cues. Questionnaires measured alcohol use and explicit alcohol expectancies.

RESULTS

Adolescent social drinkers spent significantly more time fixating to alcohol stimuli compared to controls. Total fixation time to alcohol stimuli varied in accordance with level of alcohol consumption and was significantly associated with more positive alcohol expectancies. No evidence for automatic orienting to alcohol stimuli was found in adolescent social drinkers.

CONCLUSION

Attention bias in adolescent social drinkers appears to be underpinned by controlled attention suggesting that whilst participants in this study displayed alcohol attention bias comparable to that reported in adult studies, the bias has not developed to the point of automaticity. Initial fixations appeared to be driven by alternative attentional processes which are discussed further.

Predicting naltrexone response in alcohol-dependent patients: the contribution of functional magnetic resonance imaging

BACKGROUND

Effect sizes of pharmacotherapy in alcoholism are modest. They might improve if subjects could be divided into more homogeneous subgroups and would then be treated targeted to their neurobiological profile. In such an effort, we tested neural cue reactivity as a potential predictor of treatment response to naltrexone. Alcohol-associated cues cause brain activations in mesocorticolimbic networks due to the positive reinforcing properties of alcohol. These activations were reported to be associated with relapse behavior. Naltrexone, an antagonist at the mu-opioid receptor, improves drinking behavior in some but not all patients probably by blocking the positive reinforcement of alcohol. Conversely, acamprosate is proposed to modulate negative reinforcement (withdrawal and cue-induced withdrawal). Identifying subjects with elevated cue reactivity and testing their response to medical treatment could thus improve our understanding of some of the mechanisms underlying pharmacotherapy response.

METHODS

A picture-perception task featuring alcohol-related and neutral stimuli was presented to 64 recently detoxified alcohol-dependent patients. Patients came from 1 center of a larger double-blind randomized multicenter clinical trial (the "PREDICT Study"). They were scanned prior to being randomized to either naltrexone or acamprosate. We examined the interaction between medication and functional magnetic resonance imaging (fMRI) cue reactivity, as measured by the percentage of voxels activated, using the time to the first severe relapse as the outcome criterion. Our a priori formulated hypothesis was that naltrexone but not acamprosate should be efficacious in subjects with high cue reactivity.

RESULTS

We observed an interaction effect between pretreatment brain activation induced by alcohol images and medication (acamprosate/naltrexone) on relapse behavior. In line with our hypothesis, this interaction was driven by treatment response to naltrexone in patients with elevated pretreatment cue reactivity in the ventral striatum.

CONCLUSIONS

fMRI has the potential for predicting treatment response to naltrexone in a subgroup of alcohol-dependent patients. However, this approach will be limited to researching the mechanisms and principles of treatment response.

The magnitude of drug attentional bias is specific to substance use disorder

The visual probe task with eye tracking is a sensitive measure of cocaine and alcohol cue attentional bias. Despite the high comorbidity between cocaine and alcohol dependence, attentional bias studies have examined the influence of cocaine- and alcohol-related cues separately. The aim of this experiment was to directly compare the magnitude of cocaine and alcohol cue attentional bias in individuals dependent on cocaine or cocaine and alcohol. Individuals who met criteria for cocaine dependence (n = 20) or both cocaine and alcohol dependence (n = 20) completed a visual probe task with eye tracking. Cocaine-dependent participants displayed an attentional bias toward cocaine, but not alcohol. In contrast, cocaine-alcohol dependent participants displayed an attentional bias to both cocaine and alcohol, and the magnitude of these biases did not differ. The magnitude of cocaine cue attentional bias, however, was significantly smaller in the cocaine-alcohol dependent group compared to the cocaine-dependent group. These results suggest that fixation time during the visual probe task is sensitive to clinically relevant differences in substance use disorders. The incentive value of cocaine-related cues, however, may differ for individuals who are also dependent on alcohol.

Visual cortex activation to drug cues: a meta-analysis of functional neuroimaging papers in addiction and substance abuse literature

BACKGROUND

Although the visual cortex does not typically receive much attention in addiction literature, neuroimaging studies often report significant activity in visual areas when drug users are exposed to drug cues. The purpose of this meta-analysis was to investigate the frequency with which occipital cortex activity is observed during drug cue exposure and to determine its spatial distribution.

METHODS

A comprehensive literature search was performed of human functional neuroimaging studies of drug cue-reactivity. Fifty-five studies were used to determine the frequency with which clusters of significant visual cortex activity during visual drug cues versus non-drug cues were reported. The spatial distribution of visual cortex activations was determined via activation likelihood estimation (ALE; FDR corrected, p<0.01) in a subset of these studies (n=24).

RESULTS

Eighty-six percent of studies that reported fMRI results for drug versus neutral visual cues within a substance-dependent group showed significant drug-elicited activity in the visual cortex. ALE revealed clusters in the left secondary visual cortex (BA 19) and clusters in the primary visual cortex (BA 17) that were consistently activated by drug cues.

CONCLUSIONS

These data demonstrate that the visual cortex, often overlooked in our discussions of the neural circuitry of addiction, consistently discriminates drug cues from neutral cues in substance dependent populations. While it remains unclear whether drug cue-elicited activation in occipital cortex is related to the rewarding properties of the drug and/or attentional mechanisms, these data support further exploration.

Attentional bias to alcohol-related stimuli as an indicator of changes in motivation to drink

Heavy drinkers show an attentional bias toward alcohol-related visual cues. A recent study in our laboratory (Weafer & Fillmore, 2013) showed that alcohol decreases attentional bias among heavy drinkers, suggesting that alcohol satiates motivation to drink in heavy drinkers. Little is known, however, about how this satiety effect might change across the time course of the blood alcohol concentration (BAC) curve. It is possible that attentional bias may return later in the time course if the satiety effect begins to diminish. The current study tested this hypothesis in a group of high-risk binge drinkers (n = 20). Participants completed a visual-probe task to measure their attentional bias and a self-report measure of their desire for alcohol after receiving 0.64 g/kg and 0.0 g/kg alcohol (placebo) during separate dose challenge sessions. The measures were obtained during the ascending limb of the BAC curve under alcohol (Test 1) and again during the descending limb (Test 2) at a comparable BAC. The measures also were obtained at the same times following placebo. Under alcohol, no attentional bias was observed during Test 1, but drinkers reported increased desire to drink. During Test 2, attentional bias was evident, but participants reported less desire to drink. Attentional bias was not correlated with desire to drink at any time point. Following placebo, attentional bias was evident during both tests. These findings show that alcohol causes a temporary reduction of attentional bias among heavy drinkers. These changes do not correspond with their self-reported motivation to drink.

Fixation time is a sensitive measure of cocaine cue attentional bias

BACKGROUND AND AIMS

Attentional bias has been demonstrated to a variety of substances. Evidence suggests that fixation time is a more direct measure of attentional bias than response time. The aims of this experiment were to demonstrate that fixation time during the visual probe task is a sensitive and stable measure of cocaine cue attentional bias in cocaine-using adults compared to controls.

DESIGN

A between-subject, repeated-measures experiment.

SETTING

An out-patient research unit.

PARTICIPANTS

Fifteen cocaine using and 15 non-cocaine-using adults recruited from the community.

MEASUREMENTS

Participants completed a visual probe task with eye tracking and a modified Stroop during two experimental sessions.

FINDINGS

A significant interaction between cue type and group (F = 13.5; P < 0.05) indicated that cocaine users, but not controls, displayed an attentional bias to cocaine-related images as measured by fixation time. There were no changes in the magnitude of attentional bias across sessions (F = 3.4; P > 0.05) and attentional bias correlated with self-reported life-time cocaine use (r = 0.64, P < 0.05). Response time on the visual probe (F = 1.1; P > 0.05) as well as on the modified Stroop (F = 0.1; P > 0.05) failed to detect an attentional bias.

CONCLUSIONS

Fixation time on cocaine-related stimuli (propensity to remain focused on the stimulus) is a sensitive and stable measure of cocaine cue attentional bias in cocaine-using adults.

Habit formation: implications for alcoholism research

Characteristics of individuals with severe alcohol use disorders include heightened cue sensitivity, compulsive seeking, craving, and continued alcohol use in the face of negative consequences. Animal models are useful for understanding behavioral and neurological mechanisms underlying problematic alcohol use. Seeking of operant reinforcers including alcohol is processed by two mechanisms, commonly referred to as "goal-directed" (action-outcome) and "habitual" (stimulus-response). As substance use disorders are characterized by continued use regardless of unfavorable outcomes, it is plausible that drug use causes an unnatural disruption of these mechanisms. We present a critical analysis of literature pertaining to behavioral neuroscience alcoholism research involving habit formation. Traditionally, when operant behavior is unaffected by a loss of subjective value of a reinforcer (devaluation), the behavior is considered habitual. Acquisition of instrumental behavior requires corticostriatal mechanisms that depend heavily on the prefrontal cortex and ventral striatum, whereas practiced behavior is more predominantly controlled by the dorsal striatum. Dopaminergic signaling is necessary for the neurological adaptations involved in stimulus-response action, and drugs of abuse appear to facilitate habitual behavior through high levels of dopamine release. Evidence suggests that the use of alcohol as a reinforcer expedites habit formation, and that a history of alcohol use produces alterations in striatal morphology, aids habit learning for non-psychoactive reinforcers, and promotes alcohol drinking despite aversive adulterants. In this review, we suggest directions for future alcoholism research that seeks to measure action made despite a devalued outcome, including procedural modifications and genotypic, pharmacological, or neurological manipulations. Most alcoholism models currently in use fail to reach substantial blood ethanol concentrations, a shortcoming that may be alleviated through the use of high-drinking rodent lines. Additionally, satiety, one common mechanism of devaluing reinforcers, is not recommended for alcohol research because the psychoactive effects of alcohol depress response rates, mimicking devaluation effects. Overall, further research of habit formation and potentially related perseverative behaviors could be invaluable in discovering genetic variance, traits that correlate with persistent alcohol seeking, implicated neural structures and processes of alcohol use, and eventually novel pharmacological treatment for alcoholism.

Heavy drinking and the role of inhibitory control of attention

Alcohol can disrupt goal-directed behavior by impairing the ability to inhibit attentional shifts toward salient but goal-irrelevant stimuli. Individuals who are highly sensitive to this effect of the drug may be at increased risk for problematic drinking, especially among those whose attention is drawn to alcohol-related cues in the environment (i.e., attentional bias). The current study examined the acute impairing effect of alcohol on inhibitory mechanisms of attentional control in a group of healthy social drinkers. We then examined whether increased sensitivity to this disinhibiting effect of alcohol was associated with heavy drinking, especially among those who have an attentional bias toward alcohol-related stimuli. Eighty nondependent social drinkers performed a delayed ocular response task that measured their inhibitory control of attention by their ability to suppress attentional shifts to irrelevant stimuli. Attentional bias was measured using a visual probe task. Inhibitory control was assessed following a moderate dose of alcohol (0.64 g/kg) and a placebo. Participants made more inhibitory failures (i.e., premature saccades) following 0.64 g/kg alcohol compared with placebo and the relation of this effect to their drinking habits did depend on the level of the drinker's attentional bias to alcohol-related stimuli. Among drinkers with higher attentional bias, greater impairment of inhibitory control was associated with heavier drinking. In contrast, drinkers with little or no attentional bias showed no relation between their sensitivity to the disinhibiting effects of alcohol and drinking habits. These findings have implications for understanding how heightened incentive-salience of alcohol cues and impaired attentional control can interactively contribute to excessive alcohol use.

A comparison of the anticipated and pharmacological effects of alcohol on cognitive bias, executive function, craving and ad-lib drinking

Acute alcohol administration alters automatic processing of alcohol-related cues, impairs executive functions and increases alcohol seeking. Few studies have investigated the effects of expecting to receive alcohol on these measures. Thirty-one social drinkers completed three experimental sessions receiving either 0.65 g/kg alcohol, a placebo and a control beverage (which they knew was not alcoholic) before reporting craving and completing a test battery including a measure of automatic alcohol-approach tendencies (stimulus response compatibility task), a measure of executive function (Controlled Oral Word Association Task (COWAT)) and a taste test assessing ad-lib drinking. Results indicated that alcohol administration impaired performance on the COWAT and increased ad-lib drinking; however, there were no significant differences on these measures after administration of placebo versus control beverages. Craving was increased after alcohol and (to a lesser extent) after placebo. Automatic alcohol-approach tendencies were pronounced after both alcohol and placebo compared to the control beverage, with no difference between alcohol and placebo. Results suggest craving is sensitive to the anticipated and pharmacological effects of alcohol, alcohol-approach tendencies are particularly sensitive to the anticipated effects of alcohol, and measures of executive function and ad-lib drinking are affected by the pharmacological, but not the anticipated, effects of alcohol.

Alcohol-related stimuli reduce inhibitory control of behavior in drinkers

RATIONALE

Poor behavioral control and heightened attentional bias toward alcohol-related stimuli have independently received considerable attention in regard to their roles in alcohol abuse. Theoretical accounts have begun to speculate as to potential reciprocal interactions between these two mechanisms that might promote excessive alcohol consumption, yet experimental evidence is lacking.

OBJECTIVES

The objective of the study was to integrate these two lines of research through the development of a novel laboratory task that examines the degree to which alcohol cues serve to disrupt mechanisms of behavioral control.

METHODS

Fifty adult drinkers were recruited to perform the attentional bias-behavioral activation (ABBA) task. The ABBA task, an adaptation of traditional cued go/no-go tasks, is a reaction time model that measures the degree to which alcohol-related stimuli can increase behavioral activation of a drinker and reduce the ability to inhibit inappropriate responses. Participants also completed a novel measure of attentional bias, the scene inspection paradigm (SIP), that measures fixation time on alcohol content imbedded in complex scenes.

RESULTS

As hypothesized, the proportion of inhibitory failures on the ABBA task was significantly higher following alcohol images compared to neutral images. Correlational analyses showed that heightened attentional bias on the SIP was associated with greater response activation following alcohol images on the ABBA task.

CONCLUSIONS

These findings suggest that alcohol stimuli serve to disrupt mechanisms of behavioral control, and that heightened attentional bias is associated with greater disruption of control mechanisms following alcohol images.

Effects of 0.4 g/kg alcohol on attentional bias and alcohol-seeking behaviour in heavy and moderate social drinkers

Alcohol intoxication is known to influence attentional biases for alcohol-related cues and alcohol-seeking behaviour. It is unknown if heavier drinkers are more or less sensitive to these effects of alcohol, or whether the effects of alcohol on attentional bias are associated with subsequent alcohol-seeking behaviour. In the present study, 55 social drinkers were administered either 0.4 g/kg alcohol or placebo in a repeated measures, double-blind experimental design. Participants completed a visual probe task with eye movement monitoring (to measure attentional bias) and a bogus taste test (to measure alcohol-seeking) in both alcohol and placebo sessions. Heavy drinkers showed an attentional bias for alcohol cues that was unaffected by alcohol, whereas in moderate drinkers attentional bias was present after alcohol administration, but was absent after placebo. All participants voluntarily consumed more beer during the taste test after administration of alcohol compared with placebo. The effects of alcohol on attentional bias were unrelated to the effects of alcohol on beer consumption. Results are consistent with the development of tolerance, rather than sensitization, to the acute effects of alcohol on attentional biases in heavy drinkers. However, alcohol-induced increases in attentional bias were not related to the effects of alcohol on the motivation to drink.

Acute alcohol effects on attentional bias in heavy and moderate drinkers

Heavy drinkers show an increased attentional bias to alcohol-related stimuli compared to moderate drinkers, and this bias is thought to promote motivation for alcohol consumption (Field & Cox, 2008). Studies have begun to examine acute alcohol effects on attentional bias; however, little is known regarding how these effects might differ based on drinker type. Further, the degree to which attentional bias in response to alcohol is associated with excessive alcohol consumption remains unexplored. For the current study, 20 heavy drinkers and 20 moderate drinkers completed a visual probe task in response to placebo and two active doses of alcohol (0.45g/kg and 0.65g/kg). Participants' eye-movements were monitored and attentional bias was calculated as the difference in time spent focused on alcohol compared to neutral images. Participants' alcohol consumption was assessed by a timeline follow-back calendar and a laboratory ad lib consumption task. Results showed that heavy drinkers displayed significantly greater attentional bias than did moderate drinkers following placebo. However, heavy drinkers displayed a dose-dependent decrease in attentional bias following alcohol, whereas the drug had no effect in moderate drinkers. Individual differences in attentional bias under placebo were strongly associated with both self-reported and laboratory alcohol consumption, yet bias following alcohol administration did not predict either measure of consumption. These findings suggest that attentional bias is strongest before a drinking episode begins. As such, an attentional bias might be most influential in terms of initiation of alcohol consumption, and less of a factor in promoting continued consumption within the drinking episode.

Alcohol-related context modulates performance of social drinkers in a visual Go/No-Go task: a preliminary assessment of event-related potentials

Background

Increased alcohol cue-reactivity and altered inhibitory processing have been reported in heavy social drinkers and alcohol-dependent patients, and are associated with relapse. In social drinkers, these two processes have been usually studied separately by recording event-related potentials (ERPs) during rapid picture presentation. The aim of our study was to confront social drinkers to a task triggering high alcohol cue-reactivity, to verify whether it specifically altered inhibitory performance, by using long-lasting background picture presentation.

Methods

ERP were recorded during visual Go/No-Go tasks performed by social drinkers, in which a frequent Go signal (letter “M”), and a rare No-Go signal (letter “W”) were superimposed on three different types of background pictures: neutral (black background), alcohol-related and non alcohol-related.

Results

Our data suggested that heavy social drinkers made more commission errors than light drinkers, but only in the alcohol-related context. Neurophysiologically, this was reflected by a delayed No-Go P3 component.

Conclusions

Elevated alcohol cue-reactivity may lead to poorer inhibitory performance in heavy social drinkers, and may be considered as an important vulnerability factor in developing alcohol misuse. Prevention programs should be designed to decrease the high arousal of alcohol stimuli and strengthen cognitive control in young, at-risk individuals.

Impaired control over alcohol use: An under-addressed risk factor for problem drinking in young adults?

Impaired control over alcohol use may be defined as "a breakdown of an intention to limit consumption in a particular situation" (Heather, Tebbutt, Mattick, & Zamir, 1993, p. 701) and has long been considered an important feature of alcohol dependence. Evidence suggests impaired control is highly relevant to young adult problem drinking. In the natural history of problem drinking, impaired control tends to develop early and may predict alcohol-related problems prospectively in undergraduates. Impaired control over alcohol use may be a facet of generalized behavioral undercontrol specifically related to drinking. In particular, impaired control is theoretically and empirically related to impulsivity. The question of whether impaired control represents a facet of impulsivity or a related but separate construct requires further study. However, theoretical arguments and empirical evidence suggest that there are unique qualities to the constructs. Specifically, existing data suggest that self-report measures of impaired control and impulsivity over alcohol use relate distinctly to problem drinking indices in young adults. Several lines of future research concerning impaired control are suggested, using the impulsivity literature as a guide. We conclude that impaired control is a valuable construct to the study of young adult problem drinking and that measures of impaired control should be included in more young adult alcohol studies. The extent to which impaired control over the use of other substances and impaired control over engagement in other addictive behaviors are clinically relevant constructs requires additional study.

Drinking to distraction: does alcohol increase attentional bias in adults with ADHD?

Previous research has shown that social drinkers continue to show attentional bias toward alcohol-related stimuli even after consuming a moderate dose of alcohol. In contrast, little is known about how alcohol acutely affects attentional bias in groups at risk to develop alcohol-related problems, such as adults with attention-deficit/hyperactivity disorder (ADHD). Such individuals may show increased attentional bias following alcohol relative to nonclinical controls. The present study tested this hypothesis by examining acute alcohol effects on attentional bias in 20 social drinkers with ADHD and 20 social drinkers with no history of ADHD. Participants performed a visual-probe task after receiving the following doses of alcohol: 0.64 g/kg, 0.32 g/kg, and 0.0 g/kg (placebo). Those in the ADHD group showed increased attentional bias under active alcohol doses, whereas attentional bias was similar across doses in the control group. Attentional bias predicted ad libitum alcohol consumption during a taste-rating session. This relation was observed only in the ADHD group. These findings indicate that an acute alcohol dose increases attentional bias in adults with ADHD. Further, attentional bias appears to be a predictor of ad libitum consumption in this group.