Functional, Structural, and Emotional Correlates of Impaired Insight in Cocaine Addiction
Scott J. Moeller, PhD; Anna B. Konova, MA; Muhammad A. Parvaz, PhD; Dardo Tomasi, PhD; Richard D. Lane, MD, PhD; Carolyn Fort, BA; Rita Z. Goldstein, PhD
Dug-addicted individuals often take drugs despite con- scious, well-intentioned plans to abstain. Although this practice is often viewed as a deficiency in will power, we recently suggested that a core symptom of drug addiction is dysfunction of brain regions that underlie insight and self-awareness. Because impaired insight is marked by re- duced sensitivity to negative outcomes, poorer treatment out- come, and lowered treatment adherence across various neu- ropsychiatric disorders (eg, schizophrenia and neurologic insults),2 we reasoned that this deficit could also have impor- tant implications for addiction. Discrepancies between self- reports and objective indices of behavior3-5 and compro- mised monitoring of ongoing behavior6,7 as associated with more severe drug-seeking behavior7 provided the prelimi- nary evidence for impaired insight in addiction.