title: Distress tolerance among substance users is associated with functional connectivity between prefrontal regions during a distress tolerance task.
abstract: Distress tolerance (DT), defined as the ability to persist in goal directed behavior while experiencing affective distress, is implicated in the development and maintenance of substance use disorders. While theory and evidence indicate that cortico-limbic neural dysfunction may account for deficits in goal directed behavior while experiencing distress, the neurobiological mechanisms of DT have yet to be examined. We modified a computerized DT task for use in functional magnetic resonance imaging (fMRI), the Paced Auditory Serial Addition Task (PASAT-M), and examined the neural correlates and functional connectivity of DT among a cohort of substance users (n = 21; regular cocaine and nicotine users) and healthy controls (n = 25). In response to distress during the PASAT-M, we found greater activation in a priori cortico-limbic network ROIs, namely the right insula, anterior cingulate cortex (ACC), bilateral medial frontal gyrus (MFG), right inferior frontal gyrus (IFG) and right ventromedial prefrontal cortex (vmPFC) significantly predicted higher DT among substance users, but not healthy controls. In addition, greater task-specific functional connectivity during distress between the right MFG and bilateral vmPFC/sgACC was associated with higher DT among substance users, but not healthy controls. The observed positive relationship between DT and neural activation in cortico-limbic structures, as well as functional connectivity between the rMFG and vmPFC/sgACC, is in line with theory and research suggesting the importance of these structures for persisting in goal directed behavior while experiencing affective distress.
authors.affiliation: Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Stacey B
authors.initials: SB
authors.lastname: Daughters
authors.affiliation: Neuroimaging Research Branch, Intramural Research Program National Institute on Drug Abuse, NIH, Baltimore, MD, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Ross
authors.affiliation: Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Bell
authors.affiliation: Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Jennifer Y
authors.initials: JY
authors.lastname: Yi
authors.affiliation: Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Ryan
authors.affiliation: Neuroimaging Research Branch, Intramural Research Program National Institute on Drug Abuse, NIH, Baltimore, MD, USA.
authors.forename: Elliot A
authors.initials: EA
authors.lastname: Stein
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D019970:Cocaine-Related Disorders / Q000000981:diagnostic imaging* / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D059907:Functional Neuroimaging; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging*; D013315:Stress, Psychological / Q000000981:diagnostic imaging* / Q000523:psychology; D019966:Substance-Related Disorders / Q000000981:diagnostic imaging / Q000523:psychology; D014029:Tobacco Use Disorder / Q000000981:diagnostic imaging* / Q000523:psychology
keywords: distress tolerance; emotion regulation; fMRI; prefrontal cortex; substance use disorder