title: Denial in methamphetamine users: Associations with cognition and functional connectivity in brain.
abstract: BACKGROUND
  Despite harmful consequences of drug addiction, it is common for individuals with substance use disorders to deny having problems with drugs. Emerging evidence suggests that some drug users lack insight into their behavior due to neurocognitive dysfunction, but little research has examined potential neurocognitive contributions to denial.
  
  
  METHODS
  This study explored the relationship between denial, cognitive performance and functional connectivity in brain. The participants were 58 non-treatment-seeking, methamphetamine-dependent participants who completed the URICA precontemplation scale, a self-report measure of denial of drug problems warranting change, as well as a cognitive test battery. A subset of participants (N = 21) had functional MRI scans assessing resting-state functional connectivity. Given literature indicating roles of the rostral anterior cingulate (rACC), anterior insula and precuneus in self-awareness, relationships between denial and resting-state connectivity were tested using seeds placed in these regions.
  
  
  RESULTS
  The results revealed a negative relationship between denial and an overall cognitive battery score (p = 0.001), the effect being driven particularly by performance on tests of memory and executive function. Denial was negatively associated with strength of connectivity between the rACC and regions of the frontal lobe (precentral gyri, left ventromedial prefrontal cortex, left orbitofrontal cortex), limbic system (left amygdala, left hippocampus and left parahippocampal gyrus), occipital lobes and cerebellum; and between the precuneus and the midbrain and cerebellum. Anterior insula connectivity was unrelated to denial.
  
  
  CONCLUSIONS
  These findings suggest that denial by methamphetamine users is linked with a cognitive and neural phenotype that may impede the development of insight into their behavior.
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA 90024, USA; Brain Research Institute, David Geffen School of Medicine, Los Angeles, CA 90024, USA. Electronic address: acdean@mednet.ucla.edu.
authors.forename: Andy C
authors.initials: AC
authors.lastname: Dean
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA 90024, USA.
authors.forename: Milky
authors.initials: M
authors.lastname: Kohno
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA 90024, USA.
authors.forename: Angelica M
authors.initials: AM
authors.lastname: Morales
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA 90024, USA.
authors.forename: Dara G
authors.initials: DG
authors.lastname: Ghahremani
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience, David Geffen School of Medicine, Los Angeles, CA 90024, USA; Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, Los Angeles, CA 90024 USA; Brain Research Institute, David Geffen School of Medicine, Los Angeles, CA 90024, USA.
authors.forename: Edythe D
authors.initials: ED
authors.lastname: London
mesh_terms: D000293:Adolescent; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000503:physiopathology* / Q000523:psychology*; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D003071:Cognition; D003717:Denial, Psychological; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006179:Gyrus Cinguli / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008694:Methamphetamine / Q000009:adverse effects; D008875:Middle Aged
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine
keywords: Awareness; Cognition; Connectivity; Denial; Insight; Substance abuse
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