Abstract
Rationale
Attentional bias toward drug-related stimuli is a feature of drug addiction that is linked to craving and drug-seeking behavior.
Objectives/method
An attentional bias modification (ABM) program was tested in 42 methamphetamine-dependent clients (DSM-IV criteria) receiving residential treatment for their drug use. Participants were randomly assigned to one of two groups (N = 21 each), receiving 12 sessions of either computerized ABM training (designed to train attention away from methamphetamine stimuli 100% of the time) or an attentional control condition (designed to train attention away from methamphetamine stimuli 50% of the time). Outcome measures included attentional bias to methamphetamine-related stimuli on a probe detection task, self-reported craving, and preferences to view methamphetamine-related images on a Simulated Drug Choice Task. A subset of participants (N = 17) also underwent fMRI in a cue-induced craving paradigm.
Results
Poor split-half reliability was observed for the probe detection task. Using this task, attentional bias toward methamphetamine-related stimuli was greater after training than at baseline, irrespective of group (p = 0.037). Spontaneous and cue-induced methamphetamine craving diminished with time (ps < 0.01), but ABM training did not influence these effects (group by time interactions, ps > 0.05). ABM training did not influence selection of methamphetamine-related pictures in the Simulated Drug Choice task (p > 0.05). In the fMRI assessment, cue-induced activation in the ventromedial prefrontal cortex was reduced over time, without an effect of ABM training.
Conclusions
ABM training did not improve several clinically relevant variables in treatment-seeking methamphetamine users. Additional research is needed to improve the measurement of attentional bias.
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Funding
This work was supported by a grant from the National Institute on Drug Abuse [R21DA040156 (EDL); K01DA037452 (SJM)], the Thomas P. and Katherine K. Pike Chair in Addiction Studies (EDL), and the Marjorie Greene Family Trust.
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Supplementary Figure 1.
fMRI activation in response to MA vs. neutral cues before and after training across treatment groups (N = 12). Displayed are slices from the t-statistic image from a one-sample non-parametric t-test on difference images (pre-post training) for all voxels, overlaid on the mean anatomical image (MPRAGE) across participants. Results were cluster corrected at a cluster-determining threshold of t > 2.17 (i.e., P < 0.01). Suprathreshold clusters include those within ventromedial prefrontal cortex, including medial orbitofrontal cortex. No clusters reached significance with the threshold of P < 0.001. Images are in MNI space displayed in radiological orientation (right = left). (PNG 242 kb)
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Dean, A.C., Nurmi, E.L., Moeller, S.J. et al. No effect of attentional bias modification training in methamphetamine users receiving residential treatment. Psychopharmacology 236, 709–721 (2019). https://doi.org/10.1007/s00213-018-5100-8
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DOI: https://doi.org/10.1007/s00213-018-5100-8