Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-13T03:24:17.388Z Has data issue: false hasContentIssue false

Using a drug-word Stroop task to differentiate recreational from dependent drug use

Published online by Cambridge University Press:  14 March 2014

Dana G. Smith*
Affiliation:
Behavioural and Clinical Neuroscience Institute, Department of Psychology, University of Cambridge, Cambridge, UK
Karen D. Ersche
Affiliation:
Behavioural and Clinical Neuroscience Institute, Department of Psychiatry, University of Cambridge, Cambridge, UK
*
*Address for correspondence: Dana Smith, Behavioural and Clinical Neuroscience Institute, Department of Psychology, Downing Street, Cambridge CB2 3EB, UK. (Email: ds555@cam.ac.uk)

Abstract

Distinguishing dependent from recreational drug use can be a surprisingly difficult task, and the current means for identifying substance abuse can be inadequate or even misleading. In subjective self-reports, those who are most at risk may downplay their consumption, not admitting to the full extent of their habit, and measures purely of quantity of use rarely capture the true nature of an individual's relationship to the drug, such as a psychological dependence on the substance. This trend is particularly true for heavy stimulant use, which is absent of the physical withdrawal symptoms that can help identify opiate or alcohol dependence. As such, a simple objective measure to help identify substance abuse, particularly in individuals who might not otherwise raise suspicion, would be a valuable tool in both clinical and experimental settings. We propose that the drug-word Stroop task, an objective assessment of attentional bias and distraction to salient drug-related stimuli, would be a valuable tool in helping to make these categorizations. This measure has been shown to correlate with drug craving, as well as to successfully distinguish dependent from recreational stimulant users and to help to predict outcomes in treatment-seeking individuals. Here, we survey prior literature on the drug-word Stroop task and provide a perspective on using the assessment as a potential diagnostic for drug use severity.

Type
Review Articles
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Original research presented in this review was funded by a Medical Research Council (MRC) grant (G0701497), and conducted within the Behavioural and Clinical Neuroscience Institute (BCNI), which is jointly funded by an award from the MRC and Wellcome Trust (G00001354). Dana G. Smith is supported by a studentship from the Cambridge Overseas Trust. Karen D. Ersche is supported by the MRC.

References

1.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed.Arlington, VA: American Psychiatric Publishing; 2013.Google Scholar
2.United Nations Office on Drugs and Crime. World Drug Report 2012. Vienna: United Nations; 2012.Google Scholar
3.Vonmoos, M, Hulka, LM, Preller, KH, etal. Cognitive dysfunctions in recreational and dependent cocaine users: role of attention-deficit hyperactivity disorder, craving and early age at onset. Br J Psychiatry. 2013; 203(1): 3543.Google Scholar
4.Franken, IHA, Hendriksa, VM, van den Brink, W. Initial validation of two opiate craving questionnaires: the Obsessive Compulsive Drug Use scale and the Desires for Drug questionnaire. Addict Behav. 2002; 27(5): 675685.Google Scholar
5.Field, M, Mogg, K, Mann, B, Bennett, GA, Bradley, BP. Attentional biases in abstinent alcoholics and their association with craving. Psychol Addict Behav. 2013; 27(1): 7180.Google Scholar
6.Smith, DG, Jones, PS, Bullmore, ET, Robbins, TW, Ersche, KD. Enhanced orbitofrontal cortex function and lack of attentional bias to cocaine cues in recreational stimulant users. Biol Psychiatry. 2014; 75(2): 124131.Google Scholar
7.Brewer, JA, Worhunsky, PD, Carroll, KM, Rounsaville, BJ, Potenza, MN. Pretreatment brain activation during stroop task is associated with outcomes in cocaine-dependent patients. Biol Psychiatry. 2008; 64(11): 9981004.Google Scholar
8.Carpenter, KM, Martinez, D, Vadhan, NP, Barnes-Holmes, D, Nunes, EV. Measures of attentional bias and relational responding are associated with behavioral treatment outcome for cocaine dependence. Am J Drug Alcohol Abuse. 2012; 38(2): 146154.CrossRefGoogle ScholarPubMed
9.Verdejo-García, A, Bechara, A, Recknor, EC, Pérez-García, M. Executive dysfunction in substance dependent individuals during drug use and abstinence: an examination of the behavioral, cognitive and emotional correlates of addiction. J Int Neuropsychol Soc. 2006; 12(3): 405415.CrossRefGoogle ScholarPubMed
10.Goldstein, RZ, Volkow, ND. Dysfunction of the prefrontal cortex in addiction: neuroimaging findings and clinical implications. Nat Rev Neurosci. 2011; 12(11): 652669.Google Scholar
11.Rogers, RD, Robbins, TW. Investigating the neurocognitive deficits associated with chronic drug misuse. Curr Opin Neurobiol. 2001; 11(2): 250257.Google Scholar
12.Monterosso, JR, Aron, AR, Cordova, X, Xu, J, London, ED. Deficits in response inhibition associated with chronic methamphetamine abuse. Drug Alcohol Depend. 2005; 79(2): 273277.Google Scholar
13.Hester, R, Garavan, H. Executive dysfunction in cocaine addiction: evidence for discordant frontal, cingulate, and cerebellar activity. J Neurosci. 2004; 24(49): 1101711022.Google Scholar
14.Tomasi, D, Goldstein, RZ, Telang, F, etal. Widespread disruption in brain activation patterns to a working memory task during cocaine abstinence. Brain Res. 2007; 1171: 8392.Google Scholar
15.Ersche, KD, Clark, L, London, M, Robbins, TW, Sahakian, BJ. Profile of executive and memory function associated with amphetamine and opiate dependence. Neuropsychopharmacology. 2006; 31(5): 10361047.Google Scholar
16.Bechara, A, Dolan, S, Denburg, N, etal. Decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in alcohol and stimulant abusers. Neuropsychologia. 2001; 39(4): 376389.Google Scholar
17.Ersche, KD, Fletcher, PC, Lewis, SJG, etal. Abnormal frontal activations related to decision-making in current and former amphetamine and opiate dependent individuals. Psychopharmacology (Berl). 2005; 180(4): 612623.Google Scholar
18.Gooding, DC, Burroughs, S, Boutros, NN. Attentional deficits in cocaine-dependent patients: converging behavioral and electrophysiological evidence. Psychiatry Res. 2008; 160(2): 145154.Google Scholar
19.London, ED, Berman, SM, Voytek, B, etal. Cerebral metabolic dysfunction and impaired vigilance in recently abstinent methamphetamine abusers. Biol Psychiatry. 2005; 58(10): 770778.Google Scholar
20.Ersche, KD, Roiser, JP, Robbins, TW, Sahakian, BJ. Chronic cocaine but not chronic amphetamine use is associated with perseverative responding in humans. Psychopharmacology (Berl). 2008; 197(3): 421431.Google Scholar
21.Fox, HC, Axelrod, SR, Paliwal, P, Sleeper, J, Sinha, R. Difficulties in emotion regulation and impulse control during cocaine abstinence. Drug Alcohol Depend. 2007; 89(2–3): 298301.Google Scholar
22.Ersche, KD, Turton, AJ, Chamberlain, SR, etal. Cognitive dysfunction and anxious-impulsive personality traits are endophenotypes for drug dependence. Am J Psychiatry. 2012; 169(9): 926936.Google Scholar
23.Barrós-Loscertales, A, Bustamante, JCC, Ventura-Campos, N, etal. Lower activation in the right frontoparietal network during a counting Stroop task in a cocaine-dependent group. Psychiatry Res. 2011; 194(2): 111118.CrossRefGoogle Scholar
24.Bolla, KI, Ernst, M, Kiehl, K, etal. Prefrontal cortical dysfunction in abstinent cocaine abusers. J Neuropsychiatry Clin Neurosci. 2004; 16(4): 456464.Google Scholar
25.Bechara, A. Decision making, impulse control and loss of willpower to resist drugs: a neurocognitive perspective. Nat Neurosci. 2005; 8(11): 14581463.Google Scholar
26.Copersino, ML, Serper, MR, Vadhan, N, etal. Cocaine craving and attentional bias in cocaine-dependent schizophrenic patients. Psychiatry Res. 2004; 128(3): 209218.Google Scholar
27.Field, M, Cox, WM. Attentional bias in addictive behaviors: a review of its development, causes, and consequences. Drug Alcohol Depend. 2008; 97(1–2): 120.Google Scholar
28.Garavan, H, Pankiewicz, J, Bloom, A, etal. Cue-induced cocaine craving: neuroanatomical specificity for drug users and drug stimuli. Am J Psychiatry. 2000; 157(11): 17891798.Google Scholar
29.London, ED, Ernst, M, Grant, S, Bonson, K, Weinstein, A. Orbitofrontal cortex and human drug abuse: functional imaging. Cereb Cortex. 2000; 10(3): 334342.Google Scholar
30.Schoenbaum, G, Shaham, Y. The role of orbitofrontal cortex in drug addiction: a review of preclinical studies. Biol Psychiatry. 2008; 63(3): 256262.Google Scholar
31.Franklin, TR, Acton, PD, Maldjian, JA, etal. Decreased gray matter concentration in the insular, orbitofrontal, cingulate, and temporal cortices of cocaine patients. Biol Psychiatry. 2002; 51(2): 134142.Google Scholar
32.Sim, ME, Lyoo, IK, Streeter, CC, etal. Cerebellar gray matter volume correlates with duration of cocaine use in cocaine-dependent subjects. Neuropsychopharmacology. 2007; 32(10): 22292237.Google Scholar
33.Field, M, Marhe, R, Franken, IHA. The clinical relevance of attentional bias in substance use disorders. CNS Spectr. 2013: 16.Google Scholar
34.Waters, AJ, Marhe, R, Franken, IHA. Attentional bias to drug cues is elevated before and during temptations to use heroin and cocaine. Psychopharmacology. 2012; 219(3): 909921.Google Scholar
35.Marhe, R, Waters, AJ, van de Wetering, BJM, Franken, IHA. Implicit and explicit drug-related cognitions during detoxification treatment are associated with drug relapse: An ecological momentary assessment study. J. Consult. Clin. Psychol. 2013; 81(1): 112.Google Scholar
36.Ataya, AF, Adams, S, Mullings, E, etal. Internal reliability of measures of substance-related cognitive bias. Drug Alcohol Depend. 2012; 121(1): 148151.Google Scholar
37.Stroop, JR. Studies of interference in serial verbal reactions. J Exp Psychol. 1935; 18(6): 643662.Google Scholar
38.MacDonald, AW, Cohen, JD, Stenger, VA, Carter, CS. Dissociating the role of the dorsolateral prefrontal and anterior cingulate cortex in cognitive control. Science. 2000; 288(5472): 18351838.Google Scholar
39.Franken, IHA, 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(1): 99102.Google Scholar
40.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(3): 251257.Google Scholar
41.Franken, IHA, Kroon, LY, Wiers, RW, Jansen, A. Selective cognitive processing of drug cues in heroin dependence. J Psychopharmacol. 2000; 14(4): 395400.CrossRefGoogle ScholarPubMed
42.Lubman, DI, Peters, LA, Mogg, K, Bradley, BP, Deakin, JFW. Attentional bias for drug cues in opiate dependence. Psychol Med. 2000; 30(1): 169175.Google Scholar
43.Sharma, D, Albery, IP, Cook, C. Selective attentional bias to alcohol related stimuli in problem drinkers and non-problem drinkers. Addiction. 2001; 96(2): 285295.Google Scholar
44.Field, M. Cannabis “dependence” and attentional bias for cannabis-related words. Behav Pharmacol. 2005; 16(5–6): 473476.Google Scholar
45.Gross, TM, Jarvik, ME, Rosenblatt, MR. Nicotine abstinence produces content-specific Stroop interference. Psychopharmacology (Berl). 1993; 110(3): 333336.Google Scholar
46.Nestor, L, McCabe, E, Jones, J, Clancy, L, Garavan, H. Differences in “bottom-up” and “top-down” neural activity in current and former cigarette smokers: evidence for neural substrates which may promote nicotine abstinence through increased cognitive control. Neuroimage. 2011; 56(4): 22582275.Google Scholar
47.Hitsman, B, MacKillop, J, Lingford-Hughes, A, etal. Effects of acute tyrosine/phenylalanine depletion on the selective processing of smoking-related cues and the relative value of cigarettes in smokers. Psychopharmacology (Berl). 2008; 196(4): 611621.CrossRefGoogle ScholarPubMed
48.Ersche, KD, Bullmore, ET, Craig, KJ, etal. Influence of compulsivity of drug abuse on dopaminergic modulation of attentional bias in stimulant dependence. Arch Gen Psychiatry. 2010; 67(6): 632644.Google Scholar
49.Franken, I. Drug craving and addiction: integrating psychological and neuropsychopharmacological approaches. Prog Neuropsychopharmacol Biol Psychiatry. 2003; 27(4): 563579.Google Scholar
50.Goldstein, RZ, Tomasi, D, Rajaram, S, etal. Role of the anterior cingulate and medial orbitofrontal cortex in processing drug cues in cocaine addiction. Neuroscience. 2007; 144(4): 11531159.Google Scholar
51.Grant, S, London, ED, Newlin, DB, etal. Activation of memory circuits during cue-elicited cocaine craving. Proc Natl Acad Sci U S A. 1996; 93(21): 1204012045.Google Scholar
52.Volkow, ND, Wang, GJ, Telang, F, etal. Cocaine cues and dopamine in dorsal striatum: mechanism of craving in cocaine addiction. J Neurosci. 2006; 26(24): 65836588.CrossRefGoogle ScholarPubMed
53.Childress, AR, Mozley, PD, McElgin, W, etal. Limbic activation during cue-induced cocaine craving. Am J Psychiatry. 1999; 156(1): 1118.CrossRefGoogle ScholarPubMed
54.Field, M, Munafo, MR, Franken, IHA. A meta-analytic investigation of the relationship between attentional bias and subjective craving in substance abuse. Psychol Bull. 2009; 135(4): 589607.Google Scholar
55.Luijten, M, Veltman, DJ, van den Brink, W, etal. Neurobiological substrate of smoking-related attentional bias. Neuroimage. 2011; 54(3): 23742381.Google Scholar
56.Luijten, M, Veltman, DJ, Hester, R, etal. Brain activation associated with attentional bias in smokers is modulated by a dopamine antagonist. Neuropsychopharmacology. 2012; 37(13): 27722779.Google Scholar
57.Field, M, Christiansen, P. Commentary on, “Internal reliability of measures of substance-related cognitive bias”. Drug Alcohol Depend. 2012; 124(3): 189190.Google Scholar
58.Ersche, KD, Jones, PS, Williams, GB, etal. Distinctive personality traits and neural correlates associated with stimulant drug use versus familial risk of stimulant dependence. Biol Psychiatry. 2013; 74(2): 137144.Google Scholar
59.Vadhan, NP, Carpenter, KM, Copersino, ML, etal. Attentional bias towards cocaine-related stimuli: relationship to treatment-seeking for cocaine dependence. Am J Drug Alcohol Abuse. 2007; 33(5): 727736.Google Scholar
60.Soar, K, Mason, C, Potton, A, Dawkins, L. Neuropsychological effects associated with recreational cocaine use. Psychopharmacology (Berl). 2012; 222(4): 633643.Google Scholar
61.Colzato, LS, Huizinga, M, Hommel, B. Recreational cocaine polydrug use impairs cognitive flexibility but not working memory. Psychopharmacology (Berl). 2009; 207(2): 225234.Google Scholar
62.Kemmis, L, Hall, JK, Kingston, R, Morgan, MJ. Impaired fear recognition in regular recreational cocaine users. Psychopharmacology (Berl). 2007; 194(2): 151159.Google Scholar
63.Morgan, MJ, Marshall, JP. Deficient fear recognition in regular cocaine users is not attributable to elevated impulsivity or conduct disorder prior to cocaine use. J Psychopharmacol. 2013; 27(6): 526532.Google Scholar
64.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(10): 16421652.CrossRefGoogle ScholarPubMed
65.Levy, DJ, Glimcher, PW. The root of all value: a neural common currency for choice. Curr Opin Neurobiol. 2012; 22(6): 10271038.Google Scholar
66.Field, M, Christiansen, P, Cole, J, Goudie, A. Delay discounting and the alcohol Stroop in heavy drinking adolescents. Addiction. 2007; 102(4): 579586.CrossRefGoogle ScholarPubMed
67.Townshend, J, Duka, T. Attentional bias associated with alcohol cues: differences between heavy and occasional social drinkers. Psychopharmacology (Berl). 2001; 157(1): 6774.Google Scholar
68.Janes, AC, Pizzagalli, DA, Richardt, S, etal. Brain reactivity to smoking cues prior to smoking cessation predicts ability to maintain tobacco abstinence. Biol Psychiatry. 2010; 67(8): 722729.Google Scholar
69.Carpenter, KM, Schreiber, E, Church, S, McDowell, D. Drug Stroop performance: relationships with primary substance of use and treatment outcome in a drug-dependent outpatient sample. Addict Behav. 2006; 31(1): 174181.Google Scholar
70.Marhe, R, Luijten, M, van de Wetering, BJM, Smits, M, Franken, IHA. Individual differences in anterior cingulate activation associated with attentional bias predict cocaine use after treatment. Neuropsychopharmacology. 2013; 38(6): 10851093.Google Scholar
71.Marissen, MAE, Franken, IHA, Waters, AJ, etal. Attentional bias predicts heroin relapse following treatment. Addiction. 2006; 101(9): 13061312.Google Scholar
72.Goldstein, RZ, Alia-Klein, N, Tomasi, D, etal. Anterior cingulate cortex hypoactivations to an emotionally salient task in cocaine addiction. Proc Natl Acad Sci U S A. 2009; 106(23): 94539458.Google Scholar