Week 10 RF-Addiction Flashcards
How does Incentive Salience + Cue Reactivity + Attentional Bias all link together?
-Both the IST and HHDT include incentive salience as a core component
-Incentive salience = a reward-associated cue endowed with motivational significance
Can be measured a variety of ways:
-Perhaps the most prominent way is to measure cue reactivity, which itself can be measured via attentional bias
-Cue reactivity = a learned response (e.g., an approach response) to reward-related stimuli
-Attentional Bias = Biased attention towards one type of stimulus over another
-So, we can measure the incentive salience of a cue by measuring cue reactivity via attentional bias
-To understand this potential alternative intervention (CBM), we first need to go over some key concepts…
-Incentive salience is the core neurological/biological component in addiction
What is the Background and Methods of Duckworth et al’s (2022) Attentional Bias Study?
-N = 20 (10 female)
-We measured attentional bias (AB) towards abstract cues (shapes and colours)
-Over time, participants learned to associate one colour with high reward and another colour with low reward via an Additional Singleton Task (AST)
-Participants knew they would not win any money or prizes it was just video game
-One colour is assigned ‘high-value’ (can win up to 20 ‘money’ points), the other low-value (up to 2 points) + can lose points for looking at the wrong colour. (predicted they would get covertly distracted and lose points). Counterbalanced across participants.
-They implicitly learn it’s more valuable to find the diamond on the red trial
-They completed the task whilst inside an fMRI scanner
-We wanted to compare both AB and neural activity to abstract cues which had been imbued with abstract (high vs. low) value
What are the Key outcome measures for the AST? (Duckworth et al., 2022)
-Reaction Time (RT) Bias (duration to find the diamond – across trial types)
-Omission Bias (incorrectly attending to the colour – across trial types)
What are the Cognitive Findings of Duckworth et al’s (2022) Attentional Bias Study?
-RTs slower on high- vs. low-value trials
-12 high-value omissions vs. 1 low-value omission
-Indicates greater distraction by high-value cues
-When there was a high value prize, participants did covert distracion to avoid the colourful object which took them longer
-Cognitively and behaviourally getting an abstract cue with an abstract point, people’s neurological systems adapt to associating a colour with a value, they get more distracted in the high value colour
What are the Neural Findings of Duckworth et al’s (2022) Attentional Bias Study?
Right orbitofrontal cortex:
-Encodes current object value
-Decision making
Right putamen:
-Implicit behaviour
-Reinforcement learning
Right pallidum:
-Reward processing
-Encoding hedonic reward
-Incentive salience
-Dorsolateral striatum (wherein the putamen resides) mediates OFC activity.
-Aids shift from goal-directed to habitual behaviour
-OFC controls decision-making where putamen mediates this (goal fashion or habitual fashion)
Right anterior/posterior superior temporal gyri:
-Attention shifting
-Salience detection
-‘Spotlighting’ the presence of reward
-Encoding relative value
-Encoding semantic (but not aesthetic) information
-Salience detection=detecting important objects in the environment
-Semantic and relative=contains some ranking of value
Right amygdala:
-Anticipation of reward response
-Evaluating reward outcome
-Cue-elicited craving
-Amygdala-ventral striatum complex aids stimulus-reward learning
-More active in the high value trial than the low value trial
-Just shapes and colours not drug yet craving element still seen
What has Duckworth et al’s (2022) study got to do with addiction?
-Attentional bias is real
-Which means cue reactivity is real
-Which means incentive salience is real
So…
-Even using abstract cues (colours and shapes) and abstract reward (‘money’ points), the mere presence of reward-associated cues can trigger the same neural pathways that we know are also activity in addicts when exposed to drug-related stimuli.
-This has potentially important implications for research and treatment.
What has Duckworth et al’s (2022) study got to do with treatment?
-Attentional bias is real
-Which means cue reactivity is real
-Which means incentive salience is real
So…
-Can the process be reversed?
-Attentional Bias Modification (or Cognitive Bias Modification)
What is the ABM for anxiety? (Hakamata et al., 2010)
-ABMT produced significant reductions in anxiety compared to control training
Approach-avoidance task:
-Pull soft drink towards you and push alcohol away
-Taught to approach the non-alcoholic cues and move away from alcoholic cues over many trials
-Acts as a video game where repetition will teach neural and cognitive system to move away from alcohol environmental stimuli and towards healthier ones
Dot-probe task:
-To train attention away from drug cues, 80-90% of probes (up or down arrow) are behind non-drug cues.
-This will sensitise and teach the neural and cognitive system to choose the target cue because you want to win rather than choosing the drug cue (you need to pay attention to the neutral cue as a target cue is often always behind it if they wanted to win)
What is ABM for addiction?
-It increased alcohol abstinence rates in the first 2 weeks and overall but ONLY when completing all training sessions perhaps as a result of motivation (Duckworth, 2022)
Heitmann et al. (2018):
-Multi-session ABM interventions had a positive effect on symptoms of addictive behaviour
-This was in 2018 and not much more evidence if any has come out since
-Positive effects for attentional bias modification only seems to come from a specific Dutch University
-The effect is so small it’s likely not clinically relevant
What is the overall review and summary?
-Despite overwhelming focus on the BDMA, it’s provided little in the way of treatment
-Some of it’s core proposed mechanisms (e.g., incentive salience) seem to be correct
-But our targeting of those mechanisms provides mixed results
-Either our interventions are poor
-Or our interventions need to target mechanisms holistically (Holistically e.g., not using ABM in a lab, but in real life settings)
-Or the mechanisms are not clinically significant
-Or the mechanisms are not fully reversible
-Maybe all of the above – at the minute we really don’t know!
