Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Systematic Reviews
Published in: Systematic Reviews 1/2018

Open Access 01-12-2018 | Research

The effectiveness of attentional bias modification for substance use disorder symptoms in adults: a systematic review

Authors: Janika Heitmann, Elise C. Bennik, Madelon E. van Hemel-Ruiter, Peter J. de Jong

Published in: Systematic Reviews | Issue 1/2018

Login to get access

Abstract

Background

Attentional bias modification (ABM) interventions have been developed to address addiction by reducing attentional bias for substance-related cues. This study provides a systematic review of the effectiveness of ABM interventions in decreasing symptoms of addictive behaviour, taking baseline levels of attentional bias and changes in attentional bias into account.

Methods

We included randomised and non-randomised studies that investigated the effectiveness of ABM interventions in heavy-using adults and treatment-seeking individuals with symptoms of substance use disorder to manipulate attentional bias and to reduce substance use-related symptoms. We searched for relevant English peer-reviewed articles without any restriction for the year of publication using PsycINFO, PubMed, and ISI Web in August 2016. Study quality was assessed regarding reporting, external validity, internal validity, and power of the study.

Results

Eighteen studies were included: nine studies reported on ABM intervention effects in alcohol use, six studies on nicotine use, and three studies on opiate use. The included studies differed with regard to type of ABM intervention (modified dot probe task n = 14; Alcohol Attention Control Training Programme n = 4), outcome measures, amount and length of provided sessions, and context (clinic versus laboratory versus home environment). The study quality mostly ranged from low average to high average (one study scored below the quality cut-off). Ten studies reported significant changes of symptoms of addictive behaviour, whereas eight studies found no effect of ABM interventions on symptoms. However, when restricted to multi-session ABM intervention studies, eight out of ten studies found effects on symptoms of addiction. Surprisingly, these effects on symptoms of addictive behaviour showed no straightforward relationship with baseline attentional bias and its change from baseline to post-test.

Conclusions

Despite a number of negative findings and the diversity of studies, multi-session ABM interventions, especially in the case of alcohol and when the Alcohol Attention Control Training Programme was used, appear to have positive effects on symptoms of addictive behaviour. However, more rigorous well-powered future research in clinical samples is needed before firm conclusions regarding the effectiveness of ABM interventions can be drawn.

Systematic review registration

Registration number PROSPERO: CRD42016046823
Appendix
Available only for authorised users
Literature
1.
Bernardin F, Maheut-Bosser A, Paille F. Cognitive impairments in alcohol-dependent subjects. Front Psychiatry. 2014;5:78.CrossRef
2.
Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I, Kovess V, Lepine JP, et al. Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA. 2004;291(21):2581–90.CrossRef
3.
Jhanjee S. Evidence based psychosocial interventions in substance use. Indian J Psychol Med. 2014;36(2):112–8.CrossRef
4.
Dutra L, Stathopoulou G, Basden SL, Leyro TM, Powers MG, Otto MW. A meta-analytic review of psychosocial interventions for substance use disorders. Am J Psychiatry. 2008;165(2):179–87.CrossRef
5.
Cutler RB, Fishbain DA. Are alcoholism treatments effective? The Project MATCH data. BMC Public Health. 2005;5:75.CrossRef
6.
Gladwin TE, Figner B. In: Wilhelms EA, Reyna VF, Wilhelms EA, Reyna VF, editors. ‘Hot’ cognition and dual systems: introduction, criticisms, and ways forward. New York, NY: Psychology Press; 2015. p. 157–80.
7.
Wiers RW, Bartholow BD, van dW, Thush C, Engels RCME, Sher KJ, et al. Automatic and controlled processes and the development of addictive behaviors in adolescents: a review and a model. Pharmacol Biochem Behav. 2007;86(2):263–83.CrossRef
8.
Field M, Cox WM. Attentional bias in addictive behaviors: a review of its development, causes, and consequences. Drug Alcohol Depend. 2008;97(1–2):1–20.CrossRef
9.
Sher KJ, Wiers RW, Field M, Stacy AW. Passion’s slave? Conscious and unconscious cognitive processes in alcohol and drug abuse. Oxford Handbook of Substance Use Disorders. Oxford: Oxford University Press; 2014.CrossRef
10.
van Hemel-Ruiter ME, Wiers RW, Brook FG, de Jong PJ. Attentional bias and executive control in treatment-seeking substance-dependent adolescents: a cross-sectional and follow-up study. Drug Alcohol Depend. 2016;159:133–41.CrossRef
11.
MacLeod C, Rutherford E, Campbell L, Ebsworthy G, Holker L. Selective attention and emotional vulnerability: assessing the causal basis of their association through the experimental manipulation of attentional bias. J Abnorm Psychol. 2002;111(1):107–23.CrossRef
12.
MacLeod C, Mathews A, Tata P. Attentional bias in emotional disorders. J Abnorm Psychol. 1986;95(1):15–20.CrossRef
13.
Fadardi JS, Cox WM. Reversing the sequence: reducing alcohol consumption by overcoming alcohol attentional bias. Drug Alcohol Depend. 2009;101(3):137–45.CrossRef
14.
Christiansen P, Schoenmakers TM, Field M. Less than meets the eye: reappraising the clinical relevance of attentional bias in addiction. Addict Behav. 2015;44:43–50.CrossRef
15.
MacLeod C, Grafton B. Anxiety-linked attentional bias and its modification: illustrating the importance of distinguishing processes and procedures in experimental psychopathology research. Behav Res Ther. 2016;86:68–86.CrossRef
16.
Cristea IA, Kok RN, Cuijpers P. The effectiveness of cognitive bias modification interventions for substance addictions: a meta-analysis. PLoS One. 2016;11(9):e0162226.CrossRef
17.
18.
19.
Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52(6):377–84.CrossRef
20.
Deeks JJ, Dinnes J, D’Amico R, Sowden AJ, Sakarovitch C, Song F, et al. Evaluating non-randomised intervention studies. Health Technol Assess. 2003;7(27):1–173.CrossRef
21.
Attwood AS, O’Sullivan H, Leonards U, Mackintosh B, Munafò MR. Attentional bias training and cue reactivity in cigarette smokers. Addiction. 2008;103(11):1875–82.CrossRef
22.
Begh R, Munafo MR, Shiffman S, Ferguson SG, Nichols L, Mohammed MA, et al. Lack of attentional retraining effects in cigarette smokers attempting cessation: a proof of concept double-blind randomised controlled trial. Drug Alcohol Depend. 2015;149:158–65.CrossRef
23.
Elfeddali I, de Vries H, Bolman C, Pronk T, Wiers RW. A randomized controlled trial of web-based attentional bias modification to help smokers quit. Health Psychol 2016;35(8):870–880.CrossRef
24.
Field M, Eastwood B. Experimental manipulation of attentional bias increases the motivation to drink alcohol. Psychopharmacology. 2005;183(3):350–7.CrossRef
25.
Kerst WF, Waters AJ. Attentional retraining administered in the field reduces smokers’ attentional bias and craving. Health Psychol. 2014;33(10):1232–40.CrossRef
26.
Lee S, Lee J. The effect of automatic attentional bias modification on alcohol ambivalence. Addict Behav. 2015;46:58–64.CrossRef
27.
Mayer AR, Wilcox CE, Dodd AB, Klimaj SD, Dekonenko CJ, Claus ED, et al. The efficacy of attention bias modification therapy in cocaine use disorders. Am J Drug Alcohol Abuse. 2016;42(4):459–68.CrossRef
28.
McGeary JE, Meadows SP, Amir N, Gibb BE. Computer-delivered, home-based, attentional retraining reduces drinking behavior in heavy drinkers. Psychol Addict Behav. 2014;28(2):559–62.CrossRef
29.
McHugh RK, Murray HW, Hearon BA, Calkins AW, Otto MW. Attentional bias and craving in smokers: the impact of a single attentional training session. Nicotine Tob Res. 2010;12(12):1261–4.CrossRef
30.
Schoenmakers TM, Wiers RW, Jones BT, Bruce G, Jansen AT. Attentional re-training decreases attentional bias in heavy drinkers without generalization. Addiction. 2007;102(3):399–405.CrossRef
31.
Schoenmakers TM, de Bruin M, Lux IF, Goertz AG, Van Kerkhof DH, Wiers RW. Clinical effectiveness of attentional bias modification training in abstinent alcoholic patients. Drug Alcohol Depend. 2010;109(1–3):30–6.CrossRef
32.
Ziaee SS, Fadardi JS, Cox WM, Yazdi SA. Effects of attention control training on drug abusers’ attentional bias and treatment outcome. J Consult Clin Psychol. 2016;84(10):861–73.CrossRef
33.
Field M, Duka T, Eastwood B, Child R, Santarcangelo M, Gayton M. Experimental manipulation of attentional biases in heavy drinkers: do the effects generalise? Psychopharmacology. 2007;192(4):593–608.CrossRef
34.
Lopes FM, Pires AV, Bizarro L. Attentional bias modification in smokers trying to quit: a longitudinal study about the effects of number of sessions. J Subst Abus Treat. 2014;47(1):50–7.CrossRef
35.
Cox WM, Fadardi JS, Hosier SG, Pothos EM. Differential effects and temporal course of attentional and motivational training on excessive drinking. Exp Clin Psychopharmacol. 2015;23(6):445–54.CrossRef
36.
Wiers RW, Houben K, Fadardi JS, van Beek P, Rhemtulla M, Cox WM. Alcohol cognitive bias modification training for problem drinkers over the web. Addict Behav. 2015;40:21–6.CrossRef
37.
Charles M, Wellington CE, Mokrysz C, Freeman TP, O’Ryan D, Curran HV. Attentional bias and treatment adherence in substitute-prescribed opiate users. Addict Behav. 2015;46:100–5.CrossRef
38.
Livingston JD, Milne T, Fang ML, Amari E. The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review. Addiction. 2012;107(1):39–50.CrossRef
39.
Lowther H, Newman E. Attention bias modification (ABM) as a treatment for child and adolescent anxiety: a systematic review. J Affect Disord. 2014;168:125–35.CrossRef
40.
Field M, Werthmann J, Franken I, Hofmann W, Hogarth L, Roefs A. The role of attentional bias in obesity and addiction. Health Psychol. 2016;35(8):767–80.CrossRef
41.
Rudaizky D, Basanovic J, MacLeod C. Biased attentional engagement with, and disengagement from, negative information: independent cognitive pathways to anxiety vulnerability? Cogn Emot. 2014;28(2):245–59.CrossRef
42.
Lee S, Cho S, Lee JH. Approach-avoidance pattern of visual attention in hazardous drinkers with ambivalence. Addict Behav. 2014;39(3):669–76.CrossRef
43.
Cox WM, Fadardi JS, Pothos EM. The addiction-stroop test: theoretical considerations and procedural recommendations. Psychol Bull. 2006;132(3):443–76.CrossRef
44.
Clarke PJ, Notebaert L, MacLeod C. Absence of evidence or evidence of absence: reflecting on therapeutic implementations of attentional bias modification. BMC Psychiatry. 2014;14:8.CrossRef
45.
Amir N, Beard C, Taylor CT, Klumpp H, Elias J, Burns M, et al. Attention training in individuals with generalized social phobia: a randomized controlled trial. J Consult Clin Psychol. 2009;77(5):961–73.CrossRef
46.
Schmidt NB, Richey JA, Buckner JD, Timpano KR. Attention training for generalized social anxiety disorder. J Abnorm Psychol. 2009;118(1):5–14.CrossRef
47.
Carlbring P, Apelstrand M, Sehlin H, Amir N, Rousseau A, Hofmann SG, et al. Internet-delivered attention bias modification training in individuals with social anxiety disorder—a double blind randomized controlled trial. BMC Psychiatry. 2012;12:66.CrossRef
48.
Stevenson JG, Oliver JA, Hallyburton MB, Sweitzer MM, Conklin CA, McClernon FJ. Smoking environment cues reduce ability to resist smoking as measured by a delay to smoking task. Addict Behav. 2017;67:49–52.CrossRef
49.
Waters AJ, Sayette MA, Franken IH, Schwartz JE. Generalizability of carry-over effects in the emotional Stroop task. Behav Res Ther. 2005;43(6):715–32.CrossRef
50.
Ataya AF, Adams S, Mullings E, Cooper RM, Attwood AS, Munafo MR. Internal reliability of measures of substance-related cognitive bias. Drug Alcohol Depend. 2012;121(1–2):148–51.CrossRef
51.
Schmukle SC. Unreliability of the dot probe task. Eur J Personal. 2005;19(7):595–605.CrossRef
Metadata
Title
The effectiveness of attentional bias modification for substance use disorder symptoms in adults: a systematic review
Authors
Janika Heitmann
Elise C. Bennik
Madelon E. van Hemel-Ruiter
Peter J. de Jong
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2018
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-018-0822-6

Other articles of this Issue 1/2018

Systematic Reviews 1/2018 Go to the issue

Protocol

Interprofessional collaboration and patient-reported outcomes in inpatient care: protocol for a systematic review

Research

Does information from ClinicalTrials.gov increase transparency and reduce bias? Results from a five-report case series

Research

Automated screening of research studies for systematic reviews using study characteristics

Research

A systematic review of enteric dysbiosis in chronic fatigue syndrome/myalgic encephalomyelitis

Research

Effectiveness of self-management support interventions for people with comorbid diabetes and chronic kidney disease: a systematic review and meta-analysis

Protocol

Adverse effects of psychotherapy: protocol for a systematic review and meta-analysis