Error Detection and Error Awareness in Incarcerated Cocaine Dependent Individuals

描述(由申请人提供)：现实世界的经验和临床研究相结合，表明药物滥用者将继续使用药物，尽管对身体和社会健康造成了反复的不良后果。这表明，虐待的一个特征可能是抑制功能失调的行为模式的能力降低，尽管有明显的证据表明它们不适应(Paulus等人，2002年)。事实上，越来越多的行为、认知、电生理和神经成像研究表明，可卡因滥用者对内部和外部产生的错误信号的核心不敏感。这种不敏感可能会降低引导适应性行为调节的能力，并可能会促进对功能障碍行为模式的更多坚持，包括反复吸毒行为和共同犯罪行为。尽管工作量越来越大，但这些错误监控缺陷的性质在很大程度上仍然没有区别。错误监测至少由两个可能独立的过程组成：一个是监测目标导向行为中的错误的自动错误检测系统，另一个是与有意识地呈现该错误有关的较不自动化的系统。大多数评估物质依赖人群中的错误监测的工作都集中在错误检测上，并报告了一致的损害。然而，目前对可卡因滥用者主观错误意识状态的了解很少，这排除了关于这些错误监测缺陷的根本性质的确切结论。电生理和血流动力学方法的最新发展现在分别提供了自动错误检测和有意识错误意识指标的系统分离和评估。本提案试图通过收集可卡因滥用者(和匹配的对照组)样本中的电生理(EEG)和功能磁共振成像(FMRI)数据来建立这些进展的基础上，分别表征作为错误监测的自动和有意识组成部分的神经回路的完整性。精神研究网络购买了最先进的移动核磁共振扫描仪，部署在各种男性和女性惩教机构，那里的地方学数据表明，超过65%的囚犯患有严重的药物滥用问题。因此，这一移动核磁共振系统的部署为具有共同外化特征的严重可卡因滥用者提供了前所未有的机会。通过这种访问，我们建议收集138名被监禁参与者的多模式(EEG/fMRI)数据，将其分为两组：符合可卡因滥用标准的人(n=69)和不符合可卡因滥用标准的人(n=69)。参与者将执行一项时间估计任务，对可卡因滥用者的错误监测的自动和意识部分的完整性进行仔细受控的评估。此外，我们计划在监禁后1年跟踪我们的可卡因滥用参与者，以评估错误监测完整性预测未来戒酒和复发率的程度。通过该项目获得的数据将作为对严重可卡因滥用者样本中错误监测异常情况的最全面调查。心智研究网络的最终使命是为严重的心理和精神障碍开发新的治疗方案，我们小组设想从这项研究中收集的数据是迈向未来专注于潜在的治疗和治疗应用的重要一步。 与公共健康相关：吸毒的慢性和反复性质表明，药物滥用者可能难以识别并学习他们不适应的行为模式。这些学习缺陷可能是由于对目标导向行为中的错误的自动检测和/或有意识意识的损害而产生的，并可能导致持续的药物使用。本研究将收集大量被监禁的可卡因滥用者的电生理(EEG)和功能磁共振成像(FMRI)数据，以更好地描述他们的错误监测缺陷，并调查这些缺陷在多大程度上预测未来的戒酒和复吸率。这项工作的结果将有助于描绘物质滥用背后的认知和神经认知缺陷，并可能成为未来针对这些认知缺陷的治疗选择的门户。

DESCRIPTION (provided by applicant): Real-world experience and clinical research converge in demonstrating that substance-abusers will continue to use drugs despite repeated adverse outcomes on physical and social well-being. This suggests that a characteristic of abuse may be a reduced ability to inhibit dysfunctional action patterns despite clear evidence of their maladaptivity (Paulus et al., 2002). Indeed, a growing body of behavioral, cognitive, electrophysiological and neuroimaging work suggests that cocaine abusers evidence core insensitivity to internally- and externally-generated signals of error. This insensitivity may reduce the ability to guide adaptive behavioral regulation, and may promote increased perseveration on dysfunctional action patterns, including repetitive drug-taking behavior and comorbid criminality. Despite this growing body of work, the nature of these error-monitoring deficits remains largely undifferentiated, however. Error-monitoring is composed of at least two potentially independent processes: an automatic error detection system that monitors for errors in goal-directed behavior and a less automatic system related to the conscious representation of that error. The majority of work evaluating error-monitoring in substance-dependent populations has focused on error-detection, and has reported consistent impairment. Little is currently understood regarding the state of subjective error-awareness in cocaine abusers, however, which precludes firm conclusions regarding the underlying nature of these error-monitoring deficits. Recent developments in electrophysiological and hemodynamic methods now afford the systematic isolation and evaluation of indices of automatic error-detection and conscious error-awareness, respectively. The present proposal seeks to build off these advances by collecting electrophysiological (EEG) and functional magnetic resonance imaging (fMRI) data within a sample of cocaine abusers (and matched controls), to characterize the integrity of neural circuits underlying their automatic and conscious components of error monitoring, respectively. The Mind Research Network has acquired a state-of-the-art mobile MRI scanner, deployed to various male and female correctional facilities, where epidimiological data indicates that over 65% of inmates suffer from serious substance abuse issues. The deployment of this mobile MRI system thus provides unprecedented access to a population of serious cocaine abusers with comorbid externalizing characteristics. With this access, we propose to collect multimodal (EEG/fMRI) data on 138 incarcerated participants, stratified into two groups: those who do (n = 69) and d not (n = 69) meet criteria for cocaine abuse. Participants will perform a time-estimation task that will afford a carefully controlled evaluation of the integrity of both automatic and concious components of error-monitoring within cocaine abusing individuals. In addition, we plan to follow-up our cocaine abusing participants at 1-year post-incarceration, to evaluate the extent to which error-monitoring integrity predicts future abstinence and relapse rates. The data obtained through this project will serve as the most comprehensive investigation of error monitoring abnormalities within a sample of serious cocaine abusers. The ultimate mission of The Mind Research Network is the development of novel treatment programs for serious psychological and mental disorders, and our group envisions the data collected fom this research as an important step towards future work focused on potential therepeutic and treatment applications. PUBLIC HEALTH RELEVANCE: The chronic and repetative nature of drug-taking suggests that substance abusers may have difficulty identifying, and learning from, their maladaptive behavioral patterns. These learning deficits may arise through impairment in the automatic detection of, and/or the conscious awareness of, errors in goal-directed behavior, and may lead to continued drug use. The present study will collect electrophysiological (EEG) and functional magnetic resonance imaging (fMRI) data from a large sample of incarcerated cocaine abusers, to better characterize their error-monitoring deficits, and to investigate the extent to which such deficits predict future abstinence and relapse rates. The results of this work will aid delineation of cognitive and neurocognitive deficiencies underlying substance abuse, and may serve as a gateway for future treatment options that target these cognitive deficiencies.