Attentional bias to alcohol is a well-documented effect whereby drinkers allocate greater visual attention toward alcohol-related stimuli rather than nonappetitive, neutral stimuli. Some recent research has shown that acute administration of alcohol temporarily reduces attentional bias to alcohol cues, possibly because alcohol consumption satiates the motivation to drink. However, the specificity of this effect has not been tested, and so it is unclear whether reduced attentional bias following alcohol is specific to alcohol-related stimuli or whether attention to other appetitive stimuli is also reduced (e.g., food). This study tested the degree to which acute alcohol administration selectively reduced attentional bias to alcohol-related but not to food-related cues in a group of 23 healthy young adults who reported consuming alcohol roughly twice per week. Attentional bias to alcohol-related and food-related cues was tested using visual dot probe tasks following 2 active doses of alcohol, .30 g/kg and .65 g/kg, and a placebo. Results showed that attentional bias, measured as fixation time to stimuli on the visual probe tasks, to alcohol cues declined in a dose-dependent manner, whereas attentional bias to food cues was unaffected by the doses. The evidence suggests that alcohol consumption specifically reduces attentional bias to alcohol-related stimuli whereas bias to other appetitive stimuli remains intact. Evidence that alcohol consumption reduces attentional bias specifically to alcohol cues lends further credibility to the satiation theory and to the utility of attentional bias as an indicator of acute and transient changes in an individual’s motivation to use alcohol.

Attentional bias to alcohol-related stimuli is believed to be an important contributor to the development and maintenance of drug abuse. There is a considerable body of research examining attentional bias, much of which has typically utilized image-display tasks as a means to assess the phenomenon. Little, however, is known about the nature of this bias in an individual’s natural environment. The current study sought to implement a novel approach to assessing attentional bias in vivo. Participants wore portable eye-tracking glasses that recorded video from their point of view and measured fixation time to objects they observed. They entered a room that was designed to represent a recreational setting where both alcohol and non-alcoholic “neutral” beverages were placed along with other stimuli. In two different testing sessions, participants were free to visually explore the room. Participants showed similar fixation times to alcohol and neutral beverages during session 1. Attentional bias to alcoholic beverages was observed in session 2, as fixation time decreased to neutral and but not to alcoholic beverages. The magnitude of attentional bias was positively associated with drinking habits, with heavier drinkers demonstrating a higher degree of bias to alcohol. These findings provide an ecological model of how attentional bias can develop as the net result of attention being sustained to alcoholic stimuli while diminishing to other stimuli over time.

These findings identify multisensory inhibitory signals as a potentially important environmental factor that can reduce the degree to which alcohol disinhibits behavior possibly by intersensory co-activation between the visual and auditory pathways.

Studies of visual attention find that drinkers spend more time attending to images of alcohol-related stimuli compared to neutral images. It is believed that this attentional bias contributes to the maintenance of alcohol use. However, no research has examined the possibility that this bias of visual attention might actually impede the functioning of other modalities, such as the processing of accompanying auditory stimuli. This study aimed to determine if alcohol-related images engender greater sensory dominance than neutral images, such that processing accompanying information from another modality (audition) would be impeded. Drinkers who had an attentional bias to alcohol-related images performed a multisensory perception task that measured how alcohol-related versus neutral visual images affected their ability to detect and respond to simultaneously presented auditory signals. In accord with the hypothesis, compared with neutral images, the presentation of alcohol-related images impaired the ability to detect and respond to auditory signals. Increased dominance of the visual modality was demonstrated by more bimodal targets being misclassified as visual-only targets in the alcohol target condition compared with that of the neutral. Findings suggest that increased processing of alcohol-related stimuli may impede an individual’s ability to encode and interpret information obtained from other sensory modalities.

Obesity is highly prevalent in patients with schizophrenia and, in association with metabolic syndrome, contributes to premature deaths of patients due to cardiovascular disease complications. Moreover, pharmacologic, and behavioral interventions have not stemmed the tide of obesity in schizophrenia. Therefore, novel effective interventions are urgently needed. Repetitive transcranial magnetic stimulation (rTMS) has shown efficacy for inducing weight loss in obese non-psychiatric samples but this promising intervention has not been evaluated as a weight loss intervention in patients with schizophrenia. In this narrative review, we describe three brain mechanisms (hypothalamic inflammation, dysregulated mesocorticolimbic reward system, and impaired prefrontal cortex function) implicated in the pathogenesis and pathophysiology of obesity and emphasize how the three mechanisms have also been implicated in the neurobiology of schizophrenia. We then argue that, based on the three overlapping brain mechanisms in obesity and schizophrenia, rTMS would be effective as a weight loss intervention in patients with schizophrenia and comorbid obesity. We end this review by describing how deep TMS, relative to conventional TMS, could potentially result in larger effect size for weight loss. While this review is mainly conceptual and based on an extrapolation of findings from non-schizophrenia samples, our aim is to stimulate research in the use of rTMS for weight loss in patients with schizophrenia.