Attentional Bias Is Associated With Incentive-Related Physiological and Subjective Measures

Drug cue reactivity is theoretically and clinically important. The modified Stroop task has been widely used to assess attention capture by drug cues (attentional bias). Attentional bias to drug cues is assumed to reflect the incentive value of those cues, but this has not been directly tested. The authors examined whether the smoking Stroop effect was associated with facial electromyography (EMG) assessed in real time. Heart-rate (HR) and skin conductance (SC) responses were also assessed. Smokers (n = 79) attended up to four experimental sessions. Presession Abstinence state and within-session Smoking were manipulated across sessions. Over all assessments, participants exhibited a robust smoking Stroop effect. Using Generalized Estimating Equations (GEE) analyses, the smoking Stroop effect was positively associated with zygomaticus major activity but not with corrugator supercilii activity, HR, or SC. The smoking Stroop effect was also positively associated with self-reported positive outcome expectancies from smoking and with craving. In sum, attentional bias was more strongly associated with appetitive responses (zygomaticus major activity, positive outcome expectancies) than with withdrawal responses (e.g., corrugator supercilii activity) or measures of physiological arousal (e.g., HR, SC).