Neural Correlates of Distress Tolerance Predicts Future Substance Use for Cocaine Users

Undergraduate: Katlyn McKay

Faculty Advisor: Stacey Daughters
Department: Psychology & Neuroscience

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Cocaine use disorder has wide-ranging social, economical, and health-related consequences, including changes to the cortico-limbic stress pathways that may be linked to deficits in goal-directed behavior. Distress tolerance (DT), or the ability to withstand negative affect during goal-directed activities, is implicated in maintaining substance use disorders. More specifically, individuals who exhibit low levels of distress tolerance (measured behaviorally) tend to have worse treatment outcomes, shorter abstinence attempts, and more days of substance use. Daughters et al. (2016) validated a measure of DT (the Paced Auditory Serial Addition Task, or PASAT) for use in an fMRI scanner to examine the neural correlates of DT. As a follow-up, the current study used a sample of 24 regular cocaine users to determine if the neural correlates of DT found previously could be used to predict future substance use 30 days post-scan. There were positive associations found between activation in three neural regions (left amygdala, right amygdala, and right ventromedial prefrontal cortex) and the number of days used cocaine post-scan. This finding is in line with prior studies regarding both the implication of the cortico-limbic pathway in goal-directed behavior and low DT being linked to worse outcomes when measured behaviorally. Future research should utilize a treatment-seeking population of cocaine users to determine whether DT neural regions can predict treatment outcomes as well.