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

What the researchers found

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.

Why it matters

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.

The numbers in context

66 CUD participants, 42 controls. No significant group differences in attentional bias. High-CUDIT-R subgroup showed marginally faster cannabis image responses (d = -0.10) but did not survive Bonferroni correction.

How the study worked

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.

What this study cannot tell us

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.

How to read the evidence

Preliminary: adequately powered for primary analysis but null findings need replication with more sensitive measures.

When this study was published

2025 study

The bigger picture

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.

Questions still open

• Is attentional bias truly absent in CUD, or do current measurement tools miss it? Would eye-tracking or neural measures reveal bias not captured by reaction times? Does the lack of attentional bias suggest fundamentally different maintenance mechanisms for CUD?

Common questions

Read the original research

Attentional bias in people with moderate-to-severe cannabis use disorder.

Comprehensive psychiatry, 146, 152658

Citation

Quinones-Valera, Marianna; Chan, Gary; Fraser, Madeleine I; Jones, Andrew; Freeman, Tom P; Hindocha, Chandni; Thomson, Hannah; McTavish, Eugene; Sehl, Hannah; Clemente, Adam; Cousijn, Janna; Labuschagne, Izelle; Rendell, Peter; Terrett, Gill; Greenwood, Lisa-Marie; Poudel, Govinda; Suo, Chao; Manning, Victoria; Lorenzetti, Valentina. (2025). Attentional bias in people with moderate-to-severe cannabis use disorder.. Comprehensive psychiatry, 146, 152658. https://doi.org/10.1016/j.comppsych.2025.152658

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