Attentional re-training decreases attentional bias in heavy drinkers without generalization.

AIMS: To examine whether alcohol-related attentional bias (AB) can be reduced by training heavy drinkers to attend to soft drinks as an alternative to alcohol. Diminishing AB is important because AB has been suggested to be a significant factor in the development, maintenance and relapse of addictive behaviours. AB was trained in a clinically relevant design, and we studied the generalization of this training. DESIGN, PARTICIPANTS AND INTERVENTION: We assigned randomly 106 heavy drinking male college and university students to the attentional re-training (AR; modified visual-probe task) or control condition (standard visual-probe task). SETTING: Laboratory at Maastricht University. MEASUREMENTS: We measured the effects of AR on the visual-probe task with stimuli that were presented in the AR and with new stimuli, and on an alternative measure of AB, the flicker paradigm. We further measured effects on craving and preference for either an alcohol beverage or a soft drink. FINDINGS: After AR, participants had learned to avoid alcohol stimuli and had developed an AB for soft drinks. This effect was restricted to stimuli used in the AR. The flicker task, where AB for alcohol was found in both the AR and control groups, was not affected by the AR. No effect was found on craving and the preference task. CONCLUSIONS: Although heavy drinkers can learn to attend selectively to an alternative category for alcohol, a single AR is not sufficient to decrease symptoms of problem drinking.

Heroin-related attentional bias and monthly frequency of heroin use are positively associated in attenders of a harm reduction service.

The relationship between heroin-related attentional bias (AB) and a proxy for dependence severity (monthly frequency of heroin use-injecting or inhaling) was measured in individuals attending a heroin harm reduction service. A flicker change blindness paradigm was employed in which change detection latencies were measured to either a heroin-related or to a neutral change made to a stimulus array containing an equal number of heroin-related and neutral words. Individuals given the heroin-related change to detect showed a positive relationship between heroin-related AB and the proxy for dependence severity; those given the neutral change showed a negative relationship. Both findings complement each other--and are consistent with the sending of more attention to heroin-related stimuli than neutral, the more severe is the dependence.

Alcohol-related attentional bias in problem drinkers with the flicker change blindness paradigm.

The authors used a flicker paradigm for inducing change blindness as a more direct method of measuring attentional bias in problem drinkers in treatment than the previously used, modified Stroop, Posner, and dual-task paradigms. First, in an artificially constructed visual scene comprising digitized photographs of real alcohol-related and neutral objects, problem drinkers detected a change made to an alcohol-related object more quickly than to a neutral object. Age- and gender-matched social drinkers showed no such difference. Second, problem drinkers given the alcohol-related change to detect showed a negative correlation between the speed with which the change was detected and the problem severity as measured by the number of times previously treated. Coupled with other data from heavy and light social drinkers, the data support a graded continuity of attentional bias underpinning the length of the consumption continuum.

Sleep-related attentional bias in good, moderate, and poor (primary insomnia) sleepers.

Evidence was sought of an attentional bias toward a highly representative object of the bedroom environment in good, moderate, and poor (primary insomnia) sleepers. Using a flicker paradigm for inducing change blindness, the authors briefly presented a single scene comprising a group of bedroom environment and neutral objects to participants and then briefly replaced this scene with an identical scene containing a change made to either a bedroom environment or a neutral object. In a 3 x 2 entirely between-participants design, change-detection latencies revealed a sleep-related attentional bias in poor sleepers but not in good sleepers. A possible bias in moderate sleepers was also revealed. It is suggested that attentional bias has a role in the perpetuation and possibly precipitation of primary insomnia.

A pictorial Stroop paradigm reveals an alcohol attentional bias in heavier compared to lighter social drinkers.

The findings obtained with the textual Stroop paradigm, testing for an attentional bias towards alcohol stimuli in heavier compared to lighter social drinkers, are limited in number and inconsistent in outcome. Using a pictorial rather than textual Stroop paradigm for the first time in alcohol research, a significant alcohol attentional bias is reported in heavier social drinkers compared to lighter social drinking controls. According to Cohen's scheme, the signifant effect size is classified as 'large'. The presence of an alcohol attentional bias helps to explain the perpetuation of abusive/dependent consumption and the frequency of post-treatment relapse. In a similar vein, these results add to the evidence that a differential alcohol attentional bias might also be present between two levels of social drinking and, in heavier social drinkers, has the potential to impact on the contents of awareness and the flow of thought towards alcohol. In this respect, it extends the small group of other perceptual-cognitive effects measured in social drinkers (alcohol cue reactions, alcohol associations and alcohol expectancies) that can influence the initiation of consumption in some social drinkers.

Negative alcohol consumption outcome associations in young and mature adult social drinkers: a route to drinking restraint?

Alcohol 'cognitions' were explored using an implicit methodology [Stacy, Leigh and Weingardt, 1994]. In Study 1, an Associations Questionnaire was developed with young adult undergraduates (median=20 years) comprising culturally available (i.e., high-frequency occurrence) and idiosyncratic (i.e., low-frequency occurrence) positive and negative alcohol consumption outcomes and positive and negative outcomes of behaviors-other-than-alcohol consumption. In Study 2, the relationship was explored between the alcohol consumption of young adult undergraduates (median age = 19 years) and implicit alcohol-related associations made through the Associations Questionnaire. A significant positive relationship was found between consumption and positive and negative culturally available (experimental) outcomes but not for the other two types of (control) outcome. In Study 3, the relationship between alcohol consumption and alcohol-related associations was explored in mature adults (median = 45 years) with many more years' drinking experience. The results of Study 1 were replicated except that a significant positive relationship between consumption and some control outcomes was now found--e.g., negative outcomes of what where hitherto behaviors-other-than-alcohol consumption. In Study 4, however, using the same techniques that were used to develop the Associations Questionnaire in Study 1, an extended set of negative alcohol consumption outcomes was found in mature adults (median = 44 years) that included a proportion of the negative outcomes of behaviors-other-than-alcohol consumption that had served as controls in Studies 2 and 3. A reanalysis of the data from Study 3, with such items removed from the controls and designated 'new' negative alcohol consumption outcomes, showed a positive relationship between consumption and implicit alcohol-related associations made through these 'new' items of the Associations Questionnaire. The changing profile of associations with negative outcomes of consumption is discussed and related to negative expectancy research and drinking restraint.

Alcohol consumption increases attractiveness ratings of opposite-sex faces: a possible third route to risky sex.

AIMS: To measure the effect of moderate alcohol consumption on males' and females' attractiveness ratings of unfamiliar male and female faces. PARTICIPANTS: Eighty undergraduate volunteers were used in each of three experiments. DESIGN: Participants' ratings on a 1-7 scale was the dependent variable. A three-factor mixed design was used. For experiments 1 and 2: one within-factor, sex-of-face to be rated (male/female); two between-factors, sex-of-rater (male/female) and alcohol status of rater (0 UK units/1-6 UK units). For experiment 3, the two levels of sex-of-face were replaced by two levels of a non-face object. In experiment 1, the faces were rated for attractiveness; in experiment 2, the faces were rated for distinctiveness and in experiment 3, the non-face objects were rated for attractiveness. SETTING: Quiet, prepared corners of bars and licensed eating areas on a civic university campus. METHOD: For each experiment, 118 full-colour photographic images were presented randomly on a laptop computer screen, each remaining until a rating response was made. FINDINGS: There was a significant alcohol consumption enhancement effect only for attractiveness ratings of opposite-sex faces in experiment 1. This indicates that the opposite-sex enhancement effect is not due simply to alcohol consumption causing the use of higher points of ratings scales, in general. CONCLUSION: Since Agocha & Cooper have shown that the likelihood of intentions to engage in risky sex increases as the facial attractiveness of the potential sexual partner increases, through the opposite-sex enhancement effect we identify a new possible link between risky sex and alcohol consumption.

Changing expectancies: cognitive mechanisms and context effects.

This article presents the proceedings of a symposium at the 2002 RSA Meeting in San Francisco, organized by Reinout W. Wiers and Mark D. Wood. The symposium combined two topics of recent interest in studies of alcohol expectancies: cognitive mechanisms in expectancy challenge studies, and context-related changes of expectancies. With increasing recognition of the substantial role played by alcohol expectancies in drinking, investigators have begun to develop and evaluate expectancy challenge procedures as a potentially promising new prevention strategy. The two major issues addressed in the symposium were whether expectancy challenges result in changes in expectancies that mediate intervention (outcome relations), and the influence of simulated bar environments ("bar labs," in which challenges are usually done) on expectancies. The presentations were (1) An introduction, by Jack Darkes; (2) Investigating the utility of alcohol expectancy challenge with heavy drinking college students, by Mark D. Wood; (3) Effects of an expectancy challenge on implicit and explicit expectancies and drinking, by Reinout W. Wiers; (4) Effects of graphic feedback and simulated bar assessments on alcohol expectancies and consumption, by William R. Corbin; (5) Implicit alcohol associations and context, by Barry T Jones; and (6) A discussion by Kenneth J. Sher, who pointed out that it is important not only to study changes of expectancies in the paradigm of an expectancy challenge but also to consider the role of changing expectancies in natural development and in treatments not explicitly aimed at changing expectancies.

A flicker paradigm for inducing change blindness reveals alcohol and cannabis information processing biases in social users.

AIM: To apply a new paradigm using transient changes to visual scenes to explore information processing biases relating to "social" levels of alcohol and cannabis use. PARTICIPANTS: Male and female student volunteers (n = 200) not self-reporting substance-related problems. SETTING: Quiet testing areas throughout the university campus. DESIGN: A flicker paradigm, for inducing change blindness with lighter and heavier social users of alcohol (experiment 1, n= 100) and social users and non-users of cannabis (experiment 2, n= 100), explored the associations between habitual level of use and the latency to detection of a single substance-related or neutral change made to a scene of grouped substance-related and neutral objects. MEASUREMENTS: Alcohol use was measured as the number of units of the heaviest drinking day from the previous week; cannabis use as the number of months of use in previous 12. Change-detection latency comparisons were used to evaluate processing biases. FINDINGS: In both experiments, (i) heavier social users detected substance-related changes quicker than lighter and non-users; (ii) lighter and non-users detected substance-neutral changes quicker than heavier users; (iii) heavier social users detected substance-related quicker than substance-neutral changes; and (iv) lighter and non-users detected substance-neutral changes quicker than substance-related changes. CONCLUSIONS: Alcohol and cannabis processing biases are found at levels of social use, have the potential to influence future consumption and for this reason merit further research.

Social users of alcohol and cannabis who detect substance-related changes in a change blindness paradigm report higher levels of use than those detecting substance-neutral changes.

RATIONALE: Understanding the cognitions underpinning substance use has stalled using the Stroop paradigm. OBJECTIVE: To employ a novel version of the flicker paradigm for induced change blindness to independently compare information processing biases in social users of alcohol and cannabis. METHOD: Alcohol and cannabis experiments were independently run. In both, participants were asked to view successively and repeatedly on a monitor two versions of a visual scene (an original and a slightly changed version) until the change was detected. In fact, in both experiments two simultaneous changes competed for detection: a substance-neutral and a substance-related change. RESULTS: In both the alcohol and the cannabis experiments, participants detecting the substance-related change reported higher levels of use than those detecting the substance-neutral change. CONCLUSION: A substance-related processing bias was independently revealed for both substances. The utility of the flicker paradigm for substance use research is demonstrated as sensitive and quick to administer (taking only 1 min).