A critical review of the literature on attentional bias in cocaine use disorder and suggestions for future research

Exp Clin Psychopharmacol. 2014 Dec;22(6):469-83. doi: 10.1037/a0037806. Epub 2014 Sep 15.


Cocaine use disorder (CUD) continues to be an important public health problem, and novel approaches are needed to improve the effectiveness of treatments for CUD. Recently, there has been increased interest in the role of automatic cognition such as attentional bias (AB) in addictive behaviors, and AB has been proposed to be a cognitive marker for addictions. Automatic cognition may be particularly relevant to CUD, as there is evidence for particularly robust AB to cocaine cues and strong relationships to craving for cocaine and other illicit drugs. Further, the wide-ranging cognitive deficits (e.g., in response inhibition and working memory) evinced by many cocaine users enhance the potential importance of interventions targeting automatic cognition in this population. In the current article, we discuss relevant addiction theories, followed by a review of studies that examined AB in CUD. We then consider the neural substrates of AB, including human neuroimaging, neurobiological, and pharmacological studies. We conclude with a discussion of research gaps and future directions for AB in CUD.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Animals
  • Attention / drug effects*
  • Behavior Therapy
  • Behavior, Addictive / etiology*
  • Behavior, Addictive / prevention & control
  • Biomarkers
  • Brain / drug effects
  • Brain / pathology
  • Brain / physiopathology
  • Cocaine / toxicity*
  • Cocaine-Related Disorders / pathology
  • Cocaine-Related Disorders / physiopathology
  • Cocaine-Related Disorders / psychology*
  • Cocaine-Related Disorders / therapy
  • Cognition / drug effects*
  • Combined Modality Therapy
  • Cues
  • Dopamine Uptake Inhibitors / toxicity*
  • Humans
  • Models, Neurological*
  • Neurons / drug effects
  • Neurons / metabolism
  • Neurons / pathology
  • Reaction Time / drug effects


  • Biomarkers
  • Dopamine Uptake Inhibitors
  • Cocaine