A School-Based Comparison of Positive Search Training to Enhance Adaptive Attention Regulation with a Cognitive-Behavioural Intervention for Reducing Anxiety Symptoms in Children.

Many children experience anxiety but have limited access to empirically-supported interventions. School-based interventions using brief, computer-assisted training provide a viable way of reaching children. Recent evidence suggests that computer-delivered 'positive search training' (PST) reduces anxiety in children. This multi-informant, randomised controlled trial compared classroom-based, computer-delivered PST (N = 116) to a classroom-based, therapist-delivered cognitive-behavioural intervention (CBI) (N = 127) and a curriculum-as-usual control condition (CAU) (N = 60) in 7-11 year old children. Primary outcomes were child and parent report of child anxiety symptoms. Secondary outcomes were child and parent report of child depressive symptoms and child attention biases. Outcomes were assessed before and after the interventions, and six- and 12-months post-intervention. Teacher report of children's social-emotional functioning was assessed at pre- and post-intervention. As expected, compared to CAU, children receiving PST and the CBI reported greater anxiety reductions by post-intervention and six-month follow-up but, unexpectedly, not at 12-month follow-up. Partially consistent with hypotheses, compared to CAU, parents reported greater anxiety reductions in children receiving PST, but not the CBI, at 12-month follow-up. Contrary to expectation, there was a pre- to post-intervention increase in threat attention bias in PST compared to the other conditions, with no significant differences at follow-up. In support of hypotheses, teachers reported higher post-intervention social-emotional functioning in Year 5 students receiving the CBI but, unexpectedly, lower post-intervention functioning in students receiving PST. There were no effects on depressive symptoms. Further research is needed on strategies to maintain long-term benefits and determine preventative versus early intervention effects.

Changes in neural activation underlying attention processing of emotional stimuli following treatment with positive search training in anxious children.

Prior research indicates that positive search training (PST) may be a promising home-based computerised treatment for childhood anxiety disorders. It explicitly trains anxious individuals in adaptive, goal-directed attention-search strategies to search for positive and calm information and ignore goal-irrelevant negative cues. Although PST reduces anxiety symptoms, its neural effects are unknown. The main aim of this study was to examine changes in neural activation associated with changes in attention processing of positive and negative stimuli from pre- to post-treatment with PST in children with anxiety disorders. Children's neural activation was assessed with functional magnetic resonance imaging (fMRI) during a visual-probe task indexing attention allocation to threat-neutral and positive-neutral pairs. Results showed pre- to post-treatment reductions in anxiety symptoms and neural reactivity to emotional faces (angry and happy faces, relative to neutral faces) within a broad neural network linking frontal, temporal, parietal and occipital regions. Changes in neural reactivity were highly inter-correlated across regions. Neural reactivity to the threat-bias contrast reduced from pre- to post-treatment in the mid/posterior cingulate cortex. Results are considered in relation to prior research linking anxiety disorders and treatment effects with functioning of a broad limbic-cortical network involved in emotion reactivity and regulation, and integrative functions linking emotion, memory, sensory and motor processes and attention control.

Anxiety and Threat-Related Attention: Cognitive-Motivational Framework and Treatment.

Research in experimental psychopathology and cognitive theories of anxiety highlight threat-related attention biases (ABs) and underpin the development of a computer-delivered treatment for anxiety disorders: attention-bias modification (ABM) training. Variable effects of ABM training on anxiety and ABs generate conflicting research recommendations, novel ABM training procedures, and theoretical controversy. This article summarises an updated cognitive-motivational framework, integrating proposals from cognitive models of anxiety and attention, as well as evidence of ABs. Interactions between motivational salience-driven and goal-directed influences on multiple cognitive processes (e.g., stimulus evaluation, inhibition, switching, orienting) underlie anxiety and the variable manifestations of ABs (orienting towards and away from threat; threat-distractor interference). This theoretical analysis also considers ABM training as cognitive skill training, describes a conceptual framework for evaluating/developing novel ABM training procedures, and complements network-based research on reciprocal anxiety-cognition relationships.

Selective attention to smoking cues in former smokers.

Repeated drug use modifies the emotional and cognitive processing of drug-associated cues. These changes are supposed to persist even after prolonged abstinence. Several studies demonstrated that smoking cues selectively attract the attention of smokers, but empirical evidence for such an attentional bias among successful quitters is inconclusive. Here, we investigated whether attentional biases persist after smoking cessation. Thirty-eight former smokers, 34 current smokers, and 29 non-smokers participated in a single experimental session. We used three measures of attentional bias for smoking stimuli: A visual probe task with short (500ms) and long (2000ms) picture stimulus durations, and a modified Stroop task with smoking-related and neutral words. Former smokers and current smokers, as compared to non-smokers, showed an attentional bias in visual orienting to smoking pictures in the 500ms condition of the visual probe task. The Stroop interference index of smoking words was negatively related to nicotine dependence in current smokers. Former smokers and mildly dependent smokers, as compared to non-smokers, showed increased interference by smoking words in the Stroop task. Neither current nor former smokers showed an attentional bias in maintained attention (2000ms visual probe task). In conclusion, even after prolonged abstinence smoking cues retain incentive salience in former smokers, who differed from non-smokers on two attentional bias indices. Attentional biases in former smokers operate mainly in early involuntary rather than in controlled processing, and may represent a vulnerability factor for relapse. Therefore, smoking cessation programs should strengthen self-control abilities to prevent relapses.

Attention Bias Modification (ABM): Review of Effects of Multisession ABM Training on Anxiety and Threat-Related Attention in High-Anxious Individuals.

Attention bias modification (ABM) aims to reduce anxiety by reducing attention bias (AB) to threat; however, effects on anxiety and AB are variable. This review examines 34 studies assessing effects of multisession-ABM on both anxiety and AB in high-anxious individuals. Methods include ABM-threat-avoidance (promoting attention-orienting away from threat), ABM-positive-search (promoting explicit, goal-directed attention-search for positive/nonthreat targets among negative/threat distractors), and comparison conditions (e.g., control-attention training combining threat-cue exposure and attention-task practice without AB-modification). Findings indicate anxiety reduction often occurs during both ABM-threat-avoidance and control-attention training; anxiety reduction is not consistently accompanied by AB reduction; anxious individuals often show no pretraining AB in orienting toward threat; and ABM-positive-search training appears promising in reducing anxiety. Methodological and theoretical issues are discussed concerning ABM paradigms, comparison conditions, and AB assessment. ABM methods combining explicit goal-directed attention-search for nonthreat/positive information and effortful threat-distractor inhibition (promoting top-down cognitive control during threat-cue exposure) warrant further evaluation.

Association between irritability and bias in attention orienting to threat in children and adolescents.

BACKGROUND: Irritability, a frequent complaint in children with psychiatric disorders, reflects increased predisposition to anger. Preliminary work in pediatric clinical samples links irritability to attention bias to threat, and the current study examines this association in a large population-based sample. METHODS: We studied 1,872 children (ages 6-14) using the Development and Well-Being Assessment (DAWBA), Childhood Behavior Checklist (CBCL), and dot-probe tasks. Irritability was defined using CBCL items that assessed temper tantrums and hot temper. The dot-probe task assessed attention biases for threat-related (angry face) stimuli. Multiple regression analysis was used to assess specificity of associations to irritability when adjusting for demographic variables and co-occurring psychiatric traits. Propensity score matching analysis was used to increase causal inference when matching for demographic variables and co-occurring psychiatric traits. RESULTS: Irritability was associated with increased attention bias toward threat-related cues. Multiple regression analysis suggests associations between irritability and threat bias are independent from demographic variables, anxiety, and externalizing traits (attention-deficit/hyperactivity, conduct, and headstrong/hurtful), but not from broad internalizing symptoms. Propensity score matching analysis indicated that this association was found for irritable versus nonirritable groups matched on demographic and co-occurring traits including internalizing symptoms. CONCLUSIONS: Irritability in children is associated with biased attention toward threatening information. This finding, if replicated, warrants further investigation to examine the extent to which it contributes to chronic irritability and to explore possible treatment implications.

Anxiety and attention to threat: Cognitive mechanisms and treatment with attention bias modification.

Anxiety disorders are common and difficult to treat. Some cognitive models of anxiety propose that attention bias to threat causes and maintains anxiety. This view led to the development of a computer-delivered treatment: attention bias modification (ABM) which predominantly trains attention avoidance of threat. However, meta-analyses indicate disappointing effectiveness of ABM-threat-avoidance training in reducing anxiety. This article considers how ABM may be improved, based on a review of key ideas from models of anxiety, attention and cognitive control. These are combined into an integrative framework of cognitive functions which support automatic threat evaluation/detection and goal-directed thought and action, which reciprocally influence each other. It considers roles of bottom-up and top-down processes involved in threat-evaluation, orienting and inhibitory control in different manifestations of attention bias (initial orienting, attention maintenance, threat avoidance, threat-distractor interference) and different ABM methods (e.g., ABM-threat-avoidance, ABM-positive-search). The framework has implications for computer-delivered treatments for anxiety. ABM methods which encourage active goal-focused attention-search for positive/nonthreat information and flexible cognitive control across multiple processes (particularly inhibitory control, which supports a positive goal-engagement mode over processing of minor threat cues) may prove more effective in reducing anxiety than ABM-threat-avoidance training which targets a specific bias in spatial orienting to threat.

Time course of attentional bias to drug cues in opioid dependence.

Prior research indicates attentional bias to drug cues in opioid dependence. As this bias may be a marker of vulnerability to relapse following treatment, it is useful to clarify its underlying processes. The present study examined whether the opioid-related bias operates in early attention processes such as initial orienting, or in maintained attention, or both. Evidence from prior research is limited and mixed. The time course of attentional bias for drug cues was assessed using a dot-probe task with pictorial drug cues presented at 3 stimulus exposure durations: 200, 500 and 1,500 ms. There were 2 groups: opioid-dependent (n = 19) and healthy controls (n = 20). Individuals in the opioid-dependent group were recruited from community drug and alcohol treatment services; 95% were taking methadone. Compared with the control group, the opioid-dependent group showed a significant attentional bias for opioid-related information presented at 200 ms (p = .006). There was a similar trend at 500 ms which was nonsignificant (p = .057), and no bias at 1,500 ms (p = .698). The findings indicate an attentional bias to drug cues in opioid dependence, which operates in initial orienting processes, but not maintained attention. Further research should examine whether modification of this bias by treatment reduces risk of relapse. (PsycINFO Database Record

Attentional bias to threat in children at-risk for emotional disorders: role of gender and type of maternal emotional disorder.

Previous studies suggested that threat biases underlie familial risk for emotional disorders in children. However, major questions remain concerning the moderating role of the offspring gender and the type of parental emotional disorder on this association. This study addresses these questions in a large sample of boys and girls. Participants were 6-12 years old (at screening) typically developing children participating in the High Risk Cohort Study for Psychiatric Disorders (n = 1280; 606 girls, 674 boys). Children were stratified according to maternal emotional disorder (none; mood disorder; anxiety disorder; comorbid anxiety/mood disorder) and gender. Attention biases were assessed using a dot-probe paradigm with threat, happy and neutral faces. A significant gender-by-parental emotional disorder interaction predicted threat bias, independent of anxiety and depression symptoms in children. Daughters of mothers with an emotional disorder showed increased attention to threat compared with daughters of disorder-free mothers, irrespective of the type of maternal emotion disorder. In contrast, attention bias to threat in boys only occurred in mothers with a non-comorbid mood disorder. No group differences were found for biases for happy-face cues. Gender and type of maternal emotional disorder predict attention bias in disorder-free children. This highlights the need for longitudinal research to clarify whether this pattern of threat-attention bias in children relates to the risk of developing anxiety and mood disorders later in life.

Look for good and never give up: A novel attention training treatment for childhood anxiety disorders.

Attention bias modification training (ABMT) is a promising treatment for anxiety disorders. Recent evidence suggests that attention training towards positive stimuli, using visual-search based ABMT, has beneficial effects on anxiety and attention biases in children. The present study extends this prior research using distinctive techniques designed to increase participant learning, memory consolidation, and treatment engagement. Fifty-nine clinically anxious children were randomly assigned to the active treatment condition (ATC) (N = 31) or waitlist control condition (WLC) (N = 28). In the ATC, children completed 12 treatment sessions at home on computer in which they searched matrices for a pleasant or calm target amongst unpleasant background pictures, while also engaging in techniques designed to consolidate learning and memory for these search strategies. No contact was made with children in the WLC during the wait period. Diagnostic, parent- and child-reports of anxiety and depressive symptoms, externalising behaviour problems and attention biases were assessed pre- and post-condition and six-months after treatment. Children in the ATC showed greater improvements on multiple clinical measures compared to children in the WLC. Post-treatment gains improved six-months after treatment. Attention biases for angry and happy faces did not change significantly from pre-to post-condition. However, larger pre-treatment attention bias towards threat was associated with greater reduction in anxiety at post-treatment. Also, children who showed greater consolidation of learning and memory strategies during treatment achieved greater improvement in global functioning at post-treatment. Attention training towards positive stimuli using enhanced visual-search procedures appears to be a promising treatment for childhood anxiety disorders.

Attention bias to emotional information in children as a function of maternal emotional disorders and maternal attention biases.

BACKGROUND AND OBJECTIVES: Children of parents with emotional disorders have an increased risk for developing anxiety and depressive disorders. Yet the mechanisms that contribute to this increased risk are poorly understood. The present study aimed to examine attention biases in children as a function of maternal lifetime emotional disorders and maternal attention biases. METHODS: There were 134 participants, including 38 high-risk children, and their mothers who had lifetime emotional disorders; and 29 low-risk children, and their mothers without lifetime emotional disorders. Mothers and children completed a visual probe task with emotional face pairs presented for 500 ms. RESULTS: Attention bias in children did not significantly differ solely as a function of whether or not their mothers had lifetime emotional disorders. However, attention bias in high-risk children was significantly related to their mothers' attention bias. Specifically, children of mothers with lifetime emotional disorders showed a greater negative attention bias if their mothers had a greater tendency to direct attention away from positive information. LIMITATIONS: This study was cross-sectional in nature, and therefore unable to assess long-term predictive effects. Also, just one exposure duration of 500 ms was utilised. CONCLUSION: Attention bias for negative information is greater in offspring of mothers who have lifetime emotional disorders and a reduced positive bias, which could be a risk marker for the development of emotional disorders in children.

Augmenting one-session treatment of children's specific phobias with attention training to positive stimuli.

This study examined the efficacy of combining two promising approaches to treating children's specific phobias, namely attention training and one 3-h session of exposure therapy ('one-session treatment', OST). Attention training towards positive stimuli (ATP) and OST (ATP+OST) was expected to have more positive effects on implicit and explicit cognitive mechanisms and clinical outcome measures than an attention training control (ATC) condition plus OST (ATC+OST). Thirty-seven children (6-17 years) with a specific phobia were randomly assigned to ATP+OST or ATC+OST. In ATP+OST, children completed 160 trials of attention training responding to a probe that always followed the happy face in happy-angry face pairs. In ATC+OST, the probe appeared equally often after angry and happy faces. In the same session, children completed OST targeting their phobic situation/object. Clinical outcomes included clinician, parent and child report measures. Cognitive outcomes were assessed in terms of change in attention bias to happy and angry faces and in danger and coping expectancies. Assessments were completed before and after treatment and three-months later. Compared to ATC+OST, the ATP+OST condition produced (a) significantly greater reductions in children's danger expectancies about their feared situations/object during the OST and at three-month follow-up, and (b) significantly improved attention bias towards positive stimuli at post-treatment, which in turn, predicted a lower level of clinician-rated phobia diagnostic severity three-months after treatment. There were no significant differences between ATP+OST and ATC+OST conditions in clinician, parent, or child-rated clinical outcomes. Training children with phobias to focus on positive stimuli is effective in increasing attention towards positive stimuli and reducing danger expectancy biases. Studies with larger sample sizes and a stronger 'dose' of ATP prior to the OST may reveal promising outcomes on clinical measures for training attention towards positive stimuli.

Attention processes in chronic fatigue syndrome: attentional bias for health-related threat and the role of attentional control.

Cognitive behavioural models of chronic fatigue syndrome (CFS) propose that attention processes, specifically, enhanced selective attention to health-threat related cues, may play an important role in symptom maintenance. The current study investigated attentional bias towards health-threat stimuli in CFS. It also examined whether individuals with CFS have impaired executive attention, and whether this was related to attentional bias. 27 participants with CFS and 35 healthy controls completed a Visual Probe Task measuring attentional bias, and an Attention Network Test measuring executive attention, alerting and orienting. Participants also completed self-report measures of CFS and mood symptoms. Compared to the control group, the CFS group showed greater attentional bias for health-threat words than pictures; and the CFS group was significantly impaired in executive attention. Furthermore, CFS individuals with poor executive attention showed greater attentional bias to health-threat related words, compared not only to controls but also to CFS individuals with good executive attention. Thus, this study revealed a significant relationship between attentional bias and executive attention in CFS: attentional bias to threat was primarily evident in those with impaired executive attention control. Taking account of individual differences in executive attention control in current intervention models may be beneficial for CFS.

Electrophysiological evidence for greater attention to threat when cognitive control resources are depleted.

In this study, we investigated the time course of attentional bias for threat-related (angry) facial expressions under conditions of high versus low cognitive (working memory) load. Event-related potential (ERP) and reaction time (RT) data were recorded while participants viewed pairs of faces (angry paired with neutral face) displayed for 500 ms and followed by a probe. Participants were required to respond to the probe while performing a concurrent task of holding in working memory a sequence of digits that were either in the same order (low memory load) or in a random mixed order (high memory load). The ERP results revealed that higher working memory load resulted in enhanced lateralized neural responses to threatening relative to neutral faces, consistent with greater initial orienting of attention to threatening faces (early N2pc: 180-252 ms) and enhanced maintenance of processing representations of threat (late N2pc, 252-320 ms; SPCN, 320-500 ms). The ERP indices showed significant positive relationships with each other, and also with the behavioral index of attentional bias to threat (reflected by faster RTs to probes replacing angry than neutral faces at 500 ms), although the latter index was not significantly influenced by memory load. Overall, the findings indicate that depletion of cognitive control resources, using a working memory manipulation, increases the capacity of task-irrelevant threat cues to capture and hold attention.

Attention bias to threat faces in severe mood dysregulation.

BACKGROUND: We used a dot-probe paradigm to examine attention bias toward threat (i.e., angry) and happy face stimuli in severe mood dysregulation (SMD) versus healthy comparison (HC) youth. The tendency to allocate attention to threat is well established in anxiety and other disorders of negative affect. SMD is characterized by the negative affect of irritability, and longitudinal studies suggest childhood irritability predicts adult anxiety and depression. Therefore, it is important to study pathophysiologic connections between irritability and anxiety disorders. METHODS: SMD patients (N = 74) and HC youth (N = 42) completed a visual probe paradigm to assess attention bias to emotional faces. Diagnostic interviews were conducted and measures of irritability and anxiety were obtained in patients. RESULTS: SMD youth differed from HC youth in having a bias toward threatening faces (P < .01). Threat bias was positively correlated with the severity of the SMD syndrome and depressive symptoms; degree of threat bias did not differ between SMD youth with and without co-occurring anxiety disorders or depression. SMD and HC youth did not differ in bias toward or away from happy faces. CONCLUSIONS: SMD youth demonstrate an attention bias toward threat, with greater threat bias associated with higher levels of SMD symptom severity. Our findings suggest that irritability may share a pathophysiological link with anxiety and depressive disorders. This finding suggests the value of exploring further whether attention bias modification treatments that are effective for anxiety are also helpful in the treatment of irritability.

Effects of oxytocin on attention to emotional faces in healthy volunteers and highly socially anxious males.

BACKGROUND: Evidence suggests that individuals with social anxiety demonstrate vigilance to social threat, whilst the peptide hormone oxytocin is widely accepted as supporting affiliative behaviour in humans. METHODS: This study investigated whether oxytocin can affect attentional bias in social anxiety. In a double-blind, randomized, placebo-controlled, within-group study design, 26 healthy and 16 highly socially anxious (HSA) male volunteers (within the HSA group, 10 were diagnosed with generalized social anxiety disorder) were administered 24 IU of oxytocin or placebo to investigate attentional processing in social anxiety. Attentional bias was assessed using the dot-probe paradigm with angry, fearful, happy and neutral face stimuli. RESULTS: In the baseline placebo condition, the HSA group showed greater attentional bias for emotional faces than healthy individuals. Oxytocin reduced the difference between HSA and non-socially anxious individuals in attentional bias for emotional faces. Moreover, it appeared to normalize attentional bias in HSA individuals to levels seen in the healthy population in the baseline condition. The biological mechanisms by which oxytocin may be exerting these effects are discussed. CONCLUSIONS: These results, coupled with previous research, could indicate a potential therapeutic use of this hormone in treatment for social anxiety.

The effects of alcohol on the pharmacokinetics and pharmacodynamics of the selective mu-opioid receptor antagonist GSK1521498 in healthy subjects.

The mu-opioid system has a key role in hedonic and motivational processes critical to substance addiction. However, existing mu-opioid antagonists have had limited success as anti-addiction treatments. GSK1521498 is a selective and potent mu-opioid antagonist being developed for the treatment of overeating and substance addictions. In this study, 28 healthy participants were administered single doses of GSK1521498 20 mg, ethanol 0.5 g/kg body weight, or both in combination, in a double blind placebo controlled four-way crossover design. The primary objective was to determine the risk of significant adverse pharmacodynamic and pharmacokinetic (PK) interactions. The effects of GSK1521498 on hedonic and consummatory responses to alcohol and the attentional processing of alcohol-related stimuli, and their modulation by the OPRM1 A118G polymorphism were also explored. GSK1521498 20 mg was well tolerated alone and in combination with ethanol. There were mild transient effects of GSK1521498 on alertness and mood that were greater when it was combined with ethanol. These effects were not of clinical significance. There were no effects of GSK1521498 on reaction time, hedonic or consummatory responses. These findings provide encouraging safety and PK data to support continued development of GSK1521498 for the treatment of alcohol addiction.

Attention bias for food is independent of restraint in healthy weight individuals-an eye tracking study.

OBJECTIVE: Restrained eating style and weight status are highly correlated. Though both have been associated with an attentional bias for food cues, in prior research restraint and BMI were often confounded. The aim of the present study was to determine the existence and nature of an attention bias for food cues in healthy-weight female restrained and unrestrained eaters, when matching the two groups on BMI. METHOD: Attention biases for food cues were measured by recordings of eye movements during a visual probe task with pictorial food versus non-food stimuli. Healthy weight high restrained (n = 24) and low restrained eaters (n = 21) were matched on BMI in an attempt to unconfound the effects of restraint and weight on attention allocation patterns. RESULTS: All participants showed elevated attention biases for food stimuli in comparison to neutral stimuli, independent of restraint status. DISCUSSION: These findings suggest that attention biases for food-related cues are common for healthy weight women and show that restrained eating (per se) is not related to biased processing of food stimuli, at least not in healthy weight participants.

Patterns of neural connectivity during an attention bias task moderate associations between early childhood temperament and internalizing symptoms in young adulthood.

BACKGROUND: Biased attention to threat is found in both individuals with anxiety symptoms and children with the childhood temperament of behavioral inhibition (BI). Although perturbed fronto-amygdala function is implicated in biased attention among anxious individuals, no work has examined the neural correlates of attention biases in BI. Work in this area might clarify underlying mechanisms for anxiety in a sample at risk for internalizing disorders. We examined the relations among early childhood BI, fronto-amygdala connectivity during an attention bias task in young adulthood, and internalizing symptoms, assessed in young adulthood. METHODS: Children were assessed for BI at multiple age points from infancy through age seven. On the basis of a composite of observational and maternal report data, we selected 21 young adults classified as having a history of BI and 23 classified as non-BI for this study (n = 44). Participants completed an event-related functional magnetic resonance imaging attention-bias task involving threat (angry faces) and neutral trials. Internalizing symptoms were assessed by self-report and diagnostic interviews. RESULTS: The young adults characterized in childhood with BI exhibited greater strength in threat-related connectivity than non-behaviorally inhibited young adults. Between-group differences manifested in connections between the amygdala and two frontal regions: dorsolateral prefrontal cortex and anterior insula. Amygdala-insula connectivity also interacted with childhood BI to predict young adult internalizing symptoms. CONCLUSIONS: Behavioral inhibition during early childhood predicts differences as young adults in threat and attention-related fronto-amygdala connectivity. Connectivity strength, in turn, moderated the relations between early BI and later psychopathology.

Attentional biases in abstinent alcoholics and their association with craving.

Previous investigations of attentional bias for alcohol cues in abstinent alcoholics indicate enhanced processing of alcohol cues on the modified Stroop task, and a more complicated "vigilance-avoidance" pattern of attentional bias on the visual probe task. Given that, in general, subjective craving is positively associated with attentional bias, we predicted that attentional biases in abstinent alcoholics would depend on their level of alcohol craving. In the present study 28 alcoholic patients, who had recently commenced a day treatment program, and 26 social drinking controls completed an alcohol Stroop task, a visual probe task with three stimulus durations (200, 500, and 2,000 ms), and self-report assessments of craving and alcohol dependence. On the alcohol Stroop task, abstinent alcoholics showed a greater interference effect for alcohol-related than neutral words, relative to social drinkers. On the visual probe task, alcoholic patients who reported a high level of craving exhibited a greater attentional bias toward alcohol cues, relative to both patients reporting a low level of craving, and social drinker controls. Alcoholics who reported low levels of craving showed avoidance of alcohol cues at 500 ms, relative to social drinkers. Among alcoholics, early dropout from treatment was associated with the severity of alcohol dependence and the strength of subjective craving, but it was not associated with measures of attentional bias. These results clarify the importance of subjective craving as a correlate of attentional biases in abstinent alcoholics.