Where is the bias? Measuring and retraining cognitive biases in problem drinkers

Cognitive biases in the processing of alcohol related information are thought to play a role in the etiology and maintenance of problem drinking (Wiers et al., 2007). Dual process models posit that prolonged excessive alcohol use causes alcohol related cues to selectively capture attention (attentional bias), activate positive associations (memory bias), and elicit the tendency to approach alcohol (approach bias). At the same time, the motivation and executive functions that are required to prevent these biases from eliciting alcohol use are thought to weaken. To retrain these biases, various computerized Cognitive Bias Modification (CBM) procedures have been developed, which have shown promising results in alcoholic patients as an add-on to treatment in an addiction clinic. The main aims of this theses was to investigate the effectiveness of web-based CBM in problem drinkers. The results suggest that the pictorial stimuli that were created for this study were suitable for the measurement and modification of cognitive biases. Unexpectedly, little evidence was found that alcohol use in problem drinkers was associated with the interplay between cognitive biases, executive functions and motivation to change, as hypothesized by dual process models. Furthermore, the web-based intervention aimed at retraining attentional bias, memory bias and approach bias as an add-on to a brief motivational intervention, was found ineffective in reducing alcohol use in problem drinkers more than a placebo training.