Attentional Bias During a Novel Alcohol Cue Virtual Reality Paradigm

Abstract

Background

Attentional bias to alcohol cues is largely investigated using pictorial cues (i.e., two-dimensional images). The addition of eye-tracking metrics has improved these investigations yet are limited by a lack of naturalistic cues. Virtual reality (VR) can theoretically improve ecological validity through three-dimensional alcohol object presentation while utilizing eye-tracking metrics. This report sought to test the construct validity of the Alcohol Cue VR paradigm in evoking subjective craving and attentional bias through measurement of eye-gaze characteristics.

Methods

Participants (n = 105, 53% male, M_age = 38), with varying alcohol use histories, underwent the Alcohol Cue VR paradigm, an alcohol visual probe task, and measures of alcohol craving and VR-related assessments. The Alcohol Cue VR paradigm comprised of three active scenes with alcohol cues present, and three neutral scenes devoid of alcohol cues. Eye-gaze fixation time (index of “attentional bias”) in response to alcohol and control cues was recorded. Forward-stepwise models searched for optimal alcohol-related predictors of attentional bias, then compared against eye-tracking and response time metrics from the alcohol visual probe task.

Results

Alcohol use history, age of regular use onset, recency of use, and binge episodes were significantly associated with eye-gaze fixation time to alcohol cues; how present one felt within the VR scenes did not moderate these findings. Alcohol-related predictors accounted for a larger proportion of variance in VR-based models of attentional bias (ΔR² = 0.10) than in comparable alcohol visual probe task models based on fixation time (ΔR² = 0.05) or response time (ΔR² = 0.06).

Conclusions

The Alcohol Cue VR paradigm provided commensurate measures of attentional bias in the context of alcohol cues. Unique alcohol-related characteristics impacted the extent of attentional bias to alcohol-related cues, exemplifying the utility of VR-derived measurement in assessing alcohol use. Future research can understand whether VR attentional bias is modifiable through treatment and can serve as clinical endpoints.