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Ghiţă A, Hernández-Serrano O, Moreno M, Monràs M, Gual A, Maurage P, Gacto-Sánchez M, Ferrer-García M, Porras-García B, Gutiérrez-Maldonado J. Exploring Attentional Bias toward Alcohol Content: Insights from Eye-Movement Activity. Eur Addict Res 2024; 30:65-79. [PMID: 38423002 PMCID: PMC11126206 DOI: 10.1159/000536252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 01/10/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION Attentional bias (AB) is an implicit selective attention toward processing disorder-significant information while neglecting other environmental cues. Considerable empirical evidence highlights the clinical implication of AB in the onset and maintenance of substance use disorder. An innovative method to explore direct measures of AB relies on the eye-movement activity using technologies like eye-tracking (ET). Despite the growing interest regarding the clinical relevance of AB in the spectrum of alcohol consumption, more research is needed to fully determine the AB patterns and its transfer from experimental to clinical applications. The current study consisted of three consecutive experiments. The first experiment aimed to design an ad-hoc visual attention task (VAT) consisting of alcohol-related and neutral images using a nonclinical sample (n = 15). The objective of the second and third experiments was to analyze whether the effect of type of image (alcohol-related vs. neutral images) on AB toward alcohol content using the VAT developed in the first experiment was different for type of drinker (light vs. heavy drinker in the second experiment [n = 30], and occasional social drinkers versus alcohol use disorder (AUD) patients in the third experiment [n = 48]). METHODS Areas of interest (AOIs) within each type of image (neutral and alcohol-related) were designed and raw ET-based data were subsequently extracted through specific software analyses. For experiment 1, attention maps were created and processed for each image. For experiments 2 and 3, data on ET variables were gathered and subsequently analyzed through a two-way ANOVA with the aim of examining the effects of the type of image and drinker on eye-movement activity. RESULTS There was a statistically significant interaction effect between type of image and type of drinker (light vs. heavy drinker in experiment 2, F(1, 56) = 13.578, p < 0.001, partial η2 = 0.195, and occasional social drinker versus AUD patients in the experiment 3, F(1, 92) = 35.806, p < 0.001, partial η2 = 0.280) for "first fixation" with large effect sizes, but not for "number of fixations" and "dwell time." The simple main effect of type of image on mean "first fixation" score for AUD patients was not statistically significant. CONCLUSION The data derived from the experiments indicated the importance of AB in sub-clinical populations: heavy drinkers displayed an implicit preference for alcohol-related images compared to light drinkers. Nevertheless, AB fluctuations in patients with AUD compared to the control group were found. AUD patients displayed an early interest in alcohol images, followed by an avoidance attentional processing of alcohol-related images. The results are discussed in light of recent literature in the field.
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Affiliation(s)
- Alexandra Ghiţă
- Department of Health, Medical and Neuropsychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | | | - Manuel Moreno
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Miquel Monràs
- Addictive Behaviors Unit, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Antoni Gual
- Addictive Behaviors Unit, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Pierre Maurage
- Psychological Sciences Research Institute, Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
| | | | - Marta Ferrer-García
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Bruno Porras-García
- Departament of Basic Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
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Bollen Z, Pabst A, Masson N, Wiers RW, Field M, Maurage P. Craving modulates attentional bias towards alcohol in severe alcohol use disorder: An eye-tracking study. Addiction 2024; 119:102-112. [PMID: 37658786 DOI: 10.1111/add.16333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/19/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND AND AIMS Competing models disagree on three theoretical questions regarding alcohol-related attentional bias (AB), a key process in severe alcohol use disorder (SAUD): (1) is AB more of a trait (fixed, associated with alcohol use severity) or state (fluid, associated with momentary craving states) characteristic of SAUD; (2) does AB purely reflect the over-activation of the reflexive/reward system or is it also influenced by the activity of the reflective/control system and (3) does AB rely upon early or later processing stages? We addressed these issues by investigating the time-course of AB and its modulation by subjective craving and cognitive load in SAUD. DESIGN A free-viewing eye-tracking task, presenting pictures of alcoholic and non-alcoholic beverages, combined with a concurrent cognitive task with three difficulty levels. SETTING A laboratory setting in the detoxification units of three Belgian hospitals. PARTICIPANTS We included 30 patients with SAUD self-reporting craving at testing time, 30 patients with SAUD reporting a total absence of craving and 30 controls matched on sex and age. All participants from SAUD groups met the DSM-5 criteria for SAUD. MEASUREMENTS We assessed AB through early and late eye-tracking indices. We evaluated the modulation of AB by craving (comparison between patients with/without craving) and cognitive load (variation of AB with the difficulty level of the concurrent task). FINDINGS Dwell time measure indicated that SAUD patients with craving allocated more attention towards alcohol-related stimuli than patients without craving (P < 0.001, d = 1.093), resulting in opposite approach/avoidance AB according to craving presence/absence. SAUD patients without craving showed a stronger avoidance AB than controls (P = 0.003, d = 0.806). AB did not vary according to cognitive load (P = 0.962, η2 p = 0.004). CONCLUSIONS The direction of alcohol-related attentional bias (approach/avoidance) appears to be determined by patients' subjective craving at testing time and does not function as a stable trait of severe alcohol use disorder. Alcohol-related attentional bias appears to rely on later/controlled attentional stages but is not modulated by the saturation of the reflective/control system.
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Affiliation(s)
- Zoé Bollen
- Louvain Experimental Psychopathology research group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Arthur Pabst
- Louvain Experimental Psychopathology research group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Nicolas Masson
- Numerical Cognition Group, Psychological Science Research Institute and Neuroscience Institute, UCLouvain, Louvain-la-Neuve, Belgium
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Pierre Maurage
- Louvain Experimental Psychopathology research group (LEP), Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
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Muela I, Navas JF, Ventura-Lucena JM, Perales JC. How to pin a compulsive behavior down: A systematic review and conceptual synthesis of compulsivity-sensitive items in measures of behavioral addiction. Addict Behav 2022; 134:107410. [PMID: 35780595 DOI: 10.1016/j.addbeh.2022.107410] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/08/2022] [Accepted: 06/11/2022] [Indexed: 12/15/2022]
Abstract
Experimental models identify the transition from choice to compulsivity as the main mechanism underlying addiction. In behavioral addictions research, however, the adjective compulsive is used to describe virtually any kind of excessive or dysregulated behavior, which hinders the connection between experimental and clinical models. In this systematic review, we adopted a preliminary definition of compulsive behavior based on previous theoretical work. Subsequently, a systematic review following PRISMA guidelines was conducted (a) to identify the validated instruments, currently used in behavioral addictions research, that include items that are sensitive (intendedly or not) to compulsivity, and (b) to categorize those items into differentiable operationalizations of compulsivity. Six operationalizations of compulsivity emerged from item content analysis: 1. Automatic or habitual behavior occurring in absence of conscious instrumental goals; 2. Behavior insensitive to negative consequences despite conscious awareness of them; 3. Overwhelming urge or desire that impels the individual to initiate the activity and jeopardizes control attempts; 4. Bingeing, or inability to stop or interrupt the activity once initiated, resulting in an episode substantially longer or more intense than intended; 5. Attentional capture and cognitive hijacking; and 6. Inflexible rules, stereotyped behaviors, and rituals related to task completion or execution. Subsequently, a list of 15 representative items per operationalization was elaborated for independent assessment and identification of delimitation problems. A high degree of agreement was reached in assessing them as instantiating compulsivity, as well as in their assignment to the corresponding categories. However, many of them were also considered overinclusive, i.e., uncapable of distinguishing compulsivity from value-based momentary choice. To increase their discriminative value, items in future compulsivity scales should be refined to explicitly mention disconnection between behavior and declarative goals. Further research on factorial structure of a pool of items derived from these operational definitions is warranted. Such a factorial structure could be used as an intermediate link between specific behavioral items and explanatory psychobiological, learning, and cognitive mechanisms.
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Affiliation(s)
- Ismael Muela
- Department of Experimental Psychology, Mind, Brain and Behavior Research Center (CIMCYC), Universidad de Granada, Spain.
| | - Juan F Navas
- Department of Personality, Assessment, and Clinical Psychology, Universidad Complutense de Madrid, Spain
| | - José M Ventura-Lucena
- Department of Experimental Psychology, Mind, Brain and Behavior Research Center (CIMCYC), Universidad de Granada, Spain
| | - José C Perales
- Department of Experimental Psychology, Mind, Brain and Behavior Research Center (CIMCYC), Universidad de Granada, Spain
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Takahashi RES, Kim HS, Coelho SG, Tavares H. A Systematic Review of Eye-Tracking Studies of Gambling-Related Attentional Biases. J Gambl Stud 2022; 39:813-828. [PMID: 36203047 DOI: 10.1007/s10899-022-10161-3] [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] [Accepted: 09/14/2022] [Indexed: 11/26/2022]
Abstract
Previous research has identified attentional biases towards addiction-related stimuli, including gambling-related stimuli. Eye-tracking is considered the gold standard methodology for measuring attentional biases, yet no review to date has examined its use in measuring gambling-related attentional biases. This systematic review synthesized the literature using eye-tracking to examine attentional biases among people who gamble. We reviewed articles from Web of Science and PubMed that were published from 1990 to 2021. A total of 11 articles were included, with sample sizes ranging from 38 to 173 participants. Of these studies, seven examined attentional biases for gambling-related visual stimuli. These seven studies provided support that gambling can result in the development of an attentional bias for gambling-related stimuli. With respect to correlates of gambling-related attentional biases, there were mixed results. Some studies identified significant positive associations between gambling-related attentional biases and psychosocial variables, such as problem gambling severity, gambling expectancies, gambling cravings, gambling motives, depressive symptom severity, alcohol use severity, daily stress, affective impulsivity, and immersion. Four studies examined attentional biases for responsible gambling messaging and advertisements, finding that both people who do and do not gamble attend less to responsible gambling messaging compared to other types of information such as the betting odds. Research using eye-tracking to examine attentional biases among people who gamble is in its infancy. Yet, the preliminary results support the identification of attentional biases using the gold-standard methodology. Further studies are needed to examine the correlates and potential clinical utility of assessing gambling-related attentional biases using eye-tracking.
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Affiliation(s)
| | - Hyoun S Kim
- Department of Psychology, Toronto Metropolitan University (Formerly Ryerson University), Toronto, Canada
| | - Sophie G Coelho
- Department of Psychology, Toronto Metropolitan University (Formerly Ryerson University), Toronto, Canada
| | - Hermano Tavares
- Department of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
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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; 139:104703. [PMID: 35643118 DOI: 10.1016/j.neubiorev.2022.104703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 03/29/2022] [Accepted: 05/14/2022] [Indexed: 12/01/2022]
Abstract
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.
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Affiliation(s)
- Zoé Bollen
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Pauline Billaux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Science Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium.
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