When attention takes over: attentional bias and its modification in substance use and addiction

It has been proposed that selective attention for substance-relevant information might contribute to the persistence of addiction. To improve insight about which component of attentional bias is relevant to target during treatment, the first aim of this dissertation was to investigate whether substance use is most strongly related to attentional capture of substance cues or to a difficulty to redirect attention away from these cues. In a non-clinical sample it was found that alcohol use was related to a difficulty to disengage attention from alcohol cues. However, patients diagnosed with alcohol or cannabis addiction showed heightened attentional capture of substance cues, indicating that especially heightened attentional capture might be relevant in problematic substance use. The second aim of this dissertation was to test the effectiveness of a novel computer-based add-on intervention that was designed to help patients diagnosed with alcohol or cannabis addiction to direct their attention away from substance cues. This attentional training did not result in less substance use, less craving, or less relapse one year after treatment. One explanation might be that the intervention was not sufficiently effective in reducing attentional bias or did after all not target the most relevant component of attention. Possibly more intense training procedures are necessary to reach clinically relevant changes. In general, also regular treatment seemed largely ineffective in treating alcohol and cannabis addiction; more than half of the patients relapsed within 3 month post treatment. This emphasizes the importance of improving treatment options in addiction care