In addiction, there is also evidence of a significant disruption in self-awareness, which includes the ability to recognize internal mental states (emotions, desires, and personal representation of one’s abilities). This is likely to impair an addicted individual’s awareness of disease, his/her need for treatment, and/or his/her strong desire for the drug (84). The neurocircuitry underlying self-awareness is not completely understood, but the default mode network (DMN) has been implicated in this process (85). The DMN includes regions from the dorsal and ventral ACC, insula, precuneus, and parietal cortex that become deactivated when performing a task but are active when mind-wandering (86, 87). Regions from the DMN that have been directly associated with impaired awareness in addiction include both the ACC and the insula.
