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Attentional bias in substance-related disorders.Theoretical, evaluative and treatment aspects

Abstract:

The objective of this work is to investigate attentional bias as an automatic cognitiveprocess and its implications in substance use disorders. Cognitive processes are fundamentalin the formulation of the differentexplanatory models about psychopathology.Of the various cognitive processes, attentionis a significant determinant, because althoughit fulfils various activities such as orientationand wakefulness, it is cognitive controlthat arouses relevant interest for it. This isdue to the fact that it fulfills a task of linkingbetween signal uptake and the achievementof other cognitive processes that intervene inthe behavioral response mechanism. Whena cognitive process like attention is markedlyaltered it will trigger impaired sequentialcognitive functioning, along with theemission of disturbing behavior. Psychologyconsiders that cognitive processes operateconsciously (voluntarily) and automatically(implicitly); that is, in a dual way in whichthese processes such as attention maintain acontinuum of coordinated gradual variationsthat regulate behavior. Failure to considerautomatic cognitive processes is a notoriouslimitation for current explanatory modelsof psychopathological behavior (includingcompulsive substance use); given that many ofthese underlying cognitive processes are oftennot considered to influence higher mentalprocesses and therefore behavior, without theindividual necessarily being aware of this.In fact, this can help to understand pathologicalbehaviors that for the investigator or theprofessional of psychology can be incomprehensibleor paradoxical.Among the various underlying and alteredprocesses, the attentional bias towards criticalsignals associated with substances has investigativerelevance. Since it is a dysfunctionalmechanism of selective attention, whichoperates frequently at an automatic level andin which the allocation and focus of attentionare disproportionate in time, between aspecific stimulus (image or word related to adrug) versus a neutral stimulus. And it attractsa person’s focus of attention to the criticalstimulus, from which it later becomes difficultto decouple. This later facilitates other altered cognitive processes subsequent toconsumption. The generation of an attentionalbias towards a specific signal has its originin the association between the signal and thebehavior, which can be avoidant (recurrent inphobias) or attractive (frequent in substanceor food consumption) and that is conditioneduntil becoming an automatic process of difficultvoluntary control. Although it is true thatattention bias may be present in all individuals,the evidence reveals the marked and recurrentpresence in various pathologies such as mooddisorders (depressive), anxiety, food intake,phobias, of personality among others. Andalso included in substance use disorders. Thefindings show that attention bias has an impacton substance use, course, the severity of thedisorder, craving, withdrawal, relapse, andthe probability of treatment failure. Workingwith an attentional bias for specific signals onsubstances can generate difficulty, in the caseof evaluation because it is assessed throughsoftware that usually measures the eye-handreaction time or eye movement when facedwith neutral and critical signals, which can bea limitation for the usual clinic; while at theintervention level, it is required to formulatebias retraining processes that require continuousexercise as a complementary techniqueto the usual cognitive-behavioral treatment.It is considered necessary to explore this lineof research and its relationship with substanceuse disorders within the region