title: Attentional Bias and Approach/Avoidance Tendencies Do Not Predict Relapse or Time to Relapse in Alcohol Dependency.
abstract: BACKGROUND
  Implicit processes such as attentional bias (AB) and automatic approach/avoidance tendencies (AA) play a role in substance use disorders. Whether these processes can predict a relapse in alcohol-dependent patients is still unclear and must be examined in more detail than has been done previously. We aimed to establish whether AB and AA measured during treatment would predict relapse in alcohol-dependent patients. We also investigated whether these implicit processes predicted time to relapse better than a more common binary relapse variable.
  
  
  METHODS
  A total of 50 alcohol-dependent outpatients undergoing treatment completed the study. Patients completed the Addiction Stroop Task, which assesses AB, and the relevant Stimulus-Response Compatibility Task, which measures AA. Time to relapse was assessed 1, 2, and 3 months after the bias assessment.
  
  
  RESULTS
  Twenty patients (40%) relapsed during the follow-up period. The average time to relapse was 40 days after the first session. Overall, participants had an AB for alcohol-related stimuli and a tendency to avoid these stimuli. Neither relapse nor time to relapse was predicted by either bias type.
  
  
  CONCLUSIONS
  Although both AB and avoidance tendencies were present in our sample, these measures did not predict relapse or time to relapse in an outpatient alcohol-dependent sample in the following 3 months. Future research should focus on studying the predictive value of these biases in the short term, for example, using ecological momentary assessment techniques to assess implicit processes shortly before a relapse.
authors.affiliation: IVO Addiction Research Institute, Rotterdam, the Netherlands.|Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Michelle
authors.initials: M
authors.lastname: Snelleman
authors.affiliation: IVO Addiction Research Institute, Rotterdam, the Netherlands.|Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Tim Michaël
authors.initials: TM
authors.lastname: Schoenmakers
authors.affiliation: IVO Addiction Research Institute, Rotterdam, the Netherlands.|Erasmus Medical Center, Rotterdam, the Netherlands.|Department of Health Promotion, Maastricht University, Maastricht, the Netherlands.
authors.forename: Dike
authors.initials: D
authors.lastname: van de Mheen
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis* / Q000523:psychology* / Q000628:therapy; D001288:Attention; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010775:Photic Stimulation / Q000379:methods; D011237:Predictive Value of Tests; D011597:Psychomotor Performance; D011930:Reaction Time; D012008:Recurrence; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Alcohol; Approach/Avoidance Tendencies; Attentional Bias; Predictors; Relapse