In the past two decades, a variety of cognitive training interventions have been developed to help people overcome their addictive behaviors. Conceptually, it is important to distinguish between programs in which reactions to addiction-relevant cues are trained (varieties of cognitive bias modification, CBM) and programs in which general abilities are trained such as working memory or mindfulness. CBM was first developed to study the hypothesized causal role in mental disorders: by directly manipulating the bias, it was investigated to what extent this influenced disorder-relevant behavior. In these proof-of-principle studies, the bias was temporarily modified in volunteers, either temporarily increased or decreased, with corresponding effects on behavior (e.g., beer consumption), in case the bias was successfully manipulated. In subsequent clinical randomized…

In this chapter, the authors argue that human decision making is influenced by at least three types of input: bottom-up inherently salient stimuli (e.g., a loud noise), top-down goal-directed biasing, and conditioned reward and punishment signals. In addition, conditioned reward cues can capture attention, and in this way can bias decision making in the direction of cue with corresponding actions (i.e., addictive behavior), even when this counters other goals. Akrasia comes from the Greek term “lacking command” and refers to cases where people appear to act against their better judgment or cases of “weaknesses of the will”. At first sight, human Akrasia problems may seem surprising, given that with evolution, progressively more advanced and abstract control mechanisms have developed, built…

This chapter reviews cognitive bias modification studies in addiction, with a discussion of ways forward. First, it is crucial to distinguish between proof-of-principle studies aimed at revealing mechanisms, typically performed in student volunteers not aiming for behavior change, and randomized controlled trials in which the goal is behavior change, performed either as add-on to clinical treatment or as stand-alone intervention. We discuss studies in clinical samples and ways forward. For approach bias modification, rather consistent add-on effects have been found regarding treatment outcome. For attentional bias modification, results have been more mixed, but there are promising results. Possible ways forward include adding neural enhancement methods and developing more personally relevant varieties of training, which better align with cognitive and motivating…

Cocaine use disorder (CUD) is a global public health concern. In both Europe and the USA, cocaine is one of the most commonly used illicit stimulant drugs. Cocaine use leads to an increase of dopamine, serotonin and noradrenalin in several sub-cortical structures, including the nucleus accumbens (NAcc). Due to the connections of the NAcc with brain regions involved in cognitive functioning, the effects of cocaine are dispersed throughout the brain. There is a vast body of literature reporting impaired cognitive functions associated with CUD, including cognitive functions in the domains of attention, executive functioning, learning and memory. This chapter summarizes the deviating cognitive functions and the neurobiological mechanisms associated with cocaine use. In addition, the factors that moderate these effects…

This chapter focuses on the role of motivation in the Reflective and Impulsive Model (RIM), and related dual-process models, with an emphasis on addiction. We will first consider motivational processes in the RIM and related dual-process models of addiction, then review studies assessing aspects of these models, including assessment and intervention studies. In the next section we discuss theoretical issues with dual-process models and the role of motivation in these models, and discuss some alternatives. We end with our current perspective on the role of cognitive-motivational processes in addiction.

An extensive literature in the addiction field has demonstrated that substance misusers as well as people meeting criteria for substance use disorders (SUDs) often show cognitive biases for stimuli relating to their substance of abuse. At least three different types of biases have been distinguished: biases in attention (reviews: Field and Cox, 2008; Wiers et al., 2013; Field et al., 2016), memory associations (reviews: Rooke et al., 2008; Reich et al., 2010; Stacy and Wiers, 2010), and biases in action tendencies (reviews: Kakoschke et al., 2019; Loijen et al., 2020).

Different techniques have been developed to manipulate these cognitive biases, collectively called cognitive bias modification (CBM). Note that there are other types of cognitive training – for example, working memory…