Reduce Smartphone Addiction and Improve Stress Coping in Adolescents with Meditation

Reduce Smartphone Addiction and Improve Stress Coping in Adolescents with Meditation

 

By John M. de Castro, Ph.D.

 

over a third of us check our phones in the middle of the night. And a further third check our phones within five minutes of waking up. The same survey also revealed that about a third of us have argued with our partners about using their phones too much.” – Neil Tranter

 

Over the last few decades, the internet has gone from a rare curiosity to the dominant mode of electronic communications. In fact, it has become a dominant force in daily life, occupying large amounts of time and attention. The dominant mode of accessing the internet is through smartphones creating smartphone addictions. Individuals with smartphone addiction develop greater levels of “tolerance” and experience “withdrawal” and distress when deprived. This phenomenon is so new that there is little understanding of its nature, causes, and consequences and how to treat it.

 

Adolescence is a time of mental, physical, social, and emotional growth. It is during this time that higher levels of thinking, sometimes called executive function, develops. But adolescence can be a difficult time, fraught with challenges and stresses. During this time the child transitions to young adulthood; including the development of intellectual, psychological, physical, and social abilities and characteristics. There are so many changes occurring during this time that the child can feel overwhelmed and stressed and unable to cope with all that is required.

 

Mindfulness training has been shown to be helpful with addictions, decreasing cravings, impulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  Mindfulness has also been shown to be effective for the treatment of a variety of addictions. Meditation, a core mindfulness training technique, has been shown to be effective in treating addictions. Hence, there is a need to further explore the ability of meditation training to treat smartphone addiction in adolescents.

 

In today’s Research News article “The Effect of Mind Subtraction Meditation Intervention on Smartphone Addiction and the Psychological Wellbeing among Adolescents.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246924/), Choi and colleagues recruited High School sophomores at two different schools and provided one group with school based meditation training for 20 minutes twice a week for 12 weeks while the second group received no treatment. They were measured before and after training and 4 weeks later for smartphone addiction, self-control, perceived stress, and stress coping skills.

 

They found that after treatment the meditation but not the control group had a significant reduction in perceived stress and smartphone addiction, including decreases in daily life disturbance, tolerance, and withdrawal symptoms. They also found significant increases in self-control and stress coping strategies including problem focusing coping and social support navigation coping. They also found that theses effects were still present and significant 4 weeks after the end of training.

 

These are interesting results that would have been stronger is an active control condition such as exercise was used. Nevertheless, the results suggest that school-based meditation practice can reduce stress, improve stress coping and self-control and decrease addiction to smartphones in adolescents. This should help these young people to better deal with their school stress and be better able to perform academically and socially.

 

So, reduce smartphone addiction and improve stress coping in adolescents with meditation.

 

These devices and capabilities do bring incredible benefits and possibilities for sharing information and creating global interaction than ever before. We simply (and yet with great difficulty) need to learn to hold our technology more lightly—with more awareness.” – Mitch Abblett

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Choi, E. H., Chun, M. Y., Lee, I., Yoo, Y. G., & Kim, M. J. (2020). The Effect of Mind Subtraction Meditation Intervention on Smartphone Addiction and the Psychological Wellbeing among Adolescents. International journal of environmental research and public health, 17(9), 3263. https://doi.org/10.3390/ijerph17093263

 

Abstract

As the smartphone has become an indispensable device in modern lives, consequential psychosocial problems such as smartphone addiction have been getting attention worldwide, especially regarding adolescents. Based on its positive effect on young individuals’ mental health, mind subtraction meditation has been widely applied to many school-based programs in South Korea. This study aims to identify the effects of a school program based on mind subtraction on the smartphone addiction of adolescents. A total of 49 high school sophomores, 24 from the experimental group (mean age = 16), and 25 from the control group (mean age = 16) are included in this case-control study. The experimental group is given the meditation program sessions in the morning, two times a week for 20 min per session, for a total of 12 weeks. The experimental group shows improvements regarding the ‘smartphone addiction’ section (p < 0.001), for instant satisfaction (p < 0.001) and long-term satisfaction (p < 0.001). Concerning the ‘self-control’ section and decreasing stress (p < 0.001), problem focusing (p < 0.001), and social support navigation (p = 0.018), there are improvements in these ‘stress coping strategies’ sections. This study directly shows the positive effect of mind subtraction meditation on smartphone addiction in adolescents and, thus, provides guidance to the future development of smartphone addiction prevention programs for young individuals.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246924/

 

Adherence to a Mindfulness Intervention Assists in Preventing Alcoholism Relapse

Adherence to a Mindfulness Intervention Assists in Preventing Alcoholism Relapse

 

By John M. de Castro, Ph.D.

 

“Thoughts and feelings, including urges to use substances or activities, are always temporary. Through mindfulness and its related practices (including meditation) it is possible to learn how to face uncomfortable, painful thoughts, feelings, and physical sensations, and let them pass—without obsessing on or avoiding them.” – Dan Mager

 

Inappropriate use of alcohol is a major societal problem. In fact, about 25% of US adults have engaged in binge drinking in the last month and 7% have what is termed an alcohol use disorder. Alcohol abuse is very dangerous and frequently fatal. Nearly 88,000 people in the US and 3.3 million globally die from alcohol-related causes annually, making it the third leading preventable cause of death in the United States. Drunk driving accounted for over 10,000 deaths; 31% of all driving fatalities. Excessive alcohol intake has been shown to contribute to over 200 diseases including alcohol dependence, liver cirrhosis, cancers, and injuries. It is estimated that over 5% of the burden of disease and injury worldwide is attributable to alcohol consumption.

 

Obviously, there is a need to find effective methods to prevent and treat alcohol abuse. There are a number of programs that are successful at stopping the abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of alcohol abusers relapse and return to drinking. Hence, it is important to find an effective method to both treat alcohol abuse and to prevent relapse. Mindfulness practices have been shown to improve recovery from various addictions and reduce relapse. Mindfulness training has been successfully applied to treating alcohol abuse. It appears to increase the ability of the drinker to control alcohol intake. Since, mindfulness appears to hold promise as a treatment for excessive alcohol intake, there is a need to examine the ability of mindfulness training to reduce relapse after successful cessation.

 

In today’s Research News article “Mindfulness-based relapse prevention for alcohol dependence: Findings from a randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6508889/), Zgierska and colleagues recruited alcohol dependent adults who were in early recovery in an alcohol treatment program. They were randomly assigned to either continue to receive their current treatment or to receive an 8 weekly 2-hour Mindfulness-Based Relapse Prevention (MBRP) program with home practice tailored for alcohol abuse. They were measured before and after treatment and a year later for alcohol consumption, drinking-related consequences, mindfulness, and perceived stress.

 

They reported that over the one-year follow-up period there were no significant differences between the treatment as usual or the Mindfulness-Based Relapse Prevention (MBRP) participants on any of the outcome measures. But, for the MBRP participants who attended at least 4 sessions, the greater the number of sessions attended, and the greater the amount of home practice the lower the percentage of drinking days and the fewer the heavy drinking days during the 1-year follow-up.

 

The results of the present study are surprising as prior research has consistently demonstrated that mindfulness training improves relapse prevention. The present findings may have been due to a ceiling effect. The participants in both groups were committed to stopping drinking and already had up to 14 days of sobriety prior to entry into the study. This was reflected in that 60% of the participants in both groups were abstinent at the 1-year follow-up. This is an exceptionally high success rate for alcohol relapse prevention. So, the treatment as usual group may have been so successful that it left little room for the Mindfulness-Based Relapse Prevention (MBRP) participants to show any further improvement.

 

The results of the present study indicate that participation in the program and adherence to the program requirements are exceptionally important. After taking out those non-adherent participants there was a positive relationship between adherence and relapse prevention.

 

So, adherence to a mindfulness intervention assists in preventing alcoholism relapse.

 

“We need to consider many different approaches to addiction treatment. It’s a tough problem,” Mindfulness therapy is “another possibility for people to explore,” – Sarah Bowen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Zgierska, A. E., Burzinski, C. A., Mundt, M. P., McClintock, A. S., Cox, J., Coe, C. L., Miller, M. M., & Fleming, M. F. (2019). Mindfulness-based relapse prevention for alcohol dependence: Findings from a randomized controlled trial. Journal of substance abuse treatment, 100, 8–17. https://doi.org/10.1016/j.jsat.2019.01.013

 

Highlights

MBRP-A plus usual care and usual care alone resulted in similar health benefits.

Addition of MBRP-A to usual care did not further improve drinking-related outcomes.

Greater MBRP-A intervention adherence was associated with better outcomes.

Abstract

OBJECTIVES:

To assess the effects of mindfulness-based relapse prevention for alcohol dependence (MBRP-A) intervention on drinking and related consequences.

METHODS:

123 alcohol-dependent adults in early recovery, recruited from outpatient treatment programs, were randomly assigned to MBRP-A (intervention plus usual-care; N=64) or Control (usual-care-alone; N=59) group. MBRP-A consisted of eight-weekly sessions and home practice. Outcomes were assessed at baseline, 8 weeks and 26 weeks (18 weeks post-intervention), and compared between groups using repeated measures analysis.

RESULTS:

Outcome analysis included 112 participants (57 MBRP-A; 55 Control) who provided follow-up data. Participants were 41.0±12.2 years old, 56.2% male, and 91% white. Prior to “quit date,” they reported drinking on 59.4±34.8% (averaging 6.1±5.0 drinks/day) and heavy drinking (HD) on 50.4±35.5% of days. Their drinking reduced after the “quit date” (before enrollment) to 0.4±1.7% (HD: 0.1±0.7%) of days. At 26 weeks, the MBRP-A and control groups reported any drinking on 11.5±22.5% and 5.9±11.6% of days and HD on 4.5±9.3% and 3.2±8.7% of days, respectively, without between-group differences (ps≥0.05) in drinking or related consequences during the follow-up period. Three MBRP-A participants reported “relapse,” defined as three-consecutive HD days, during the study. Subgroup analysis indicated that greater adherence to session attendance and weekly home practice minutes were associated with improved outcomes.

CONCLUSIONS:

MBRP-A as an adjunct to usual-care did not show to improve outcomes in alcohol-dependent adults in early recovery compared to usual-care-alone; a return to drinking and relapse to HD were rare in both groups. However, greater adherence to MBRP-A intervention may improve long-term drinking-related outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6508889/

 

Improve Smoking Abstinence with Mindfulness

Improve Smoking Abstinence with Mindfulness

 

By John M. de Castro, Ph.D.

 

mindfulness training (MT) may decouple the association between craving and smoking, thus facilitating smoking cessation.” – J. Kim Pemberthy

 

Tobacco use remains the single largest preventable cause of death and disease in the United States.” (Centers for Disease Control and Prevention). So, treating nicotine addiction and producing smoking cessation could greatly improve health. But smoking has proved devilishly difficult to treat. There are a wide variety of methods and strategies to quit smoking which are to only a very limited extent effective. According to the National Institutes of Health, about 40% of smokers who want to quit make a serious attempt to do so each year, but fewer than 5% actually succeed. Most people require three or four failed attempts before being successful.

 

One problem is that nicotine is one of the most addictive substances known and withdrawal from nicotine is very stressful, producing many physical and psychological problems, including negative emotional states and depression. In essence, the addict feels miserable without the nicotine. This promotes relapse to relieve the discomfort. Better methods to quit which can not only promote quitting but also prevent relapse are badly needed. Mindfulness practices have been found to be helpful in treating addictions, including nicotine addiction, and reducing the risk of relapse.

 

In today’s Research News article “Mechanisms linking mindfulness and early smoking abstinence: An ecological momentary assessment study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483850/), Spears and colleagues recruited adult smokers desiring to quit and provided them with “six smoking cessation counseling sessions (10–20 minutes each).” They completed questionnaires on demographics and mindfulness. They were also asked to complete assessments at baseline and for 4 weeks after cessation of smoking on a smartphone of positive and negative emotions, smoking urges, and expectancy of regulating emotions whenever they had an urge to smoke, smoked a cigarette, and 4 randomly selected times per day prompted on their smartphone.

 

Of the participants 63% achieved smoking abstinence after treatment and 41% remained abstinent 7 days later. They found that on the day of smoking cessation and 7 days later, the higher the levels of mindfulness the lower the levels of negative emotions, stress, smoking urges, and expectancies that smoking would improve mood and the higher the levels of positive emotions. They also found that lower smoking urges were associated with higher levels of abstinence when the participants were low in mindfulness but not when they were high in mindfulness. In addition, the higher the levels of mindfulness, the higher the levels of positive emotions and the lower the levels of negative emotions which were in turn associated with higher levels of smoking abstinence.

 

Even though the smoking cessation therapy did not include a mindfulness component, the participant’s level of mindfulness was an important contributor to successful smoking abstinence. Mindfulness appeared to be associated with improved mood and lower stress levels and urges to smoke which were in turn associated with improved outcomes. Hence, mood and stress appear to mediate the association of mindfulness with successfully quitting smoking. Mindful people appear to have more positive moods which works to improve the likelihood of quitting smoking.

 

So, improve smoking abstinence with mindfulness.

 

stress is caused by craving. If you can let go of that craving, then your stress will dissolve, and practicing mindfulness is the way to do that.” – Judson Brewer

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Spears, C. A., Li, L., Wu, C., Vinci, C., Heppner, W. L., Hoover, D. S., Lam, C., & Wetter, D. W. (2019). Mechanisms linking mindfulness and early smoking abstinence: An ecological momentary assessment study. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 33(3), 197–207. https://doi.org/10.1037/adb0000451

 

Abstract

Research suggests that individuals with greater dispositional mindfulness (i.e., non-judgmental, present-focused attention) are more likely to quit smoking, but the underlying mechanisms are unclear. This study investigated mechanisms linking mindfulness and early smoking abstinence using ecological momentary assessment (EMA). Participants were 355 smokers (33% Caucasian, 33% African American, 32% Latino; 55% female) receiving smoking cessation treatment. Mindfulness was assessed at baseline and on the quit date. For 4 days pre-quit and 1 week post-quit, participants completed up to 4 EMAs per day indicating levels of negative affect (NA), positive affect (PA), smoking urges, and affect regulation expectancies. Mean, slope, and volatility were calculated for each pre-quit and post-quit EMA variable. Associations among mindfulness, EMA parameters, and abstinence on the quit day and 7 days post-quit, as well as indirect effects of mindfulness on abstinence through EMA parameters were examined. Mindfulness predicted higher odds of abstinence in unadjusted but not covariate-adjusted models. Mindfulness predicted lower NA, higher PA, and lower affective volatility. Lower stress mediated the association between mindfulness and quit-day abstinence. Higher ratings of happy and relaxed, and lower ratings of bored, sad and angry, mediated the association between mindfulness and post-quit abstinence. Mindfulness appeared to weaken the association between craving and post-quit abstinence. This study elucidates real-time, real-life mechanisms underlying dispositional mindfulness and smoking abstinence. During the early process of quitting smoking, more mindful individuals appear to have more favorable emotional profiles, which predicts higher likelihood of achieving abstinence 1 week after the quit date.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483850/

 

The Relationship between Cravings and Mindfulness in Patients Recovering from Substance Abuse

Mindfulness, doi:10.1007/s12671-018-1023-z

The Relationship between Cravings and Mindfulness in Patients Recovering from Substance Abuse

 

By John M. de Castro, Ph.D.

 

“when people cultivate mindfulness, they’re developing a tool to become aware of that inclination to want only pleasurable things and escape uncomfortable things.” – Sarah Bowen

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse. Hence, it is important to find an effective method to treat substance abuse and prevent relapse.

 

An effective treatment for addiction has been elusive. Most programs and therapies to treat addictions have poor success rates. Recent research is indicating that mindfulness has been found to be effective in treating addictions. One way that mindfulness may produce these benefits is by reducing cravings. Mindfulness-based Relapse Prevention (MBRP) has been developed to specifically assist in relapse prevention and has been shown to be effective. “MBRP integrates mindfulness practices with cognitive-behavioral Relapse Prevention therapy and aims to help participants increase awareness and acceptance of difficult thoughts, feelings, and sensations to create changes in patterns of reactive behavior that commonly lead to relapse. Mindfulness training in MBRP provides clients with a new way of processing situational cues and monitoring internal reactions to contingencies, and this awareness supports proactive behavioral choices in the face of high-risk relapse situation.” – Grow et al. 2015.

 

In a previous study it was reported that Mindfulness-based Relapse Prevention (MBRP) improved mindfulness which in turn resulted in reduced cravings. In today’s Research News article “The (Lack of) Replication of Self-Reported Mindfulness as a Mechanism of Change in Mindfulness-Based Relapse Prevention for Substance Use Disorders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435335/), Hsiao and colleagues attempted to replicate their previous findings of mindfulness as a mediator between MBRP and reduced cravings. They recruited adults who had completed intensive treatment for cessation of alcohol or drug abuse in the prior 2 weeks. The patients were randomly assigned to receive either treatment as usual or 8 weekly 2-hour sessions of Mindfulness-based Relapse Prevention (MBRP). They were measured before and after training and 2 and 4 months later for acceptance, mindfulness and drug or alcohol cravings.

 

In a previous, virtually identical study, they had found that in comparison to baseline and treatment as usual Mindfulness-based Relapse Prevention (MBRP) resulted in significantly increased mindfulness and acceptance and decreased cravings. They also found that mindfulness mediated the effect of MBRP on cravings such that MBRP increased mindfulness which in turn decreased cravings. But in the present study MBRP did not increase mindfulness and acceptance and did not decrease cravings and there was no significant mediation.

 

These were surprising results. The previous study was highly significant with moderate effect sizes. They hypothesized that part of the failure to replicate the prior results may have been due to the increased acceptance of mindfulness in the therapeutic community over the years. They speculated that mindfulness may have been incorporated in the therapy included in treatment as usual in the present study whereas it wasn’t in the prior study. More research is needed to examine this possibility.

 

It should be noted that the effectiveness of mindfulness in producing benefits has been replicated multiple times in other domains. Thus, the results underline the need for replication of published results in the studies of mindfulness and addiction. They may be more fragile than thought.

 

One of the biggest challenges of recovering from addiction is dealing with cravings. . . Being mindful in a craving means seeing the craving for what it really is and really experiencing it. . . Once you can accept that a craving is just a feeling and the object of the craving will never deliver on that promise, you will be able to regain some control.” – Recovery Ways

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are a also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Hsiao, Y. Y., Tofighi, D., Kruger, E. S., Lee Van Horn, M., MacKinnon, D. P., & Witkiewitz, K. (2019). The (Lack of) Replication of Self-Reported Mindfulness as a Mechanism of Change in Mindfulness-Based Relapse Prevention for Substance Use Disorders. Mindfulness, 10(4), 724–736. https://doi.org/10.1007/s12671-018-1023-z

 

Abstract

The development and evaluation of mindfulness-based interventions for a variety of psychological and medical disorders has grown exponentially over the past 20 years. Yet, calls for increasing the rigor of mindfulness research and recognition of the difficulties of conducting research on the topic of mindfulness have also increased. One of the major difficulties is the measurement of mindfulness, with varying definitions across studies and ambiguity with respect to the meaning of mindfulness. There is also concern about the reproducibility of findings given few attempts at replication. The current secondary analysis addressed the issue of reproducibility and robustness of the construct of self-reported mindfulness across two separate randomized clinical trials of mindfulness-based relapse prevention (MBRP), as an aftercare treatment for substance use disorder. Specifically, we tested the robustness of our previously published findings, which identified a latent construct of mindfulness as a significant mediator of the effect of MBRP on reducing craving following treatment. First, we attempted to replicate the findings in a separate randomized clinical trial of MBRP. Second, we conducted sensitivity analyses to test the assumption of the no-omitted confounder bias in a mediation model. The effect of MBRP on self-reported mindfulness and overall mediation effect failed to replicate in a new sample. The effect of self-reported mindfulness in predicting craving following treatment did replicate and was robust to the no-omitted confounder bias. The results of this work shine a light on the difficulties in the measurement of mindfulness and the importance of examining the robustness of findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435335/

 

Lower Opioid Cravings are Associated with Lower Depression, Higher Self-Regulation, and Higher Mindfulness

Lower Opioid Cravings are Associated with Lower Depression, Higher Self-Regulation, and Higher Mindfulness

 

By John M. de Castro, Ph.D.

 

mindfulness-based interventions could help people dependent on opioids increase their self-awareness and self-control over cravings and be less reactive to emotional and physical pain.” – Science Daily

 

Substance abuse and addiction is a terrible problem, especially opioid pain relievers. Opioid addiction has become epidemic and is rapidly increasing affecting more than 2 million Americans and an estimated 15 million people worldwide. In the U.S more than 20,000 deaths yearly were attributed to an overdose of prescription opioids, and another 13,000 deaths from heroin overdose. These statistics, although startling are only the tip of the iceberg. Drug use is associated with suicide, homicide, motor-vehicle injury, HIV infection, pneumonia, violence, mental illness, and hepatitis. It can render the individual ineffective at work, it tears apart families, it makes the individual dangerous both driving and not.

 

An effective treatment for addiction has been elusive. Most programs and therapies to treat addictions have poor success rates. Recent research is indicating that mindfulness has been found to be effective in treating addictions. One way that mindfulness may produce these benefits is by reducing cravings for opioids. It may also do so by affecting the ability of the addict to regulate their emotions. Indeed, mindfulness has been shown to improve emotional regulation.

 

In today’s Research News article “Autonomic and affective mediators of the relationship between mindfulness and opioid craving among chronic pain patients. Experimental and clinical psychopharmacology.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355352/), Baker and Garland recruited non-cancer chronic pain patients who were taking opioid analgesics and had them complete self-report measures of mindfulness, opioid craving, and depression. They also measured their heart rates with an electrocardiogram (ECG) while looking at either neutral pictures or “opioid-related image (e.g., pills, pill bottles).” These data were analyzed to determine heart rate variability as a measure of the activity of the peripheral autonomic nervous system.

 

They found that the higher the levels of mindfulness the higher the levels of heart rate variability while looking at opioid-related pictures. And the lower the levels of depression and opioid cravings. Also, the higher the levels of depression, the higher the levels of opioid cravings. Employing a multivariate path analysis, they found that mindfulness was not associated with lower opioid cravings directly, but indirectly via mindfulness’ associations with heart rate variability and depression. That is, they found that mindfulness was associated with higher heart rate variability which was in turn associated with lower opioid cravings and also with lower depression which was in turn associated with lower opioid cravings.

 

Heart rate variability is thought to measure the nervous systems adjustments to the physiology involved in regulating its physical responses to stimuli. In other words, it’s a measure of self-regulation. The present results suggest that mindfulness is associated with greater self-regulation and this is associated with lower cravings for opioids. The results also suggest that depression is associated with higher cravings for opioids and that mindfulness interrupts this by being associated with lower depression.

 

These results are correlative and as such causation cannot be determined. Nevertheless, prior research has demonstrated causal links between mindfulness and lower cravings and depression. So, the present results likely result from causal connections. The findings also suggest the mechanism whereby mindfulness may lower cravings by contributing to the ability to regulate physical responses to opioid-related stimuli and by reducing depression. These results provide more support for the use of mindfulness training as a treatment for addictions.

 

So, lower opioid cravings are associated with lower depression, higher self-regulation, and higher mindfulness.

 

people suffering from opioid addiction and chronic pain may have fewer cravings and less pain when adding mindfulness to the traditional methadone treatment.” – Grace Bullock

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Baker, A. K., & Garland, E. L. (2019). Autonomic and affective mediators of the relationship between mindfulness and opioid craving among chronic pain patients. Experimental and clinical psychopharmacology, 27(1), 55–63. https://doi.org/10.1037/pha0000225

 

Abstract

Prescription opioid misuse among chronic pain patients is associated with self-regulatory deficits, affective distress and opioid cue reactivity. Dispositional mindfulness has been associated with enhanced self-regulation, lower distress, and adaptive autonomic responses following drug cue exposure. We hypothesized that dispositional mindfulness might serve as a protective factor among opioid-treated chronic pain patients. We examined heart rate variability (HRV) during exposure to opioid cues and depressed mood as mediators of the association between dispositional mindfulness and opioid craving. Data were obtained from a sample of chronic pain patients (N=115) receiving long-term opioid pharmacotherapy. Participants self-reported opioid craving and depression, and HRV was measured during an opioid-cue dot probe task. Dispositional mindfulness was significantly positively correlated with HRV, and HRV was significantly inversely associated with opioid craving. Dispositional mindfulness was significantly negatively correlated with depression, and depression was significantly positively correlated with opioid craving. Path analysis revealed significant indirect effects of dispositional mindfulness on craving through both HRV and depression. Dispositional mindfulness may buffer against opioid craving among chronic pain patients prescribed opioids; this buffering effect may be a function of improved autonomic and affective responses.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6355352/

 

Improve Smartphone Addiction with Mindfulness

Improve Smartphone Addiction with Mindfulness

 

By John M. de Castro, Ph.D.

 

As we get more connected to our wireless technology, we appear to run the risk of damaging our brains’ wiring, and disconnecting from the face-to-face interaction that our social and psychological systems need. With its emphasis on harnessing attention with intention (i.e. redirecting it on purpose), mindfulness—with all its scientifically-established health and well-being benefits—has the potential to keep us from drifting hopelessly away from one another.” – Mitch Abblett

 

Over the last few decades, the internet has gone from a rare curiosity to the dominant mode of electronic communications. In fact, it has become a dominant force in daily life, occupying large amounts of time and attention. As useful as the internet may be, it can also produce negative consequences. “Problematic Internet Use” is now considered a behavioral addiction, with almost half of participants in one study considered “Internet addicts”, developing greater levels of “tolerance” and experiencing “withdrawal” and distress when deprived. This phenomenon is so new that there is little understanding of its nature, causes, and consequences and how to treat it. The dominant mode of accessing the internet is through smartphones creating smartphone addictions.

 

Future time perspective is the ability to anticipate and plan to bring about desired outcomes in the future. Most addictions involve being completely driven by present needs. So, future time perspective is contrary to addiction and may help to overcome addiction. Mindfulness training has been shown to be helpful with each of the components of addictions, decreasing cravings, impulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  Mindfulness has also been shown to be associated with a balanced time perspective. It is no wonder then that mindfulness training has been found to be effective for the treatment of a variety of addictions. Hence, there is a need to further explore the relationships of smartphone addiction with future time perspective and mindfulness.

 

In today’s Research News article “Smartphone use disorder and future time perspective of college students: the mediating role of depression and moderating role of mindfulness.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6969420/), Zhang and colleagues recruited freshman and sophomore college students aged 18-22 years. The completed measures of future time perspective, smartphone use disorder, depression, and mindfulness.

 

They found that the higher the levels of mindfulness the higher the levels of future time perspective and the lower the levels of depression and smartphone use disorder. They also found that the higher the levels of future time perspective the higher the levels of mindfulness and the lower the levels of depression and smartphone use disorder. They then performed a mediation analysis and found that future time perspective had not only a direct and relationship with smartphone use disorder but also was indirectly related via depression such that future time perspective was negatively related to depression which, in turn, was positively related to. smartphone use disorder. Finally, they found that mindfulness moderated the indirect path with high mindfulness decreasing the relationship of future time perspective on depression and decreasing the relationship of depression with smartphone use disorder.

 

This study is correlational and as such causation cannot be determined. Nevertheless, the results suggest that the ability of college students to focus on the future is associated with lower depression and smartphone addictions. Also, college students’ addictions to smartphones are lower when mindfulness is present. This relationship occurs directly and as a result of moderating the relationships between thinking and planning for the future, depression, and smartphone use disorder. It remains for future research to train students in mindfulness to determine if mindfulness can be used to treat addictions to smartphones.

 

So, improve smartphone addiction with mindfulness.

 

“just as technology is increasingly being developed to attract and hold our attention, with mindfulness we can develop the capability to be much more aware of where the spotlight of our attention is being drawn to, and consciously choose to direct and place our attention and energy on an activity of our choosing.” – Neil Tranter

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Zhang, Y., Lv, S., Li, C., Xiong, Y., Zhou, C., Li, X., & Ye, M. (2020). Smartphone use disorder and future time perspective of college students: the mediating role of depression and moderating role of mindfulness. Child and adolescent psychiatry and mental health, 14, 3. doi:10.1186/s13034-020-0309-9

 

Abstract

Background

Smartphone use disorder (SUD) of college students has drawn increasing attention. Although future time perspective (FTP) may be an important protective factor for individual SUD, the moderating and mediating mechanisms underlying this relationship remain unknown. We tested the individual roles of depression and mindfulness as moderators of this relationship.

Methods

A cross-sectional study was conducted in two colleges in Shandong and Chongqing in China using a sample of 1304 college students recruited by stratified cluster sampling. Data were collected through a validated self-report instrument. A moderation–mediation model was constructed, and an SPSS PROCESS macro was used to analyse the data.

Results

The correlation analyses showed that FTP was negatively associated with SUD of college students. The mediation model revealed that depression partially mediated the link between FTP and SUD of college students. The moderation–mediation model suggested that mindfulness moderates two direct paths: FTP to depression and depression to SUD. In the first path (FTP to depression), a high level of mindfulness among college students had weakened the relationship between FTP and depression. Here, the relationship is strengthened by a low level of mindfulness. In the second path (depression to SUD), low levels of mindfulness strengthen the link between depression and FTP. In contrast, significant association was not found with high levels of mindfulness.

Conclusions

Results suggest that interventions, such as improving the individual level of FTP and mindfulness, should be conducted. These interventions, in turn, help control the level of depression in college students and ultimately decrease their level of SUD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6969420/

 

Improve Emotional Response Inhibition in Patients with Chronic Pain and Opioid Use with Mindfulness

Improve Emotional Response Inhibition in Patients with Chronic Pain and Opioid Use with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness meditation could represent a viable alternative to opioid-based therapy for chronic pain, and may be useful in helping patients taper their use of high doses of opioid-acting agents.” – Hymie Anisman

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

There is an accumulating volume of research findings to demonstrate that mindfulness practices, in general, are effective in treating pain. In today’s Research News article “Effects of Mindfulness-Oriented Recovery Enhancement Versus Social Support on Negative Affective Interference During Inhibitory Control Among Opioid-Treated Chronic Pain Patients: A Pilot Mechanistic Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735955/), Garland and colleagues examine the mechanisms by which mindfulness reduces perceived pain.

 

They recruited adult patients with non-cancer related chronic pain who were taking daily opioids. They were randomly assigned to receive 8-weeks of a Mindfulness-Oriented Recovery Enhancement (MORE) program or to an 8-week support groups meeting. Mindfulness-Oriented Recovery Enhancement (MORE) involves mindful breathing and body scan meditations, cognitive reappraisal to decrease negative emotions and craving, and savoring to augment natural reward processing and positive emotion. The patients were measured before and after treatment and 3 months later for pain severity and the mindfulness facet of nonreactivity. The patients also performed a go – no-go task. They viewed either neutral or pain related images in which was embedded either the letter “M” or “W”. They were asked to press a key a quickly as possible when the letter “M” was present.

 

They found that in comparison to baseline and the support group, after the mindfulness treatment there was a significant reduction in pain severity and increase in nonreactivity and improvement in go – no-go task accuracy. These changes were maintained 3 months after the completion of th treatment. In addition, they found that the higher the levels of nonreactivity and the greater the amount of meditation practice, the fewer errors occurred in the go – no-go task with pain-related images. In other words, the greater the improvement in response inhibition to emotional stimuli. Finally, they found that the greater the reductions in go – no-go task errors with pain related images, the greater the reduction in pain severity.

 

The results are complicated and so are the conclusions. Nevertheless, the results suggest that mindfulness training reduces pain severity and increases the mindfulness facet of nonreactivity. This suggests that the mindfulness training improves the patient’s ability to not react to pain stimuli and thereby reduce the perceived severity of the pain. This increase in nonreactivity would also explain why the patients didn’t react to pain related distractors in the go – no-go task and thereby improve their accuracy.

 

These results suggest that Mindfulness-Oriented Recovery Enhancement (MORE) enhances the chronic pain patient’s ability to inhibit emotional responses in the presence of pain related stimuli. This ability in turn reduces perceived pain. It remains to be seen if these improvements make it easier for the patients to wean off of opiates.

 

So, improve emotional response inhibition in patients with chronic pain and opioid use with mindfulness.

 

Meditation teaches patients how to react to the pain. People are less inclined to have the ‘Ouch’ reaction, then they are able to control the emotional reaction to pain.” – Fadel Zeidan

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available at the Contemplative Studies Blog http://contemplative-studies.org/wp/

They are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Garland, E. L., Bryan, M. A., Priddy, S. E., Riquino, M. R., Froeliger, B., & Howard, M. O. (2019). Effects of Mindfulness-Oriented Recovery Enhancement Versus Social Support on Negative Affective Interference During Inhibitory Control Among Opioid-Treated Chronic Pain Patients: A Pilot Mechanistic Study. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 53(10), 865–876. doi:10.1093/abm/kay096

 

Abstract

Background

Among opioid-treated chronic pain patients, deficient response inhibition in the context of emotional distress may contribute to maladaptive pain coping and prescription opioid misuse. Interventions that aim to bolster cognitive control and reduce emotional reactivity (e.g., mindfulness) may remediate response inhibition deficits, with consequent clinical benefits.

Purpose

To test the hypothesis that a mindfulness-based intervention, Mindfulness-Oriented Recovery Enhancement (MORE), can reduce the impact of clinically relevant, negative affective interference on response inhibition function in an opioid-treated chronic pain sample.

Methods

We examined data from a controlled trial comparing adults with chronic pain and long-term prescription opioid use randomized to either MORE (n = 27) treatment or to an active support group comparison condition (n = 30). Participants completed an Emotional Go/NoGo Task at pre- and post-treatment, which measured response inhibition in neutral and clinically relevant, negative affective contexts (i.e., exposure to pain-related visual stimuli).

Results

Repeated-measures analysis of variance indicated that compared with the support group, participants in MORE evidenced significantly greater reductions from pre- to post-treatment in errors of commission on trials with pain-related distractors relative to trials with neutral distractors, group × time × condition F(1,55) = 4.14, p = .047, η2partial = .07. Mindfulness practice minutes and increased nonreactivity significantly predicted greater emotional response inhibition. A significant inverse association was observed between improvements in emotional response inhibition and treatment-related reductions in pain severity by 3-month follow-up.

Conclusions

Study results provide preliminary evidence that MORE enhances inhibitory control function in the context of negative emotional interference.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735955/

 

Reduce Stress and Substance Abuse in Ex-Prisoner HIV Patients with Yoga

Reduce Stress and Substance Abuse in Ex-Prisoner HIV Patients with Yoga

 

By John M. de Castro, Ph.D.

 

“Yoga is an ideal exercise for people with HIV. It not only helps build muscle and energy, but also reduces stress.” – Matt McMillen

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. These include a significant number of children and adolescents. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20-year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people. People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include chronic pain, muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV.

 

Incarcerated people are 5 times more likely to have HIV infection and also are much more likely to suffer from substance abuse problems. Dealing with these issues upon release from prison is essential for successful reintegration into society. Mindfulness training has been shown to improve psychological well-being, lower depression and strengthen the immune system of patients with HIV infection. Yoga practice has also been found to be effective in treating HIV and with substance abuse.  It is not known whether yoga can help with these HIV patients with substance abuse upon release from prison.

 

In today’s Research News article “A randomized trial of yoga for stress and substance use among people living with HIV in reentry.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397425/), Wimberly and colleagues recruited adult HIV patients who had a history of substance abuse and who were recently released from prison. The participants were randomly assigned to either treatment as usual or to treatment as usual plus once a week for 12 weeks, 90-minute yoga practice. They were measured before and after training for perceived stress and substance abuse.

 

They found that in comparison to baseline and treatment as usual the patients who practiced yoga had significant reductions in perceived stress and the percentage of days with substance abuse (20% for yoga participants vs. 41% for treatment as usual). The patients had difficulty attending yoga classes with an average attendance of 35% of the classes.

 

It is well documented that yoga practice reduces stress and is helpful in controlling substance abuse. The present results are encouraging in that they suggest that yoga practice may be helpful in reducing stress and substance abuse in this vulnerable group of HIV patients who had a history of substance abuse and who were recently released from prison. Finding ways to improve attendance would seem important, perhaps online yoga classes would help. Regardless, participation in yoga appears to improve the likelihood that these ex-prisoners will be able to deal with HIV infection and life outside of prison.

 

So, reduce stress and substance abuse in ex-prisoner HIV patients with yoga.

 

Drugs, I believe, are keeping me alive. But yoga,” he says, “keeps my spirit alive.” – Ken Lowstetter

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Wimberly, A. S., Engstrom, M., Layde, M., & McKay, J. R. (2018). A randomized trial of yoga for stress and substance use among people living with HIV in reentry. Journal of substance abuse treatment, 94, 97–104. doi:10.1016/j.jsat.2018.08.001

 

Highlights

– Compared stress and substance use outcomes of yoga versus treatment as usual.

– Participants included returning citizens with HIV and substance use problems.

– At three-months, the yoga group had reduced stress and slightly reduced substance use.

– Future research with this population can compare yoga with an active intervention.

Abstract

Background:

People in reentry from prison or jail (returning citizens) living with HIV and substance use problems often experience numerous stressors and are at high risk for resumed substance use. Interventions are needed to manage stress as a pathway to reduced substance use.

Objective:

This study explored the effect of a Hatha yoga intervention as compared to treatment as usual on stress and substance use among returning citizens living with HIV and substance use problems.

Methods:

Participants were randomized to either a 12-session, 90-minute weekly yoga intervention or treatment as usual. All participants were clients of a service provider for returning citizens that offered case management, health care, and educational classes. Outcomes included stress as measured by the Perceived Stress Scale at the completion of the yoga intervention (three-months) and substance use as measured by the Timeline Followback at one-month, two- months, and three-months.

Results:

Seventy-five people were enrolled, two of whom were withdrawn from the study because they did not have HIV. Of the 73 remaining participants, 85% participated in the three- month assessment. At three-months, yoga participants reported less stress than participants in treatment as usual [F (1,59)=9.24, p<.05]. Yoga participants reported less days of substance use than participants in treatment as usual at one-month, two-months, and three-months [X2 (1)= 11.13, p<.001].

Conclusion:

Yoga interventions for returning citizens living with HIV and substance use problems may reduce stress and substance use. This finding is tentative because the control group did not receive an intervention of equal time and intensity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397425/

 

Reduce Depression Produced by Internet Addiction with Mindfulness

Reduce Depression Produced by Internet Addiction with Mindfulness

 

By John M. de Castro, Ph.D.

 

“As we get more connected to our wireless technology, we appear to run the risk of damaging our brains’ wiring, and disconnecting from the face-to-face interaction that our social and psychological systems need. With its emphasis on harnessing attention with intention (i.e. redirecting it on purpose), mindfulness—with all its scientifically-established health and well-being benefits—has the potential to keep us from drifting hopelessly away from one another.” – Mitch Abblett

 

Over the last few decades the internet has gone from a rare curiosity to the dominant mode of electronic communications. In fact, it has become a dominant force in daily life, occupying large amounts of time and attention. As useful as the internet may be, it can also produce negative consequences. “Problematic Internet Use” is now considered a behavioral addiction, with almost half of participants in one study considered “Internet addicts”, developing greater levels of “tolerance” and experiencing “withdrawal” and distress when deprived. This phenomenon is so new that there is little understanding of its nature, causes, and consequences and how to treat it.

 

Mindfulness training has been shown to be helpful with each of the components of addictions, decreasing cravings, impulsiveness, and psychological and physiological responses to stress, and increasing emotion regulation.  It is no wonder then that mindfulness training has been found to be effective for the treatment of a variety of addictions. Hence, there is a need to further explore the consequences of internet addiction and the relationship of mindfulness with internet addiction and its consequences.

 

In today’s Research News article “Internet Addiction and Depression in Chinese Adolescents: A Moderated Mediation Model.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6865207/), Chi and colleagues recruited middle school students (aged 11 to 15 years) and had them complete a questionnaire measuring internet addiction, depression, positive youth development (measuring positive psychological qualities), and mindfulness.

 

They found that 20% of the youths showed symptoms of internet addiction and 24% showed symptoms of depression. They also observed that the higher the levels of mindfulness, the lower the levels of depression and internet addiction and the higher the levels of positive youth development. On the other hand, the higher the levels of internet addiction the lower the levels of mindfulness and positive youth development and the higher the levels of depression. They also found mediation. The positive relationship between internet addiction and depression was present when mindfulness was low but not when it was high. Similarly, the negative relationship between depression and positive youth development was present when mindfulness was low but not when it was high.

 

These results are correlative and caution must be exercised in concluding causation. Nevertheless, the results replicate previous findings of mindfulness being negatively related to depression and internet addiction and positively related to positive psychological qualities. But the present findings add to these understandings by demonstrating that being addicted to the internet is related to higher depression and lower positive psychological qualities. Importantly, they found that mindfulness moderates the relationships between depression and both internet addiction and positive psychological qualities. High levels of mindfulness appear to prevent internet addiction from producing depression and from depression reducing positive psychological qualities.

 

Internet addiction is a growing problem especially in youths. These results are encouraging though that mindfulness not only is related to less internet addiction but also appears to blunt the relationships of internet addiction with depression and positive psychological qualities. This suggests that training in mindfulness with youths may help prevent addiction to the internet and its consequent effects on depression and youth development. Testing this remains for future research.

 

So, reduce depression produced by internet addiction with mindfulness.

 

when correctly practised and administered, mindfulness meditation is a safe, non-invasive, and cost-effective tool for treating behavioural addictions and for improving psychological health more generally.” – Mark Griffiths

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Chi, X., Liu, X., Guo, T., Wu, M., & Chen, X. (2019). Internet Addiction and Depression in Chinese Adolescents: A Moderated Mediation Model. Frontiers in Psychiatry, 10, 816. doi:10.3389/fpsyt.2019.00816

 

Abstract

Research has revealed that Internet addiction is a risk factor for adolescents’ development of depressive symptoms, although the underlying mechanisms are largely unknown. The present study examines the mediating role of positive youth development and the moderating role of mindfulness to determine the association between Internet addiction and depression. A sample of 522 Chinese adolescents completed measures related to Internet addiction, positive youth development, mindfulness, depression, and their background information, for which the results reveal that positive youth development mediates the relation between Internet addiction and depression. Moreover, the associations between both Internet addiction and depression as well as positive youth development and depression are moderated by mindfulness. These two effects were stronger for adolescents with low mindfulness than for those with high mindfulness. The present study contributes to a more thorough understanding of how and when Internet addiction increases the risk of depression in adolescents, suggesting that Internet addiction may affect adolescent depression through positive youth development and that mindfulness can alleviate the negative effect of Internet addiction or a low level of psychological resources on depression. The implications for research and practice are finally discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6865207/

 

Mindfulness Reduces Addiction by Improving Pleasure Appreciation in Opioid Users

Mindfulness Reduces Addiction by Improving Pleasure Appreciation in Opioid Users

 

By John M. de Castro, Ph.D.

 

“mindfulness-based interventions could help people dependent on opioids increase their self-awareness and self-control over cravings and be less reactive to emotional and physical pain. Individuals with an opioid addiction could also be taught to change their negative thoughts and savor pleasant events, which may help them to regulate their emotions and experience more enjoyment.” – Science News

 

Substance abuse and addiction is a terrible problem, especially opioid pain relievers. Opioid addiction has become epidemic and is rapidly increasing affecting more than 2 million Americans and an estimated 15 million people worldwide. In the U.S more than 20,000 deaths yearly were attributed to an overdose of prescription opioids, and another 13,000 deaths from heroin overdose. These statistics, although startling are only the tip of the iceberg. Drug use is associated with suicide, homicide, motor-vehicle injury, HIV infection, pneumonia, violence, mental illness, and hepatitis. It can render the individual ineffective at work, it tears apart families, it makes the individual dangerous both driving and not.

 

An effective treatment for addiction has been elusive. Most programs and therapies to treat addictions have poor success rates. Recent research is indicating that mindfulness has been found to be effective in treating addictionsMindfulness-Oriented Recovery Enhancement (MORE) was specifically developed to employ mindfulness training along with other proven methods to assist addicts in remaining off of drugs. MORE involves mindful breathing and body scan meditations, cognitive reappraisal to decrease negative emotions and craving, and savoring to augment natural reward processing and positive emotion.

 

One method to observe reward processing in the brain is to measure the changes in the electrical activity that occur in response to specific reward related stimuli. These are called event-related potentials or ERPs. The signal following a stimulus changes over time. The fluctuations of the signal after specific periods of time are thought to measure different aspects of the nervous system’s processing of the stimulus. The Late Positive Potential (LPP) response in the evoked potential (ERP) is a positive going electrical response occurring between a 4 to 8 tenths of a second following the target stimulus presentation. The LPP is thought to reflect attention to the emotional features of a stimulus.

 

In today’s Research News article “Mindfulness-Oriented Recovery Enhancement remediates hedonic dysregulation in opioid users: Neural and affective evidence of target engagement.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795512/), Garland and colleagues recruited chronic pain patients who were opioid users. They were randomly assigned to receive 8 weeks of either Mindfulness-Oriented Recovery Enhancement (MORE) or a therapist led support group. They were measured for brain activity with an electroencephalogram (EEG) before and after treatment and opioid use at 3-month follow-up. In one experiment they measure the EEG response (Late Positive Potential (LPP)) while being presented with opioid cues (pictures of pills and pill bottles) or a neutral picture either normally or while attempting to not react or judge the stimuli. In a separate experiment with a similar procedure except that the participants were presented with natural reward pictures (e.g., social affiliation, natural beauty, and athletic victories) or neutral pictures.

 

They found that before treatment opioid and natural reward stimuli reliably produced significantly larger Late Positive Potentials (LPP) indicating that the LPP reflected emotional responses to rewards. After treatment the group that received Mindfulness-Oriented Recovery Enhancement (MORE) had significantly smaller LPP responses to opioid related cues than the support group. When the participants were asked to not react or judge the stimuli the MORE group had significantly greater reductions in the LPP. Importantly, the participants in the MORE group had a significantly larger LPPs to natural reward stimuli and when the participants were asked to not react or judge the natural reward stimuli the MORE group had a significantly larger increases in the LPP.

 

They also investigated the subjective emotional responses of the participants to the opioid and natural reward stimuli and found that after Mindfulness-Oriented Recovery Enhancement (MORE) the participants had larger increases in response to natural reward stimuli and smaller responses to opioid related stimuli. At the 3 month follow-up they found that MORE reduced the use of opioids to a greater extent than the support group and that it did so directly and also indirectly by increasing natural reward responses which, in turn, reduced opioid use.

 

These results suggest that responses to the rewarding aspects of stimuli is important in opioid addiction and that Mindfulness-Oriented Recovery Enhancement (MORE) reduces opioid use in addicted individuals they demonstrate that MORE reduces emotional responses to opioid cues while amplifying responses to natural rewards. This suggests that mindfulness treatment reduces opioid use by altering the addict’s responses to stimuli related to the addiction and naturally rewarding stimuli; amplifying natural reward while suppressing opioid rewards. This makes opioids less rewarding and natural stimuli more rewarding.

 

So, mindfulness reduces addiction by altering pleasure appreciation in opioid users.

 

Mindfulness-Oriented Recovery Enhancement (MORE), increases the brain’s response to natural, healthy rewards while also decreasing the brain’s response to opioid-related cues.” – University of Utah

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Garland, E. L., Atchley, R. M., Hanley, A. W., Zubieta, J. K., & Froeliger, B. (2019). Mindfulness-Oriented Recovery Enhancement remediates hedonic dysregulation in opioid users: Neural and affective evidence of target engagement. Science advances, 5(10), eaax1569. doi:10.1126/sciadv.aax1569

 

Abstract

Addiction neuroscience models posit that recurrent drug use increases reactivity to drug-related cues and blunts responsiveness to natural rewards, propelling a cycle of hedonic dysregulation that drives addictive behavior. Here, we assessed whether a cognitive intervention for addiction, Mindfulness-Oriented Recovery Enhancement (MORE), could restructure reward responsiveness from valuation of drug-related reward back to valuation of natural reward. Before and after 8 weeks of MORE or a support group control, prescription opioid users (N = 135) viewed opioid and natural reward cues while an electroencephalogram biomarker of target engagement was assessed. MORE was associated with decreased opioid cue-reactivity and enhanced capacity to regulate responses to opioid and natural reward cues. Increased positive affective responses to natural reward cues were associated with decreased craving and mediated MORE’s therapeutic effects on opioid misuse. This series of randomized experiments provide the first neurophysiological evidence that an integrative behavioral treatment can remediate hedonic dysregulation among chronic opioid users.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795512/