Real-world experience and clinical research converge in demonstrating that substance-dependent individuals will continue to use drugs despite an often strong desire to cease taking drugs. This suggests that a cardinal characteristic of dependency is reduced ability to inhibit dysfunctional action patterns despite clear evidence of their maladaptivity (Paulus et al., 2002). A growing body of behavioral, cognitive, electrophysiological and neuroimaging work suggests that cocaine-dependent individuals 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-dependent populations, however, which precludes firm conclusions regarding the underlying nature of these error-monitoring deficits. Recent developments have identified methods of systematically interrogating indices of error-detection and error-awareness, respectively. The present proposal seeks to use multi-modal imaging (ERP/fMRI) to characterize the integrity of neural circuits engaged in automatic and conscious components of error monitoring in incarcerated cocaine-dependent individuals. To this end, the MIND Institute has recently acquired a state-of-the-art mobile MRI scanner, currently deployed at the Western New Mexico Correctional Facility. In the last two months, we have completed 235 scanning sessions within this facility, and feel that the mobile scanner presents an unprecedented opportunity to examine the neurocognitive systems implicated in error- monitoring within incarcerated populations. Here we propose to utilize high-resolution electrophysiology and functional magntetic resonance imaging to assess the integrity of error-monitoring systems within 15 incarcerated cocaine-dependent individuals, 15 matched incarcerated non-dependent individuals, and 15 matched non-incarcerated healthy controls. We hypothesize that incarcerated cocaine-dependent individuals will show reduced error awareness, and that this impairment will predict relevant outcome measures including drug-use severity and level of comorbid criminal activity. Our goal is to use the I/START mechanism to provide support for a protocol we anticipate serving as pilot data for a larger, more comprehensive research endeavor focused on neurocognitive influences on error-monitoring integrity in cocaine-dependent individuals. The chronic and repetative nature of drug-addiction suggests that drug-dependent individuals may have difficulty identifying, and learning from, their maladaptive behavioral patterns. These learning deficits may arise from core impairment in processes underlying the identification and monitoring of errors in goal-directed behavior, and may lead to continued drug use, and recidivistic criminal tendencies. The present study will collect electrophysiological (EEG) and functional magnetic resonance imaging (fMRI) data from incarcerated cocaine-dependent individals in order to better characterize the nature of these error-monitoring deficits. The results of this work will aid delineation of mechanisms of dependency and comorbid criminality, and will provide increased insight into treatments capable of targeting those cognitive capacities damaged in drug-dependent populations. ? ?
