Functional, Structural, and Emotional Correlates of Impaired Insight in Cocaine Addiction

Moeller, Scott J.; Konova, Anna B.; Parvaz, Muhammad A.; Tomasi, Dardo; Lane, Richard D.; Fort, Carolyn; Goldstein, Rita Z.

doi:10.1001/jamapsychiatry.2013.2833

Cited by 90 publications

(85 citation statements)

References 91 publications

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“…One recent study of individuals with a range of problematic drinking levels (up to and including dependence) showed a negative relationship between error-related activity in the rACC on a go/no-go task and alcohol use severity (33). In our work, we found that cocaine abusers with impaired self-awareness, as demonstrated by their inability to monitor their own choice behavior (34, 35), had lower error-related activity in the rACC on a classical Stroop task relative to both controls and cocaine abusers whose self-awareness (choice awareness) was intact (Figure 3A); similarly to (31), this reduced activation correlated with more frequent cocaine use (36). These findings could collectively indicate that errors fail to engender the appropriate tagging of personal relevance or emotional significance in addicted individuals.…”

Section: Neural Correlates Of Self-awareness In Drug Addictionmentioning

confidence: 62%

Impaired self-awareness in human addiction: deficient attribution of personal relevance

Moeller¹,

Goldstein²

2014

Trends in Cognitive Sciences

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Compromised self-awareness of illness-related deficits and behaviors in psychopathology (e.g., schizophrenia) has been associated with deficient functioning of cortical midline regions including the ventromedial prefrontal cortex (vmPFC), implicated in personal relevance. Here, we review and critically analyze recent evidence to suggest that vmPFC abnormalities could similarly underlie deficient tagging of personal relevance in drug addiction, evidenced by a constellation of behaviors encompassing drug-biased attention, negative outcome insensitivity, self-report/behavior dissociation, and social inappropriateness. This novel framework might clarify, for example, why drug-addicted individuals often ruin long-standing relationships or forego important job opportunities while continuing to engage in uncontrolled drug-taking. Therapeutic interventions targeting personal relevance and associated vmPFC functioning could enhance self-awareness and facilitate more adaptive behavior in this chronically relapsing psychopathology.

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Section: Neural Correlates Of Self-awareness In Drug Addictionmentioning

confidence: 62%

Impaired self-awareness in human addiction: deficient attribution of personal relevance

Moeller¹,

Goldstein²

2014

Trends in Cognitive Sciences

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“…Participants performed three runs of an event-related fMRI color word Stroop task, which has been described in detail elsewhere (Moeller, Honorio, 2014a, Moeller et al, 2014b, Moeller et al, 2012). Briefly, participants pressed for ink color of color words printed in their congruent (94% of trials) or incongruent colors (6% of trials, spaced by ≥ 5 congruent stimuli).…”

Section: Methodsmentioning

confidence: 99%

“…Calculation of the fMRI contrasts followed our prior work (Moeller, Honorio, 2014a, Moeller, Konova, 2014b, Moeller, Tomasi, 2012). Briefly, two general linear models (Friston et al , 1995), each with six motion regressors (3 translation and 3 rotation) and up to three task conditions (incongruent correct events, congruent error events, and/or incongruent error events) convolved with a canonical hemodynamic response function and high-pass filtered (cut-off frequency: 1/90 s), were used to calculate the following 1 st Level main effect contrasts: (Incongruent Error + Incongruent Correct) – (Congruent Error + Congruent Correct) (incongruent>congruent); and (B) (Incongruent Error + Congruent Error) – (Incongruent Correct + Congruent Correct) (error>correct).…”

Section: Methodsmentioning

confidence: 99%

Common and distinct neural correlates of inhibitory dysregulation: Stroop fMRI study of cocaine addiction and intermittent explosive disorder

Moeller

Froböse

Konova

et al. 2014

Journal of Psychiatric Research

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Despite the high prevalence and consequences associated with externalizing psychopathologies, little is known about their underlying neurobiological mechanisms. Studying multiple externalizing disorders, each characterized by compromised inhibition, could reveal both common and distinct mechanisms of impairment. The present study therefore compared individuals with intermittent explosive disorder (IED) (N=11), individuals with cocaine use disorder (CUD) (N=21), and healthy controls (N=17) on task performance and functional magnetic resonance imaging (fMRI) activity during an event-related color-word Stroop task; self-reported trait anger expression was also collected in all participants. Results revealed higher error-related activity in the two externalizing psychopathologies as compared with controls in two subregions of the dorsolateral prefrontal cortex (DLPFC) (a region known to be involved in exerting cognitive control during this task), suggesting a neural signature of inhibitory-related error processing common to these psychopathologies. Interestingly, in one DLPFC subregion, error-related activity was especially high in IED, possibly indicating a specific neural correlate of clinically high anger expression. Supporting this interpretation, error-related DLPFC activity in this same subregion positively correlated with trait anger expression across all participants. These collective results help to illuminate common and distinct neural signatures of impaired self-control, and could suggest novel therapeutic targets for increasing self-control in clinical aggression specifically and/or in various externalizing psychopathologies more generally.

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“…In turn, cocaine-dependent adults have less grey matter and less activation of the anterior rostral cingulate cortex, and this would be subjacent to the low behavioural self-awareness and/or self-monitoring these people usually display (Moeller et al, 2014). All of this, together with the deficits in empathic processes, would affect decision-making processes, given the role they play as somatic markers of behaviour (Verdejo-Garcia & Bechara, 2009).…”

Section: Brain Structuresmentioning

confidence: 99%

Déficits neuropsicológicos asociados a la relación entre abuso de cocaína y violencia: mecanismos neuronales facilitadores

Romero‐Martínez

Moya-Albiol

2015

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Introducción. El abuso de la cocaína, así como la exposición prenatal a la misma parece ser un factor relevante en el desencadenamiento de comportamientos violentos. Los déficits neuropsicológicos, así como el género y la combinación con el alcohol, serían los posibles mecanismos facilitadores. Objetivo. Revisar y recapitular los resultados obtenidos sobre los déficits neuropsicológicos debidos al abuso o a la exposición prenatal a la cocaína y relacionarlos con la expresión de la violencia. Además, se enfatiza el papel del género y el abuso del alcohol junto a la cocaína, así como la posible existencia de daño orgánico cerebral como mecanismos facilitadores. Desarrollo. Se ha revisado la bibliografía científica usando los buscadores Google Scholar, PsycINFO, PubMed, Medline e ISI Web of Knowledge. Conclusiones.La cocaína facilitaría la expresión de la violencia debido a los déficits en la decodificación emocional, la capacidad de abstracción e inhibición, así como en las habilidades verbales y mnémicas. Esto explicaría, además, los problemas en la toma de decisiones. Los déficits y la expresión de la violencia parecen ser más evidentes en los hombres. Sin embargo, a pesar de que la combinación de la cocaína con el alcohol incrementaría el riesgo de reaccionar de forma violenta, los déficits no serían mayores que el consumo de cada una de ellas por separado.Estos déficits podrían ser producto de un funcionamiento anormal de algunas áreas del lóbulo frontal (especialmente el prefrontal) y el parietal, así como estructuras subcorticales como la amígdala. Todo ello permitiría planificar estrategias de intervención cuyos objetivos serían estos dominios cognitivos.

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Functional, Structural, and Emotional Correlates of Impaired Insight in Cocaine Addiction

Cited by 90 publications

References 91 publications

Impaired self-awareness in human addiction: deficient attribution of personal relevance

Impaired self-awareness in human addiction: deficient attribution of personal relevance

Common and distinct neural correlates of inhibitory dysregulation: Stroop fMRI study of cocaine addiction and intermittent explosive disorder

Déficits neuropsicológicos asociados a la relación entre abuso de cocaína y violencia: mecanismos neuronales facilitadores

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