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Naets T, Vermeiren E, Vervoort L, Van Eyck A, Ysebaert M, Verhulst S, De Winter B, Van Hoorenbeeck K, Bruyndonckx L, Tanghe A, De Guchtenaere A, Verbeken S, Braet C. Self-control training supplementing inpatient multidisciplinary obesity treatment in children and adolescents. Behav Res Ther 2023; 167:104335. [PMID: 37327533 DOI: 10.1016/j.brat.2023.104335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 03/31/2023] [Accepted: 05/15/2023] [Indexed: 06/18/2023]
Abstract
Research points to self-control as a possible mechanism for facilitating health behaviour and weight loss. The dual pathway model underpins the role of strong bottom-up reactivity towards food and weak top-down executive functions in obesity. Despite flourishing lab studies on attention bias modification or inhibition trainings, relatively few focused on training both processes to improve self-control in children and adolescents in inpatient multidisciplinary obesity treatment (MOT). Being part of the WELCOME project, this study investigated the effectiveness of Brain Fitness training (using the Dot Probe and Go/No-Go) as an adjunct to inpatient MOT in 131 Belgian children and adolescents. Changes in self-control (performance-based inhibitory control and attention bias as well as self-reported eating behaviour) in the experimental group were compared to sham training. Multiple Imputation was used to handle missing data. Inhibitory control and external eating improved over time (pre/post/follow-up), but we found no evidence for a significant interaction between time and condition. Future research should pay more attention to the role of individual variability in baseline self-control, sham training, and ecological validity of self-control training to improve real-life health behaviour and treatment perspectives for children and adolescents with weight problems.
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Affiliation(s)
- Tiffany Naets
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium.
| | - Eline Vermeiren
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Leentje Vervoort
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium; Department of Developmental Psychology, Radboud University, Nijmegen, the Netherlands
| | - Annelies Van Eyck
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | | | - Stijn Verhulst
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - Benedicte De Winter
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - Kim Van Hoorenbeeck
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | - Luc Bruyndonckx
- Lab of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Antwerp University Hospital, Antwerp, Belgium
| | | | | | - Sandra Verbeken
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Caroline Braet
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
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A Literature Review of Attentional Biases amongst Individuals with Substance Dependency: Individual Differences and Modulating Factors. PSYCHIATRY INTERNATIONAL 2020. [DOI: 10.3390/psychiatryint1020013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Advances in experimental psychology have led to a better understanding of automatic, unconscious processes, referred to as attentional biases. Despite the growing evidence from meta-analytical studies, we still do not understand why some individuals have a greater magnitude of these biases, and why others have none. There has been little focus on elucidating individual differences and task parameters that affect the overall magnitude of the biases. In this opinion piece, we will attempt to identify these. We will then discuss both the research and clinical implications. Methods and Analysis: To identify the factors that modulated the magnitude of attentional biases across all the substance disorders (i.e., opioid use, cannabis use, and stimulant-use disorders), we performed a search using the bibliographic databases PubMed and MEDLINE. The search terminologies “attention bias” or “cognitive bias” or “approach bias” or “avoidance bias” were used when we looked for relevant articles. Results: It was evident from the published literature that several individual differences and factors modulated the magnitude of baseline biases. Across opioid, cannabis, and stimulant-use disorders, the most common individual differences identified were the severity of the dependence and the quantity of substance used. For both opioid and cannabis disorders the timing of stimulus presentation influenced the detection of attentional bias; it appeared that short stimulus timing was better able to detect attentional bias. Other identified individual differences included subjective craving and impulsiveness. The results highlight several research and clinical implications. Conclusions: The discovery of these individual differences and factors of the task paradigm that affect the magnitude of attentional biases will help in the future conceptualization of attention-bias-modification intervention.
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Zhang MWB, Smith HE. Challenges When Evaluating Cognitive Bias Modification Interventions for Substance Use Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217821. [PMID: 33114579 PMCID: PMC7662791 DOI: 10.3390/ijerph17217821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 01/25/2023]
Abstract
In recent years, advances in experimental psychology have led to a better understanding in automatic, unconscious processes, referred to as attentional and approach biases amongst individuals with substance use disorders. Attentional biases refer to the relatively automatic tendencies for attention to be preferentially allocated towards substance-related cues. Whereas, approach bias refers to the relatively automatic behavioral tendencies of individuals to reach out to substance-related cues in their natural environment. While, several reviews confirm the existence of these biases, and the effectiveness of bias modification, the conduct of cognitive bias modification amongst substance-using individuals is not without its challenges. One of these is that cognitive biases, both attentional and approach biases, are not universally present; and several individual differences factors modulate the magnitude of the biases. Another challenge that investigators faced in their conduct of cognitive bias modification relates to the selection of the appropriate task for bias assessment and modification. Other challenges intrinsic to cognitive bias modification intervention relates to that of participant attrition, much like conventional psychotherapies. Negative findings, of the absence of biases at baseline, or the lack of effectiveness of bias modification have been reported in studies of cognitive bias modification. All these challenges could have an impact on bias assessment and modification. In this perspective paper, we will explore the literature surrounding each of these challenges and discuss potential measures that could be undertaken to mitigate these clinical and research challenges.
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Affiliation(s)
- Melvyn W. B. Zhang
- National Addiction Management Service, Institute of Mental Health, Singapore 539747, Singapore
- Correspondence:
| | - Helen E. Smith
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore 308232, Singapore;
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A Scoping Review of Cognitive Bias in Internet Addiction and Internet Gaming Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17010373. [PMID: 31935915 PMCID: PMC6981817 DOI: 10.3390/ijerph17010373] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 12/23/2019] [Accepted: 01/01/2020] [Indexed: 01/17/2023]
Abstract
Internet addiction and Internet gaming disorders are increasingly prevalent. Whilst there has been much focus on the use of conventional psychological approaches in the treatment of individuals with these addictive disorders, there has also been ongoing research exploring the potential of cognitive bias modification amongst individuals with Internet and gaming addiction. Some studies have documented the presence of cognitive biases and the effectiveness of bias modification for Internet addiction and gaming disorders. However, there have not been any reviews that have synthesized the findings related to cognitive biases for Internet addiction and Internet gaming disorders. It is important for us to undertake a scoping review as an attempt to map out the literature for cognitive biases in Internet addiction and gaming disorders. A scoping review was undertaken, and articles were identified using a search through the following databases: PubMed, MEDLINE, and PsycINFO. Six articles were identified. There were differences in the methods of ascertaining whether an individual has an underlying Internet or gaming addiction, as several different instruments have been used. With regards to the characteristics of the cognitive bias assessment task utilized, the most common task used was that of the Stroop task. Of the six identified studies, five have provided evidence documenting the presence of cognitive biases in these disorders. Only one study has examined cognitive bias modification and provided support for its effectiveness. Whilst several studies have provided preliminary findings documenting the presence of cognitive biases in these disorders, there remains a need for further research evaluating the effectiveness of bias modification, as well as the standardization of the diagnostic tools and the task paradigms used in the assessment.
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