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The aim of this study was to investigate sex\u2010dependent differences in insular morphometry and associations with craving, in a sample of regular cocaine users (CUs) and non\u2010drug using controls (non\u2010CUs). It was hypothesized that insular volume, thickness and surface area would be lower in CU women, compared with CU men and non\u2010CUs. It was furthermore hypothesized that insular morphometry, particularly insular thickness, would be negatively associated to reward craving in CU men, while being negatively associated with stress\u2010relief craving in CU women. In contrast to the hypothesis, we did not find evidence of sex\u2010specific differences in insular morphometry in CUs. However, sex\u2010specific association between stress\u2010relief craving and insular morphometry were found: Right insular volume was negatively associated with stress\u2010relief craving in CU women, whereas this association was positive in CU men. Additionally, right insular surface area was negatively associated with stress\u2010relief craving in cocaine\u2010using men, whereas this association was positive in cocaine\u2010using women. In conclusion, the current study provides first evidence of sex\u2010specific differences in the association between craving and insular morphometry in a sample of regular cocaine users. Although speculative, these sex\u2010specific alterations in insular morphometry may underlie higher stress\u2010induced craving and relapse in CU women compared with CU men.<\/jats:p>","DOI":"10.1111\/adb.13157","type":"journal-article","created":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T05:59:47Z","timestamp":1645509587000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The relationship between craving and insular morphometry in regular cocaine users: Does sex matter?"],"prefix":"10.1111","volume":"27","author":[{"given":"George S.","family":"Abdel Malek","sequence":"first","affiliation":[{"name":"Department of Clinical, Neuro and Developmental Psychology Vrije University Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna E.","family":"Goudriaan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Amsterdam University Medical Center University of Amsterdam  Amsterdam The Netherlands"},{"name":"Arkin Mental Health and Jellinek  Amsterdam The Netherlands"},{"name":"Amsterdam Institute for Addiction Research  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5696-5758","authenticated-orcid":false,"given":"Anne Marije","family":"Kaag","sequence":"additional","affiliation":[{"name":"Department of Clinical, Neuro and Developmental Psychology Vrije University Amsterdam  Amsterdam The Netherlands"},{"name":"The Amsterdam Brain and Cognition Center (ABC) University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,2,21]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"European Monitoring Centre for Drugs.European drug report [Internet].European Union Publications Office.2019.1\u201394. 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