Craving is everything: An eye-tracking exploration of attentional bias in binge drinking

Abstract

Background: Attentional bias towards alcohol-related stimuli is a core characteristic of severe alcohol use disorders (AUD), directly linked to clinical variables (e.g. alcohol consumption, relapse). Nevertheless, the extent of this bias in subclinical populations remains poorly documented. This is particularly true for binge drinking, an alcohol consumption pattern highly prevalent in youth, characterised by an alternation between excessive intakes and withdrawal periods. Aims: We used eye-tracking to: (a) measure attentional bias in binge drinking, (b) determine its time course by dissociating early/late processing stages, (c) clarify its specificity for alcohol-related stimuli compared to other appetitive stimulations and (d) explore its modulation by current craving intensity. Methods: Binge drinkers ( n=42) and matched controls ( n=43) performed a visual probe task, requiring visual targets preceded by pairs of pictures to be processed, with three conditions (i.e. alcohol vs. soft drink, alcohol vs. high-calorie food, high-calorie food vs. low-calorie food). Results: No group difference was observed for early processing (i.e. first area of interest visited). Dwell times highlighted a bias towards soft drinks and healthy food among controls, without any global bias towards alcohol in binge drinkers. Centrally, a comparison of binge drinkers with low versus high current craving intensity indicated that binge drinking was associated with a bias towards alcohol and high-calorie food only in the presence of a high craving towards these stimuli. Conclusion: Attentional bias towards alcohol reported in severe AUD is only found in binge drinkers in the presence of high craving and is generalised to other appetitive cues.

Alcohol-related attentional biases in recently detoxified inpatients with severe alcohol use disorder: an eye-tracking approach

“…Both measures (second fixation direction, dwell time) provided excellent reliability (internal consistency, split-half reliability). Eye-tracking indexes thus highly increase VPT reliability (Bollen et al, 2020;Christiansen et al, 2015b), these sound results suggesting that detoxified inpatients present avoidance AB at later processing stages.…”

“…untreated individuals) but the opposite pattern observed here among recently detoxified patients invalidates the proposal of consistent and stable AB in AUD. Previous findings in subclinical populations suggested that AB fluctuate alongside motivational states related to subjective craving (Bollen et al, 2020), stress (Field and Quigley, 2009) or ambivalence (Lee et al, 2014). Similarly, currently drinking patients with AUD presented reaction time-based AB towards alcohol, while abstinent patients rather showed avoidance AB (Sinclair et al, 2016).…”

“…bottle of water) without context, extracted from the validated Amsterdam Beverage Picture Set (ABPS; Pronk et al, 2015), were displayed on a black background. The picture sets were identical to those used in Bollen et al (2020). Brands and writings were blurred to avoid reading and each picture pair was matched on color, size (444 × 444 pixels or 10.7 × 10.7 • angle), brightness, and salience.…”

“…The visual probe task procedure was identical to the one used in Bollen et al (2020). Each trial started with a central fixation dot on a black background and participants had to fixate their gaze on it.…”

“…Combining traditional paradigms with eye-tracking would thus clarify the spatial and temporal dynamics of AB, improving their measure's reliability (Christiansen et al, 2015b). Studies assessing AB in subclinical populations through combined VPT/eye-tracking (Maurage et al, 2020 for a review) showed that eye-tracking indexes are more reliable than reaction times (Christiansen et al, 2015b), and suggested the presence of alcohol-related AB in these populations (Fernie et al, 2012;Miller and Fillmore, 2010;Weafer and Fillmore, 2013), particularly under alcohol intoxication (Schoenmakers et al, 2008) or high craving (Bollen et al, 2020). These results were mostly observed at the late and controlled stages of attentional processing (i.e.…”