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都表明，药物滥用者将继续使用药物，尽管对身体和社会福祉产生了反复的不良后果。这表明，虐待的一个特征可能是抑制功能失调行为模式的能力下降，尽管有明确的证据表明它们的不适应（Paulus et al., 2002）。事实上，越来越多的行为学、认知学、电生理学和神经影像学研究表明，可卡因滥用者对内部和外部产生的错误信号根本不敏感。这种不敏感可能会降低引导适应性行为调节的能力，并可能促进对功能失调行为模式的持续增加，包括重复吸毒行为和共病犯罪。尽管工作越来越多，但这些错误监测缺陷的性质在很大程度上仍然没有区别。错误监控至少由两个潜在的独立过程组成：一个是自动错误检测系统，它监视目标导向行为中的错误，另一个是与该错误的有意识表征相关的不太自动的系统。大多数评估药物依赖人群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的主观错误意识状况了解甚少，因此无法就这些错误监测缺陷的根本性质得出明确结论。电生理学和血流动力学方法的最新发展，分别提供了自动错误检测和有意识错误感知指标的系统分离和评估。目前的建议试图通过收集可卡因滥用者样本（以及匹配的对照）中的电生理（EEG）和功能性磁共振成像（fMRI）数据来建立这些进展，分别表征其自动和有意识的错误监测成分的神经回路的完整性。心智研究网络获得了一台最先进的移动核磁共振扫描仪，部署在各种男女惩教设施中，在这些设施中，流行病学数据表明，超过65%的囚犯患有严重的药物滥用问题。因此，这种移动MRI系统的部署为具有合并症外化特征的严重可卡因滥用者提供了前所未有的机会。通过这种途径，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（n = 69）和不符合可卡因滥用标准的（n = 69）。参与者将执行一项时间估计任务，对可卡因滥用者内部错误监测的自动和有意识组成部分的完整性进行仔细控制的评估。此外，我们计划对可卡因滥用者进行监禁后1年的随访，以评估错误监测完整性预测未来戒断和复发率的程度。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。心智研究网络的终极使命是为严重的心理和精神障碍开发新的治疗方案，我们的团队设想从这项研究中收集的数据是未来工作的重要一步，重点是潜在的治疗和治疗应用。

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.