Attentional bias in problematic drinkers with and without mild to borderline intellectual disability.
Eye-tracking and reaction-time alcohol bias tasks are too unreliable in adults with mild-borderline ID to guide treatment decisions.
01Research in Context
What this study did
The team asked adults with mild-borderline intellectual disability and drinking problems to look at alcohol pictures and neutral pictures.
They used eye-tracking and a quick button-press task to see if the adults looked at or responded to alcohol cues faster.
The same tasks were given to adults without intellectual disability to compare attention bias scores.
What they found
Both groups showed almost identical attention to alcohol cues—no extra looking time, no faster button presses.
The eye and reaction-time numbers jumped around so much that the authors warn the tools are too shaky for clinical use.
How this fits with other research
Waldron et al. (2023) systematic review says attention in ID should be judged against mental age, not calendar age. That view helps explain why the alcohol-bias tasks failed: the tools were built for typical-IQ drinkers, not adults whose cognitive level is younger.
Lancioni et al. (2009) found real attention deficits when adults with mild ID also have ADHD. Their negative result came from a different lab task, showing that some attention problems do appear in ID when the right test is used.
MShawler et al. (2021) used the same eye-tracker with autistic adults and found a clear bias, but only in those who were also depressed. Together these studies tell us that attention bias shows up only when the test matches the population and the co-occurring condition.
Why it matters
If you assess adults with mild ID for alcohol misuse, skip eye-tracking or reaction-time bias tests—they give noisy, unreliable data. Use interviews, questionnaires, or functional checks instead. Save the high-tech gear for research until better norms exist for ID samples.
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02At a glance
03Original abstract
BACKGROUND: Problematic drinkers favour the processing of alcohol-related stimuli at the cost of other stimuli and also find it difficult to disengage their attention from these stimuli. This is indicative of an attentional bias towards alcohol. The goal of this study was to examine this bias in problematic drinkers with and without mild to borderline intellectual disability (MBID) using both eye tracking methodology and behavioural data (i.e. reaction time (RT) data). METHOD: Participants (N = 133) were divided into four groups based on (estimated) full scale intelligence quotient (IQ) and severity of alcohol use-related problems. The severity of substance use-related problems was assessed with the Alcohol Use Disorder Identification Test (AUDIT). The visual dot probe task was used to measure the attentional bias. We analysed both eye tracking data and behavioural data (i.e. RT data) of the visual dot probe task. RESULTS: Problematic drinkers were not more likely than light drinkers to direct their attention towards pictures of alcoholic beverages, did not look at these pictures longer than light drinkers and did also not respond faster than light drinkers to probes replacing pictures of alcoholic beverages. However, the strength of the attentional bias varied profusely. CONCLUSION: Taking the large variability in the strength of the attentional bias and the poor psychometric qualities of the measures into consideration, it is concluded that the use of these measures for clinical purposes is discouraged.
Journal of intellectual disability research : JIDR, 2017 · doi:10.1111/jir.12335