The insula cortex is an important area for integrating emotional and homeostatic information to and from limbic and cortical areas, and has been implicated in negative emotional states such as craving and anxiety. Evidence for a role of the insula in conscious urges to take drugs comes from studies involving damage to the insula in both human 17–19 and animals 20. Furthermore, insula activation has been associated with cue-induced drug craving 17, 21, 22, maintaining urge to the use of drugs 23 in addicts, and anticipation of aversive exposure in individuals with anxiety disorder 24. Studies in nonclinical samples have revealed an association between insula function and self-report measures of anxiety 25. These emotional stages of urge, anxiety, and anticipation of negative events may be related to Urgency, an impulsiveness trait involving rash actions under intense negative affect 26.
