Heavy cocaine users who repeatedly fail in treatment account for a disproportionately large share of cocaine consumption and associated demand of community health resources. We have recently developed a tailored cognitive behavioral treatment protocol for the treatment of cocaine abuse. In a large study (n=157), our tailored treatment protocol, Substance Expectation Therapy (SET), was compared to Relapse Prevention (RP) and Addiction Counseling (AC) for the treatment of cocaine abuse (NIDA R01;PI Jaffe). SET was found to be superior to RP and AC for preventing relapse in cocaine abusers. A major aim of this proposal is to replicate the efficacy of SET for the treatment of cocaine abusers. A second major aim of this proposal is to build upon research that has shown abnormalities in the brain's response to distracting stimuli predicts relapse in cocaine abusers. We will use multimodal brain imaging, combined with advanced image processing techniques, including Independent Components Analyses, to further delineate the neurocognitive systems that convey risk for relapse in cocaine abusers. In addition, this proposal will examine changes in neurocognitive systems associated response inhibition, deviance detection, salient stimulus processing and expectancy across the three treatment protocols (SET, RP, and AC). Our primary hypotheses are that SET will be superior to RP and AC for preventing relapse in cocaine abuses. It is also hypothesized that multimodal, compared to unimodal, brain imaging will convey superior predictive power for assessing relapse in cocaine abusers. Finally, we hypothesize that SET therapy will show increased modulation in the brain systems associated with inhibitory processing and expectancy over the course of the 12 week treatment protocol. In summary, the results of this proposal will test the efficacy of SET therapy compared to RP and AC, will further delineate the functional architecture underlying risk for relapse in cocaine abusers, and will examine neuronal changes associated with tailored cognitive-behavioral therapy.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Special Emphasis Panel (ZDA1-MXS-M (21))
Program Officer
Grant, Steven J
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The Mind Research Network
United States
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