Affective impulsivity moderates the relationship between disordered gambling severity and attentional bias in electronic gaming machine (EGM) players.

Background and aims: Attentional bias to gambling-related stimuli is associated with increased severity of gambling disorder. However, the addiction-related moderators of attentional bias among those who gamble are largely unknown. Impulsivity is associated with attentional bias among those who abuse substances, and we hypothesized that impulsivity would moderate the relationship between disordered electronic gaming machine (EGM) gambling and attentional bias. Methods: We tested whether facets of impulsivity, as measured by the UPPS-P (positive urgency, negative urgency, sensation seeking, lack of perseverance, lack of premeditation) and the Barratt Impulsiveness Scale-11 (cognitive, motor, non-planning) moderated the relationship between increased severity of gambling disorder, as measured by the Problem Gambling Severity Index (PGSI), and attentional bias. Seventy-five EGM players participated in a free-viewing eye-tracking paradigm to measure attentional bias to EGM images. Results: Attentional bias was significantly correlated with Barratt Impulsiveness Scale-11 (BIS-11) motor, positive urgency, and negative urgency. Only positive and negative urgency moderated the relationship between PGSI scores and attentional bias. For participants with high PGSI scores, higher positive and negative urgency were associated with larger attentional biases to EGM stimuli. Discussion: The results indicate that affective impulsivity is an important contributor to the association between gambling disorder and attentional bias.

The Effect of Alcohol Cue Exposure on Tobacco-Related Cue Reactivity: A Systematic Review.

AIMS: To examine the effect of alcohol cue exposure on tobacco-related cravings, self-administration and other measures of tobacco-related cue reactivity. METHODS: We searched Medline, PsycINFO, Embase, CINAHL and Scopus from inception to May 2020 for articles reporting on a combination of cue reactivity (and/or cross-cue reactivity), alcohol use and tobacco consumption. A semi-quantitative analysis and study quality assessment were performed for the included articles. RESULTS: A total of 37 articles met our inclusion criteria and were included in the systematic review. Most studies (60%) reported that alcohol cue exposure increased tobacco cravings, but only 18% of studies reported that alcohol cue exposure resulted in an increase in ad libitum smoking. There was also substantial heterogeneity between studies due to differences in methodology related to alcohol cue exposure, measures of tobacco cravings, as well as variable participant and study characteristics. CONCLUSIONS: Alcohol cue exposure can increase cravings for tobacco. This has important implications for individuals who use both substances but are trying to quit one or both.

A systematic review of addiction substitution in recovery: Clinical lore or empirically-based?

This systematic review synthesized the literature examining addiction substitution during recovery from substance use or behavioral addictions. A total of 96 studies were included with sample sizes ranging from 6 to 14,885. The most common recovery addictions were opioids (30.21%), followed by cannabis (20.83%), unspecified use (17.71%), nicotine (12.50%), alcohol (12.50%), cocaine (4.17%), and gambling (2.08%). Statistical results were provided by 70.83% of the studies. Of these, 17.65% found support for addiction substitution, whereas 52.94% found support for concurrent recovery. A total of 19.12% found no statistical changes and 10.29% found both significant increases and decreases. The remaining 29.17% of studies provided descriptive data, without statistical tests. Predictors of addiction substitution were provided by 22.92% of the studies and 11.46% included information on impact of addiction substitution on treatment outcomes. Overall, male gender, younger age, greater substance use severity, and presence of mental health disorders were associated with addiction substitution. Addiction substitution was associated with poorer treatment outcomes. A limitation of the present systematic review is the use of significance counting for the quantitative synthesis. More research examining changes in addiction during recovery would aid in the development of more effective treatments for addictive disorders and prevent addiction substitution.

Gambling-related psychological predictors and moderators of attentional bias among electronic gaming machine players.

Objective: Attentional biases (ABs) have been shown to develop in the context of substance use disorders. Relatively less focus has been paid toward the development of ABs in behavioral addictions such as gambling disorder (GD). Furthermore, the psychological predictors and moderators of AB in GD remain unknown. The present study addressed these empirical gaps. Methods: Fifty-two non-GD electronic gaming machine (EGM) players, 25 GD-EGM players, and 61 non-gamblers completed measures of gambling-related behaviors and cognitions (problem gambling severity, cravings, expectancies, motives) and substance use and mental health (alcohol use severity, depression symptoms). The relationships between these constructs and AB for EGM images were then assessed using a free-viewing eye-tracking paradigm. Results: Non-GD EGM players and GD-EGM players attended to EGM images significantly more than neutral images (with the largest AB for the EGM players with GD). For all EGM players, gambling expectancies regarding the negative emotional impact of gambling and alcohol use severity were associated with greater AB. For non-GD EGM players only, AB was moderated by the anticipation aspect of gambling craving and the self-enhancement aspect of gambling expectancies. Conclusion: The results provide further evidence that ABs develop in the context of excessive gambling and are associated with gambling and psychological variables. The findings support the incentive-salience theory of ABs in gambling and provide a rationale for the development of AB modification programs in the treatment of gambling disorder. Given the predominantly white sample, our results may not generalize to individuals of other ethnicities. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Clinical Utility of Food Addiction: Characteristics and Psychosocial Impairments in a Treatment-Seeking Sample.

Little is known about the characteristics of individuals seeking treatment for food addiction (FA), and the clinical utility of FA has yet to be established. To address these gaps, we examined (i) the demographic, eating pathology, and psychiatric conditions associated with FA and (ii) whether FA is associated with psychosocial impairments when accounting for eating-related and other psychopathology. Forty-six patients seeking treatment for FA completed self-report questionnaires and semi-structured clinical interviews. The majority of the sample were women and self-identified as White, with a mean age of 43 years. Most participants (83.3%) presented with a comorbid psychiatric condition, most commonly anxiety and mood disorders, with a mean of 2.31 comorbid conditions. FA was associated with binge eating severity and anxiety symptoms, as well as psychological, physical, and social impairment. In regression analyses controlling for binge eating severity, food cravings, depression, and anxiety, FA remained a significant predictor only of social impairment. Taken together, the results suggest that individuals seeking treatment for FA are likely to present with significant comorbid conditions, in particular anxiety disorders. The results of the present research provide evidence for the clinical utility of FA, particularly in explaining social impairment.