Making Sense of Negative Findings from Mobile Attention Bias Modification Interventions for Individuals with Addictive Disorders: Quantitative Feasibility Study

Abstract

BackgroundAdvances in experimental psychology have led to a better understanding of unconscious, automatic processes that result in individuals relapsing into their substance-using habits. While some reviews have demonstrated the effectiveness of bias retraining of these unconscious biases, there have been other reviews that have highlighted that bias retraining is not always effective. Other studies have revealed there was no baseline biases among some participants. An examination of mobile bias retraining interventions has also revealed mixed results, with some reporting effectiveness and others null findings. A recent feasibility and acceptability study, done by the authors, revealed that 53% of participants have had no baseline biases and 21% of those with positive baseline biases did not have a positive change in magnitude following intervention.ObjectiveThe aim of this paper was to explore potential variables (demographic and clinical) that could account for the negative baseline biases in the prior feasibility and acceptability study, and to discuss some of the factors that could account for the absence of baseline biases. We also explored potential reasons for why there was no reduction in the magnitude of attentional biases among individuals with baseline biases.MethodsParticipants who were in the rehabilitation phase of their treatment were invited to participate. During the study they had to complete a set of baseline questionnaires, and on each day that they were on the ward they had to complete an attention bias assessment and modification task and rate their cravings using a visual analogue scale. Attention bias was deemed to be present if individuals had a positive score.ResultsIn our study, 53% (16/30) of individuals did not present with baseline attentional biases, and among those with positive baseline biases a total of 21% (3/14) of participants did not have a reduction in the overall magnitude of attentional biases. Chi-square analyses undertaken to compare the demographic characteristics of participants with and without baseline biases did not reveal any significant findings. However, with respect to clinical characteristics, those who had positive baseline biases had experimented with more substances.ConclusionsOur study is one of the first to have explored negative findings in attention bias modification interventions for individuals with addictive disorders. We postulate that several factors could account for the absence of baseline biases and there being no changes following bias retraining. Future research ought to take into consideration these factors.

A Literature Review of Attentional Biases amongst Individuals with Substance Dependency: Individual Differences and Modulating Factors

“…The absence of baseline biases amongst some substance users was evident in our previous study [7] evaluating the feasibility and acceptability of a mobile attention-bias-modification intervention. We found that 53% of the sampled individuals did not have baseline biases [7,8]. Previously MacLean et al (2018) [5] had highlighted that individuals diagnosed with opioid use disorder had baseline biases, but non-dependent users of prescription opioids did not exhibit such biases.…”

Gamified M-Health Attention Bias Modification Intervention for Individuals with Opioid Use Disorder: Protocol for a Pilot Randomised Study

“…In Zhang et al (2019)'s [15] prior study, they reported the feasibility and acceptability of a mobile attention bias intervention and reported there being individuals without baseline biases. In their sample of 30 participants, 17 participants had a diagnosis of opioid dependence, of which eight had an absence of baseline biases [16]. Zhang et al (2019)'s [15] prior study did demonstrate that there was a change amongst participants with baseline biases, and this warrants further exploration.…”