Neuroimaging Metrics of Drug and Food Processing in Cocaine-Dependence, as a Function of Psychopathic Traits and Substance Use Severity

Abstract

Previous studies suggest that psychopathic traits commonly present as comorbid with substance use disorders. Moreover, neuroimaging and psychometric findings suggest that psychopathic traits may predispose individuals to a sensitized reward response to drugs. Given that substance use disorders are characterized by a neurocognitive bias toward drug-reward relative to non-drug reward, it is possible that heightened psychopathic characteristics may further predispose to this processing bias. To evaluate this possibility, we assessed psychopathic traits (measured using the PCL-R; Hare, 2003) in 105 probationers/parolees and evaluated the relationship between PCL-R scores, lifetime duration of drug use, and biases in neural response to drug- compared to food-related videos. Psychopathic traits (potentially driven by interpersonal/affective traits) were positively correlated with drug > food reactivity within the right insula and left amygdala. In addition, psychopathic traits modulated the relationship between drug use and drug > food reactivity within the left dorsomedial prefrontal cortex, right insula, and left caudate nucleus. Specifically, lifetime duration of drug use correlated positively with drug > food reactivity in participants with lower levels of psychopathic traits and correlated negatively with drug > food reactivity in individuals with higher levels of psychopathic traits. These results help reconcile prior studies on psychopathy and drug-stimulus processing and provide neurocognitive support for the notion that psychopathic traits serve as an underlying risk factor for substance use disorders. These results suggest that different treatment regimens for substance abuse for individuals with higher or lower levels of psychopathy may be beneficial and suggest that reduction of neurocognitive biases to drug-related stimuli may offer useful targets for future treatment protocols.

Psychopathy and Corticostriatal Connectivity: The Link to Criminal Behavior in Methamphetamine Dependence

“…These results are consistent with studies that suggest MA-induced abnormalities in corticostriatal circuits, which may manifest in poor decision-making, impulsivity, and behavioral phenotypes associated with addiction. The results with PPI-R total scores are also consistent with other studies that report heightened levels of psychopathy in drug-dependent groups (1,28), and here we extend the literature to show that MA use disorder is also associated with significantly higher levels of psychopathy total scores and in the impulsive antisocial dimension of psychopathy (PPI-2). The MA group also exhibited significantly more criminal offenses than controls, which is in line with a report that MA use is a significant predictor in criminal behavior and recidivism (7).…”

Dysfunctional neurocognition in individuals with clinically significant psychopathic traits

“…57 , 58 The results of the third study were somewhat more complex. 56 In contrast to the previous two studies, this study reported that psychopathic traits were positively correlated with responsiveness to drug relative to food cues within the right anterior insula cortex and the left amygdala. However, only individuals with lower psychopathic traits showed an increasing differentiation in their response to drug vs food cues as a function of duration of drug use.…”

“…If psychopathy is associated with heightened reward responsiveness, one might predict that this learning would occur more rapidly and underlie the emergence of the substance abuse disorders which are often comorbid in this population. 56 Individuals with psychopathy should show heightened responsiveness to drug cues. Alternatively, if psychopathy is associated with reduced reward responsiveness, one might predict that individuals with psychopathy should show reduced responsiveness to drug cues.…”

Addiction and the Dark Triad of Personality

“…A similar finding was recently obtained for adolescents: psychopathic characteristics negatively modulated neural cue reactivity, though in the youth sample, the negative association was more pronounced for factor 1 (82). However, most recently, a study on adult parolees with substance use disorder found evidence for a positive modulation of brain activation to drug cues by psychopathic traits (factor 1) (83). An important difference between this study and the prior investigations is the use of food cues rather than neutral stimuli as a control condition.…”

“…The authors argue that individuals with higher psychopathic traits display stronger desensitization of non-drug-related cues. However, this effect was moderated by drug use history in such a way that highly psychopathic individuals with a longer drug use history showed lower sensitivity to drug cues (83).…”