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A new study published in PNAS looked at attention bias modification in drug addiction and enhancing control of subsequent habits.

“In substance use disorder, cues and contexts that remind an individual of the experience of substance use start to habitually grab attention and elicit a physiological response (arousal) that is thought to result in craving and culminate in compulsive substance use,” study author Muhammad A. Parvaz told us. “In this study, our goal was to examine whether such arousal to substance-related cues (or pictures) can be reduced and whether such instructed and effortful reduction in arousal can disrupt habitual (automatic and spontaneous) allocation of attention to these cues.”

In this study, researchers employed cognitive reappraisal, a specific emotion regulation technique that engages the areas of the brain responsible for self-control (i.e., the prefrontal cortex), to self-regulate the arousal to substance-related cues. They then assessed whether such cognitive-reappraisal based self-regulation brings about a change in subsequent interactions with substance-related cues.

“All robust scientific studies derive their hypotheses based on prior evidence,” Parvaz told us. “Similarly, given previous findings in nicotine use disorder, we expected that individuals suffering from cocaine use disorder will be able to self-regulate the arousal elicited by cocaine-related cues.”

Furthermore, since prior studies have shown that the engagement of the prefrontal cortex (a brain region that is involved in self-control) can disrupt habitual behaviors, researchers expected that the effortful engagement of the prefrontal cortex during cognitive reappraisal will dampen the automatic/habitual attention that is typically allocated to these cues in individuals with substance use disorder.

“Our research focuses on understanding the neuroscience of substance use disorder and on performing research that provides a basis for neuroscience-informed evidence-based treatment development for substance use disorders,” Parvaz told us. “This study is part of that effort, where we studied whether cognitive reappraisal, a cognitive behavioral technique, could help reduce the arousal to substance-related cues and have an impact on disrupting the subsequent (and spontaneous) habitual attention to these cues.”

In this study, researchers asked participants (those suffering from cocaine use disorder and those who do not use cocaine) to either continue to "look" at cocaine-related cues (or pictures) and other emotional and non-emotional pictures or to "decrease" their arousal to these cues using cognitive reappraisal. Using electroencephalography (EEG) they objectively measured the extent of reduction of arousal to each type of cue.

After asking participants to either "look" at or "decrease" their arousal to these cues, researchers presented different types of pictures (including cocaine-related pictures) on the screen and using eye-tracking, they measured the attention allocated to each picture based on how long a participant viewed each picture. Comparing the EEG response and the eye-gaze duration to cocaine-related pictures and other pictures between those suffering from cocaine use disorder and those who do not use cocaine, allowed researchers to test our hypotheses.

“We observed that individuals suffering from cocaine use disorder were able to reduce their arousal to cocaine-related pictures using cognitive reappraisal,” Parvaz told us, “and such effortful self-regulation resulted in lowering the time they spontaneously spent looking at cocaine-related pictures.

Although novel, Parvaz explained that the results are not surprising as they expected these results based on prior studies and theories related to substance use disorders. Parvaz believes these results pave the way for future studies to build and test a cognitive reappraisal training regimen for the disruption of habitual/automatic attention (i.e., spontaneous eye-gaze duration) to substance-related cues. Such training in attention allocation may results in better clinical outcomes, for example, lower craving and longer abstinence in people with drug addiction.

“Just as for other chronically relapsing neuropsychiatric disorders, we need a more concerted effort to develop neuroscientifically grounded and evidence-based treatments and interventions for substance use disorders,” Parvaz told us. “Results like ours are truly exciting because they provide the fundamental evidence for the development of empirically-based future treatments and interventions urgently needed by people addicted to drugs.”