Where's the wine? Heavy social drinkers show attentional bias towards alcohol in a visual conjunction search task

Effects of virtual reality-based cue exposure therapy on craving and physiological responses in alcohol-dependent patients-a randomised controlled trial

BACKGROUND

Cue exposure therapy is used to treat alcohol dependence. However, its effectiveness is controversial due to the limitations of the clinical treatment setting. Virtual reality technology may improve the therapeutic effect. The aim of this study is to explore whether virtual reality-based cue exposure therapy can reduce the psychological craving and physiological responses of patients with alcohol dependence.

METHODS

Forty-four male alcohol-dependent patients were recruited and divided into the study group (n = 23) and the control group (n = 21) according to a random number table. The control group received only conventional clinical treatment for alcohol dependence. The study group received conventional clinical treatment with the addition of VR cue exposure (treatment). The primary outcome was to assess psychological craving and physiological responses to cues of patients before and after treatment.

RESULTS

After virtual reality-based cue exposure therapy, the changes in VAS and heart rate before and after cue exposure in the study group were significantly lower than those in the control group (P < 0.05), while the changes in skin conductance and respiration between the study group and the control group were not significantly different (P > 0.05). The changes in VAS and heart rate before and after cue exposure in the study group were significantly lower than those before treatment (P < 0.05), while the changes in skin conductance and respiration were not significantly different from those before treatment (P > 0.05). The changes in VAS, heart rate, skin conductance and respiration before and after cue exposure in the control group were not significantly different from those before treatment (P > 0.05).

CONCLUSION

Virtual reality-based cue exposure therapy can reduce the psychological craving and part of the physiological responses of alcohol-dependent patients during cue exposure in the short term and may be helpful in the treatment of alcohol dependence.

TRIAL REGISTRATION

The study protocol was registered at the China Clinical Trial Registry on 26/02/2021 ( www.chictr.org.cn ; ChiCTR ID: ChiCTR2100043680).

"Danmu" preference, problematic online video watching, loneliness and personality: An eye-tracking study and survey study

'Danmu' (i.e., comments that scroll across online videos), has become popular on several Asian online video platforms. Two studies were conducted to investigate the relationships between Danmu preference, problematic online video watching, loneliness and personality. Study 1 collected self-report data on the study variables from 316 participants. Study 2 collected eye-tracking data of Danmu fixation (duration, count, and the percentages) from 87 participants who watched videos. Results show that fixation on Danmu was significantly correlated with problematic online video watching, loneliness, and neuroticism. Self-reported Danmu preference was positively associated with extraversion, openness, problematic online video watching, and loneliness. The studies indicate the potential negative effects of Danmu preference (e.g., problematic watching and loneliness) during online video watching. The study is one of the first empirical investigations of Danmu and problematic online video watching using eye-tracking software. Online video platforms could consider adding more responsible use messaging relating to Danmu in videos. Such messages may help users to develop healthier online video watching habits.

Emotion regulation strategies moderate the impact of negative affect induction on alcohol craving in college drinkers: an experimental paradigm

Objectives: Observational studies suggest emotion regulation (ER) as a potential treatment target for problematic college drinking. The primary aim of this laboratory study was to determine whether trait ER strategies would moderate the impact of negative affect induction on alcohol craving in college drinkers. Methods: Participants were randomly assigned to a neutral (n = 74) or a negative affect induction (n = 76) and reported their craving after the affect inductions. Results: Greater use of drinking to cope and less use of cognitive reappraisal predicted greater alcohol craving after the negative affect induction, but not after the neutral condition. In contrast, emotion suppression did not predict alcohol craving in either condition. Conclusion: Our results highlight the role of ER tendencies-particularly the benefits of cognitive reappraisal-on alcohol craving when experiencing emotional distress. Therefore, ER strategies may be an important target for college drinkers to prevent and reduce problematic drinking.

The who and how of attentional bias in cannabis users: associations with use severity, craving and interference control

AIMS

Cognitive and motivational processes are thought to underlie cannabis use disorder (CUD), but research assessing how cognitive processes [e.g. interference control (IC)] interact with implicit [e.g. attentional bias (AB)] and explicit motivation (i.e. craving) is lacking. We assessed the presence of AB in cannabis users with varying use severity and tested models of moderation, mediation and moderated mediation to assess how AB, craving and IC interact in their association with measures of cannabis use.

DESIGN

A cross-sectional study design was used.

SETTING AND PARTICIPANTS

Eight studies performed by our laboratory in the Netherlands including never-sporadic, occasional (≤ 1/month) and regular cannabis users (≥ 2/week), and individuals in treatment for CUD were combined (n = 560; 71% male).

MEASUREMENTS

Studies included a classic Stroop task (IC), a cannabis Stroop task (AB) and measures of session-induced and average session craving. Both heaviness of cannabis use (grams/week) and severity of use related problems were included.

FINDINGS

Only those in treatment for CUD showed an AB to cannabis (P = 0.019) and group differences were only observed when comparing CUD with never-sporadic users (P = 0.007). In occasional and regular users, IC was negatively associated with heaviness (β = 0.015, P < 0.001), but not severity of use. Average session craving (exploratory), but not session-induced craving (confirmatory), mediated this association between AB and heaviness (β = 0.050, P = 0.011) as well as severity of use (β = 0.083, P = 0.009); higher AB was associated with heavier use and more severe problems through increased craving.

CONCLUSIONS

Attentional bias only appears to be present in cannabis users with the most severe problems and craving appears to mediate the association between attentional bias and both heaviness and severity of use in occasional and regular users. The association of interference control with heaviness but not severity of use may point to subacute intoxication effects of cannabis use on interference control.

Attentional Bias Is Associated with Negative Emotions in Problematic Users of Social Media as Measured by a Dot-Probe Task

OBJECTIVE

Social media (SM) have flourished and are affecting human lives on an unprecedented scale. Problematic social media use (PSMU) is a recently emerging problematic behavior that affects both physical and mental health. The purpose of this study was to investigate whether problematic users of SM display attentional bias (AB) toward SM-related cues, as well as the relationships between AB, the severity of PSMU, and negative emotions.

METHOD

1000 college students were recruited through classes and online forums and then tested using the Bergen Social Media Addiction Scale (BSMAS). Eventually, 60 participants, identified by the cut-off point for BSMAS, consented to participate in the study and were divided into two groups (i.e., a problematic use group and a typical use group). The severity of PSMU and negative emotions (i.e., anxiety, depression, social fear, and loneliness) were evaluated by self-report questionnaires. AB was assessed by an addiction Stroop task and a dot-probe task (DPT).

RESULTS

PSMU was found to be positively associated with anxiety (r = 0.28, p < 0.05), depression (r = 0.35, p < 0.01), and social fear (r = 0.38, p < 0.01), but not with loneliness (r = 0.19, p = 0.15). Participants with a tendency toward PSMU displayed AB toward SM-related cues in the DPT [F (1, 58) = 26.77, p < 0.001, ηp2 = 0.32], but not in the Stroop task [F (1, 58) = 0.61, p = 0.44, ηp2 = 0.01]. Moreover, AB toward SM-related stimuli was found to be positively correlated with the severity of PSMU (r = -0.51, p < 0.001), anxiety (r = -0.37, p < 0.01), depression (r = -0.51, p < 0.001), and social fear (r = -0.30, p < 0.05) in the DPT.

CONCLUSIONS

Problematic users of SM show AB towards SM-related cues in the DPT, which is more reliable for assessing AB than the Stroop task. Moreover, it is suggested that in clinical interventions we should work to change the AB towards SM-related stimuli and improve negative emotions to decrease risks of PSMU.

Anti-saccade as a Tool to Evaluate Neurocognitive Impairment in Alcohol Use Disorder

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.

When Alcohol Adverts Catch the Eye: A Psychometrically Reliable Dual-Probe Measure of Attentional Bias

Existing tasks assessing substance-related attentional biases are characterized by low internal consistency and test–retest reliability. This study aimed to assess the psychometric properties of a novel dual-probe task to measure alcohol-related attentional bias. Undergraduate students were recruited in June 2019 (N = 63; final N = 57; mean age = 20.88, SD = 2.63, 67% females). In the dual-probe task, participants were presented with simultaneous visual streams of adverts promoting either alcoholic or non-alcoholic drinks, and probes were presented in both streams. The dual-probe task measured the percentage of accurately identified probes that appeared on alcohol adverts in relation to total accuracy. The dual-probe task displayed excellent split-half reliability (M = 0.90, SD = 0.11; α = 0.90; 95% CI [0.84, 0.93]), and the derived attentional bias measure was significantly positively associated with beer drinking in a taste-test (r (57) = 0.33, p = 0.013; 95% CI [0.07, 0.54]), with habitual drinking (r (57) = 0.27, p = 0.045; 95% CI [0.01, 0.49]), and with increased craving (r (57) = 0.29, p = 0.031; 95% CI [0.03, 0.51]). Thus, the dual-probe task assessed attentional bias with excellent internal consistency and was associated with laboratory and habitual drinking measures, demonstrating initial support for the task’s utility in addiction research.

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.

Prioritization of personally relevant stimuli in male abstinent heroin users

The prioritization of the processing of highly relevant personal stimuli pervades various cognitive domains and is vital to our survival and normal functioning. However, the extent to which this process is altered by drug addiction remains to be elucidated. The present study examined the self-prioritization effect in abstinent heroin users (AHUs) using the perceptual matching task, which controls for the confounding effect of familiarity, and further modified it to revalidate the drug-prioritization effect (DPE). Eighty male AHUs and forty healthy control (HC) participants were recruited for this study. Participants filled in the questionnaire and completed two perceptual matching tasks. The questionnaire included demographic information (e.g., age, education) and characteristics of drug use, whereas the HC participants only completed the demographic information. AHUs exhibited a robust self-advantage in the self-perceptual matching task, and that the magnitude of the self-prioritization effect (MSPE) was comparable to that in HCs. Only AHUs prioritized the processing of drug-related stimuli in the drug-perceptual matching task, and showed similar prioritization effects during self- and drug-related processing. The MSPE and magnitude of the drug-prioritization effect (MDPE) were correlated with the heroin consumption behavior in AHUs. The process of self-prioritization is intact in drug users, and they uniquely prioritize the processing of drug cues. The similar pattern between the self- and drug-related processing provided behavioral evidence to support that drug cues are likely to be associated with heightened personal relevance in drug users. These prioritization processes may play critical roles in addiction and provide a promising route for intervention.

Instrumental and Pavlovian Mechanisms in Alcohol Use Disorder

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.

A Promising Candidate to Reliably Index Attentional Bias Toward Alcohol Cues-An Adapted Odd-One-Out Visual Search Task

Attentional bias (AB) has been suggested to contribute to the persistence of substance use behavior. However, the empirical evidence for its proposed role in addiction is inconsistent. This might be due to the inability of commonly used measures to differentiate between attentional engagement and attentional disengagement. Attesting to the importance of differentiating between both components of AB, a recent study using the odd-one-out task (OOOT) showed that substance use was differentially related to engagement and disengagement bias. However, the AB measures derived from the OOOT showed insufficient reliability to be used as a solid measure of individual differences. Therefore, the current study aimed to improve the reliability of the AB measures derived from the OOOT by using more distinct contrast stimuli, adding practice trials, increasing the number of trials, and by having participants perform the task in an alcohol-relevant context. We contrasted the original OOOT with the adapted OOOT (i.e., OOOT-adapt) and assessed AB in low- and high-drinking individuals. Participants were 245 undergraduate students who typically tend to drink either low or high amounts of alcohol. In one condition, AB was measured with the original OOOT in a typical laboratory context, whereas in the other condition, AB was measured with the OOOT-adapt in a bar (i.e., alcohol-relevant) context. The OOOT-adapt showed superior internal consistency, especially for the high-drinking group. Further, specifically the OOOT-adapt differentiated between low- and high-drinking participants showing that high drinkers engaged faster with alcohol cues than did low drinkers. Thus, the OOOT-adapt was found to be a promising candidate to reliably index AB in the context of alcohol use. The OOOT-adapt further showed superior criterion validity as it could differentiate between low- and high-drinking individuals, thereby adding to the evidence that AB might be involved in substance use behavior.