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Subjective craving for opiates: evaluation of a cue exposure protocol for use with detoxified opiate addicts.

Cue exposure has been advocated as an intervention for reducing relapse rates in detoxified addicts, by extinguishing classically conditioned drug effects/craving which may have developed. Several studies with alcoholics have found cue exposure to be associated with reductions in craving, but no controlled study has yet shown such an effect in opiate addicts. The present controlled group design evaluates a protocol which draws from experience in the treatment of anxiety and requires that each stimulus exposure should be continued until within-session habituation has occurred. It also explores whether there is any benefit of using a 'cognitive aversion' strategy during cue exposure, based on the social learning analysis that craving derives from expectancies of positive drug effects. A total of 21 detoxified in-patients were randomized to routine ward treatment plus two sessions of either cue exposure (Group E) or cue exposure and cognitive aversion (Group E/CA), or to routine treatment alone (Group C). A specially designed Craving Test was carried out before and after treatment, to assess change in cue-elicited reactions. The two treated groups showed significantly greater reductions in craving than Group C, but did not differ from each other. The cue exposure protocol has therefore been adopted for use in an ongoing clinical trial.

Adult↗

Comodulation masking release: effects of varying the level, duration, and time delay of the cue band.

The phenomenon of comodulation masking release (CMR) was studied in a series of experiments. When the relative level of the correlated cue band was more than about 10 dB less than that of the masker band, the CMR was abolished. When the duration of the tonal signal was varied with continuous maskers and cues, the course of the standard temporal-integration function (about -10 dB/decade) was followed by both the correlated-cue and the uncorrelated-cue conditions. In a burst masker paradigm employing several burst durations, the data for the correlated-cue condition closely followed the previously determined temporal-integration function. Finally, when the cue band was time delayed more than about 1.6 ms, the CMR began to decline, and it was abolished somewhere between 3 and 15 ms of delay, depending upon the subject. This latter outcome was essentially the same for masker and cue bands of both 75 and 100 Hz in width; in neither instance was there evidence of a cyclic, autocorrelation-like pattern following the period of the envelope. Supplementary experiments revealed two facts: The detectability of a masked narrow-band signal is not improved by the simultaneous presence of a correlated (or uncorrelated) noise band, and a small CMR can be obtained under conditions of forward masking.

Acoustic Stimulation↗

Comodulation masking release: evidence for multiple cues.

Signal detection was determined in conditions where the masker was a 10-Hz-wide noise band centered on the signal, and in conditions where either a comodulated or noncomodulated noise band (centered at 0.8 times the signal frequency) was also present. Signal frequencies of 500 or 2000 Hz were investigated. In one condition of the first experiment, the signal was exactly the same 10-Hz-wide noise band as the masker, added to the masker in phase. This condition was designed to limit the availability of cues based upon dip listening, suppression, beating, or across-frequency differences in noise envelope correlation, but to afford a cue based upon across-frequency envelope amplitude difference. The narrow-band noise signal resulted in approximately the same magnitude of comodulated masking release (CMR) as was found for a pure-tone signal. This result suggested that one important cue for CMR is an across-frequency difference in envelope amplitude. Stimulus conditions in the second experiment were intended to disrupt cues of across-frequency envelope amplitude difference, but to afford cues based upon across-frequency differences in noise envelope correlation. In this experiment, cues based upon envelope amplitude were impoverished by randomly varying the level of the flanking band from interval to interval, and by adjusting the level in the on-signal band to be the same in the nonsignal intervals as the level of noise plus signal in the signal interval. Again, substantial CMRs occurred, suggesting that another cue for CMR may be envelope pattern or correlation. The results of these experiments indicated that CMR is probably based upon more than one stimulus variable.

Adult↗

Effects of irritability on craving before and after cue exposure in abstinent alcoholic inpatients: experimental data on subjective response and heart rate.

OBJECTIVE: Irritability is often linked with problem drinking. The aim of this study is to examine the possible influence of irritability on craving induced by a cue-exposure paradigm. METHODS: 30 male abstinent alcoholic inpatients of the Psychiatric Hospital of Munich University, Germany gave answers to a series of personality questionnaires. Results of this study concerning the impact of aggressivity on craving for alcohol has recently been published. In this study, the subjects were subdivided into a low- and a high-irritable group based on their scores on the irritability subscale of the Buss-Durkee Hostility Inventory and were exposed to alcohol cues. Craving was measured by means of the Alcohol Craving Questionnaire (ACQ) and Visual Analogue Scales (VAS). The heart rate was also assessed throughout the whole process. ANCOVA for repeated measurement was employed to evaluate the data - irritability disposition as the between-subject factor and the experimental manipulation (absence vs. presence of alcohol cues) as the within-subject factor. RESULTS: Major findings are: (1). main effects of irritability on 'emotionality', 'purposefulness', and 'expectancy' of the ACQ as well as on 'craving for alcohol' of the VAS were significant; (2). cue exposure also exerted a significant main effect on 'craving for alcohol' of the VAS and on the heart rate after the presentation of alcohol cues; (3). on 'compulsivity' of the ACQ and 'intention to alcohol intake' of the VAS; there was a significant interaction between irritability and cue exposure. The high-irritable alcoholics, compared with their statements in the baseline, tended to report a higher control over alcohol intake and a lower intention to alcohol use after cue exposure. However, after confrontation with alcohol stimuli, their low-irritable counterparts reported a much lower control and a slightly higher intention than they did in the baseline. CONCLUSIONS: The results of this study indicate that induced craving in hospitalized alcohol addicts probably varies with the magnitude of their irritability; it might make patients more aware of their vulnerability to alcohol, help them develop more differential coping strategies and improve medical therapy against alcohol craving.

Adult↗

Comparison of two weighted integration models for the cueing task: linear and likelihood.

In a task in which the observer must detect a signal at two locations, presenting a precue that predicts the location of a signal leads to improved performance with a valid cue (signal location matches the cue), compared to an invalid cue (signal location does not match the cue). The cue validity effect has often been explained with a limited capacity attentional mechanism improving the perceptual quality at the cued location. Alternatively, the cueing effect can also be explained by unlimited capacity models that assume a weighted combination of noisy responses across the two locations. We compare two weighted integration models, a linear model and a sum of weighted likelihoods model based on a Bayesian observer. While qualitatively these models are similar, quantitatively they predict different cue validity effects as the signal-to-noise ratios (SNR) increase. To test these models, 3 observers performed in a cued discrimination task of Gaussian targets with an 80% valid precue across a broad range of SNR's. Analysis of a limited capacity attentional switching model was also included and rejected. The sum of weighted likelihoods model best described the psychophysical results, suggesting that human observers approximate a weighted combination of likelihoods, and not a weighted linear combination.

Adult↗

Stereo and motion parallax cues in human 3D vision: can they vanish without a trace?

In an immersive virtual reality environment, subjects fail to notice when a scene expands or contracts around them, despite correct and consistent information from binocular stereopsis and motion parallax, resulting in gross failures of size constancy (A. Glennerster, L. Tcheang, S. J. Gilson, A. W. Fitzgibbon, & A. J. Parker, 2006). We determined whether the integration of stereopsis/motion parallax cues with texture-based cues could be modified through feedback. Subjects compared the size of two objects, each visible when the room was of a different size. As the subject walked, the room expanded or contracted, although subjects failed to notice any change. Subjects were given feedback about the accuracy of their size judgments, where the "correct" size setting was defined either by texture-based cues or (in a separate experiment) by stereo/motion parallax cues. Because of feedback, observers were able to adjust responses such that fewer errors were made. For texture-based feedback, the pattern of responses was consistent with observers weighting texture cues more heavily. However, for stereo/motion parallax feedback, performance in many conditions became worse such that, paradoxically, biases moved away from the point reinforced by the feedback. This can be explained by assuming that subjects remap the relationship between stereo/motion parallax cues and perceived size or that they develop strategies to change their criterion for a size match on different trials. In either case, subjects appear not to have direct access to stereo/motion parallax cues.

Adult↗

Test for effects of visual and position cues on T-maze learning in toads.

This research was concerned with the effects of different classes of cues on the ability of toads (Bufo marinus) to learn an escape task, discrimination learning, in a T-maze. The cues were either a black or white brightness cue, a right or left position cue, or combinations of brightness and position cues. The toads were given a .6-A shock until they made the correct response. Results suggested that toads are capable of learning a discrimination task based on either a position or brightness cue. However, the rate of learning was influenced by strong aversion to the white arm when escaping from an aversive stimulus. No particular preference for either brightness or position cues was found independent of this aversion.

Animals↗

Comparing effects of 2-D and 3-D visual cues during aurally aided target acquisition.

The aim of the present study was to investigate interactions between vision and audition during a visual target acquisition task performed in a virtual environment. In two experiments, participants were required to perform an acquisition task guided by auditory and/or visual cues. In both experiments the auditory cues were constructed using virtual 3-D sound techniques based on nonindividualized head-related transfer functions. In Experiment 1 the visual cue was constructed in the form of a continuously updated 2-D arrow. In Experiment 2 the visual cue was a nonstereoscopic, perspective-based 3-D arrow. The results suggested that virtual spatial auditory cues reduced acquisition time but were not as effective as the virtual visual cues. Experiencing the 3-D perspective-based arrow rather than the 2-D arrow produced a faster acquisition time not only in the visually aided conditions but also when the auditory cues were presented in isolation. Suggested novel applications include providing 3-D nonstereoscopic, perspective-based visual information on radar displays, which may lead to a better integration with spatial virtual auditory information.

Adolescent↗

Alcohol cue reactivity: effects of detoxification and extended exposure.

Alcoholics' reactions to drinking-related stimuli (cue reactivity) have been well documented and alcohol cue exposure treatment has been conducted recently in several clinical trials. Prior to conducting large-scale clinical trials it is important to know what effects detoxification may have on cue reactivity. However, no information is available about the effects of stage of detoxification or of detoxification medication on alcohol cue reactivity. In this study, 45 male alcoholics, detoxified without medication, were assessed during either their second, fourth or sixth day of withdrawal. Further, their reactivity was compared to that of alcoholics detoxified with chlordiazepoxide (n = 15), and to that of alcoholics in their fourth week after drinking (n = 28). Cue reactivity assessment investigated salivation and urge to drink after 3 minutes of water cue exposure and then after 3 minutes of alcohol cue exposure. Urges to drink were assessed during an additional 15 minutes of alcohol exposure to explore latency to maximum reactivity and habituation. Reactivity did not differ as a function of group membership, although salivation was elevated to both beverages during the first week of detoxification. Of the sample, 70% reacted to alcohol with increased urge and 65% with increased salivation, with no difference between groups in proportions of reactors. The maximum urge to drink occurred in the first 6 minutes of alcohol exposure, followed by a gradual and significant decrease. There were no differences on these measures between alcoholics in their first or fourth week after their last drink. Implications for theory and clinical applications are discussed.

Adaptation, Psychological↗

Alcohol cue reactivity and mood induction in male and female alcoholics.

The purpose of this study was twofold: to investigate gender differences in alcohol cue reactivity, and to study the effect of individualized mood induction on cue reactivity. Male (n = 38) and female (n = 19) alcoholics were exposed to an alcoholic beverage before and after mood induction to assess their reactivity to the beverage cues. The mood induction was based on a situation the subject had identified as being high risk for relapse. Subjects showed urge and salivary reactivity in response to alcohol beverage cues prior to mood induction, and the induction of mood enhanced urge reactivity in both men and women. Analyses with alcohol urge reactors (subjects that demonstrate an increased urge to drink alcohol in response to an alcoholic beverage cue) suggested that women show more urge reactivity in response to negative moods than do men. No gender differences were seen in reactivity to beverage cues alone. These results identify an important gender difference in the effect of negative moods on cue reactivity and suggest that negative mood situations may place women at a higher risk for relapse than men.

Adolescent↗

Control of attention by a peripheral visual cue depends on whether the target is difficult to discriminate.

The influence of a peripheral cue represented by a gray ring on responsivity to a subsequent target varies. When a vertical line inside a ring was a go target and a white small ring inside a ring was a no-go target, reaction time was shorter at the same location relative to a different location. However, no reaction time difference between the two locations occurred when a white cross inside the ring, instead of the white vertical line inside the ring, was the go target. We investigated whether this last finding was due to a forward masking influence of the cue, a requirement of low attention for the discrimination or a lack of attention mobilization by the cue. In Experiment 1, the intensity of the cue was reduced in an attempt to reduce forward masking. In Experiment 2, the vertical line and the cross were presented in the same block of trials so as to be dealt with a common attentional strategy. In Experiments 3 and 4, the no-go target was a 45 masculine rotated cross inside a ring to increase the difficulty of the discrimination. No evidence was obtained that the cross was forward masked by the cue nor that it demanded less attention to be discriminated from the small ring. There was a facilitation of responsivity by the cue when the small ring was replaced by the rotated cross. The results suggest that when the discrimination to be performed is too easy the cue does not mobilize attention.

Adult↗

Rapid behavioral responses of an invertebrate larva to dissolved settlement cue.

Larvae of the nudibranch Phestilla sibogae were used to study whether a natural dissolved settlement cue (from their prey, Porites compressa, an abundant coral on Hawaiian reefs) induces behavioral responses that can affect larval transport to suitable settlement sites. As cue and larvae are mixed in the turbulent flow over a reef, cue is distributed in fine-scale filaments that the larva experiences as rapid (seconds) on/off encounters. To examine larval responses in this setting, individual larvae were tethered in a small flume with flow simulating water velocity relative to a freely swimming larva, and their responses to realistic temporal patterns of cue encounter were videotaped. Competent larvae quickly ceased swimming in cue filaments and resumed swimming after exiting filaments. The threshold cue concentration eliciting a response was 3%-17% of concentrations within heads of P. compressa in nature. When moving freely in filtered seawater, competent larvae swam along straight paths in all directions at approximately 0.2 cm s(-1), whereas in water conditioned by P. compressa, most ceased swimming and sank at approximately 0.1 cm s(-1). The ability of larvae to rapidly respond (by sinking) to brief encounters with dissolved settlement cues can enhance their rapid transport to the substratum, even in wave-driven turbulent flow.

Analysis of Variance↗

Individual differences in cue utilization on spatial tasks.

Two studies examined individual differences in cue utilization for spatial tasks. Study 1 investigated sex and weight differences in the use of proprioceptive and tactile cues for negotiating a finger maze while blindfolded. The results indicate that females and overweight persons were more likely to use a tactile cue than a proprioceptive one, while the reverse was true for males. Also, the 16 females were more likely to use a tactile cue and less likely to use a proprioceptive cue than the 16 males were. These individual difference reflected an attentional bias on the part of male subjects and a response bias on the part of female and overweight subjects. Study 2 investigated sex differences in congenitally blind subjects' use of proprioceptive and exteroceptive cues when giving directions to get from one place to another. The results showed that the 5 males provided more proprioceptive than exteroceptive cues, while a trend in the opposite direction was observed for the 5 females.

Body Weight↗

Spatial probability as an attentional cue in visual search.

We investigated the role of spatial probabilities in target location during participants' performance of a visual search task. Experiments 1 and 2 demonstrated that spatial probabilities could serve as a powerful attentional bias that produced faster detection of targets in high-probability locations than of those in low- or random-probability locations. The effect could not be explained by repetition priming alone. Moreover, responses to targets in low-probability locations were slowed only when a distractor was present in the high-probability location. In Experiments 3-5, we compared the effects of spatial probability with an explicit endogenous cue and a salient exogenous cue. Facilitation due to spatial probability was independent of any benefit afforded by the explicit endogenous cue but interacted with the salient exogenous cue, such that the exogenous cue validity effect was compressed for targets in the high-probability location. Together, these results suggest that the spatial probabilities governing target location constitute a potent bias of visual processing and, as such, can be considered an attentional cue that differs from both typical explicit endogenous and salient exogenous cues.

Adolescent↗

No evidence for overshadowing or facilitation of spatial pattern learning by visual cues.

Two experiments were conducted to examine the effects of redundant and relevant visual cues on spatial pattern learning. Rats searched for hidden food items on the tops of poles that formed a square (Experiment 1) or a checkerboard (Experiment 2) pattern. The experimental groups were trained with visual cues that specified the locations of the baited poles. All groups were tested without visual cues so that any overshadowing or facilitation of spatial pattern learning by visual cues could be detected. Spatial choices were controlled by the spatial pattern and by the visual cues in both experiments. However, there was no evidence of overshadowing or facilitation of spatial pattern learning by visual cues in either experiment. The results are consistent with the idea that the representation of the spatial pattern that guides choices is not controlled by the same learning processes as those that produce associations between visual cues and food locations.

Animals↗

The effect of the physical characteristics of cues and targets on facilitation and inhibition.

The present experiment was conducted in order to examine the role of cue-target discriminability on early occurring attentional cuing effects and late occurring inhibition of return (IOR). The experiment used a single target stimulus in conjunction with three different cue stimuli. The cues were the same as the target, different in color, shape, and luminance to the target, or did not spatially overlap with the target. At shorter stimulus onset asynchronies (SOAs; 100 and 200 msec), attentional cuing effects were only found with the nonoverlapping cues. However, at longer SOAs (400 and 800 msec), approximately equal IOR effects were found with all three types of cues. The results indicated that the physical characteristics of the cues and targets affected the pattern of reaction times at the shorter SOAs but not at the longer SOAs. The conclusion is that the biphasic pattern of early facilitation and late inhibition following a peripheral cue should not be considered the definitive signature of the peripheral cuing paradigm.

Adult↗

Dynamic interactions between local surface cues, distal landmarks, and intrinsic circuitry in hippocampal place cells.

A number of computational models of hippocampal place cells incorporate attractor neural network architecture to simulate key findings in the place cell literature, including the properties of pattern completion, firing in the absence of visual input, and nonlinear responses to environmental manipulations. To test for evidence of attractor dynamics, ensembles of place cells were recorded using multiple-tetrode techniques. After many days of experience in an environment with salient local surface cues on a circular track and salient distal landmarks on the wall, the local surface cues were rotated as a set in opposition to the distal landmarks. The amount of mismatch between the local and distal sets of cues varied from 45 to 180 degrees. If place cells were parts of strong attractors, then their place fields should follow either the local cues or the distal cues as an integrated ensemble. Instead, in single recording sessions, some place cells were controlled by the distal landmarks, other cells were controlled by the local cues, and other cells became silent or gained new fields. In some cases, individual place fields split in half, following both the local and distal cues. If place cells are indeed parts of attractor networks in the hippocampus, then the attractors may be weak relative to the inputs from external sources, such as representations of the sensory environment and representations of heading direction, in a familiar, well explored environment.

Animals↗

Drug-onset cues as signals: intraadministration associations and tolerance.

On the basis of a conditioning analysis of drug tolerance, drug-associated cues become associated with the drug effect. These cues elicit conditional compensatory responses and modulate the expression of tolerance. Although there are many findings consistent with the conditioning analysis of tolerance, there also are contrary findings. The results of these experiments suggest that some of the apparently contradictory findings result because interoceptive pharmacological cues, as well as exteroceptive environmental cues, are paired with a drug effect. That is, within each administration, early drug-onset cues may become associated with the later, larger drug effect, and these pharmacological cues may overshadow simultaneously present environmental cues. We demonstrate the contribution of such intraadministration associations to tolerance to the analgesic effect of morphine and to the expression of conditional compensatory hyperalgesia.

Animals↗