Neural correlates of self-focused and other-focused strategies for coping with cigarette cue exposure.

Brain imaging research has begun to characterize the neurocognitive processes that cigarette smokers utilize to cope with cue-elicited craving. Presently, however, it remains unclear whether distinct neural substrates support different types of coping. We sought to address this knowledge gap by examining neural responses associated with self-focused and other-focused coping techniques. Fifty-seven treatment-seeking male cigarette smokers initiated an attempt to quit smoking and subsequently underwent functional MRI, during which they were asked to hold and view neutral cues and a cigarette. Participants were instructed to engage in either self-focused or other-focused coping while being presented with the cigarette and an opportunity to smoke. Those who were told to engage in self-focused coping, but not those told to utilize other-focused coping, exhibited significant activation of several regions previously implicated in self-referential processing, including the medial prefrontal cortex, precuneus, and insula. In addition, coping strategy modulated the relationship between cigarette-related brain activation and self-reported craving in a subset of these regions. These findings indicate that coping strategies that entail the generation and maintenance of self-relevant information rely upon different psychological and neurobiological mechanisms than those that are not self-focused, even when the latter incorporate information that is very similar in content. Results extend previous work examining the neural substrates of coping with craving. Given the potential mnemonic and motivational advantages associated with self-related processing, findings may have significant implications for selecting and improving techniques for helping quitting smokers resist the urge to smoke.