Effectiveness of attentional bias modification training as add-on to regular treatment in alcohol and cannabis use disorder: A multicenter randomized control trial

Background Attentional bias for substance-relevant cues has been found to contribute to the persistence of addiction. Attentional bias modification (ABM) interventions might, therefore, increase positive treatment outcome and reduce relapse rates. The current study investigated the effectiveness of a newly developed home-delivered, multi-session, internet-based ABM intervention, the Bouncing Image Training Task (BITT), as an add-on to treatment as usual (TAU). Methods Participants (N = 169), diagnosed with alcohol or cannabis use disorder, were randomly assigned to one of two conditions: the experimental ABM group (50%; TAU+ABM); or the control group (50%; split in two subgroups the TAU+placebo group and TAU-only group, 25% each). Participants completed baseline, post-test, and 6 and 12 months follow-up measures of substance use and craving allowing to assess long-term treatment success and relapse rates. In addition, attentional bias (both engagement and disengagement), as well as secondary physical and psychological complaints (depression, anxiety, and stress) were assessed. Results No significant differences were found between conditions with regard to substance use, craving, relapse rates, attentional bias, or physical and psychological complaints. Conclusions The findings may reflect unsuccessful modification of attentional bias, the BITT not targeting the relevant process (engagement vs. disengagement bias), or may relate to the diverse treatment goals of the current sample (i.e., moderation or abstinence). The current findings provide no support for the efficacy of this ABM approach as an add-on to TAU in alcohol or cannabis use disorder. Future studies need to delineate the role of engagement and disengagement bias in the persistence of addiction, and the role of treatment goal in the effectiveness of ABM interventions.

Download Full-text

Attentional bias modification and pain: The role of sensory and affective stimuli

Behaviour Research and Therapy ◽

10.1016/j.brat.2016.06.002 ◽

2016 ◽

Vol 83 ◽

pp. 53-61 ◽

Cited By ~ 16

Author(s):

Jemma Todd ◽

Louise Sharpe ◽

Ben Colagiuri

Keyword(s):

Attentional Bias ◽

Attentional Bias Modification ◽

Affective Stimuli ◽

Bias Modification

Download Full-text

The clinical relevance of attentional bias in substance use disorders

CNS Spectrums ◽

10.1017/s1092852913000321 ◽

2013 ◽

Vol 19 (3) ◽

pp. 225-230 ◽

Cited By ~ 86

Author(s):

Matt Field ◽

Reshmi Marhe ◽

Ingmar H. A. Franken

Keyword(s):

Substance Use ◽

Attentional Bias ◽

Substance Use Disorders ◽

Future Research ◽

Clinical Implications ◽

Motivational State ◽

Attentional Bias Modification ◽

Predictive Relationship ◽

Bias Modification ◽

Subsequent Relapse

Individuals with substance use disorders typically show an “attentional bias” for substance-related cues: Those cues are able to grab and hold the attention, in preference to other cues in the environment. We discuss the theoretical context for this work before reviewing the measurement of attentional bias, and its relationship to motivational state and relapse to substance use after a period of abstinence. Finally, we discuss the implications of this research for the treatment of substance use disorders. We conclude that attentional bias is associated with subjective craving, and that moment-by-moment fluctuations in attentional bias may precede relapse to substance use. The evidence regarding the predictive relationship between attentional bias assessed in treatment contexts and subsequent relapse is inconsistent. Furthermore, there is currently insufficient evidence to endorse attentional bias modification as a treatment for substance use disorders. Clinical implications and suggestions for future research are highlighted.

Download Full-text

Attentional bias, craving and cannabis use in an inpatient sample of adolescents and young adults diagnosed with cannabis use disorder: The moderating role of cognitive control

Addictive Behaviors ◽

10.1016/j.addbeh.2019.106126 ◽

2020 ◽

Vol 100 ◽

pp. 106126 ◽

Cited By ~ 1

Author(s):

A. Dunkerbeck Van Kampen ◽

J. Cousijn ◽

C. Engel ◽

M. Rinck ◽

B.A.G. Dijkstra

Keyword(s):

Young Adults ◽

Cognitive Control ◽

Attentional Bias ◽

Cannabis Use ◽

Adolescents And Young Adults ◽

Cannabis Use Disorder ◽

Moderating Role

Download Full-text

Attentional Bias in Alcohol and Cannabis Use Disorder Outpatients as Indexed by an Odd-One-Out Visual Search Task: Evidence for Speeded Detection of Substance Cues but Not for Heightened Distraction

Frontiers in Psychology ◽

10.3389/fpsyg.2021.626326 ◽

2021 ◽

Vol 12 ◽

Author(s):

Janika Heitmann ◽

Peter J. de Jong

Keyword(s):

Substance Use ◽

Visual Search ◽

Attentional Bias ◽

Search Task ◽

Visual Search Task ◽

Cannabis Use ◽

Cannabis Use Disorder ◽

Attentional Processes ◽

Comparison Groups ◽

The Difference

Current cognitive models of addiction imply that speeded detection and increased distraction from substance cues might both independently contribute to the persistence of addictive behavior. Speeded detection might lower the threshold for experiencing craving, whereas increased distraction might further increase the probability of entering a bias-craving-bias cycle, thereby lowering the threshold for repeated substance use. This study was designed to examine whether indeed both attentional processes are involved in substance use disorders. Both attentional processes were indexed by an Odd-One-Out visual search task in individuals diagnosed with alcohol use disorder (AUD; n = 63) and cannabis use disorder (CUD; n = 28). To test whether the detection and/or the distraction component are characteristic for AUD and CUD, their indices were compared with matched individuals without these diagnoses (respectively, n = 63 and n = 28). Individuals with CUD showed speeded detection of cannabis cues; the difference in detection between AUD and the comparison group remained inconclusive. Neither the AUD nor the CUD group showed more distraction than the comparison groups. The sample size of the CUD group was relatively small. In addition, participants made relatively many errors in the attentional bias (AB) task, which might have lowered its sensitivity to detect ABs. The current study provided no support for the proposed role of increased distraction in CUD and AUD. The findings did, however, provide support for the view that speeded detection might be involved in CUD. Although a similar trend was evident for AUD, the evidence was weak and remained therefore inconclusive.

Download Full-text