Effects of Attentional Bias Research on Understanding Nature of Craving and Relapse

Abstract

Addictive behaviors (substance use, craving, drug seeking behavior) are characterized by severe alcohol/substance use. People with addiction problems become more sensitive subtance related stimuli and they react excessive to the subtance related stimuli. This is called as attentional bias. Attentional bias occurs as impilicit/ automatic. Studies show that attentional bias plays an important role in substance craving and relapse. In this review, the reason of addiction attentional bias and its consequences was analyzed. In this frame, the attentional bias paradigms were explanied briefly. Because these paradigms are utilized as tool for attentional bias measurement. After that, the relationship between attentional bias and craving and the effect of attentional bias on relapse were summarizied. From this point it can be said that, alcohol/subtance attentional bias is positively related with craving and it can determinate the risk of relapse earlier. Attentional bias researches may benefit for treatment as usual. Because, researchers are suggested that, attentional bias is promising a usefull measurement tool to prevent the people with addiction problems from the craving and risk of relapse. However, being able to utilized attentional bias as a tool in the clinical field, it is needed to develop further theoretical knowledge and overcome methodological shortcomings.

Keywords

• attentional bias
• craving
• relapse

Dikkat Yanlılığı Araştırmalarının Aşerme ve Nüksün Doğasını Anlama Üzerine Etkisi

Öz

Bağımlılık davranışları (madde kullanımı, aşerme, madde arama) şiddetli alkol/madde kullanımının bağımlılık yapıcı maddeyle ilişkili uyaranlara karşı kişinin hassaslaşarak dikkat yanlılığı geliştirmesiyle karakterize edilir. Bu süreç örtük olarak gerçekleşir. Yapılan çalışmalar dikkat yanlılığının madde aşermesi ve nüks üzerinde önemli bir rol oynadığını göstermektedir. Bu derleme çalışmasında bağımlılıkla ilgili dikkat yanlılığının nedenleri ve sonuçları incelenmiştir. Bu çerçevede öncelikle dikkat yanlılığı ölçümünde kullanılan paradigmalar ile dikkat yanlılığının nasıl araştırıldığı hakkında bilgi verilmiştir. Sonrasında dikkat yanlılığı ile aşerme arasındaki ilişki ve dikkat yanlılığının nüks üzerindeki etkisinden elde edilen araştırma bulguları özetlenmiştir. İlgili literatüre göre, alkol/madde dikkat yanlılığının aşerme ile pozitif ilişkisinin olduğu ve tedavi sonrası nüks riskini öngörebileceği söylenebilir. Araştırmacılar, dikkat yanlılığı ile yapılan çalışmaların bağımlılık tedavisine yararı olabileceğini düşünmektedir. Dikkat yanlılığının, aşerme seviyesini azaltma ve nüksü önlemede kullanılabilecek bir araç haline getirilmesi klinik alanda bağımlılık tedavisi için umut vaat etmektedir. Ancak, dikkat yanlılığının sahada kullanılabilir hale gelebilmesi için daha fazla teorik bilginin geliştirilmesine ve metodolojik eksikliklerin giderilerek yeni araştırmaların ihtiyaç duyulduğuna vurgu yapılmaktadır.

Anahtar Kelimeler

• dikkat yanlılığı
• aşerme
• nüks

Kaynakça

1. Ruiz P, Strain EC. The Substance Abuse Handbook. 2nd Edition, Philadelphia: Lippincot Williams & Wilkins, 2014; 11-16.
2. Yüksel N, Dereboy Ç, Çifter İ. Üniversite öğrencileri arasında madde kullanımı. Turk Psikiyatri Derg 1994; 5(4): 279-282.
3. Öztürk MO, Uluşahin NA. Ruh Sağlığı Ve Bozuklukları, 14 Baskı, Ankara: Miki Matbaacılık, 2016: 511-554.
4. Uzbay T. Madde Bağımlılığı: Tüm Boyutlarıyla Bağımlılık Ve Bağımlılık Yapan Maddeler. 1 Baskı, İstanbul: Medikal Yayıncılık, 2015: 1-3.
5. Stacy AW, Wiers RW. Implicit cognition and addiction: a tool for explaining paradoxical behavior. Annu Rev Clin Psychol 2010; 6: 551–575.
6. Türkoğlu S, Amado S, Gönül AS, Eker MÇ. Comparison of alcohol attentional bias and craving among alcohol abusers and non-abusers. Psikiyatride Güncel Yaklaşımlar 2022; 14(Suppl 1): 75-82.
7. May C. Attentional bias in craving. Peter MM (editor). Principle of Addiction: Comprehensive Addictive Behaviors and Disorders. USA: Charleston, 2013: 435-441.
8. Waters AJ, Feyerabend C. Determinants and effects of attentional bias in smokers. Psychol Addict Behav 2000; 14(2): 111–120.

9. Macleod C, Mathews A, Tata P. Attentional bias in emotional disorders. J Abnorm Psychol 1986; 95(1): 15-20.
10. Rinck M, Becker ES. Approach and avoidance in fear of spiders. J Behav Ther Exp Psychol 2007; 38(2): 105-120.
11. Stroop JR. (1935). Studies of interference in serial verbal reactions. J Exp Psychol 1935; 18(6): 643–662.
12. Bower GH. Mood and memory. Am Psychol 1981; 36(2): 129–148.
13. Wiers RW, Field M, Stacy AW. Passion's slave? cognitive processes in alcohol and drug abuse. Oxford Handbook of Substance Use Disorders. New York: Oxford University Press, 2014.
14. Greenwald AG, McGhee DE, Schwartz JLK. Measuring individual differences in implicit cognition: the implicit association test. J Pers Soc Psychol 1998; 74(6): 1464–1480.
15. Cox WM, Fadardi JS, Pothos EM. The addiction stroop test: theoretical considerations and procedural recommendations. Psychol Bull 2006; 132(3): 443-476.
16. Miller MA, Fillmore M. The effect of image complexity on attentional bias toward alcohol-related images in adult drinkers. Addiction 2013; 105(5): 883-890.
17. MacLeod C, Mathews A. Anxiety and the allocation of attention to threat. Q J Exp Psychol 1998; 51A(4): 653-670.
18. Bradley BP, Mogg K, White J, Groom C, de Bono J. Attentional bias for emotional faces in generalized anxiety disorder. Br J Clin Psychol 1999; 38(3): 267-278.
19. Klumpp H, Amir N. Examination of vigilance and disengagement of threat in social anxiety with a probe detection task. Anxiety Stress Coping 2009; 22(3): 283-296.
20. Koster EH, Crombe G, Verschuere B, De Houwer J. Selective attention to threat in the dot probe paradigm: differentiating vigilance and difficulty to disengage. Behav Res Ther 2004; 42(10): 1183-1192.
21. Ehrman RN, Robbins SJ, Bromwell MA, et al. Comparing attentional bias to smoking cues in current smokers, former smokers, and non-smokers using a dot-probe task. Drug Alcohol Depend 2002; 67(2): 185–191.
22. Field M, Eastwood B, Bradley BP, Mogg K. Selective processing of cannabis cues in regular cannabis users. Drug Alcohol Depend 2006; 85(1): 75–82.
23. Bradley BP, Field M, Healy H, Mogg K. Do the affective properties of smoking-related cues influence attentional and approach biases in cigarette smokers? J Psychopharmacol 2008; 22(7): 737–745.
24. Wiers CE, Kühn S, Javadi AH, Korucuoglu O, et al. Automatic approach bias towards smoking cues is present in smokers but not in ex-smokers. Psychopharmacology 2013; 229(1): 187-197.
25. Miller MA, Fillmore M. The effect of image complexity on attentional bias toward alcohol-related images in adult drinkers. Addiction 2010; 105(5): 883-890.
26. Carter BL, Tiffany ST. Meta-analysis of cue-reactivity in addiction research. Addiction 1999; 94(3): 327-340.
27. Cox WM, Hogan LM, Kristian MR, Race JH. Alcohol attentional bias as a predictor of alcohol abusers’ treatment outcome. Drug Alcohol Depend 2002; 68(3): 237–243.
28. Marissen MA, Franken IH, Waters AJ, et al. Attentional bias predicts heroin relapse following treatment. Addiction 2006; 101(9): 1306-1312.
29. Waters AJ, Shiffman S, Sayette MA, et al. Attentional bias predicts outcome in smoking cessation. Health Psychol 2003; 22(4): 378-387.
30. Field M, Eastwood B. Experimental manipulation of attentional bias increases the motivation to drink alcohol. Psychopharmacology 2008; 183(2): 350–357.
31. Mogg K, Bradley BP. Selective processing of smoking-related cues in smokers: manipulation of deprivation level and comparison of three measures of processing bias. J Psychopharmacol 2002; 16(4): 385–392.
32. Sayette MA, Monti PM, Rohsenow DJ, et al. The effects of cue exposure on reaction time in male alcoholics. J Stud Alcohol 1994; 55(5): 629–633.
33. Vadhan NP, Carpenter KM, Copersino ML, et al. Attentional bias towards cocaine-related stimuli: relationship to treatment-seeking for cocaine dependence. Drug Alcohol Abuse 2007; 33(6): 727–736.
34. Field M, Rush M, Cole J, Goudie A. The smoking stroop and delay discounting in smokers: effects of environmental smoking cues. J Psychopharmacol 2007; 21(6): 603–610.
35. MacLeod C, Mathews A. Anxiety and the allocation of attention to threat. Q J Exp Psychol 2005; 58(1): 653-670.
36. Cox WM, Pothos EM, Hosier SG. Cognitive-motivational predictors of excessive drinkers' success in changing. Psychopharmacology 2007; 192(4): 499–510.
37. Mogg K, Bradley BP, Field M, De Houwer, J. Eye movements to smoking-related pictures in smokers: relationship between attentional biases and implicit and explicit measures of stimulus valence. Addiction 2003; 98(6): 825–836.
38. Christiansen P, Schoenmakers TM, Field M. Less than meets the eye: reappraising the clinical relevance of attentional bias in addiction. Addict Behav 2015; 44(43): 43-50.
39. Bollen Z, Field M, Billaux P, Maurage P. Attentional bias in alcohol drinkers: a systematic review of its link with consumption variables. Neurosci Biobehav Rev 2022; 139: 104-127.
40. Field M, Werthmann J, Franken I, Hofmann W, et al. The role of attentional bias in obesity and addiction. Health Psychol 2016; 35(8): 767–780.
41. Mogg K, Field M, Bradley BP. Attentional and approach biases for smoking cues in smokers: an investigation of competing theoretical views of addiction. Psychopharmacology 2005; 180(3): 333–341.
42. Copersino ML, Serper MR, Vadhan N, Goldberg BR, et al. Cocaine craving and attentional bias in cocaine-dependent schizophrenic patients. Psychiatry Res 2004; 128(3): 209–218.
43. Franken IHA, Kroon LY, Hendriks VM. Influence of individual differences in craving and obsessive cocaine thoughts on attentional processes in cocaine abuse patients. Addict Behav 2000; 25(1): 99–102.
44. Rosse RB, Miller MW, Hess AL, et al. Measures of visual scanning as a predictor of cocaine cravings and urges. Biol Psychiatry 1993; 33(5): 554–556.
45. Duka T, Townshend JM. The priming effect of alcohol pre-load on attentional bias to alcohol-related stimuli. Psychopharmacology (Berl) 2004; 176(3-4): 353–362.
46. Field M, Mogg K, Bradley BP. Cognitive bias and drug craving in recreational cannabis users. Drug Alcohol Depend 2004; 74(1): 105–111.
47. Franken IHA. Drug craving and addiction: integrating psychological and neuropsychopharmacological approaches. Prog Neuropsychopharmacol Biol Psychiatry 2003; 27(4): 563–579.
48. Gross TM, Jarvik ME, Rosenblatt MR. Nicotine abstinence produces content-specific Stroop interference. Psychopharmacology (Berl) 1993; 110(3): 333–336.
49. Schuh KJ, Stitzer ML. Desire to smoke during spaced smoking intervals. Psychopharmacology (Berl) 1995; 120(3): 289-295.
50. Cox WM, Brown MA, Rowlands LJ. The effects of alcohol cue exposure on non-dependent drinkers’ attentional bias for alcohol-related stimuli. Alcohol Alcohol 2003; 38(1): 45–49.
51. Cox WM, Yeates GN, Regan CM. Effects of alcohol cues on cognitive processing in heavy and light drinkers. Drug Alcohol Depend 1999; 55(1-2): 85–89.
52. Schoenmakers T, Wiers RW, Field M. Effects of a low dose of alcohol on cognitive biases and craving in heavy drinkers. Psychopharmacology 2008; 197(1): 169–178.
53. Schulze D, Jones BT. The effects of alcohol cues and an alcohol priming dose on a multi-factorial measure of subjective cue reactivity in social drinkers. Psychopharmacology (Berl) 1999; 145(4): 452–454.
54. Robinson TE, Berridge KC. The neural basis of drug craving: an incentive-sensitization theory of addiction. Brain Res 1993; 18(2): 247-291.
55. Kavanagh DJ, Andrade J, May J. Imaginary relish and exquisite torture: the elaborated intrusion theory of desire. Psychol Rev 2005; 112(2): 446–467.
56. Carpenter KM, Schreiber E, Church S, McDowell D. Drug Stroop performance: relationships with primary substance of use and treatment outcome in a drug-dependent outpatient sample. Addict Behav 2006; 31(9): 174–181.
57. Waters AJ, Shiffman S, Bradley BP, Mogg K. Attentional shifts to smoking cues in smokers. Addiction 2003; 98(10): 1409-1407.
58. Field M, Cox WM. Attentional bias in addictive behaviors: a review of its development, causes, and consequences. Drug Alcohol Depend 2008; 97(1-2): 1–20.
59. Marhe R, Luijten M, Van De Wetering BJM, et al. Individual differences in anterior cingulate activation associated with attentional bias predict cocaine use after treatment. Neuropsychopharmacology 2013; 38(6): 1085–1093.
60. Mitchell MR, Balodis IM, Devito EE, et al. A preliminary investigation of Stroop-related intrinsic connectivity in cocaine dependence: associations with treatment outcomes. Am J Drug Alcohol Abuse 2013; 39(6): 392–402.
61. Spiegelhalder K, Jähne A, Kyle SD, et al. Is smoking related attentional bias a useful marker for treatment effects? Behav Med 2011; 37(1): 26–34.