Relationship between attentional bias and psychological craving in methamphetamine use disorder

Background Psychological craving and attentional bias are important indicators of addiction, as well as critical factors influencing relapse. Psychological craving includes withdrawal craving (a persistent background state during abstinence) and cue-induced craving (an acute, impulsive desire provoked by drug-related stimuli). However, the relationship between attentional bias and these two types of craving remains unclear. This study aims to investigate the association between attentional bias and psychological craving in individuals with methamphetamine use disorder (MUD) using a picture-based addiction Stroop task. Methods A total of 134 individuals with MUD were recruited. General demographic information and details regarding substance use were collected through questionnaires. For withdrawal craving, the visual analog craving scale (VAS) was used to assess the level of drug craving during the abstinence period. To assess cue-induced craving, participants were presented with drug-related scenarios through virtual reality (VR). Craving was then measured in each virtual scenario using a visual analog scale (VAS) integrated into the system. Subsequently, attentional bias was evaluated by the picture addiction Stroop task. Results Methamphetamine use disorder participants demonstrated significantly longer reaction times to MA-related image stimuli compared to neutral image stimuli ( p < 0.001). Attentional bias scores were positively correlated with both withdrawal craving ( p = 0.001) and cue-induced craving ( p = 0.043). Significant differences in attentional bias scores were observed among groups with varying levels of withdrawal craving ( F = 5.364, p = 0.006). Multiple linear regression analysis revealed that withdrawal craving was independently and specifically associated with attentional bias ( β = 8.135, p = 0.006). Conclusion Individuals with MUD exhibit significant attentional bias toward MA-related cues, which is associated with the intensity of both withdrawal and cue-induced craving. Furthermore, attentional bias is significantly associated with withdrawal craving rather than cue craving. These findings provide a foundation for developing interventions targeting attentional bias and craving in MUD.