Neurophysiological Deficits During Reappraisal of Negative Emotional Stimuli in Opioid Misuse

The ineffective emotion regulation of deaf college students: an ERP study

Introduction

Deaf students have more difficulties with emotion regulation due to their hearing loss. They are suffering higher socio-emotional risk than the hearing person. But there are few studies explored the neural mechanisms of impaired emotion regulation in the deaf college students.

Methods

Thirty hearing college students and 27 deaf college students completed the emotion regulation task while recording ERP data and subjective emotion intensity.

Results

Behavioral results found that deaf college students had higher emotional experience intensity compared to healthy controls. The ERP results showed the deaf college students had lower LPP amplitudes both using reappraisal and suppression strategies. Moreover, the LPP of expression suppression was associated with the increase of depression scores among deaf college students.

Discussion

Deaf college students may have impaired emotion regulation so that they are more accustomed to using expression suppression strategies to regulate their negative emotions which lead to high risk to be depression.

Association of Cortico-Striatal Engagement During Cue Reactivity, Reappraisal, and Savoring of Drug and Non-Drug Stimuli With Craving in Heroin Addiction

OBJECTIVE

The authors investigated cortico-striatal reactivity to drug cues (as compared with neutral and food cues), drug cue reappraisal, food cue savoring, and their correlations with heroin craving in individuals with heroin use disorder compared with healthy control subjects.

METHODS

Cross-sectional changes in functional MRI blood-oxygen-level-dependent signal during a novel cue reactivity task were assessed in 32 individuals with heroin use disorder (mean age, 40.3 years; seven women) and 21 age- and sex-matched healthy control subjects (mean age, 40.6 years; eight women).

RESULTS

Drug cue reactivity (vs. neutral cues) was significantly higher in the nucleus accumbens in the heroin use disorder group compared with the control group and nominally significantly higher in the orbitofrontal cortex (OFC); ventromedial prefrontal cortex (vmPFC) activity positively correlated with drug craving. Drug cue reactivity (vs. salient food cues) was also higher in the inferior frontal gyrus (IFG) in the heroin use disorder group compared with the control group. Drug reappraisal and food savoring (vs. passive viewing) showed increased IFG and supplementary motor area activity in all participants; in the heroin use disorder group, higher IFG/dorsolateral PFC (dlPFC) activity during drug reappraisal and rostral anterior cingulate cortex (ACC) activity during food savoring were associated with lower drug cue-induced craving and longer treatment, respectively. A direct comparison of regulation of reactivity to both salient cues revealed widespread group differences such that drug reappraisal activity was higher in the heroin use disorder group and food savoring activity was higher in the control group in both cortical (e.g., OFC, IFG, ACC, vmPFC, and insula) and subcortical (e.g., dorsal striatum and hippocampus) regions. Higher drug reappraisal versus food savoring in the dlPFC was associated with higher self-reported methadone dosage in the heroin use disorder group.

CONCLUSIONS

The results demonstrate cortico-striatal upregulation during drug cue exposure and impaired reactivity during processing of alternative non-drug rewards in the heroin use disorder group. Normalizing cortico-striatal function by reducing drug cue reactivity and enhancing natural reward valuation may inform therapeutic mechanisms for reducing drug craving and seeking in heroin addiction.

Neural activations to loss anticipation mediates the association between difficulties in emotion regulation and screen media activities among early adolescent youth: A moderating role for depression

BACKGROUND

Screen media activities (SMAs; e.g., watching videos, playing videogames) have become increasingly prevalent among youth as ways to alleviate or escape from negative emotional states. However, neural mechanisms underlying these processes in youth are incompletely understood.

METHOD

Seventy-nine youth aged 11-15 years completed a monetary incentive delay task during fMRI scanning. Neural correlates of reward/loss processing and their associations with SMAs were explored. Next, brain activations during reward/loss processing in regions implicated in the processing of emotions were examined as potential mediating factors between difficulties in emotion regulation (DER) and engagement in SMAs. Finally, a moderated mediation model tested the effects of depressive symptoms in such relationships.

RESULT

The emotional components associated with SMAs in reward/loss processing included activations in the left anterior insula (AI) and right dorsolateral prefrontal cortex (DLPFC) during anticipation of working to avoid losses. Activations in both the AI and DLPFC mediated the relationship between DER and SMAs. Moreover, depressive symptoms moderated the relationship between AI activation in response to loss anticipation and SMAs.

CONCLUSION

The current findings suggest that DER link to SMAs through loss-related brain activations implicated in the processing of emotions and motivational avoidance, particularly in youth with greater levels of depressive symptoms. The findings suggest the importance of enhancing emotion-regulation tendencies/abilities in youth and, in particular, their regulatory responses to negative emotional situations in order to guide moderate engagement in SMAs.

Learning from addiction: Craving of prescription opioids in chronic pain sufferers

Prescription opioids are a primary driver of opioid-related deaths. Although craving is a substantial component of OUD, the degree to which craving leads to misuse among chronic pain patients on long-term prescription opioids is unknown. A clear understanding of the factors that lead to misuse in this vulnerable population is needed for the development of safe and effective practices for opioid taper. This narrative review summarizes the relevant literature on the role of craving in addiction and chronic pain through epidemiological and behavioral studies. The first part of this review examines the role of craving in predicting opioid use/misuse in individuals with chronic pain with and without OUD. The second part covers methods on how craving is evaluated experimentally using both subjective and objective measures and provides related findings. The overall goal of this review is to facilitate the development of a population-specific description of craving in those who use opioids to control chronic pain and to describe how it may be mechanistically linked to patterns of opioid (mis)use.

Mindfulness-Oriented Recovery Enhancement for Addictive Behavior, Psychiatric Distress, and Chronic Pain: A Multilevel Meta-Analysis of Randomized Controlled Trials

Objectives

Mindfulness-Oriented Recovery Enhancement (MORE) is an integrative intervention designed to ameliorate addiction, chronic pain, and psychiatric symptoms. Although multiple randomized controlled trials (RCTs) have examined the clinical efficacy of MORE, no study has quantitatively synthesized this body of research. Thus, we conducted a meta-analysis of RCTs examining the effects of MORE on addictive behaviors, craving, opioid dose, pain, and psychiatric symptoms.

Methods

Relevant manuscripts were identified through comprehensive searches of four bibliographic databases. Two- and three-level random-effects models were used to generate synthesized effect size estimates, and meta-regressions were performed to examine whether study and sample characteristics influenced the magnitude of aggregate effect sizes.

Results

Our search identified 16 manuscripts reporting data from eight RCTs (N = 816). Moderate to small effects in favor of MORE were observed for addictive behaviors (SMC =  - .54, p = .007), craving (SMC =  - .42, p = .010), opioid dose (MC =  - 17.95, p < .001), chronic pain (SMC =  - .60, p < .001), and psychiatric symptoms (SMC =  - .34, p < .001). MORE's effects on psychiatric symptoms and craving were not moderated by participant race, gender, age, or income.

Conclusions

Study findings provide empirical evidence of MORE's efficacy for a wide diversity of individuals, and as such, MORE should now be disseminated broadly throughout the healthcare system.

Meta-analysis Pre-registration PROSPERO #CRD42022319006

Supplementary Information

The online version contains supplementary material available at 10.1007/s12671-022-01964-x.