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Impaired self-awareness in human addiction: deficient attribution of personal relevance

Journal

TRENDS IN COGNITIVE SCIENCES
Volume 18, Issue 12, Pages 635-641

Publisher

ELSEVIER SCIENCE LONDON
DOI: 10.1016/j.tics.2014.09.003

Keywords

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Funding

  1. National Institute on Drug Abuse [1R01DA023579, R21DA034954, 1F32DA030017-01]

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Compromised self-awareness of illness-related deficits and behaviors in psychopathology (e.g., schizophrenia) has been associated with deficient functioning of cortical midline regions including the ventromedial prefrontal cortex (vmPFC), implicated in personal relevance. Here, we review and critically analyze recent evidence to suggest that vmPFC abnormalities could similarly underlie deficient tagging of personal relevance in drug addiction, evidenced by a constellation of behaviors encompassing drug-biased attention, negative outcome insensitivity, self-report/behavior dissociation, and social inappropriateness. This novel framework might clarify, for example, why drug-addicted individuals often ruin long-standing relationships or forego important job opportunities while continuing to engage in uncontrolled drug-taking. Therapeutic interventions targeting personal relevance and associated vmPFC functioning could enhance self-awareness and facilitate more adaptive behavior in this chronically relapsing psychopathology.

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