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This review of 122 research reports (184 independent samples, 14,900 subjects) found average r = .274 for prediction of behavioral, judgment, and physiological measures by Implicit Association Test (IAT) measures. Parallel explicit (i.e., self-report) measures, available in 156 of these samples (13,068 subjects), also predicted effectively (average r = .361), but with much greater variability of effect size. Predictive validity of self-report was impaired for socially sensitive topics, for which impression management may distort self-report responses. For 32 samples with criterion measures involving Black-White interracial behavior, predictive validity of IAT measures significantly exceeded that of self-report measures. Both IAT and self-report measures displayed incremental validity, with each measure predicting criterion variance beyond that predicted by the other. The more highly IAT and self-report measures were intercorrelated, the greater was the predictive validity of each.

https://faculty.washington.edu/agg/pdf/GPU&B.meta-analysis.JPSP.2009.pdf

Understanding and using the Implicit Association Test: III. Meta-analysis of predictive validity.

https://www.commed.vcu.edu/Chronic_Disease/2012/cochranrvwrschbias.pdf

The Cochrane Collaboration's tool for assessing risk of bias in randomised trials

The loss of control over drug intake that occurs in addiction was initially believed to result from disruption of subcortical reward circuits. However, imaging studies in addictive behaviours have identified a key involvement of the prefrontal cortex (PFC) both through its regulation of limbic reward regions and its involvement in higher-order executive function (for example, self-control, salience attribution and awareness). This Review focuses on functional neuroimaging studies conducted in the past decade that have expanded our understanding of the involvement of the PFC in drug addiction. Disruption of the PFC in addiction underlies not only compulsive drug taking but also accounts for the disadvantageous behaviours that are associated with addiction and the erosion of free will.

Dysfunction of the prefrontal cortex in addiction: neuroimaging findings and clinical implications

The self-medication hypothesis of addictive disorders derives primarily from clinical observations of patients with substance use disorders. Individuals discover that the specific actions or effects of each class of drugs relieve or change a range of painful affect states. Self-medication factors occur in a context of self-regulation vulnerabilities--primarily difficulties in regulating affects, self-esteem, relationships, and self-care. Persons with substance use disorders suffer in the extreme with their feelings, either being overwhelmed with painful affects or seeming not to feel their emotions at all. Substances of abuse help such individuals to relieve painful affects or to experience or control emotions when they are absent or confusing. Diagnostic studies provide evidence that variously supports and fails to support a self-medication hypothesis of addictive disorders. The cause-consequence controversy involving psychopathology and substance use/abuse is reviewed and critiqued. In contrast, clinical observations and empirical studies that focus on painful affects and subjective states of distress more consistently suggest that such states of suffering are important psychological determinants in using, becoming dependent upon, and relapsing to addictive substances. Subjective states of distress and suffering involved in motives to self-medicate with substances of abuse are considered with respect to nicotine dependence and to schizophrenia and posttraumatic stress disorder comorbid with a substance use disorder.

The Self-medication Hypothesis of Substance Use Disorders: A Reconsideration and Recent Applications

Attentional bias in addictive behaviors: A review of its development, causes, and consequences

Theoretical models of addiction suggest that attentional bias for substance-related cues should be associated with self-reported craving. The authors evaluated the strength of the association by performing a meta-analysis on 68 independent data sets from which correlation coefficients between subjective craving and attentional bias indices were derived. Additional stratified analyses were conducted to identify any variables that might moderate the association between craving and attentional bias. The primary meta-analysis indicated a significant, albeit weak (r = .19), association between attentional bias and craving. Stratified analyses revealed that the association was larger for illicit drug and caffeine craving than for alcohol and tobacco craving, larger for direct measures of attention (eye movement measures and event-related potential measures) than for indirect behavioral measures of attentional bias, and larger when craving strength was high than when it was low (all ps < .05). The size of the correlation did not differ among patients in treatment and individuals who were not seeking treatment. These results suggest that attentional bias and craving are related phenomena, although the relationship is generally modest and appears to be moderated by various factors. Theoretical implications are discussed.

/pdf/a-meta-analytic-investigation-of-the-relationship-between-4ouhe21cde.pdf

A Meta-Analytic Investigation of the Relationship Between Attentional Bias and Subjective Craving in Substance Abuse

Aims To investigate biases in overt orienting of attention to smoking-related cues in cigarette smokers, and to examine the relationship between measures of visual orienting and the affective and motivational valence of smoking cues. Design Smokers and non-smokers took part in a single session in which their attentional and evaluative responses to smoking-related and matched control pictures were recorded. Participants Twenty smokers and 25 non-smokers. Measurements Direction and duration of gaze was measured while participants completed a visual probe task. Subjective and cognitive-experimental measures of the motivational and affective valence of the stimuli were recorded. Findings Smokers, but not non-smokers, maintained their gaze for longer on smoking-related pictures than control pictures. They were also faster to detect probes that replaced smoking-related than control pictures, consistent with an attentional bias for smoking-related cues. Furthermore, smokers showed greater preferences for smoking-related than control pictures, compared with non-smokers, on both the subjective (explicit) and cognitive-experimental (implicit) indices of stimulus valence. Within smokers, longer initial fixations of gaze on smoking-related pictures were associated with a bias to rate the smoking pictures more positively, with greater approach tendencies for smoking pictures on the cognitive-experimental task, and with a greater urge to smoke. Conclusions These results demonstrate that smokers show biased attentional orientating to smoking cues, which is related to craving and the affective and motivational valence of the stimuli.

Eye movements to smoking-related pictures in smokers: relationship between attentional biases and implicit and explicit measures of stimulus valence

Rationale
Attentional bias for alcohol-related cues is associated with the motivation to drink alcohol, possibly because attentional bias increases craving.

Experimental manipulation of attentional bias increases the motivation to drink alcohol.

Rationale
There has been considerable theoretical interest in attentional biases for drug-related cues. However, there is little research on the component processes of such attentional biases.

Matt Field

Papers

Attentional bias in addictive behaviors: A review of its development, causes, and consequences

A Meta-Analytic Investigation of the Relationship Between Attentional Bias and Subjective Craving in Substance Abuse

Eye movements to smoking-related pictures in smokers: relationship between attentional biases and implicit and explicit measures of stimulus valence

Experimental manipulation of attentional bias increases the motivation to drink alcohol.

Attentional biases for alcohol cues in heavy and light social drinkers: the roles of initial orienting and maintained attention