Enhanced choice for viewing cocaine pictures in cocaine addiction.
BACKGROUND
Individuals with cocaine use disorder (CUD) chose cocaine over nondrug rewards. In two newly designed laboratory tasks with pictures, we document this modified choice outside of a cocaine administration paradigm.


METHODS
Choice for viewing cocaine, pleasant, unpleasant, or neutral pictures--under explicit contingencies (choice made between two fully visible side-by-side images) and under more implicit contingencies (selections made between pictures hidden under flipped-over cards)--was examined in 20 CUD and 20 matched healthy control subjects. Subjects also provided self-reported ratings of each picture's pleasantness and arousal.


RESULTS
Under both contingencies, CUD subjects chose to view more cocaine pictures than control subjects, group differences that were not fully explained by the self-reported picture ratings. Furthermore, whereas CUD subjects' choice for viewing cocaine pictures exceeded choice for viewing unpleasant pictures (but did not exceed choice for viewing pleasant pictures, in contrast to their self-reported ratings), healthy control subjects avoided viewing cocaine pictures as frequently as, or even more than, unpleasant pictures. Finally, CUD subjects with the most cocaine viewing selections, even when directly compared with selections of the pleasant pictures, also reported the most frequent recent cocaine use.


CONCLUSIONS
Enhanced drug-related choice in cocaine addiction can be demonstrated even for nonpharmacologic (pictorial) stimuli. This choice, which is modulated by alternative stimuli, partly transcends self-reports (possibly indicative of a disconnect in cocaine addiction between self-reports and objective behavior) to provide an objective marker of addiction severity. Neuroimaging studies are needed to establish the neural underpinnings of such enhanced cocaine-related choice.
Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109, USA. smoeller@umich.edu
Scott J
SJ
Moeller
Thomas
T
Maloney
Muhammad A
MA
Parvaz
Jonathan P
JP
Dunning
Nelly
N
Alia-Klein
Patricia A
PA
Woicik
Greg
G
Hajcak
Frank
F
Telang
Gene-Jack
GJ
Wang
Nora D
ND
Volkow
Rita Z
RZ
Goldstein
D000328:Adult; D001143:Arousal / Q000502:physiology; D002755:Choice Behavior / Q000187:drug effects*; D019970:Cocaine-Related Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010775:Photic Stimulation; D011569:Psychiatric Status Rating Scales; D011597:Psychomotor Performance / Q000502:physiology