Ingmar H.A. Franken

A Meta-Analytic Investigation of the Relationship between Attentional Bias and Subjective Craving in Substance Abuse.

Theoretical models of addiction suggest that attentional bias for substance-related cues should be associated with self-reported craving. The authors evaluated the strength of the association by performing a meta-analysis on 68 independent data sets from which correlation coefficients between subjective craving and attentional bias indices were derived. Additional stratified analyses were conducted to identify any variables that might moderate the association between craving and attentional bias. The primary meta-analysis indicated a significant, albeit weak (r=.19), association between attentional bias and craving. Stratified analyses revealed that the association was larger for illicit drug and caffeine craving than for alcohol and tobacco craving, larger for direct measures of attention (eye movement measures and event-related potential measures) than for indirect behavioral measures of attentional bias, and larger when craving strength was high than when it was low (all ps<.05). The size of the correlation did not differ among patients in treatment and individuals who were not seeking treatment. These results suggest that attentional bias and craving are related phenomena, although the relationship is generally modest and appears to be moderated by various factors. Theoretical implications are discussed.

Differences in attention to food and food intake between overweight/obese and normal-weight females under conditions of hunger and satiety.

Starting from an addiction model of obesity, the present study examined differences in attention for food-related stimuli and food intake between overweight/obese and normal-weight women under conditions of hunger and satiety. Twenty-six overweight/obese (BMI: 30.00+/-4.62) and 40 normal-weight (BMI: 20.63+/-1.14) females were randomly assigned to a condition of hunger or satiety. Three indexes of attention were employed, all including pictures of food items: an eye-tracking paradigm (gaze direction and duration), a visual probe task (reaction times), and a recording of electrophysiological brain activity (amplitude of the P300 event-related potential). In addition, the acute food intake of participants was assessed using a bogus taste task. In general, an attentional bias towards food pictures was found in all participants. No differences between groups or conditions were observed in the eye-tracking data. The visual probe task revealed an enhanced automatic orientation towards food cues in hungry versus satiated, and in overweight/obese versus normal-weight individuals, but no differences between groups or conditions in maintained attention. The P300 amplitude showed that only in normal-weight participants the intentional allocation of attention to food pictures was enhanced in hunger versus satiety. In hungry overweight/obese participants, the P300 bias for food pictures was not clearly present, although an increased food intake was observed especially in this group. In conclusion, various attention-related tasks yielded various results, suggesting that they measure different underlying processes. Strikingly, overweight/obese individuals appear to automatically direct their attention to food-related stimuli, to a greater extent than normal-weight individuals, particularly when food-deprived. Speculatively, hungry overweight/obese individuals also appear to use cognitive strategies to reduce a maintained attentional bias for food stimuli, perhaps in an attempt to prevent disinhibited food intake. However, in order to draw firm conclusions, replication studies are needed.

Individual differences in reward sensitivity are related to food craving and relative body weight in healthy women

According to the theory of J.A. Gray, a strongly reactive approach system is highly sensitive to reward or to cues that signal reward. This implies that intake driven by the rewarding properties of food should be affected by individual differences in reactivity of the approach system. The present study examined whether reward sensitivity is associated with food craving and relative body weight in a sample of female college students. Participants completed the Sensitivity to Punishment and Sensitivity to Reward Questionnaire and the trait version of the Food Craving Questionnaire and also reported their weight and height in order to compute Body Mass Index (BMI). Sensitivity to reward was significantly related to food craving and BMI. Furthermore, the correlation between reward sensitivity and BMI was not attenuated when the influence of food craving was partialled out, indicating that the relation between sensitivity to reward and BMI was not mediated by food craving. This is the first study demonstrating a relation between the personality trait of sensitivity to reward and BMI. These findings are discussed in the context of the involvement of dopaminergic reward circuitry in overeating.

Selective cognitive processing of drug cues in heroin dependence

Previous studies provide evidence for the selective processing of disorder related stimuli on anxiety, depression, and eating disorders. There exist some preliminary indications that selective processing of drug cues may be involved in drug craving and relapse that deserve further investigation. In order to investigate the role of processing bias in an abnormal motivational system, the attentional bias for drug related stimuli was studied in a heroin dependent population. Heroin dependent participants (n = 21) and control participants (n= 30) performed a supra- and subliminal heroin Stroop task and heroin craving was assessed. Heroin dependent participants showed a considerable attentional bias for supraliminally presented heroin cues. However, there was no evidence for a preattentive bias on the subliminal presented cues. Reaction time on heroin cues was significantly predicted by heroin craving-levels. Results indicate that selective processing may be related to motivational induced states in general. The finding are discussed in the context of selective information processing in general psychopathology and in motivational processes as addiction specifically.

Impulsivity is associated with behavioral decision-making deficits

Impaired decision-making is a key-feature of many neuropsychiatric disorders. In the present study, we examined task performance in a healthy population consisting of those whose scores indicated high and low impulsivity on several behavioral decision-making tasks reflecting orbitofrontal functioning. The measures included tasks that assess decision-making with and without a learning component and choice flexibility. The results show that subjects high on impulsivity display an overall deficit in their decision-making performance as compared with subjects low on impulsivity. More specifically, subjects with high impulsivity show weaknesses in learning of reward and punishment associations in order to make appropriate decisions (reversal-learning task and Iowa Gambling Task), and impaired adaptation of choice behavior according to changes in stimulus-reward contingencies (reversal-learning task). Simple, non-learning, components of reward- and punishment-based decision-making (Rogers Decision-Making Task) seem to be relatively unaffected. Above all, the results indicate that impulsivity is associated with a decreased ability to alter choice behavior in response to fluctuations in reward contingency. The findings add further evidence to the notion that trait impulsivity is associated with decision-making, a function of the orbitofrontal cortex.

Behavioral approach system (BAS) sensitivity predicts alcohol craving

In typical cue reactivity paradigms there are large individual differences found in subjective alcohol craving. Despite the fact that this is observed in many studies, research on the relation between craving and personality is scarce. In the present study the relation between sensitivity on Grays personality dimensions (behavioral inhibition and behavioral approach systems) and cue elicited craving was studied. It was found that Behavioural Approach System (BAS) sensitivity was related to both desire and negative reinforcement aspects of alcohol craving, and that drinking history was related to both control and negative reinforcement aspects of craving. Subjects with high BAS-drive scores experienced significantly more strong desires, intentions to drink alcohol, and negative reinforcement craving during exposure to alcohol related cues than subjects with low BAS-drive scores. The findings are supportive for the personality theory of J.A. Gray, that predicts that high BAS activity is positively correlated with increased desire for alcohol drinking.

Initial validation of two opiate craving questionnaires: The Obsessive Compulsive Drug Use Scale and the Desires for Drug Questionnaire

In the present study, the factor structure, internal consistency, and the concurrent validity of two heroin craving questionnaires are examined. The Desires for Drug Questionnaire (DDQ) measures three factors: desire and intention, negative reinforcement, and control. The Obsessive Compulsive Drug Use Scale (OCDUS) also measures three factors: thoughts about heroin and interference, desire and control, and resistance to thoughts and intention. Subjects were 102 Dutch patients who were currently in treatment for drug dependency. All proposed scales have good reliability and concurrent validity. Implementation of these instruments in both clinical and research field is advocated.

Error-processing deficits in patients with cocaine dependence

Cocaine abuse and addiction can be characterized by a persisting use of cocaine in the face of adverse consequences. In the present study we focus on one specific element of adverse consequences: the making of errors. The aim of this study was to determine whether cocaine-dependent persons have error-processing deficits as measured using error-related negativity (ERN) and error positivity (Pe). Event-related potentials (ERPs) during an Eriksen flanker task were recorded from cocaine-dependent patients and a control group. Cocaine-addicted patients showed reduced ERN and Pe components as compared to a control group. On the behavioral level, patients showed reduced post-error accuracy improvement. The present findings reveal that cocaine addiction is associated with reduced error processing and impaired behavioral correction of errors after an error is made. These deficits may be associated with a compromised dopamine system. It is argued that these cognitive deficits may contribute to the maintenance of the cocaine addiction.

Neurophysiological evidence for abnormal cognitive processing of drug cues in heroin dependence

RationaleRecent studies provide evidence for specific aspects of cue processing in addictive disorders.ObjectiveThe present study employs event related potentials (ERPs) to investigate heroin related visual information processingMethodsNeutral and heroin related pictures were presented to 19 male abstinent heroin dependent patients and 14 male healthy controls.ResultsPatients exhibited larger slow positive wave (SPW) components of the ERP on heroin related pictures than on neutral pictures. Within healthy control subjects there was no difference on the SPW between neutral and heroin pictures. Within heroin dependent patients, mean SPW response to heroin pictures was correlated with post-experiment craving.ConclusionThis study provides neurophysiological evidence that information processing of drug-related information is abnormal in heroin dependent patients. The results provide further evidence for the cognitive and neurobiological accounts of substance dependence such as the incentive-sensitization theory.

The modified Trait and State Food-Cravings Questionnaires : Development and validation of a general index of food craving

In the present study, the multidimensional Trait and State Food Cravings Questionnaires (FCQ-T and FCQ-S), as developed by Cepeda-Benito, Gleaves, Williams, and Erath, [2000. The development and validation of the State and Trait Food Cravings Questionnaires. Behavior Therapy, 31, 151-173], were modified in order to construct an index of general food craving instead of specific food craving. The factor structure, validity and reliability of the modified questionnaires, renamed as the Trait and State General Food Cravings Questionnaires (G-FCQ-T and G-FCQ-S), were investigated in three separate studies. Firstly, exploratory factor analyses were conducted, which yielded a G-FCQ-T with a four-factor structure, that was considerably shorter as compared to the original (nine-factor) FCQ-T, and a G-FCQ-S of which the factor structure was highly comparable to the original FCQ-S. Secondly, in an attempt to replicate the factor structures of the G-FCQ-T and the G-FCQ-S as found in Study 1, confirmative factor analyses were performed. Results indicated adequate fits for both questionnaires. In addition, the test-retest reliability of both versions was satisfactory and an analysis of the construct validity generally revealed the expected results. In Study 3, the validity of the state version of the G-FCQ was further investigated by relating scores on this questionnaire to indices of food deprivation and satiation. Results indicated that the G-FCQ-S indeed measures food craving as a variable state, which is influenced by situational and temporal variables. Altogether, it can be concluded that the G-FCQ-T and G-FCQ-S are both reliable and valid measures of general trait-like and state-dependent food craving.