A flicker change blindness task employing eye tracking reveals an association with levels of craving not consumption

The imbalance of self-reported wanting and liking is associated with the degree of attentional bias toward smoking-related stimuli in low nicotine dependence smokers

Background and aims

The Incentive Sensitization Theory (IST) offers a comprehensive framework that explains how attentional mechanisms contribute to the maintenance and relapse of addictive behavior. However, the extent to which the underlying neuropsychological mechanisms are consciously accessible for report remains unknown. Thus, the aim of this study was to investigate the association between self-reported wanting and liking among smokers and its relationship with detecting changes in smoking-related stimuli.

Design

An online experiment was designed deploying a flicker paradigm with neutral and smoking-related changes, completed by 422 individuals (mean age = 29.1 years, 214 non-smokers, 123 current smokers, and 85 former smokers). Additionally, the Fagerström Test for Cigarette Dependence and the Imaginative Wanting and Liking Questionnaire were administered.

Findings

Consistent with prior research findings, smokers exhibited faster detection of smoking-related changes compared to non-smokers, while former smokers displayed an intermediate level of attentional bias, falling between the levels observed in smokers and non-smokers. Further, higher levels of nicotine dependence were associated with a greater discrepancy between self-reported wanting and liking, which was associated with better change detection performance for high salience smoking-related stimuli in smokers.

Conclusion

These findings support the predictions of IST and support the notion that attentional bias might develops early in the course of nicotine addiction. Furthermore, the results indicate that the underlying cognitive mechanisms might be partially within conscious awareness, which opens up potential avenues for research design, treatment, and interventions.

Tell me how you feel, I will tell you what you look at: Impact of mood and craving on alcohol attentional bias in binge drinking

BACKGROUND

Alcohol-related attentional bias (AB) is thought to play a key role in the emergence and maintenance of excessive alcohol use. Recent models suggest that AB, classically considered as a permanent feature in alcohol use disorders, is rather modulated by temporary motivational states.

AIMS

We explored the influence of current mood and craving on AB in binge drinking, through a mood induction procedure combined with eye-tracking measures of AB.

METHODS

In Experiment 1, we measured AB (visual probe task with eye-tracking measures) among binge drinkers (n = 48) and light drinkers (n = 32) following positive, negative and neutral mood inductions. Participants reported subjective craving and mood before/after induction. In Experiment 2, we measured AB among the same binge drinkers compared with 29 moderate drinkers following alcohol-related negative, non-alcohol-related negative and neutral mood inductions.

RESULTS

In Experiment 1, induced negative mood and group positively predicted subjective craving, which was positively associated with AB. We found no effect of induced positive mood nor a direct mood-AB association. In Experiment 2, the relationships AB presented with both induced negative mood and group were again mediated by craving. Inducing alcohol-related negative mood did not modify the mood-craving association.

CONCLUSIONS

Alcohol-related AB is not a stable binge drinking characteristic but rather varies according to transient motivational (i.e., craving) and emotional (i.e., negative mood) states. This study provides important insights to better understand AB in subclinical populations and emphasizes the importance of considering motivational and affective states as intercorrelated, to offer multiple ways to reduce excessive alcohol use.

Attentional bias in alcohol drinkers: A systematic review of its link with consumption variables

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.

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.

Attentional blink to alcohol cues in binge drinkers versus non-binge drinkers

Previous studies have shown alcohol-related attentional biases in social drinkers; however, the temporal dynamics of these biases are not well understood. The current study examined this issue in 94 participants (27 male) categorized as binge drinkers (BD) or non-binge drinkers (NBD). Two versions of an alcohol-related attentional blink (AB) paradigm were used: one with words and one with images. It was predicted that BDs (versus NBDs) would exhibit reduced AB for alcohol cues, which would be enhanced for the pictorial version of the task (versus words). The relationships between AB and alcohol craving, quantity and frequency of alcohol consumption, symptoms of alcohol use disorder, and family history of alcohol use disorder (AUD) were also examined. While an AB was observed for both alcohol and non-alcohol targets in the NBD group, no AB was found for alcohol targets in the BD group. Furthermore, the magnitude of the AB was related to drinking, such that higher self-reported hazardous drinking was associated with smaller ABs to alcohol-related targets. However, AB was not related to craving or family history of AUD. These results suggest that alcohol-related stimuli are processed more efficiently by BDs, especially those with hazardous alcohol consumption patterns. These results may inform treatment and prevention efforts targeting binge drinkers.

Attentional bias in problematic drinkers with and without mild to borderline intellectual disability

BACKGROUND

Problematic drinkers favour the processing of alcohol-related stimuli at the cost of other stimuli and also find it difficult to disengage their attention from these stimuli. This is indicative of an attentional bias towards alcohol. The goal of this study was to examine this bias in problematic drinkers with and without mild to borderline intellectual disability (MBID) using both eye tracking methodology and behavioural data (i.e. reaction time (RT) data).

METHOD

Participants (N = 133) were divided into four groups based on (estimated) full scale intelligence quotient (IQ) and severity of alcohol use-related problems. The severity of substance use-related problems was assessed with the Alcohol Use Disorder Identification Test (AUDIT). The visual dot probe task was used to measure the attentional bias. We analysed both eye tracking data and behavioural data (i.e. RT data) of the visual dot probe task.

RESULTS

Problematic drinkers were not more likely than light drinkers to direct their attention towards pictures of alcoholic beverages, did not look at these pictures longer than light drinkers and did also not respond faster than light drinkers to probes replacing pictures of alcoholic beverages. However, the strength of the attentional bias varied profusely.

CONCLUSION

Taking the large variability in the strength of the attentional bias and the poor psychometric qualities of the measures into consideration, it is concluded that the use of these measures for clinical purposes is discouraged.

Comparison of interstimulus intervals on change detection in nondriving and driving scenarios

Change detection across disruptions of visual scenes is typically studied using brief durations of the interstimulus interval (ISI) (i.e., up to 300 ms). We investigated change detection across durations that approximate longer, voluntary glances away from a visual scene (i.e., 500-2,000 ms), which are often actualized in driving situations. Experiment 1 found that in nondriving scenarios, change detection performance, as measured by accuracy and response time, decreased as ISI increased. Experiment 2 found that in driving scenarios, change detection for plausible changes also decreased as the ISI increased, but there was no similar decrease in performance for implausible changes. Both Experiments 1 and 2 showed that the necessary number of exposures to the change decreased as ISIs approximated voluntary glances, suggesting that change detection strategies may be modified at longer ISI durations.

Self-control and the effects of movie alcohol portrayals on immediate alcohol consumption in male college students

BACKGROUND

In movies, alcohol-related cues are frequently depicted and there is evidence for a link between movie alcohol cues and immediate alcohol consumption. Less is known about factors influencing immediate effects movie alcohol exposure on drinking. The exertion of self-control is thought to be important in avoiding or resisting certain temptations.

AIMS

The aim of the present study was to assess the immediate effects of movie alcohol portrayals on drinking of male social drinkers and to assess the moderating role of self-control in this relation. It was hypothesized that participants would drink more when exposed to movie alcohol portrayals and that especially participants with low self-control would be affected by these portrayals.

METHODS

A between-subjects design comparing two movie conditions (alcohol or no portrayal of alcohol) was used, in which 154 pairs of male friends (ages 18-30) watched a 1-h movie in a semi-naturalistic living room setting. Their alcohol consumption while watching was examined. Participants completed a questionnaire assessing self-control as well as their self-reported weekly alcohol use. A multivariate regression analysis was conducted to test the effects of movie condition on alcohol comsumption.

RESULTS

Self-control moderated the relation between movie condition and alcohol consumption. Assignment to the alcohol movie condition increased alcohol consumption during the movie for males with high self-control but not for males with low self-control.

CONCLUSION

Viewing a movie with alcohol portrayals can lead to higher alcohol consumption in a specific sample of young men while watching a movie.