A Smartphone App for Attentional Bias Retraining in Smokers: Mixed Methods Pilot Study

Background Smoking is a global health threat. Attentional bias influences smoking behaviors. Although attentional bias retraining has shown benefits and recent advances in technology suggest that attentional bias retraining can be delivered via smartphone apps, there is a paucity of research on this topic. Objective This study aims to address this gap by exploring the use of attentional bias retraining via a novel smartphone app using a mixed methods pilot study. In the quantitative phase, it is hypothesized that participants in the training group who undertake attentional bias retraining via the app should have decreased levels of attentional bias, subjective craving, and smoking frequency, compared with those in the control group who do not undertake attentional bias retraining. The qualitative phase explores how the participants perceive and experience the novel app. Methods In all, 10 adult smokers (3 females and 7 males) between the ages of 26 and 56 years (mean 34.4 years, SD 9.97 years) were recruited. The participants were randomly allocated to the training and control groups. In weeks 1 and 3, participants from both groups attempted the standard visual probe task and rated their smoking frequency and subjective craving. In week 2, the participants in the training group attempted the modified visual probe task. After week 3, participants from both groups were interviewed about their views and experiences of the novel app. Results The results of the quantitative analysis did not support this study’s hypothesis. The qualitative data were analyzed using thematic analysis. The results yielded 5 themes: ease, helpfulness, unhelpful aspects, barriers, and refinement. Conclusions Findings from the qualitative study were consistent with those from previous studies on health-related smartphone apps. The qualitative results were helpful in understanding the user perspectives and experiences of the novel app, indicating that future research in this innovative area is necessary.

Measuring Food-Related Attentional Bias

Objective: Food-related attentional bias has been defined as the tendency to give preferential attention to food-related stimuli. Attentional bias is of interest as studies have found that increased attentional bias is associated with obesity; others, however, have not. A possible reason for mixed results may be that there is no agreed upon measure of attentional bias: studies differ in both measurement and scoring of attentional bias. Additionally, little is known about the stability of attentional bias over time. The present study aims to compare attentional bias measures generated from commonly used attentional bias tasks and scoring protocols, and to test re-test reliability.Methods: As part of a larger study, 69 participants (67% female) completed two food-related visual probe tasks at baseline: lexical (words as stimuli), and pictorial (pictures as stimuli). Reaction time bias scores (attentional bias scores) for each task were calculated in three different ways: by subtracting the reaction times for the trials where probes replaced (1) neutral stimuli from the trials where the probes replaced all food stimuli, (2) neutral stimuli from the trials where probes replaced high caloric food stimuli, and (3) neutral stimuli from low caloric food stimuli. This resulted in three separate attentional bias scores for each task. These reaction time results were then correlated. The pictorial visual probe task was administered a second time 14-days later to assess test-retest reliability.Results: Regardless of the scoring use, lexical attentional bias scores were minimal, suggesting minimal attentional bias. Pictorial task attentional bias scores were larger, suggesting greater attentional bias. The correlation between the various scores was relatively small (r = 0.13–0.20). Similarly, test-retest reliability for the pictorial task was poor regardless of how the test was scored (r = 0.20–0.41).Conclusion: These results suggest that at least some of the variation in findings across attentional bias studies could be due to differences in the way that attentional bias is measured. Future research may benefit from either combining eye-tracking measurements in addition to reaction times.

‘Not only faces’: specialized visual representation of human hands revealed by adaptation

Classical neurophysiological studies demonstrated that the monkey brain is equipped with neurons selectively representing the visual shape of the primate hand. Neuroimaging in humans provided data suggesting that a similar representation can be found in humans. Here, we investigated the selectivity of hand representation in humans by means of the visual adaptation technique. Results showed that participants' judgement of human-likeness of a visual probe representing a human hand was specifically reduced by a visual adaptation procedure when using a human hand adaptor but not when using an anthropoid robotic hand or a non-primate animal paw adaptor. Instead, human-likeness of the anthropoid robotic hand was affected by both human and robotic adaptors. No effect was found when using a non-primate animal paw as adaptor or probe. These results support the existence of specific neural mechanisms encoding human hand in the human's visual system.

A Smartphone App for Attentional Bias Retraining in Smokers: Mixed Methods Pilot Study (Preprint)

BACKGROUND Smoking is a global health threat. Attentional bias influences smoking behaviors. Although attentional bias retraining has shown benefits and recent advances in technology suggest that attentional bias retraining can be delivered via smartphone apps, there is a paucity of research on this topic. OBJECTIVE This study aims to address this gap by exploring the use of attentional bias retraining via a novel smartphone app using a mixed methods pilot study. In the quantitative phase, it is hypothesized that participants in the training group who undertake attentional bias retraining via the app should have decreased levels of attentional bias, subjective craving, and smoking frequency, compared with those in the control group who do not undertake attentional bias retraining. The qualitative phase explores how the participants perceive and experience the novel app. METHODS In all, 10 adult smokers (3 females and 7 males) between the ages of 26 and 56 years (mean 34.4 years, SD 9.97 years) were recruited. The participants were randomly allocated to the training and control groups. In weeks 1 and 3, participants from both groups attempted the standard visual probe task and rated their smoking frequency and subjective craving. In week 2, the participants in the training group attempted the modified visual probe task. After week 3, participants from both groups were interviewed about their views and experiences of the novel app. RESULTS The results of the quantitative analysis did not support this study’s hypothesis. The qualitative data were analyzed using thematic analysis. The results yielded 5 themes: ease, helpfulness, unhelpful aspects, barriers, and refinement. CONCLUSIONS Findings from the qualitative study were consistent with those from previous studies on health-related smartphone apps. The qualitative results were helpful in understanding the user perspectives and experiences of the novel app, indicating that future research in this innovative area is necessary. CLINICALTRIAL

Experimental Control of Conflict in a Predictive Visual Probe Task: Highly Reliable Bias Scores Related to Anxiety

Concerns have been raised about the low reliability of measurements of spatial attentional bias via RT differences in dot-probe tasks. The anticipatory form of the bias, directed towards predicted future stimuli, appears to have relatively good reliability, reaching around .70. However, studies thus far have not attempted to experimentally control task-related influence on bias, which could further improve reliability. Evoking top-down versus bottom-up conflict may furthermore reveal associations with individual differences related to mental health. In the current study, a sample of 143 participants performed a predictive Visual Probe Task (predVPT) with angry and neutral face stimuli online. In this task, an automatic bias is induced via visually neutral cues that predict the location of an upcoming angry face. A task-relevant bias was induced via blockwise shifts in the likely location of target stimuli. The bias score resulting from these factors was calculated as RTs to target stimuli at locations of predicted but not actually presented angry versus neutral faces. Correlations were tested with anxiety, depression, self-esteem and aggression scales. An overall bias towards threat was found with a split-half reliability of.90, and .89 after outlier removal. Avoidance of threat in blocks with a task-relevant bias away from threat was correlated with anxiety, with correction for multiple testing. The same relationship was nominally significant for depression and low self-esteem. In conclusion, we showed high reliability of spatial attentional bias that was related to anxiety.

No Difference in Trait-Level Attentional Bias Between Daily and Non-Daily Smokers

Objective: Daily and non-daily smokers display fundamentally different smoking habits and motives. However, both smoking groups find it difficult to quit smoking long-term. One factor associated with addictive behaviour is attentional bias, but previous research in daily and non-daily smokers found inconsistent results. Method: Using an online sample, we compared daily (n = 106) and non-daily (n = 60) smokers in their attentional bias towards smoking pictures. Participants completed a visual probe task with two picture presentation times: 200ms and 500ms. Results: We expected non-daily smokers to display greater attentional bias than daily smokers, but the results did not support this. In confirmatory analyses, there were no significant effects of interest, and in exploratory analyses, equivalence testing showed the effects were statistically equivalent to zero. Conclusions: The results can be interpreted in line with contemporary theories of attentional bias where there are unlikely to be stable trait-level differences between smoking groups. Future research in attentional bias should focus on state-level differences to focus on how smoking cues are being evaluated in the moment.

Spatial Anticipatory Attentional Bias for Threat: Reliable Individual Differences with RT-based Online Measurement

Cues that predict the future location of emotional stimuli may evoke an anticipatory form of automatic attentional bias. The reliability of this bias towards threat is uncertain: experimental design may need to be optimized or individual differences may simply be relatively noisy in the general population. The current study therefore aimed to determine the split-half reliability of the bias, in a design with fewer factors and more trials than in previous work. A sample of 63 participants was used for analysis, who performed the cued Visual Probe Task online, which aims to measure an anticipatory attentional bias. The overall bias towards threat was tested and split-half reliability was calculated over even and odd blocks. Results showed a significant bias towards threat and a reliability of around .7. The results support systematic individual differences in anticipatory attentional bias and demonstrate that RT-based bias scores, with online data collection, can be reliable.

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

Background and Aims: Research indicates that high consumers of alcohol exhibit attentional bias (AB) towards alcohol-related cues, suggestive of a cognitive mechanism that might drive substance seeking. Many tasks that measure AB (e.g., visual probe, addiction Stroop), however, are limited by their reliance on non-appetitive control cues, the serial presentation of stimuli, and their poor internal reliability. The current study employed a visual conjunction search (VCS) task capable of presenting multiple alcoholic and non-alcoholic appetitive cues simultaneously to assess whether social drinkers attend selectively to alcoholic stimuli. To assess the construct validity of this task, we examined whether alcohol consumption and related problems, subjective craving, and drinking motives predict alcohol-specific AB. Design & Setting: A VCS task was performed in a laboratory setting, which required participants to detect the presence of appetitive alcoholic (wine, beer) and non-alcoholic (cola, lemonade) targets within arrays of matching and non-matching distractors. Participants: Data from 99 participants were assessed (MAge = 20.77, SD = 2.98; 64 [65%] females), with 81.8% meeting the threshold for harmful alcohol consumption (MAUDIT = 12.89, SD = 5.79). Measurements: Self-reports of alcohol consumption and related problems (AUDIT), subjective craving (Alcohol Craving Questionnaire Short Form) and drinking motives (Drinking Motives Questionnaire Short Form) were obtained, and the VCS task measured response times for the correct detection of alcoholic and non-alcoholic targets. Findings: Participants were significantly quicker to detect alcoholic relative to non-alcoholic appetitive targets (p < .001, dz = .41), which was predicted positively by AUDIT scores (p = .013, R2 = .06%). The VCS task achieved excellent reliability (α > .79), superior to other paradigms. Conclusions: The Visual Conjunction Search task presents as a highly reliable method for assessing alcohol-related attentional bias, and shows that heavy social drinkers prioritise alcoholic cues in their immediate environment.

Pupil Dilation Is Sensitive to Semantic Ambiguity and Acoustic Degradation

Speech comprehension is challenged by background noise, acoustic interference, and linguistic factors, such as the presence of words with more than one meaning (homonyms and homophones). Previous work suggests that homophony in spoken language increases cognitive demand. Here, we measured pupil dilation—a physiological index of cognitive demand—while listeners heard high-ambiguity sentences, containing words with more than one meaning, or well-matched low-ambiguity sentences without ambiguous words. This semantic-ambiguity manipulation was crossed with an acoustic manipulation in two experiments. In Experiment 1, sentences were masked with 30-talker babble at 0 and +6 dB signal-to-noise ratio (SNR), and in Experiment 2, sentences were heard with or without a pink noise masker at –2 dB SNR. Speech comprehension was measured by asking listeners to judge the semantic relatedness of a visual probe word to the previous sentence. In both experiments, comprehension was lower for high- than for low-ambiguity sentences when SNRs were low. Pupils dilated more when sentences included ambiguous words, even when no noise was added (Experiment 2). Pupil also dilated more when SNRs were low. The effect of masking was larger than the effect of ambiguity for performance and pupil responses. This work demonstrates that the presence of homophones, a condition that is ubiquitous in natural language, increases cognitive demand and reduces intelligibility of speech heard with a noisy background.

Predictive attentional bias modification induces stimulus-evoked attentional bias for threat

Attentional Bias Modification (ABM) aims to modulate attentional biases, but questions remain about its efficacy and there may be new variants yet to explore. The current study tested effects of a novel version of ABM, predictive ABM (predABM), using visually neutral cues predicting the locations of future threatening and neutral stimuli that had a chance of appearing after a delay. Such effects could also help understand anticipatory attentional biases measured using cued Visual Probe Tasks. One hundred and two participants completed the experiment online. We tested whether training Towards Threat versus Away from Threat contingencies on the predABM would cause subsequent attentional biases towards versus away from threat versus neutral stimuli, respectively. Participants were randomly assigned and compared on attentional bias measured via a post-training Dot-Probe task. A significant difference was found between the attentional bias in the Towards Threat versus Away from Threat group. The training contingencies induced effects on bias in the expected direction, although the bias in each group separately did not reach significance. Stronger effects may require multiple training sessions. Nevertheless, the primary test confirmed the hypothesis, showing that the predABM is a potentially interesting variant of ABM. Theoretically, the results show that automatization may involve the process of selecting the outcome of a cognitive response, rather than a simple stimulus-response association. Training based on contingencies involving predicted stimuli affect subsequent attentional measures and could be of interest in future clinical studies.