Dissertation for M.A. degree
Attitude
Abstract
Modification of attentional bias in methadone treatment users
Abstract: Attentional bias refers to which stimulus can attract a person's attention when several stimuli compete for attention. This research confirms the importance of attention bias towards the stimuli related to addiction in the continuation of use and also the relapse of quitters. In the current research, attention bias correction using ProbeDat software has been investigated in reducing the attention bias of users under methadone treatment. Also, operant conditioning is combined for the first time with attentional bias correction process. In this study, there were three groups of users under methadone treatment (control, correction of attention bias, and correction of attention bias with reinforcement and punishment) in three times (pre-test, post-test and follow-up), which were measured in terms of the amount of attention bias using Probe Dot software at two stimulus presentation times (600 milliseconds to measure attention bias and 200 milliseconds to measure pre-attentional bias) with word and picture stimuli. Between the pre-test and the post-test, the control group received a neutral intervention, while the second group was intervened with the usual attention bias correction process, and the third group was manipulated with an intervention that combined attention bias correction with reinforcement and punishment. The findings indicated that in the post-test and follow-up attention bias and pre-attention bias, the interventions made caused a significant difference between all three groups. In addition, in all the hypotheses that compared the attention bias correction intervention and attention bias correction along with reinforcement and punishment, the attention bias correction group with reinforcement and punishment showed less attention bias in the post-test and follow-up.
It seems that attention bias correction is a meaningful and efficient intervention. In addition, combining reinforcement and punishment with attention bias correction exercises can increase the efficiency of this method. It is suggested to investigate this new method of intervention in other drug use disorders in future studies.
Key words: correction of attentional bias, operant conditioning, probe-dot test, attentional bias, pre-attentional bias
Introduction
Addiction to all kinds of drugs has become one of the biggest challenges facing humanity. Every year, a significant number of people die due to drug addiction. This has made investigating the causes of addiction and the solutions to overcome it into one of today's research goals.
The concept of substance dependence has many formal definitions and its common meanings have changed many times over the course of several decades. Two concepts are used to define different aspects of dependence: behavioral dependence and physical dependence. In behavioral dependence, drug-seeking activities and evidence related to different patient consumption patterns are emphasized, but physical dependence refers to the physiological effects of multiple periods of drug use (Kaplan and Sadok, 2007, page 477). The words addiction [1] and addict [2] are somewhat related to dependence. The word "addict" has implicitly acquired a special, unpleasant and derogatory meaning that does not convey the concept of substance abuse as a medical disorder. Addiction is also commonly used, such as TV addiction, money addiction, etc. has lost its importance. Although these implicit meanings have caused the use of the word addiction to be avoided in official nomenclature, there may be a common neuroanatomical and neurochemical background among all addictions, including similar effects on the activities of specific reward areas of the brain such as the ventral tegmental area, locus coeruleus, and nucleus accumbens. The characteristic of psychological dependence, which is also called habituation[3] is a persistent or intermittent strong desire to consume drugs in order to avoid boredom (Kaplan and Sadok, 2007, page 477).
Worldwide, more than 20 separate opioid drugs are in clinical use. Heroin is the most abused opioid drug in developed countries. These drugs are all typical agonists of µ-opioid receptors and they all have similar mental effects. However, the consumption patterns and some aspects of the toxicity of opioid-like substances are greatly influenced by the way of administration and metabolism of the opioid-like substance used, as well as the social conditions that determine the price and purity of the substance and the prohibitions of its non-medical use.However, the consumption patterns and some aspects of the toxicity of opioid-like substances are greatly influenced by the way of administration and metabolism of the opioid-like substance used, as well as the social conditions that determine the price and purity of the substance and the prohibitions of its non-medical use (Kaplan and Sadok, 2007, page 551). One of the factors that particularly attracted the attention of researchers is the bias of addicted people's attention towards drug-related symptoms.
When people repeatedly use a certain addictive substance, they automatically tend to these stimuli instead of avoiding them (Kosain[4], Guderian[5] and Wiers[6], 2011); This tendency is called attentional bias. Repeated use of drugs can be associated with various conditional stimuli such as words, images and auditory stimuli related to the act of drug use as an unconditioned stimulus, and thus a person reacts to those signs with physical arousal and mental temptation. (Volko[7] et al., 2006). These stimuli trigger memories of substance-related events and trigger the mechanism of temptation. (Cell[8] et al. 2000). The current research aims to reduce this mechanism in these people through the training of methadone users with attention bias correction tools. Problem Statement Attention bias has become a key variable in connection with drug addiction. Research shows that attentional bias to substance-related stimuli predicts treatment outcomes in different substance abusers (Marrison[9] et al., 2006; Scanmakers[10] et al., 2010). Also, the amount of substance abuse people consume (Field [11] and Cox, 2008). In addition, after treatment, drug abusers show less attentional bias towards substance-related cues, regardless of the type of treatment (Gardini[12], Caffara[13] and Veneri[14], 2009) (Marrison et al., 2006). In general, researches emphasize the key role of attention bias in the process of relapse and treatment.
Regarding the key role of attention bias, if attention bias can be modified and manipulated, it is possible to achieve favorable treatment results in the prevention of relapse.