Craving modulates attentional bias towards alcohol in severe alcohol use disorder: An eye-tracking study

IF 5.2 1区医学 Q1 PSYCHIATRY Addiction Pub Date : 2023-09-02 DOI:10.1111/add.16333

Zoé Bollen, Arthur Pabst, Nicolas Masson, Reinout W. Wiers, Matt Field, Pierre Maurage

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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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渴求调节严重酒精使用障碍患者对酒精的注意偏向：眼动追踪研究

背景和目的关于酒精相关注意偏差（AB）这一严重酒精使用障碍（SAUD）的关键过程，不同的模型在三个理论问题上存在分歧：(1) 酒精相关注意偏差是SAUD的特质（固定的，与酒精使用严重程度相关）还是状态（流动的，与瞬间渴求状态相关）特征；(2) 酒精相关注意偏差是否纯粹反映了反射/奖赏系统的过度激活，还是也受到反射/控制系统活动的影响；(3) 酒精相关注意偏差依赖于早期还是后期处理阶段？为了解决这些问题，我们研究了SAUD中AB的时间过程及其受主观渴望和认知负荷的调节。设计自由观看眼动跟踪任务，呈现酒精饮料和非酒精饮料的图片，同时结合三个难度级别的认知任务。地点比利时三家医院戒毒科的实验室。参与者我们纳入了 30 名在测试时自我报告有渴求的 SAUD 患者、30 名报告完全没有渴求的 SAUD 患者以及 30 名性别和年龄匹配的对照组患者。所有 SAUD 组的参与者均符合 DSM-5 的 SAUD 标准。测量我们通过早期和晚期眼动追踪指数评估 AB。我们评估了渴求对 AB 的调节（有渴求/无渴求患者之间的比较）和认知负荷（AB 随同时进行的任务的难度而变化）。研究结果停留时间测量表明，有渴求的 SAUD 患者比无渴求的患者对酒精相关刺激分配了更多的注意力（P < 0.001，d = 1.093），导致接近/回避 AB 与有/无渴求相反。与对照组相比，无渴求的 SAUD 患者表现出更强的回避 AB（P = 0.003，d = 0.806）。AB 不随认知负荷的变化而变化（P = 0.962，η2P = 0.004）。结论酒精相关注意偏向（接近/回避）的方向似乎由测试时患者的主观渴求决定，并不是严重酒精使用障碍的稳定特征。酒精相关注意偏向似乎依赖于后期/控制注意阶段，但不受反思/控制系统饱和度的调节。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction 医学-精神病学

CiteScore

10.80

自引率

6.70%

发文量

319

审稿时长

3 months

期刊介绍： Addiction publishes peer-reviewed research reports on pharmacological and behavioural addictions, bringing together research conducted within many different disciplines. Its goal is to serve international and interdisciplinary scientific and clinical communication, to strengthen links between science and policy, and to stimulate and enhance the quality of debate. We seek submissions that are not only technically competent but are also original and contain information or ideas of fresh interest to our international readership. We seek to serve low- and middle-income (LAMI) countries as well as more economically developed countries. Addiction’s scope spans human experimental, epidemiological, social science, historical, clinical and policy research relating to addiction, primarily but not exclusively in the areas of psychoactive substance use and/or gambling. In addition to original research, the journal features editorials, commentaries, reviews, letters, and book reviews.