Interventions aimed at automatic processes in addiction: considering necessary conditions for efficacy

Automatic processes related to addiction can be directly targeted in novel training paradigms. First studies have demonstrated that Cognitive Bias Modification (CBM) targeting approach biases can enhance treatment outcomes when added to regular treatment. However, the overall efficacy of CBM is debated. We argue that considering the modulating role of motivation and the mediating role of actual bias change are essential to drawing valid conclusions. Findings on mediating cognitive and neural mechanisms underlying clinical effects provide further sources of evidence on CBM. Taken together the literature supports the claim that cognitive bias change can improve clinical outcome, but that there are necessary conditions that must be met. Improved theoretical understanding of changing biases and new techniques such as neuromodulation may be needed to optimally apply CBM to help patients overcome addictive behavior

Imaging the neural effects of cognitive bias modification training

Cognitive bias modification (CBM) was first developed as an experimental tool to examine the causal role of cognitive biases, and later developed into complementary interventions in experimental psychopathology research. CBM involves the "re-training" of implicit biases by means of multiple trials of computerized tasks, and has been demonstrated to change anxious, depressive and drug-seeking behavior, including clinically relevant effects. Recently, the field has progressed by combining CBM with neuroimaging techniques, which provides insight into neural mechanisms underlying how CBM affects implicit biases in anxiety, depression, and addiction, and potentially other pathologies. This narrative literature review summarizes the state of the art of studies on the neural effects of CBM and provides directions for future research in the field. A total of 13 published studies were found and discussed: n=9 in anxiety, n=2 in depressive behavior, and n=2 in addiction

Motivation and Self-Regulation in Addiction: A Call for Convergence

Addiction models have frequently invoked motivational mechanisms to explain the initiation and maintenance of addictive behaviors. However, in doing so, these models have emphasized the unique characteristics of addictive behaviors and overlooked the commonalities that they share with motivated behaviors in general. As a consequence, addiction research has failed to connect with and take advantage of promising and highly relevant advances in motivation and self-regulation research. The present article is a call for a convergence of the previous approaches to addictive behavior and the new advances in basic motivation and self-regulation. The authors emphasize the commonalities that addictive behaviors may share with motivated behavior in general. In addition, it is suggested that the same psychological principles underlying motivated action in general may apply to understand challenging aspects of the etiology and maintenance of addictive behaviors

Automatic approach bias towards smoking cues is present in smokers but not in ex-smokers

Rationale :Drug-addicted individuals show automatic approach tendencies towards drug-related cues, i.e., an approach bias (ApB). Nevertheless, little is known about ApB in tobacco smokers and about the presence of ApB after smoking abstinence. Objectives: We investigated ApB to smoking cues in heavy tobacco smokers versus never-smokers and studied its relation to smoking characteristics and craving. Second, we compared ApBs of heavy smokers with biases of abstinent heavy smokers. Method: A group of current heavy smokers (n = 24), ex-smokers who were abstinent for at least 5 years (n = 20), and never-smokers (n = 20) took part in the experiment. An indirect smoking approach avoidance task was performed, in which participants were required to respond to pictures of smoking and neutral cues by pulling (approach) or pushing (avoid) on a joystick, according to the content-irrelevant format of the picture (landscape or portrait). Craving scores were examined using the Questionnaire of Smoking Urges. Results: Heavy smokers showed an ApB for smoking cues compared to ex-smokers and never-smokers, which correlated positively to craving scores. There were no group differences in ApB scores for ex-smokers and never-smokers. Conclusion: These results suggest that ApBs for smoking cues are present in heavy smokers and decrease after long-term successful smoking cessation