A Promising Candidate to Reliably Index Attentional Bias Toward Alcohol Cues-An Adapted Odd-One-Out Visual Search Task

Attentional bias (AB) has been suggested to contribute to the persistence of substance use behavior. However, the empirical evidence for its proposed role in addiction is inconsistent. This might be due to the inability of commonly used measures to differentiate between attentional engagement and attentional disengagement. Attesting to the importance of differentiating between both components of AB, a recent study using the odd-one-out task (OOOT) showed that substance use was differentially related to engagement and disengagement bias. However, the AB measures derived from the OOOT showed insufficient reliability to be used as a solid measure of individual differences. Therefore, the current study aimed to improve the reliability of the AB measures derived from the OOOT by using more distinct contrast stimuli, adding practice trials, increasing the number of trials, and by having participants perform the task in an alcohol-relevant context. We contrasted the original OOOT with the adapted OOOT (i.e., OOOT-adapt) and assessed AB in low- and high-drinking individuals. Participants were 245 undergraduate students who typically tend to drink either low or high amounts of alcohol. In one condition, AB was measured with the original OOOT in a typical laboratory context, whereas in the other condition, AB was measured with the OOOT-adapt in a bar (i.e., alcohol-relevant) context. The OOOT-adapt showed superior internal consistency, especially for the high-drinking group. Further, specifically the OOOT-adapt differentiated between low- and high-drinking participants showing that high drinkers engaged faster with alcohol cues than did low drinkers. Thus, the OOOT-adapt was found to be a promising candidate to reliably index AB in the context of alcohol use. The OOOT-adapt further showed superior criterion validity as it could differentiate between low- and high-drinking individuals, thereby adding to the evidence that AB might be involved in substance use behavior

Evaluation of the Perceived Persuasiveness Questionnaire:User-Centered Card-Sort Study

Background: eHealth technologies aim to change users’ health-related behavior. Persuasive design and system features can make an eHealth technology more motivating, engaging, or supportive to its users. The Persuasive Systems Design (PSD) model incorporates software features that have the possibility to increase the persuasiveness of technologies. However, the effects of specific PSD software features on the effectiveness of an intervention are still largely unknown. The Perceived Persuasiveness Questionnaire (PPQ) was developed to gain insight into the working mechanisms of persuasive technologies. Although the PPQ seems to be a suitable method for measuring subjective persuasiveness, it needs to be further evaluated to determine how suitable it is for measuring perceived persuasiveness among the public. Objective: This study aims to evaluate the face and construct validity of the PPQ, identify points of improvement, and provide suggestions for further development of the PPQ. Methods: A web-based closed-ended card-sort study was performed wherein participants grouped existing PPQ items under existing PPQ constructs. Participants were invited via a Massive Open Online Course on eHealth. A total of 398 people (average age 44.15 years, SD 15.17; 251/398, 63.1% women) completed the card sort. Face validity was evaluated by determining the item-level agreement of the original PPQ constructs. Construct validity was evaluated by determining the construct in which each item was placed most often, regardless of the original placement and how often 2 items were (regardless of the constructs) paired together and what interitem correlations were according to a cluster analysis. Results: Four PPQ constructs obtained relatively high face validity scores: perceived social support, use continuance, perceived credibility, and perceived effort. Item-level agreement on the other constructs was relatively low. Item-level agreement for almost all constructs, except perceived effort and perceived effectiveness, would increase if items would be grouped differently. Finally, a cluster analysis of the PPQ indicated that the strengths of the newly identified 9 clusters varied strongly. Unchanged strong clusters were only found for perceived credibility support, perceived social support, and use continuance. The placement of the other items was much more spread out over the other constructs, suggesting an overlap between them. Conclusions: The findings of this study provide a solid starting point toward a redesigned PPQ that is a true asset to the field of persuasiveness research. To achieve this, we advocate that the redesigned PPQ should adhere more closely to what persuasiveness is according to the PSD model and to the mental models of potential end users of technology. The revised PPQ should, for example, enquire if the user thinks anything is done to provide task support but not how this is done exactly

Why Dieters Succeed or Fail:The Relationship Between Reward and Punishment Sensitivity and Restrained Eating and Dieting Success

Background: The current study set out to improve our understanding of the characteristics of individuals who are motivated to restrict their food intake yet who nevertheless fail to do so. We examined whether punishment sensitivity (PS) was related to restrained eating, and reward sensitivity (RS) to perceived dieting success. Additionally, it was examined whether executive control (EC) moderates the association between RS and perceived dieting success. Methods: Female student participants (N = 290, aged 17-29, BMI between 18.5 and 38.0) completed questionnaires on restrained eating, perceived dieting success, RS and PS, and carried out a behavioral task to index EC. Results: PS was indeed positively related to restrained eating. RS was positively related to perceived dieting success, yet, EC did not moderate this association. Conclusion: The current study adds to the evidence that PS is related to individuals' motivation to restrict their food intake. Furthermore, it shows support for the suggestion that RS may facilitate food restriction

Punishment sensitivity and the persistence of anorexia nervosa:High punishment sensitivity is related to a less favorable course of anorexia nervosa

OBJECTIVE: Cross-sectional research provides robust evidence that individuals with anorexia nervosa (AN) report higher punishment sensitivity (PS) than individuals without an eating disorder (ED). High PS might interfere with treatment motivation and the ability to learn from experience. The current study took a longitudinal approach to test predictions that follow from the proposed relevance of PS as a factor in the persistence of AN symptoms. More specifically we tested (1) if higher PS at the start of treatment was related to less improvement in ED symptoms after one year, and (2) if a decrease in ED symptoms was associated with a concurrent decrease in PS. METHOD: Participants were 69 adolescents with a diagnosis of AN at the start of treatment of whom 62 participated again one year later. ED symptom severity and PS were assessed at both time points. RESULTS: Findings showed that (1) higher PS at the start of treatment was related to less improvement in ED symptoms, and (2) an improvement in ED symptoms was related to a decrease in PS. DISCUSSION: These findings are consistent with the proposed relevance of PS in the persistence of AN and suggest that it might be beneficial to address high PS in treatment. PUBLIC SIGNIFICANCE: Consistent with the view that punishment sensitivity (PS) is related to the persistence of anorexia nervosa, high PS at the start of treatment was related to less improvement in eating disorder symptoms in patients with anorexia nervosa. Furthermore, an improvement in eating disorder symptoms was associated with a concurrent decrease in PS, suggesting that PS can be subject to change and may be a relevant target for treatment

Reinforcement sensitivity and restrained eating:the moderating role of executive control

Purpose As the prevalence of overweight and obesity are still increasing, it is important to help individuals who encounter difficulty with losing weight. The current study was set out to further investigate characteristics of individuals who are highly motivated to restrict their food intake to lose weight, but fail to do so (i.e., restrained eaters). The motivation to lose weight might stem from high punishment sensitivity, whereas the failure to succeed in restricting food intake might be the result of high reward sensitivity. Thus, it was examined whether restrained eaters are characterized by both high reward sensitivity and high punishment sensitivity. Additionally, this is the first study to examine executive control as a potential moderator of this relationship. Methods Female undergraduates (N = 60) performed a behavioral measure of executive control, and completed the Restraint Scale to index level of restrained eating as well as two questionnaires on reinforcement sensitivity; the Behavioral Inhibition Scale/Behavioral Activation Scale, and the Sensitivity to Punishment and Sensitivity to Reward Questionnaire. Results There was a positive relationship between restrained eating and punishment sensitivity as indexed by both questionnaires. Reward sensitivity as measured by both indices was not directly related to restrained eating. Executive control moderated the relation between reward responsivity (but not reward-drive) and restrained eating; specifically in women with relatively weak executive control there was a positive relationship between reward responsivity and restrained eating behavior. Conclusion In women with low executive control, restrained eating is associated with both heightened sensitivity to punishment and heightened responsivity to reward

Visual attention to food cues and the course of anorexia nervosa

Previously, adolescents with anorexia nervosa (AN) showed reduced attentional engagement with food cues compared to adolescents without eating disorder (Jonker, Glashouwer, Hoekzema, Ostafin, & De Jong, 2019). This study tested whether (i) improvement in eating disorder symptoms and BMI are related to an increase in attentional engagement with food, and whether (ii) relatively low attentional engagement is related to persistent AN symptomatology, in the same sample of adolescents with AN (N = 69) from the study of Jonker et al. (2019). Eating disorder symptoms, BMI, and attention for food cues were measured during baseline and at one year follow-up. Adolescents with AN showed a substantial improvement in symptoms and BMI. However, their low attentional engagement with food cues remained unchanged. Change in attentional engagement with food was not related to change in symptoms, nor was low baseline attentional engagement with food predictive of symptom persistence. These findings indicate that improvement in AN symptoms does not seem to require an increase in attentional engagement with food

Influence of hunger on attentional engagement with and disengagement from pictorial food cues in women with a healthy weight

Because of inconsistencies in the field of attentional bias to food cues in eating behavior, this study aimed to re-examine the assumption that hungry healthy weight individuals have an attentional bias to food cues, but satiated healthy weight individuals do not. Since attentional engagement and attentional disengagement have been proposed to play a distinct role in behavior, we used a performance measure that is specifically designed to differentiate between these two attentional processes. Participants were healthy weight women who normally eat breakfast. In the satiated condition (n = 54), participants were instructed to have breakfast just before coming to the lab. In the fasted condition (n = 50), participants fasted on average 14 h before coming into the lab. Satiated women showed no stronger attentional engagement or attentional disengagement bias to food cues than to neutral cues. Fasted women did show stronger attentional engagement to food cues than to neutral cues that were shown briefly (100 ms). They showed no bias in attentional engagement to food cues that were shown longer (500 ms) or in attentional disengagement from food cues. These findings are in line with the assumption that healthy weight individuals show an attentional bias to food cues when food stimuli are motivationally salient. Furthermore, the findings point to the importance of differentiating between attentional engagement and attentional disengagement