Attentional Bias During a Novel Alcohol Cue Virtual Reality Paradigm

Authors

• Ryan M. Sullivan, University of California San Diego Health
• Benjamin S. McKenna, University of California San Diego Health
• Weichen Liu, University of California San Diego Health
• Arwynn McKinty, University of California San Diego Health
• Camarin Laurance, University of California San Diego Health
• Craig R. Rush, University of KentuckyFollow
• Nadir Weibel, University of California San Diego Health
• Kelly E. Courtney, University of California San Diego HealthFollow

Abstract

Background: Attentional bias to alcohol cues is largely investigated using pictorial cues (i.e., two-dimensional images). The addition of eye-tracking metrics has improved these investigations yet are limited by a lack of naturalistic cues. Virtual reality (VR) can theoretically improve ecological validity through three-dimensional alcohol object presentation while utilizing eye-tracking metrics. This report sought to test the construct validity of the Alcohol Cue VR paradigm in evoking subjective craving and attentional bias through measurement of eye-gaze characteristics. Methods: Participants (n = 105, 53% male, M_age = 38), with varying alcohol use histories, underwent the Alcohol Cue VR paradigm, an alcohol visual probe task, and measures of alcohol craving and VR-related assessments. The Alcohol Cue VR paradigm comprised of three active scenes with alcohol cues present, and three neutral scenes devoid of alcohol cues. Eye-gaze fixation time (index of “attentional bias”) in response to alcohol and control cues was recorded. Forward-stepwise models searched for optimal alcohol-related predictors of attentional bias, then compared against eye-tracking and response time metrics from the alcohol visual probe task. Results: Alcohol use history, age of regular use onset, recency of use, and binge episodes were significantly associated with eye-gaze fixation time to alcohol cues; how present one felt within the VR scenes did not moderate these findings. Alcohol-related predictors accounted for a larger proportion of variance in VR-based models of attentional bias (ΔR² = 0.10) than in comparable alcohol visual probe task models based on fixation time (ΔR² = 0.05) or response time (ΔR² = 0.06). Conclusions: The Alcohol Cue VR paradigm provided commensurate measures of attentional bias in the context of alcohol cues. Unique alcohol-related characteristics impacted the extent of attentional bias to alcohol-related cues, exemplifying the utility of VR-derived measurement in assessing alcohol use. Future research can understand whether VR attentional bias is modifiable through treatment and can serve as clinical endpoints.

Document Type

Article

Publication Date

8-1-2026

Notes/Citation Information

Publisher Copyright: © 2026 The Author(s). Alcohol, Clinical and Experimental Research published by Wiley Periodicals LLC on behalf of Research Society on Alcohol.

Digital Object Identifier (DOI)

10.1111/acer.70386

Archival?

Archival

Repository Citation

Sullivan, Ryan M.; McKenna, Benjamin S.; Liu, Weichen; McKinty, Arwynn; Laurance, Camarin; Rush, Craig R.; Weibel, Nadir; and Courtney, Kelly E., "Attentional Bias During a Novel Alcohol Cue Virtual Reality Paradigm" (2026). Psychology Faculty Publications. 272.
https://uknowledge.uky.edu/psychology_facpub/272