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Decreased drug-cue-induced attentional bias in individuals with treated and untreated drug dependence

  • Simona Gardini (a1) (a2), Paolo Caffarra (a1) (a2) and Annalena Venneri (a2) (a3)



The present study investigated the attentional bias induced by drug-related stimuli in active abusers; abstinent abusers on opioid substitution therapy; and abstinent drug-dependent patients in recovery on a community-based non-pharmacological therapy programme. Drug-dependent groups included both cocaine and heroin abusers.


Classical and emotional Stroop tasks were used to test all drug-dependent patients and controls with no history of addiction. Response times were recorded. An interference effect was obtained by comparing the congruent and incongruent conditions in the classical Stroop version. An attentional bias towards drug cues was derived by comparing latencies in the neutral and emotional conditions of the emotional Stroop.


No between-group differences were found in the classical Stroop. In the emotional Stroop, active drug-dependent patients showed higher attentional bias (i.e. longer response times to drug-related words) than any of the other three groups.


The attentional bias induced by drug cues in patients with addiction disorder might change depending on the patients' clinical status. All treated patients, whether on opioid substitution therapy or on community therapy, showed less attentional bias towards drug-related stimuli than active drug users, although the observed smaller bias was most likely induced by therapy acting through different mechanisms. Although drug-cues response is influenced by other multiple variables, e.g. motivation, craving, classical conditioning and substance availability, these data lend support to the hypothesis that treatment might contribute to decrease the attentional bias towards drug cues, which seems to play a critical role in achieving a positive outcome in the treatment of addiction.


Corresponding author

Professor Annalena Venneri, Clinical Neuroscience Centre, University of Hull, Cottingham Road, Hull HU6 7RX, England, UK. Tel: +44-1482-465558; Fax: +44-1482-465599; E-mail:


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1.Field, M, Cox, WM.Attentional bias in addictive behaviors: a review of its development, causes, and consequences. Drug Alcohol Depend 2008;97:120.
2.Wertz, JM, Sayette, MA.Effects of smoking opportunity on attentional bias in smokers. Psychol Addict Behav 2001;15:268271.
3.Wertz, JM, Sayette, MA.A review of the effects of perceived drug use opportunity of self-reported urge. Exp Clin Psychopharmacol 2001;9:313.
4.Childress, AR, Mozley, PD, McElgin, Wet al. Limbic activation during cue-induced cocaine craving. Am J Psychiatry 1999;156:1118.
5.Wexler, BE, Gottschalk, CH, Fulbright, RKet al. Functional magnetic resonance imaging of cocaine craving. Am J Psychiatry 2001;158:8695.
6.Volkow, ND, Wang, GJ, Telang, Fet al. Cocaine cues and dopamine in dorsal striatum: mechanism of craving in cocaine addiction. J Neurosci 2006;26:65836588.
7.Kosten, TR, Scanley, BE, Tucker, KAet al. Cue-induced brain activity changes and relapse in cocaine-dependent patients. Neuropsychopharmacology 2006;31:644650.
8.Franken, IH, Kroon, LY, Hendriks, VM.Influence of individual differences in craving and obsessive cocaine thoughts on attentional processes in cocaine abuse patients. Addict Behav 2000;25:99102.
9.Franken, IH, Kroon, LY, Wiers, RW, Jansen, A.Selective cognitive processing of drug cues in heroin dependence. J Psychopharmacol (Oxford, England) 2000;14:395400.
10.Lusher, J, Chandler, C, Ball, D.Alcohol dependence and the alcohol Stroop paradigm: evidence and issues. Drug Alcohol Depend 2004;75:225231.
11.Carrigan, MH, Drobes, DJ, Randall, CL.Attentional bias and drinking to cope with social anxiety. Psychol Addict Behav 2004;18:374380.
12.Kelley, AE, Schiltz, CA, Landry, CF.Neural systems recruited by drug- and food-related cues: studies of gene activation in corticolimbic regions. Physiol Behav 2005;86:1114.
13.Stroop, JR.Studies of interference in serial reactions. J Exp Psychol 1935;18:643662.
14.Robbins, SJ, Ehrman, RN.The role of attentional bias in substance abuse. Behav Cogn Neurosci Rev 2004;3:243260.
15.Hester, R, Dixon, V, Garavan, H.A consistent attentional bias for drug-related material in active cocaine users across word and picture versions of the emotional Stroop task. Drug Alcohol Depend 2006;81:251257.
16.Franken, IH, Hendriks, VM, Stam, CJ, Van den Brink, W.A role for dopamine in the processing of drug cues in heroin dependent patients. Eur Neuropsychopharmacol 2004; 14:503508.
17.Field, M.Cannabis ‘dependence’ and attentional bias for cannabis-related words. Behav Pharmacol 2005;16:473476.
18.Munafo, MR, Lingford-Hughes, AR, Johnstone, EC, Walton, RT.Association between the serotonin transporter gene and alcohol consumption in social drinkers. Am J Med Genet B Neuropsychiatr Genet 2005;135B:1014.
19.Bauer, D, Cox, WM.Alcohol-related words are distracting to both alcohol abusers and non-abusers in the Stroop colour-naming task. Addiction (Abingdon, England) 1998;93:15391542.
20.Cox, WM, Fadardi, JS, Pothos, EM.The addiction-stroop test: theoretical considerations and procedural recommendations. Psychol Bull 2006;132:443476.
21.Garavan, H, Pankiewicz, J, Bloom, Aet al. Cue-induced cocaine craving: neuroanatomical specificity for drug users and drug stimuli. Am J Psychiatry 2000;157:17891798.
22.Cox, WM, Hogan, LM, Kristian, MR, Race, JH.Alcohol attentional bias as a predictor of alcohol abusers' treatment outcome. Drug Alcohol Depend 2002;68:237243.
23.Sell, LA, Morris, JS, Bearn, Jet al. Neural responses associated with cue evoked emotional states and heroin in opiate addicts. Drug Alcohol Depend 2000;60:207216.
24.Goldstein, RZ, Volkow, ND.Drug addiction and its underlying neurobiological basis: neuroimaging evidence for the involvement of the frontal cortex. Am J Psychiatry 2002;159:16421652.
25.Lee, JL, Milton, AL, Everitt, BJ.Cue-induced cocaine seeking and relapse are reduced by disruption of drug memory reconsolidation. J Neurosci 2006;26:58815887.
26.Volkow, ND, Fowler, JS, Wang, GJ.The addicted human brain viewed in the light of imaging studies: brain circuits and treatment strategies. Neuropharmacology 2004; 47(Suppl. 1): 313.
27.Vadhan, NP, Carpenter, KM, Copersino, MLet al. Attentional bias towards cocaine-related stimuli: relationship to treatment-seeking for cocaine dependence. Am J Drug Alcohol Abuse 2007;33:727736.
28.Gardini, S, De Beni, R, Cornoldi, Cet al. Different neuronal pathways support the generation of general and specific mental images. Neuroimage 2005;27:544552.
29.Gardini, S, Nocetti, L, Toraci, Cet al. Taratura e validazione di parole cocaina ed eroina-correlate in un campione di individui con storia di dipendenza da droghe. G Ital Psicol 2009 (in press).
30.Goldstein, RZ, Tomasi, D, Rajaram, Set al. Role of the anterior cingulate and medial orbitofrontal cortex in processing drug cues in cocaine addiction. Neuroscience 2007;144:11531159.
31.Streeter, CC, Terhune, DB, Whitfield, THet al. Performance on the Stroop predicts treatment compliance in cocaine-dependent individuals. Neuropsychopharmacology 2008;33:827836.
32.Verdejo-Garcia, A, Perez-Garcia, M.Profile of executive deficits in cocaine and heroin polysubstance users: common and differential effects on separate executive components. Psychopharmacology (Berl) 2007;190:517530.
33.Koob, GF, Le Moal, M.Addiction and the brain antireward system. Annu Rev Psychol 2008;59:2953.
34.Volkow, ND, Fowler, JS, Wang, GJ, Goldstein, RZ.Role of dopamine, the frontal cortex and memory circuits in drug addiction: insight from imaging studies. Neurobiol Learn Mem 2002;78:610624.
35.Koob, GF, Le Moal, M.Drug addiction, dysregulation of reward, and allostasis. Neuropsychopharmacology 2001;24:97129.
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Acta Neuropsychiatrica
  • ISSN: 0924-2708
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