Maracic Crista E, Moeller Scott J
Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, 11794.
Curr Behav Neurosci Rep. 2021 Dec;8(4):113-123. doi: 10.1007/s40473-021-00240-x. Epub 2021 Nov 6.
Clinical insight is an emerging interest in substance use disorder research, but is difficult to study empirically. We reviewed recent research examining the behavioral and neural correlates of several psychological processes tapping into self-awareness that may in turn contribute to insight.
Individuals with substance use disorder exhibit deficits in self-monitoring (especially self-report / behavior dissociations), metacognition, alexithymia, readiness for behavior change, and interoception. Behavioral impairments have been further linked to neural abnormalities in a diverse network of brain regions encompassing cortical midline areas, insula, and frontal cortex, among others. Various treatment modalities may target these deficits, though corresponding effects on neural circuitry remain to be determined.
Compromised insight in substance use disorder may be relevant to a constellation of behaviors that suggest a lack of behavioral awareness linked to drug use. Future work needs to refine and advance the measurements, continuing to investigate insight problems in addiction that may become important therapeutic targets.
临床洞察力是药物使用障碍研究中一个新兴的研究方向，但实证研究难度较大。我们回顾了近期的研究，这些研究考察了几种涉及自我意识的心理过程的行为和神经关联，而这些心理过程可能反过来有助于洞察力的形成。
患有药物使用障碍的个体在自我监测（尤其是自我报告/行为解离）、元认知、述情障碍、行为改变意愿和内感受方面存在缺陷。行为障碍进一步与包括皮质中线区域、脑岛和额叶皮质等在内的不同脑区网络中的神经异常有关。各种治疗方式可能针对这些缺陷，不过对神经回路的相应影响仍有待确定。
药物使用障碍中洞察力受损可能与一系列行为有关，这些行为表明缺乏与药物使用相关的行为意识。未来的工作需要完善和改进测量方法，继续研究成瘾中的洞察力问题，这些问题可能成为重要的治疗靶点。
