Katherine R. Marks

Fixation time is a sensitive measure of cocaine cue attentional bias

BACKGROUND AND AIMS Attentional bias has been demonstrated to a variety of substances. Evidence suggests that fixation time is a more direct measure of attentional bias than response time. The aims of this experiment were to demonstrate that fixation time during the visual probe task is a sensitive and stable measure of cocaine cue attentional bias in cocaine-using adults compared to controls. DESIGN A between-subject, repeated-measures experiment. SETTING An out-patient research unit. PARTICIPANTS Fifteen cocaine using and 15 non-cocaine-using adults recruited from the community. MEASUREMENTS Participants completed a visual probe task with eye tracking and a modified Stroop during two experimental sessions. FINDINGS A significant interaction between cue type and group (F = 13.5; P < 0.05) indicated that cocaine users, but not controls, displayed an attentional bias to cocaine-related images as measured by fixation time. There were no changes in the magnitude of attentional bias across sessions (F = 3.4; P > 0.05) and attentional bias correlated with self-reported life-time cocaine use (r = 0.64, P < 0.05). Response time on the visual probe (F = 1.1; P > 0.05) as well as on the modified Stroop (F = 0.1; P > 0.05) failed to detect an attentional bias. CONCLUSIONS Fixation time on cocaine-related stimuli (propensity to remain focused on the stimulus) is a sensitive and stable measure of cocaine cue attentional bias in cocaine-using adults.

Test-retest reliability of eye tracking during the visual probe task in cocaine-using adults.

BACKGROUND Stimuli associated with cocaine use capture attention. Evidence suggests that fixation time measured on the visual probe task is a valid measure of cocaine cue attentional bias. The aim of this experiment was to demonstrate the test-retest reliability of cocaine cue attentional bias as measured by fixation time during the visual probe task. METHODS In a within-subject, repeated-measures design, thirty-six non-treatment seeking cocaine-using adults completed a visual probe task with eye tracking. RESULTS Participants displayed an attentional bias to cocaine-related images as measured by fixation time across two occasions (F (1, 35) = 56.5, p < 0.0001). A Pearson correlation indicated significant test-retest reliability for this effect (r = 0.51, p = 0.001). Response time failed to detect an attentional bias and test-retest reliability was low (r = 0.24, p = 0.16). CONCLUSION Fixation time during the visual probe task is a reliable measure of cocaine cue attentional bias in cocaine-using adults across time.

The Magnitude of Drug Attentional Bias Is Specific to Substance Use Disorder

The visual probe task with eye tracking is a sensitive measure of cocaine and alcohol cue attentional bias. Despite the high comorbidity between cocaine and alcohol dependence, attentional bias studies have examined the influence of cocaine- and alcohol-related cues separately. The aim of this experiment was to directly compare the magnitude of cocaine and alcohol cue attentional bias in individuals dependent on cocaine or cocaine and alcohol. Individuals who met criteria for cocaine dependence (n = 20) or both cocaine and alcohol dependence (n = 20) completed a visual probe task with eye tracking. Cocaine-dependent participants displayed an attentional bias toward cocaine, but not alcohol. In contrast, cocaine-alcohol dependent participants displayed an attentional bias to both cocaine and alcohol, and the magnitude of these biases did not differ. The magnitude of cocaine cue attentional bias, however, was significantly smaller in the cocaine-alcohol dependent group compared to the cocaine-dependent group. These results suggest that fixation time during the visual probe task is sensitive to clinically relevant differences in substance use disorders. The incentive value of cocaine-related cues, however, may differ for individuals who are also dependent on alcohol.

Separate and Combined Effects of Naltrexone and Extended-Release Alprazolam on the Reinforcing, Subject-Rated, and Cardiovascular Effects of Methamphetamine.

Abstract Opioid antagonists (eg, naltrexone) and positive modulators of &ggr;-aminobutyric acid type A receptors (eg, alprazolam) each modestly attenuate the abuse-related effects of stimulants. A previous study demonstrated that acute pretreatment with the combination of naltrexone and alprazolam attenuated a greater number of the subject-rated effects of D-amphetamine than the constituent drugs alone. This study tested the hypothesis that maintenance on the combination of naltrexone and alprazolam XR would attenuate the reinforcing and “positive” subject-rated effects of methamphetamine to a greater extent than the constituent drugs alone. Eight non–treatment-seeking, stimulant-using individuals completed a placebo-controlled, crossover, double-blind inpatient protocol. Participants were maintained on naltrexone (0 and 50 mg), alprazolam XR (0 and 1 mg), and the combination of naltrexone and alprazolam XR (50 mg and 1 mg, respectively) for 6 to 7 days. Under each maintenance condition, participants sampled intranasal doses of methamphetamine (0, 10, and 30 mg), and were then offered the opportunity to work for the sampled dose on a modified progressive-ratio procedure. Subject-rated drug effect questionnaires, psychomotor, and physiology assessments were collected. Intranasal methamphetamine functioned as a reinforcer and produced prototypical stimulant-like “positive” subject-rated and physiological effects. Maintenance on naltrexone significantly decreased the reinforcing, but not subject-rated drug effects of 10-mg methamphetamine. Alprazolam XR and the combination of naltrexone and alprazolam XR did not impact methamphetamine self-administration or subject-rated drug effects. The results support the continued evaluation of naltrexone for methamphetamine dependence, as well as the identification of other drugs that enhance its ability to reduce drug-taking behavior.

Cocaine-related stimuli impair inhibitory control in cocaine users following short stimulus onset asynchronies

BACKGROUND AND AIMS Cocaine users display a significant increase in inhibitory failures following cocaine-related images compared with neutral images in a modified cued Go/No-Go task, the Attentional Bias-Behavioral Activation (ABBA) task. The aim of this study was to demonstrate that stimulus onset asynchrony (SOA) impacts inhibitory failures on the ABBA task. DESIGN A between-subjects experiment. SETTING An out-patient research unit in the United States. PARTICIPANTS Ninety-one cocaine users recruited from the community. MEASUREMENTS Participants were assigned to groups in which they saw either cocaine (n=46) or neutral (n=45) images as the go condition. Cues were presented for one of five SOAs (i.e. 100, 200, 300, 400 or 500 ms) before a go or no-go target was displayed. FINDINGS Participants in the cocaine go condition had a significantly higher proportion of inhibitory failures to no-go targets (F4,356=2.50, P=0.04) with significantly more inhibitory failures following all SOAs (P<0.05) than those in the neutral go condition. Within the cocaine go condition, significantly more inhibitory failures were observed following the 100 and 200 ms SOAs than after the 300, 400 or 500 ms SOAs (P<0.05). CONCLUSIONS Cocaine-related stimuli appear to decrease inhibitory control in cocaine users at short (100 and 200 ms) stimulus onset asynchronies (SOAs: the amount of time between the start of one stimulus and the start of another stimulus), but not at longer (300, 400 and 500 ms) SOAs.

Alcohol Administration Increases Cocaine Craving But Not Cocaine Cue Attentional Bias.

BACKGROUND Alcohol consumption is a known antecedent to cocaine relapse. Through associative conditioning, it is hypothesized that alcohol increases incentive motivation for cocaine and thus the salience of cocaine-related cues, which are important in maintaining drug-taking behavior. Cocaine-using individuals display a robust cocaine cue attentional bias as measured by fixation time during the visual probe task. The purpose of this study was to evaluate the influence of alcohol administration on cocaine cue attentional bias using eye-tracking technology to directly measure attentional allocation. METHODS Twenty current cocaine users completed a double-blind, placebo-controlled, within-subjects study that tested the effect of 3 doses of alcohol (0.00, 0.325, and 0.65 g/kg) on cocaine cue attentional bias using the visual probe task with eye-tracking technology. The participant-rated and physiological effects of alcohol were also assessed. RESULTS Participants displayed a robust cocaine cue attentional bias following both placebo and alcohol administration as measured by fixation time, but not response time. Alcohol administration did not influence cocaine cue attentional bias, but increased craving for cocaine in a dose-dependent manner. Alcohol produced prototypic psychomotor and participant-rated effects. CONCLUSIONS Alcohol administration increases cocaine craving but not cocaine cue attentional bias. Alcohol-induced cocaine craving suggests that alcohol increases incentive motivation for cocaine but not the salience of cocaine-related cues.

Cigarette Cue Attentional Bias in Cocaine-Smoking and Non-Cocaine-Using Cigarette Smokers

INTRODUCTION Cigarette smoking in cocaine users is nearly four times higher than the national prevalence and cocaine use increases cigarette smoking. The mechanisms underlying cigarette smoking in cocaine-using individuals need to be identified to promote cigarette and cocaine abstinence. Previous studies have examined the salience of cigarette and cocaine cues separately. The present aim was to determine whether cigarette attentional bias (AB) is higher in cigarettes smokers who smoke cocaine relative to individuals who only smoke cigarettes. METHODS Twenty cigarette smokers who smoke cocaine and 20 non-cocaine-using cigarette smokers completed a visual probe task with eye-tracking technology. During this task, the magnitude of cigarette and cocaine AB was assessed through orienting bias, fixation time, and response time. RESULTS Cocaine users displayed an orienting bias towards cigarette cues. Cocaine users also endorsed a more urgent desire to smoke to relieve negative affect associated with cigarette craving than non-cocaine users (g = 0.6). Neither group displayed a cigarette AB, as measured by fixation time. Cocaine users, but not non-cocaine users, displayed a cocaine AB as measured by orienting bias (g = 2.0) and fixation time (g = 1.2). There were no significant effects for response time data. CONCLUSIONS Cocaine-smoking cigarettes smokers display an initial orienting bias toward cigarette cues, but not sustained cigarette AB. The incentive motivation underlying cigarette smoking also differs. Cocaine smokers report more urgent desire to smoke to relieve negative affect. Identifying differences in motivation to smoke cigarettes may provide new treatment targets for cigarette and cocaine use disorders. IMPLICATIONS These results suggest that cocaine-smoking cigarette smokers display an initial orienting bias towards cigarette cues, but not sustained attention towards cigarette cues, relative to non-cocaine-using smokers. Smoked cocaine users also report a more urgent desire to smoke to relieve negative affect than non-cocaine users. Identifying differences in motivation to smoke cigarettes may provide new treatment targets for both cigarette and cocaine use disorders.

The Telescoping Phenomenon: Origins in Gender Bias and Implications for Contemporary Scientific Inquiry

ABSTRACT Background: In an article published in International Journal of the Addictions in 1989, Nick Piazza and his coauthors described “telescoping,” an accelerated progression through “landmark symptoms” of alcoholism, among a sample of recovering women. Objectives: The aim of this critical analysis is to apply a feminist philosophy of science to examine the origins of the framework of telescoping research and its implications for contemporary scientific inquiry. Methods: A feminist philosophy of science framework is outlined and applied to key source publications of telescoping literature drawn from international and United States-based peer-reviewed journals published beginning in 1952. Results: A feminist philosophy of science framework identifies gender bias in telescoping research in three ways. First, gender bias was present in the early conventions that laid the groundwork for telescoping research. Second, a “masculine” framework was present in the methodology guiding telescoping research. Third, gender bias was present in the interpretation of results as evidenced by biased comparative language. Conclusions: Telescoping research contributed to early evidence of critical sex and gender differences helping to usher in womens substance abuse research more broadly. However, it also utilized a “masculine” framework that perpetuated gender bias and limited generative, novel research that can arise from women-focused research and practice. A feminist philosophy of science identifies gender bias in telescoping research and provides an alternative, more productive approach for substance abuse researchers and clinicians.

Contribution of cocaine-related cues to concurrent monetary choice in humans

RationaleTheoretical accounts highlight the importance of drug-related cues for the development and persistence of drug-taking behavior. Few studies have evaluated the ability of spatially contiguous drug cues to bias decisions between two concurrently presented non-drug reinforcers.ObjectiveEvaluate the contribution of spatially contiguous cocaine cues to choice between two concurrently presented monetary reinforcersMethodsParticipants with cocaine use disorder completed a cued concurrent choice task. Two cues (one cocaine and one control image) were presented side-by-side followed by concurrent monetary offers below each image. Concurrent choice was measured for cocaine-side advantageous, equal, and disadvantageous concurrent monetary offers. The primary dependent measure was bias for selecting cocaine-cued monetary reinforcers. Three experiments tested selectivity of cocaine-cued bias in individuals with a cocaine use history (Experiment 1), replication when including additional control trials (Experiment 2), and a potential attentional mechanism evaluated using eye-tracking technology (Experiment 3).ResultsSignificant and robust cocaine-cued bias at equal monetary value was observed in three experiments (mean percent choice = 65–77%) and higher Drug Abuse Screening Test (DAST) scores were associated with greater cocaine-choice bias. These experiments demonstrated that cocaine-cued bias was (1) selective to individuals with a cocaine use history, (2) specific to trials involving a cocaine cue, and (3) partially associated with attentional bias.ConclusionsThese experiments provide evidence that drug-related cues can influence choice and potentially promote maladaptive decision making during concurrent choice events. Future research evaluating prospective associations of drug-cued bias with drug-associated behaviors will help reveal the clinical relevance for substance use disorder.

Recovering to Recovery Among Adolescent Youth

This chapter provides an overview of selected factors related to adolescents recovering from substance use, a framework for thinking about recovering, a critical overview of definitions of adolescent recovery, and factors that can support recovering. Recovering is an active and ongoing engagement in change over time rather than an endpoint and relapse is a part of the recovering process. However, specific recovering definitions and outcomes (e.g., abstinence, personal growth, wellness) for adolescents have not been established. This reflects that lack of research on adolescents more broadly, as well as the broader focus on treatment outcomes rather than long-term recovering outcomes. Recovering supports include recovery community centers, sober living environments, education, transportation, and life-skills development. Recovering support groups and self-help groups are promising practices, but additional data is needed to rise to the level of evidence based. Gender contributes to the risks and resiliencies that impact recovering outcomes, although the effects are complex and variable. As such, recovering supports which are not gender-responsive do not work. For recovering adolescent females, strength-based, trauma-informed recovery support is often indicated. More adolescent-centered research is essential to better understand the unmet needs of recovering adolescent and identify evidence-based recovering supports. Such research needs to be grounded in the experiences of adolescents and validated with instrumentation designed for adolescents.