Under pressure: adolescent substance users show exaggerated neural processing of aversive interoceptive stimuli
Open accessAbstract
Aims: Adolescents with substance use disorders (SUD) exhibit hyposensitivity to pleasant internally generated (interoceptive) stimuli and hypersensitivity to external rewarding stimuli. It is unclear whether similar patterns exist for aversive interoceptive stimuli. We compared activation in the insular cortex and other brain regions during the anticipation and experience of aversive stimuli between adolescents with SUD and those without. Design: Cross‐sectional experimental study with two groups. Participants: Adolescents (ages 15–17 years) with an alcohol or marijuana SUD (n = 18) and healthy comparison subjects (CON, n = 15). Participants were recruited by distributing flyers at local high schools. Setting: Keck Imaging Center, University of California San Diego, CA, USA. Measurements: Behavioral and neural responses to a continuous performance task with inspiratory breathing load recorded during an fMRI session. Questionnaires assessed life‐time drug use, anxiety, sensation‐seeking, impulsivity, affect and bodily awareness. Visual analog scales assessed drug craving and breathing load responses. Findings: Across subjects, experience of breathing load elicited greater bilateral anterior and posterior insula (AI and PI, respectively) activation than anticipation (F(1,31) = 4.16, P < 0.05). SUD exhibited greater left AI and bilateral PI activation during breathing load than anticipation, compared with CON (F(1,31) = 4.16, P < 0.05). In contrast, CON showed greater activation during anticipation than breathing load in left PI, compared with SUD (F(1,31) = 4.16, P < 0.05). Conclusions: Adolescents with alcohol and marijuana substance use disorders may be hypersensitive to aversive interoceptive stimuli.
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Atypical insula activation to interoceptive signals has been reported in adolescents with obesity and those with substance use disorders.
“Atypical insula activation to interoceptive signals, for example, has been reported in adolescents with obesity (Delgado-Rico et al., 2013; Mata et al., 2015) and those with substance use disorders (Berk et al., 2015; Migliorini et al., 2013).”
From Atypical interoception as a common risk factor for psychopathology: A review (2021) · cites this paper as Berk et al., 2015
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- Authors
- Berk, L., Stewart, J. L., May, A. C., Wiers, R. W., Davenport, P. W., Paulus, M. P., & Tapert, S. F.
- Affiliations
- University of California San Diego (US)
- Queens College, CUNY (US)
- University of Amsterdam (NL)
- University of Florida (US)
- Corresponding author
- Tapert, Susan F.
- ORCID
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2015-09-28
- Volume
- 110
- Issue
- 12
- Pages
- 2025-2036
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- PMC
- PMC4644498
- OpenAlex
- W2158944539
- Cited by
- 42
- References
- 67
- Citations by year
- 2025: 3 · 2024: 4 · 2023: 4 · 2022: 4 · 2021: 7 · 2020: 2 · 2019: 8 · 2018: 4 · 2017: 2 · 2016: 1 · 2015: 3
- FWCI
- 2.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion, other-oa)
- PubMed Central (acceptedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute on Drug Abuse (5P20DA027843)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- adolescent substance use disorders, interoceptive sensitivity, insula, anterior insula, posterior insula, alcoholism, cannabis use disorder, drug craving, sensation seeking, impulsivity
- MeSH terms
- Adolescent, Alcohol Drinking, Analysis of Variance, Carbon Dioxide, Cerebral Cortex, Cross-Sectional Studies, Female, Humans, Male, Marijuana Smoking, Mental Processes, Neuropsychological Tests, Photic Stimulation, Psychomotor Performance, Respiration, Anticipation, Psychological, Craving
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