People With Cannabis Use Disorder Did Not Show Consistent Attentional Bias Toward Cannabis Images

Among 66 people with moderate-to-severe CUD and 42 controls, there were no significant group differences in attentional bias toward cannabis images using a visual probe task. Within the CUD group, those with higher CUDIT-R scores showed marginally faster responses to cannabis versus neutral images, but this effect did not survive correction for multiple comparisons.

Case-control study comparing 66 participants with moderate-to-severe CUD to 42 controls using a visual probe task measuring reaction times to cannabis versus neutral images at two stimulus onset asynchronies (200/500 ms). Linear mixed effect models adjusted for alcohol use examined group differences and moderators including craving, arousal/valence ratings, and nicotine use.

Attentional bias, the tendency to notice drug-related stimuli more quickly, is a cornerstone theory in addiction. This study challenges whether it reliably applies to cannabis use disorder, suggesting CUD may operate through different cognitive mechanisms than other substance use disorders.

If attentional bias is not a robust feature of cannabis use disorder, interventions designed to retrain attention away from cannabis cues may be less effective than for alcohol or tobacco. This could redirect treatment development toward other cognitive processes driving problematic cannabis use.

Visual probe task may not be sensitive enough to detect attentional bias. Moderate sample size. CUD was clinically defined but attentional bias may vary by severity in ways not captured. Cannot rule out that attentional bias exists but operates at different timescales.