Neuroimaging and Psychosocial Addiction Treatment An
Integrative Guide for Researchers and Clinicians
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Neuroimaging and
Psychosocial Addiction
Treatment
An Integrative Guide for Researchers and
Clinicians
Edited by
Sarah W. Feldstein Ewing
Associate Professor, Oregon Health & Science University, USA
Katie Witkiewitz
Associate Professor, University of New Mexico, USA
and
Francesca M. Filbey
Associate Professor, Center for Brain Health, University of Texas-Dallas, USA
Selection and editorial matter © Sarah W. Feldstein Ewing, Katie Witkiewitz and Francesca
M. Filbey 2015
Individual chapters © Contributors 2015
Softcover reprint of the hardcover 1st edition 2015 978-1-137-36264-3
All rights reserved. No reproduction, copy or transmission of this
publication may be made without written permission.
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permitting limited copying issued by the Copyright Licensing Agency,
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Any person who does any unauthorized act in relation to this publication
may be liable to criminal prosecution and civil claims for damages.
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accordance with the Copyright, Designs and Patents Act 1988.
First published 2015 by
PALGRAVE MACMILLAN
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ISBN 978-1-349-56759-1 ISBN 978-1-137-36265-0 (eBook)
DOI 10.1007/978-1-137-36265-0
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Library of Congress Cataloging-in-Publication Data
Neuroimaging and psychosocial addiction treatment : an integrative guide for
researchers and clinicians / edited by Sarah W. Feldstein Ewing, Associate Professor,
Oregon Health & Science University, USA, Katie Witkiewitz, Associate Professor,
University of New Mexico, USA, and Francesca M. Filbey, Associate Professor, Center for
Brain Health, University of Texas-Dallas, USA.
pages cm
Summary: “Addiction continues to affect a large portion of society, but we still only
have a modest understanding of how and why addiction treatment works. This book
uses an innovative translational approach to weave together basic biological (brain)
mechanisms with human behaviour in order to provide a critical insight into why people
do (and do not) change in the context of treatment. With sections focusing on bothadults
and adolescents, this book bridges the gap between experimental scientists and clinical
practitioners to guide how to improve treatment outcomes for those most at need.”—
Provided by publisher.
1. Drug addiction—Treatment. 2. Human behavior. I. Feldstein Ewing, Sarah W.,
1976– editor. II. Witkiewitz, Katie, editor. III. Filbey, Francesca M., 1972– editor.
RC564.N475 2015
362.29—dc23
2015002973
To Ber, Amy, Elliott, and Josh–
Thank you for providing me my best data on acceptance and
lovingkindness.
–SFE
To Sandy and Barry Myers for your unconditional love and
support.
–KW
For Colin, Alastair, and David – the brilliant energy that keeps
me going.
–FMF
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Contents
List of Tables x
List of Figures xi
Acknowledgments xii
Preface xiii
About the Editors xvi
List of Contributors xviii
Section I: Introduction
1 Translational Approaches to Addiction Treatment 3
Sarah W. Yip, Kathleen M. Carroll, and Marc N. Potenza
2 Fundamentals of Addiction Neuroscience 15
Ariel Ketcherside and Francesca M. Filbey
Section II: Translational Approaches with Adults
3 Using Clinical Neuroscience to Understand Addiction
Treatment 29
Joseph P. Schacht and Kent E. Hutchison
4 Neuropsychopharmacology in Addiction Treatment 48
Lara A. Ray, Kelly E. Courtney, Daniel Roche, and Karen Miotto
5 The Promise of Repetitive Transcranial Magnetic
Stimulation to Treat Addiction 67
Rachel A. Rabin, Daniel M. Blumberger, Zafiris J. Daskalakis,
Tony P. George, and Mera S. Barr
6 Neuroscience and Mindfulness-Based Interventions:
Translating Neural Mechanisms to Addiction Treatment 85
Matthew R. Pearson, Corey R. Roos, David B. Brown, and Katie
Witkiewitz
7 New Approaches to Treating Cannabis Dependence:
From Neuroscience to Practice 97
Janna Cousijn and Francesca M. Filbey
viii Contents
8 Morphometric Biomarkers of Addiction and Treatment
Response 111
Teresa R. Franklin, Joel Mumma, Kanchana Jagannathan,
Reagan R. Wetherill, and Anna Rose Childress
9 Neural Mechanisms Supporting the Regulation of
Cigarette Craving 125
Stephen J. Wilson
10 Neuroeconomics: Implications for Understanding
and Treating Addictive Behavior 141
David P. Jarmolowicz, Derek D. Reed, and Warren K. Bickel
11 Using Neuroimaging to Improve Emotion Regulation
Treatments for Substance Use Disorders 158
Claire E. Wilcox and Bryon Adinoff
Section III: Translational Approaches with Adolescents
12 Introduction to Functional Brain Connectivity:
Potential Contributions to Understanding Adolescent
Vulnerability to Substance Abuse 181
Monique Ernst, Elizabeth A. Hale, Nicholas Balderston, and
Salvatore Torrisi
13 Approaching Adolescent Substance Abuse Treatment
through Neuroscience 200
Anita Cservenka, Tam T. Nguyen-Louie, Susan F. Tapert, and
Bonnie J. Nagel
14 Prenatal Exposure to Maternal Cigarette Smoking,
Addiction, and the Offspring Brain 212
Tomáš Paus and Zdenka Pausova
15 Deconstructing the Neural Substrates of Motivational
Interviewing: A New Look at an Unresolved Question 231
Sarah W. Feldstein Ewing, Hollis Karoly, and Jon M. Houck
16 Neural Influences in Contingency Management
for Adolescent Substance Use 244
Catherine Stanger and Hugh Garavan
Contents
t ix
Section IV: Epilogue
17 How to Practically Apply Lessons Learned from
Translational Neuroscience to Intervention Development:
Ideas for the Road Ahead 259
Sarah W. Feldstein Ewing, Katie Witkiewitz, and
Francesca M. Filbey
Index 265
List of Tables
3.1 Psychosocial treatment effects on cue-elicited
brain activation (as organized by substance) 31
3.2 Associations between cue-elicited brain activation
and relapse to substance use (as organized by substance) 38
5.1 Summary of studies evaluating the effect of rTMS on
tobacco dependence 73
5.2 Summary of studies evaluating the effect of rTMS on
alcohol dependence 76
5.3 Summary of studies evaluating the effect of rTMS on
cocaine dependence 78
5.4 Summary of studies evaluating the effect of rTMS on
methamphetamine dependence 79
11.1 Self-report measures of dimensions of emotion regulation 159
11.2 fMRI
f tasks and brain regions involved in the four
dimensions of emotion regulation 163
12.1 A selection of resting state functional connectivity
studies in typically developing adolescents 185
14.1 Saguenay Youth Study: Baseline in adolescence –
phenotypes 215
14.2 Percent of adolescents reporting drug experimentation
(lifetime) and current use (last 30 days) for cannabis,
alcohol, and cigarettes in the SYS adolescents 217
x
List of Figures
3.1 Reward and inhibitory control networks believed to
underlie positive treatment outcomes 30
6.1 Depicts a simple model of substance use 87
6.2 Summarizes brain regions implicated in the development/
maintenance of substance use disorders (SUDs) as well as
affected by mindfulness meditation (MM) 90
8.1 Gray and white matter differences between active cocaine
users, abstainers, and matched controls 115
8.2 Illustration of the effects of state on VBM results 120
9.1 Brain regions exhibiting significantly greater activation
during cigarette cue exposure for those using a self-focused
cognitive coping strategy than for those using an other-
focused cognitive coping strategy 134
11.1 Four dimensions of emotion regulation 161
11.2 BOLD response is attenuated during stress provocation
in disorders associated with emotional dysregulation 166
14.1 Surface maps of statistical significance of prenatal
exposure to maternal cigarette smoking on cortical
thickness 218
14.2 Group differences in the relationship between the
thickness of the orbitofronal cortex (OFC) and drug
experimentation 220
15.1 An empirically informed translational model of
Motivational Interviewing (MI) 233
xi
Acknowledgments
We sincerely appreciate the enthusiasm and encouragement of Nicola
Jones, Eleanor Christie, and Elizabeth Forrest at Palgrave, without whom
this book would not have happened. In addition, we are thankful to
Rebecca Ezechukwu, PhD, Hollis Karoly, MA, and Julie Salvador, PhD,
for their careful review and edits of this work.
xii
Preface
Worldwide, at least 17 percent of men and 8 percent of women will meet
substance use disorder (SUD) criteria at some point during their lives
(Hasin, Stinson, Ogburn, & Grant, 2007). Problem substance use results
in significant morbidity and mortality, with 3.8 percent of global deaths
attributable to alcohol use (Rehm et al., 2009). While many interven-
tions for the treatment of addiction exist, psychosocial treatments are
the most frequently utilizedd (DHHS, 2009). Unfortunately, psychosocial
treatments have widely varying outcomes, with large-scale addiction
studies showing rates of abstinence ranging from 32 percent to 95 per-
cent one year following treatment (UKATT Research Team, 2005; Anton
et al., 2006; Project MATCH Research Group, 1998). This range indicates
the need to better understand how psychosocial interventions operate
and how they can be improved.
Novel approaches integrating basic biological measures offer one ave-
nue to elucidate what may be happening during effective (and ineffec-
tive) psychosocial interventions. To this end, numerous researchers have
advocated for translational efforts, such as neuroimaging, to be applied
to the investigation of psychotherapy (Brewer, Bowen, Smith, Marlatt,
& Potenza, 2010; Etkin, Pittenger, Polan, & Kandel, 2005; Goldstein
et al., 2009; Hutchison, 2010). Translational efforts can improve our
understanding of the mechanisms of psychosocial interventions, as they
directly connect neurobiological changes (within the brain) to within-
session, as well as post-treatment behavior change, thereby highlighting
crucial brain mechanisms that underlie successful treatment response.
Despite being an area of great interest, only a handful of studies have
empirically evaluated neurobiological mechanisms within psychosocial
treatments for addiction. Further, fewer have approached these trans-
lational investigations from the perspective of the treating provider.
As a result, existing translational studies that are compelling to experi-
mental scientists may feel distant, incomprehensible, and unhelpful to
clinical practitioners. Our goal within this collected volume is to directly
bridge that gap. Specifically, in this book, we aim to contribute to the
extant literature by presenting an overview of basic addictions neurosci-
ence (Section I), as well as two clear sections that directly inform how
neuroscience can (and does) improve addiction treatment, for both
xiii
xiv Preface
adults (Section II) and adolescents struggling with SUDs (Section III).
Ultimately, through this book, we hope that clinical and experimental
readers will gain a clear and practical understanding of the basic brain
mechanisms that contribute to patients’ responses across many differ-
ent types of psychosocial addiction treatment. We could not be more
delighted with the contributions within this collective work. We have
found these chapters to be highly exciting and inventive. We firmly
believe that these chapters will inspire fundamental changes in how
readers understand how psychosocial addiction treatments work. Fur-
ther, reading this book has catalyzed our own ideas about successful
mechanisms of change within clinical interventions and how we can
galvanize greater treatment outcomes.
We hope that the same is true for all readers.
Sarah W. Feldstein Ewing, PhD
Katie Witkiewitz, PhD
Francesca M. Filbey, PhD
2 December 2014
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