A Single Session of Attentional Bias Modification Reduces Alcohol Craving and Implicit Measures of Alcohol Bias in Young Adult Drinkers

Abstract

Background Attentional bias modification (ABM) techniques for reducing problematic alcohol consumption hold promise as highly-accessible and cost-effective treatment approaches. A growing body of literature has examined ABM as a potentially efficacious intervention for reducing drinking and drinking-related cognitions in alcohol-dependent individuals as well as those at-risk of developing problem drinking habits. Methods The present study tested the effectiveness of a single session of visual probe-based ABM training in a cohort of 60 non-treatment-seeking young adult drinkers, with a focus on examining mechanisms underlying training efficacy. Participants were randomly assigned to a single session of active ABM training or a sham training condition in a laboratory setting. Measures of implicit drinking-related cognitions (alcohol Stroop and an Implicit Association Test) and attentional bias (alcohol visual probe) were administered, and subjective alcohol craving was reported in response to in-vivo alcohol cues. Results Results showed that active ABM training, relative to sham, resulted in significant differences in measures of implicit alcohol-related cognition, alcohol-related attentional bias, and self-reports of alcohol craving. Mediation analysis showed that reductions in craving were fully mediated by ABM-related reductions in alcohol-Stroop interference scores, suggesting a previously undocumented relationship between the two measures. Conclusion Results document the efficacy of brief ABM to reduce both implicit and explicit processes related to drinking, and highlight the potential intervention-relevance of alcohol-related implicit cognitions in social drinkers.

Alcohol-Specific Computerized Interventions to Alter Cognitive Biases: A Systematic Review of Effects on Experimental Tasks, Drinking Behavior, and Neuronal Activation

“…Research investigating the effects of VPT-AtBM has reported changes in VPT-AtB in the expected direction in young adult drinkers (38), heavy social drinkers (35), heavy drinkers (HD) (10,32,40), and AUD (31). Another study in AUD showed a trend (27), while two studies in AUD (29,30), and one in binge drinkers (36) found no effects.…”

“…the Stroop (10), the flicker (10, 40), the stimulus response task (10), the implicit association task (30) or the visual search task [32)]. Meanwhile, one study found VPT-AtBM to inflict expected changes in both an implicit association task and an alcohol-specific Stroop task (38). Further, two studies reported an effect of AtBM on alcohol approach inclination as measured by an approach-avoidance test (27) or by eye-movements in a free viewing task (37).…”

Failed attempts to improve the reliability of the alcohol visual probe task following empirical recommendations.

“…Several theoretical models of addiction suggest that individuals who drink alcohol demonstrate preferential attention to alcohol-related cues in their environment, at the expense of competing cues (Franken, 2003; Robinson & Berridge, 2001). This preferential attention is often referred to as an “attentional bias.” Meta-analyses have demonstrated a small but robust link between attentional bias and craving (Field, Munafò, & Franken, 2009), and experimental manipulations of attentional bias have directly influenced alcohol consumption/relapse (Field & Eastwood, 2005; Schoenmakers et al, 2010) and craving (Luehring-Jones, Louis, Dennis-Tiwary, & Erblich, 2017) suggesting a possible causal relationship. However, more recently the clinical relevance of attentional bias has been challenged, with suggestions that weak findings are often overinterpreted and “null” findings ignored (Christiansen, Schoenmakers, & Field, 2015).…”

Beyond BASICS: A scoping review of novel intervention content to enhance the efficacy of brief alcohol interventions for emerging adults.

“…This pilot study reported support for feasibility and acceptability of this approach, as well as small between-group and large within-group effect size reductions in DPW in support of the efficacy of a counter-attitudinal advocacy paradigm for brief alcohol interventions. A third intervention employed attentional bias modification (ABM) training (Luehring-Jones et al, 2017) in which participants’ attention was actively drawn toward a neutral image compared to an alcohol-related image. Relative to sham training, participants who received active training reported reduced alcohol craving and this reduction was fully mediated by reductions in measures of implicit biases toward alcohol.…”