title: Brain substrates of social decision-making in dual diagnosis: cocaine dependence and personality disorders.
abstract: Cocaine dependence frequently co-occurs with personality disorders, leading to increased interpersonal problems and greater burden of disease. Personality disorders are characterised by patterns of thinking and feeling that divert from social expectations. However, the comorbidity between cocaine dependence and personality disorders has not been substantiated by measures of brain activation during social decision-making. We applied functional magnetic resonance imaging to compare brain activations evoked by a social decision-making task-the Ultimatum Game-in 24 cocaine dependents with personality disorders (CDPD), 19 cocaine dependents without comorbidities and 19 healthy controls. In the Ultimatum Game participants had to accept or reject bids made by another player to split monetary stakes. Offers varied in fairness (in fair offers the proposer shares ~50 percent of the money; in unfair offers the proposer shares <30 percent of the money), and participants were told that if they accept both players get the money, and if they reject both players lose it. We contrasted brain activations during unfair versus fair offers and accept versus reject choices. During evaluation of unfair offers CDPD displayed lower activation in the insula and the anterior cingulate cortex and higher activation in the lateral orbitofrontal cortex and superior frontal and temporal gyri. Frontal activations negatively correlated with emotion recognition. During rejection of offers CDPD displayed lower activation in the anterior cingulate cortex, striatum and midbrain. Dual diagnosis is linked to hypo-activation of the insula and anterior cingulate cortex and hyper-activation of frontal-temporal regions during social decision-making, which associates with poorer emotion recognition.
authors.affiliation: School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Monash University, Melbourne, Australia.|Institute of Neuroscience F. Olóriz and Department of Personality, Assessment and Psychological Treatment, Universidad de Granada, Granada, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Verdejo-Garcia
authors.affiliation: Institute of Neuroscience F. Olóriz and Department of Personality, Assessment and Psychological Treatment, Universidad de Granada, Granada, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Verdejo-Román
authors.affiliation: Cognitive Neuroscience Unit, School of Psychology, Deakin University, Melbourne, Australia.
authors.forename: Natalia
authors.initials: N
authors.lastname: Albein-Urios
authors.affiliation: Centro Provincial de Drogodependencias, Diputación de Granada, Granada, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Martínez-González
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital-IDIBELL and Carlos III Health Institute, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.|Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Soriano-Mas
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016022:Case-Control Studies; D019970:Cocaine-Related Disorders / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D015897:Comorbidity; D003657:Decision Making; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology; D059907:Functional Neuroimaging; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010554:Personality Disorders / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology; D012919:Social Behavior; D013702:Temporal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology
keywords: Functional magnetic resonance imaging; interpersonal function; multi-player games; personality disorders; social decision-making