Mindfulness in Treatment Approaches for Addiction — Underlying Mechanisms and Future Directions

Mindfulness facets are differentially related with reward processing stages in striatum and alcohol use in adolescence

Attenuated functional processing of non-drug rewards in striatal regions is an important mechanism in the transition from normal to hazardous alcohol use. Recent interventions seek to enhance nondrug reward processing through mindfulness, a mechanism that targets attention regulation and self-regulatory processes. It is yet unclear which specific aspects of mindfulness and which stages of reward processing are relevant preventive targets, particularly in adolescence, where alcohol use is often initiated and reward relating processing streams undergo continuous maturation. Fifty-four 14- and 16-year-old adolescents (54% female) completed the monetary incentive delay task (MID) during event-related functional magnetic resonance imaging. Alcohol use and dispositional mindfulness facets were measured using self-report instruments. Mindful Attention Regulation was positively associated with anticipatory reward processing in ventral striatum, whereas feedback-related processing in dorsal striatum was associated with the mindfulness facet Body-Listening. Only Attention Regulation was additionally associated with frequency of alcohol consumption and mediated the relationship between functional activation in ventral striatum during reward anticipation and alcohol use. Attention Regulation, beyond other mindfulness facets, might contribute to potentially triggering neural mechanisms of anticipatory, but not feedback-related reward processing and alcohol use, presenting a potential target for preventive efforts in combating transitions to substance-related disorders in adolescents.

Prevalence of substance use disorders and associations with mindfulness, impulsive personality traits and psychopathological symptoms in a representative sample of adolescents in Germany

Adolescence is a critical phase for the development of substance use disorders (SUDs). For Europe and Germany, there are limited data on problematic substance use from representative youth samples. Trait mindfulness is relevant in buffering against substance use-related problems and associated deficits in self-regulatory control. The objective of this study is to estimate 12-month prevalence rates for SUDs in a representative sample of adolescents in Germany and to examine associations with mindfulness and related factors such as stress, impulsivity, sensation seeking and symptoms of psychopathology. A sample of 4001 adolescents aged 12-18 years from Germany was surveyed based on DSM-IV diagnostic criteria for SUDs. Logistic regression analyses were used to examine associations with mindfulness-related variables. Criteria of at least one of the assessed SUDs were endorsed by 11.2% of the adolescents. Alcohol use disorders had the highest prevalence rate (10.1%) followed by cannabis use disorders (2.6%). For both substances, the criteria for abuse were met about twice as often as those for dependence. The prevalence of cigarette dependence was 1.7%, while the prevalence for e-cigarette dependence was only 0.1%. Prevalence rates were higher for male youth and increasing with age. SUD prevalence was also related to mindfulness, impulsivity and sensation seeking and externalizing symptoms of psychopathology. The statistically significant associations varied across different SUDs. SUDs appear highly prevalent among German adolescents. The results have public health implications with regard to treatment needs and prevention measures in the youth population in Germany.

Be more mindful: Targeting addictive responses by integrating mindfulness with cognitive bias modification or cue exposure interventions

This review provides an overview of the most prominent neurocognitive effects of cognitive bias modification (CBM), cue-exposure therapy and mindfulness interventions for targeting addictive responses. It highlights the key insights that have stemmed from cognitive neuroscience and brain imaging research and combines these with insights from behavioural science in building a conceptual model integrating mindfulness with response-focused CBM or cue-exposure interventions. This furthers our understanding of whether and how mindfulness strategies may i) facilitate or add to the induced response-focused effects decreasing cue-induced craving, and ii) further weaken the link between craving and addictive responses. Specifically, awareness/monitoring may facilitate, and decentering may add to, response-focused effects. Combined awareness acceptance strategies may also diminish the craving-addiction link. The conceptual model presented in this review provides a specific theoretical framework to deepen our understanding of how mindfulness strategies and CBM or cue-exposure interventions can be combined to greatest effect. This is important in both suggesting a roadmap for future research, and for the further development of clinical interventions.

Psychological processes linking problematic smartphone use to sleep disturbance in young adults

OBJECTIVES

With such high rates of sleep and mental health problems among undergraduate students, understanding potential antecedents of these interrelated problems has emerged as a critical area of examination. One potential factor underlying these problems is problematic smartphone use, which is defined as excessive phone use, impulse control problems related to the use, and negative consequences stemming from these behaviors. Accordingly, the current study sought to examine how relative changes in problematic smartphone use might impact college students' sleep disturbance via their psychological functioning (ie, psychological inflexibility and anxiety symptoms).

METHODS

The 2-wave (baseline and 2-month follow-up) online sample consisted of 385 undergraduates (81% female; M = 20.0, SD = 1.6), who reported problematic smartphone use, psychological flexibility, anxiety symptoms, and sleep disturbance.

RESULTS

Controlling for baseline levels of sleep hygiene, age, and gender, our model demonstrated a significant indirect effect from problematic smartphone use to sleep disturbance. Specifically, relative increases from baseline to the 2-month follow-up in students' problematic smartphone use predicted subsequent increases in psychological inflexibility, which predicted increases in anxiety symptoms, which, in turn, predicted increases in sleep disturbance.

CONCLUSIONS

Given the ubiquity of college students' smartphone use, the potential for problematic use remains high. Results suggest that the negative consequences of problematic smartphone use not only can include college students' mental health but also their sleep. With such high levels of college students suffering from mental health and sleep problems, clinicians and college administrators should consider the potential sequelae of the problematic use of smartphones.

Lower Mindfulness is Associated with Problematic Social Media Use: A Meta-Analysis

Problematic social media use consists of use that interferes with individuals’ functioning, such as for example in failing to complete important tasks. A number of studies have investigated the association of trait mindfulness with problematic social media use. This meta-analysis synthesised research from 14 studies and a total of 5355 participants to examine the association between mindfulness and problematic social media use across studies. A lower level of mindfulness was associated with more problematic social media use, with a weighted effect size of r = -.37, 95% CI [-.42, -.33], k = 14, p < .001.

Effectiveness of web-based mindfulness program on college students with social network addiction

AIMS

In this study a web-based mindfulness cultivation program was implemented to investigate its effectiveness on the addiction symptoms and negative emotions of college students with social network addiction.

METHODS

A total of 66 students were recruited and randomly divided into the intervention group or the control group. Participants in the intervention group received a web-based mindfulness cultivation program including the group training and self-cultivating. The primary outcome was addiction level, and the secondary outcome was anxiety, depression and perceived stress. Repeated measures analysis of variance were utilized to analyze the differences between the control and intervention group over the course of the intervention and the follow-up.

RESULTS

There were significant interaction effects on addiction level (F = 39.39, P < .00), anxiety (F = 31.17, P < .00), depression (F = 37.93, P < .00) and perceived stress (F = 22.04, P < .00).

CONCLUSION

A web-based mindfulness cultivation program could improve the addiction level and negative emotions of college students with social network addiction.

Emotion dysregulation mediates the relationship between adverse childhood experiences and problematic gaming

Gaming disorder (i.e., gaming addiction) is a relatively common mental health disorder with a worldwide prevalence rate of 3.05%. In the present research, we examined whether emotion dysregulation mediates the relation between adverse childhood experiences and problematic gaming in two samples of current video game players. The first sample consisted of 1,262 students recruited from five universities across Canada. The second sample comprised 417 community adults residing in Canada. Both samples of participants completed an online survey which included measures of adverse childhood experiences, problematic gaming, and emotion dysregulation. A total of 45.64% (n = 576) in the university sample and 49.76% (n = 205) in the community sample met the threshold for problematic gaming. In the student sample, adverse childhood experiences were positively associated with problematic gaming. In contrast, there was no significant association between adverse childhood experiences and problematic gaming in the community sample. In both samples, adverse childhood experiences were positively associated with emotion dysregulation, and emotion dysregulation was positively associated with problematic gaming. Importantly for the present research, emotion dysregulation mediated the relationship between adverse childhood experiences and problematic gaming in both the university and community sample. Although adverse childhood experiences are distal and static risk factors for problematic gaming, emotion dysregulation is a more proximal and modifiable risk factor. The results suggest that increasing adaptive emotion regulation skills may decrease the risk of problematic gaming among individuals who have experienced an adverse childhood experience.

Effects of a brief mindfulness meditation practice on Pavlovian-to-instrumental transfer in alcohol use disorder - a pilot study

Introduction

Pavlovian conditioned contextual cues have been suggested to modulate instrumental action and might explain maladaptive behavior such as relapse in participants suffering from alcohol use disorder (AUD). Pavlovian-to-Instrumental transfer (PIT) experimentally assesses the magnitude of this context-dependent effect and studies have shown a larger PIT effect in AUD populations. Taken this into account, a reduction of the influence of cues on behavior seems warranted and one approach that could alter such cue reactivity is mindfulness. Mindfulness-based interventions have been shown to be efficient in the treatment of AUD, but underlying mechanisms are yet to be elucidated. Therefore, we aim at investigating the effect of a brief mindful body scan meditation on the magnitude of the PIT effect in AUD subjects and matched controls.

Methods

Using a randomized within-subjects design, we compared the effect of a short audio guided body scan meditation against a control condition (audio of nature sounds) on PIT in healthy (n = 35) and AUD (n = 27) participants.

Results

We found no differences in PIT effect between healthy and AUD participants as well as between conditions. However, a significant interaction effect points to a decreased PIT effect after body scan meditation in AUD subjects only.

Discussion

These pilot results suggest that AUD might be susceptible to mindfulness-induced changes in PIT, with these findings contributing to entangling the underlying mechanisms of the efficacy of mindfulness-based interventions in AUD. However, further investigation should confirm these preliminary results and the efficacy of mindfulness meditation practice in decreasing the PIT effect.

Mindfulness for internet use disorder: a study protocol of a systematic review and meta-analysis

INTRODUCTION

Internet use disorder (IUD) is on the rise and is associated with detrimental health consequences. Growing evidence suggests that mindfulness-either as a trait or cultivated in mindfulness-based programmes (MBPs)-is promising in preventing and treating IUD. With this systematic review and meta-analysis, we will examine (1) the association between trait mindfulness (TM) and IUD and (2) the effectiveness of MBPs in reducing IUD.

METHODS AND ANALYSIS

In October 2022, we will screen Medline, PsycINFO, PSYINDEX, CINAHL, Web of Science, and the Cochrane Register of Controlled Trials without language or publication date restrictions. We will conduct backward and forward citation searches of included studies and relevant reviews. We will include studies that evaluate either (1) the association between TM and IUD or (2) the effectiveness of MBPs in reducing IUD. Two reviewers will independently screen records, select and extract data, and rate the risk of bias. In total, we will conduct three meta-analyses: a first meta-analysis will be on the correlation between TM and IUD, a second meta-analysis will be on between-group data examining the effectiveness of MBPs in reducing IUD in randomised controlled trials (RCTs), and a third meta-analysis will be on within-group pre-postdata examining the effectiveness of MBPs in reducing IUD in all kinds of intervention studies. For the second and third meta-analyses, the primary outcome will be changes in IUD. We will explore moderators and sources of between-study heterogeneity and pursue a narrative synthesis of results. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the overall quality of evidence across intervention studies.

ETHICS AND DISSEMINATION

Ethics approval is not required. Results will be published in a peer-reviewed journal and presented at (inter)national conferences.

PROSPERO REGISTRATION NUMBER

CRD42022350071.

Exploring the links between alexithymia and cognitive emotion regulation strategies in internet addiction: A network analysis model

Alexithymia and emotion regulation are closely related to internet addiction. However, no research has examined how the different components of alexithymia are associated with cognitive emotion regulation in the context of multi-strategy use in internet addiction. The current study aimed to investigate the relation between alexithymia and cognitive emotion regulation in individuals with internet addiction via network analysis. Participants included 560 students with Young’s Internet Addiction Test scores greater than 50 points; they were also asked to complete the Toronto Alexithymia Scale (TAS-20) and the Cognitive Emotion Regulation Questionnaire (CERQ). The results revealed two bridge nodes emerging within the combined alexithymia and cognitive emotion regulation network model: “catastrophizing” and “externally oriented thoughts.” These findings indicate a more specific relation between alexithymia and cognitive emotion regulation and provide empirical evidence for targeted prevention and targeted interventions for internet addiction.