El sesgo atencional en los trastornos relacionados con sustancias. Aspectos teóricos, evaluativos y de tratamiento.

The objective of this work is to investigate attentional bias as an automatic cognitive process and its implications in substance use disorders. Cognitive processes are fundamental in the formulation of the different explanatory models about psychopathology. Of the various cognitive processes, attention is a significant determinant, because although it fulfils various activities such as orientation and wakefulness, it is cognitive control that arouses relevant interest for it. This is due to the fact that it fulfills a task of linking between signal uptake and the achievement of other cognitive processes that intervene in the behavioral response mechanism. When a cognitive process like attention is markedly altered it will trigger impaired sequential cognitive functioning, along with the emission of disturbing behavior. Psychology considers that cognitive processes operate consciously (voluntarily) and automatically (implicitly); that is, in a dual way in which these processes such as attention maintain a continuum of coordinated gradual variations that regulate behavior. Failure to consider automatic cognitive processes is a notorious limitation for current explanatory models of psychopathological behavior (including compulsive substance use); given that many of these underlying cognitive processes are often not considered to influence higher mental processes and therefore behavior, without the individual necessarily being aware of this. In fact, this can help to understand pathological behaviors that for the investigator or the professional of psychology can be incomprehensible or paradoxical. Among the various underlying and altered processes, the attentional bias towards critical signals associated with substances has investigative relevance. Since it is a dysfunctional mechanism of selective attention, which operates frequently at an automatic level and in which the allocation and focus of attention are disproportionate in time, between a specific stimulus (image or word related to a drug) versus a neutral stimulus. And it attracts a person's focus of attention to the critical stimulus, from which it later becomes difficult to decouple. This later facilitates other altered cognitive processes subsequent to consumption. The generation of an attentional bias towards a specific signal has its origin in the association between the signal and the behavior, which can be avoidant (recurrent in phobias) or attractive (frequent in substance or food consumption) and that is conditioned until becoming an automatic process of difficult voluntary control. Although it is true that attention bias may be present in all individuals, the evidence reveals the marked and recurrent presence in various pathologies such as mood disorders (depressive), anxiety, food intake, phobias, of personality among others. And also included in substance use disorders. The findings show that attention bias has an impact on substance use, course, the severity of the disorder, craving, withdrawal, relapse, and the probability of treatment failure. Working with an attentional bias for specific signals on substances can generate difficulty, in the case of evaluation because it is assessed through software that usually measures the eye-hand reaction time or eye movement when faced with neutral and critical signals, which can be a limitation for the usual clinic; while at the intervention level, it is required to formulate bias retraining processes that require continuous exercise as a complementary technique to the usual cognitive-behavioral treatment. It is considered necessary to explore this line of research and its relationship with substance use disorders within the region. [ABSTRACT FROM AUTHOR]