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Roos CR, Kiluk B, Carroll KM, Bricker JB, Mun CJ, Sala M, Kirouac M, Stein E, John M, Palmer R, DeBenedictis A, Frisbie J, Haeny AM, Barry D, Fucito LM, Bowen S, Witkiewitz K, Kober H. Development and initial testing of mindful journey: a digital mindfulness-based intervention for promoting recovery from Substance use disorder. Ann Med 2024; 56:2315228. [PMID: 38382111 PMCID: PMC10883107 DOI: 10.1080/07853890.2024.2315228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/30/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND/OBJECTIVES There is a great unmet need for accessible adjunctive interventions to promote long-term recovery from substance use disorder (SUD). This study aimed to iteratively develop and test the initial feasibility and acceptability of Mindful Journey, a novel digital mindfulness-based intervention for promoting recovery among individuals with SUD. PATIENTS/MATERIALS Ten adults receiving outpatient treatment for SUD. METHODS Phase 1 (n = 5) involved developing and testing a single introductory digital lesson. Phase 2 included a separate sample (n = 5) and involved testing all 15 digital lessons (each 30- to 45-minutes) over a 6-week period, while also receiving weekly brief phone coaching for motivational/technical support. RESULTS Across both phases, quantitative ratings (rated on a 5-point scale) were all at or above a 4 (corresponding with 'agree') for key acceptability dimensions, such as usability, understandability, appeal of visual content, how engaging the content was, and helpfulness for recovery. Additionally, in both phases, qualitative feedback indicated that participants particularly appreciated the BOAT (Breath, Observe, Accept, Take a Moment) tool for breaking down mindfulness into steps. Qualitative feedback was used to iteratively refine the intervention. For example, based on feedback, we added a second core mindfulness tool, the SOAK (Stop, Observe, Appreciate, Keep Curious), and we added more example clients and group therapy videos. In Phase 2, 4 out of 5 participants completed all 15 lessons, providing initial evidence of feasibility. Participants reported that the phone coaching motivated them to use the app. The final version of Mindful Journey was a smartphone app with additional features, including brief on-the-go audio exercises and a library of mindfulness practices. Although, participants used these additional features infrequently. CONCLUSIONS Based on promising initial findings, future acceptability and feasibility testing in a larger sample is warranted. Future versions might include push notifications to facilitate engagement in the additional app features.
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Affiliation(s)
- Corey R. Roos
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Brian Kiluk
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Kathleen M. Carroll
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | | | - Chung Jung Mun
- Edson College of Nursing and Health Innovation, AZ State University, Tempe, AZ, USA
| | - Margarita Sala
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
| | - Megan Kirouac
- Center on Alcohol, Substance Use, and Addiction, Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Elena Stein
- Medical Center, VA Puget Sound Health Care System, Seattle, VA, USA
| | - Maya John
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Robert Palmer
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Andrew DeBenedictis
- Department of Mental Health Counseling, Boston College, Chestnut Hill, MA, USA
| | | | - Angela M. Haeny
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Declan Barry
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Lisa M. Fucito
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Sarah Bowen
- Department of Psychology, Pacific University
| | - Katie Witkiewitz
- Center on Alcohol, Substance Use, and Addiction, Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Hedy Kober
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Garland EL, Recasens M, Taple BJ, Donaldson GW, Weisberg RB. Virtual reality-based Mindfulness-Oriented Recovery Enhancement (MORE-VR) as an adjunct to medications for opioid use disorder: a Phase 1 trial. Ann Med 2024; 56:2392870. [PMID: 39172534 PMCID: PMC11342816 DOI: 10.1080/07853890.2024.2392870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/15/2024] [Accepted: 06/26/2024] [Indexed: 08/24/2024] Open
Abstract
INTRODUCTION Medications for opioid use disorder (MOUD) are the most effective interventions for this condition, yet many patients discontinue treatment. Though adjunct psychosocial treatments are recommended to increase retention and reduce relapse, the scarcity of trained providers hinders access to and utilization of evidence-based interventions. We conducted a Phase 1 study to assess the feasibility of a virtual reality-delivered Mindfulness-Oriented Recovery Enhancement (MORE-VR) intervention for patients receiving MOUD. PATIENTS AND METHODS Patients receiving buprenorphine or methadone for OUD (N = 34) were scheduled for 8 weekly sessions of MORE-VR. Enrollment and retention rates were analyzed. Participants reported on the usability and acceptability of MORE-VR, opioid use, and craving and affect before and after each VR session. Heart rate was monitored during one session of MORE-VR. RESULTS Twenty-three participants completed four or more MORE-VR sessions (minimum recommended intervention dose). Participants reported high usability and acceptability of MORE-VR, which had an excellent safety profile. Illicit opioid use decreased significantly from pre- to post-treatment (F = 4.44, p=.04). We observed a significant within-session decrease in opioid craving (F = 39.3, p<.001) and negative affect (F = 36.3, p<.001), and a significant within-session increase in positive affect (F = 23.6, p<.001). Heart rate shifted during cue-exposure and mindfulness practices (F = 6.79, p<.001). CONCLUSIONS High retention, usability and acceptability rates and low adverse events demonstrated that MORE-VR is a feasible, engaging, and safe intervention. Our findings show that MORE-VR can be delivered as an adjunctive intervention to MOUD and suggest that MORE-VR may improve OUD treatment outcomes and modulate autonomic responses. MORE-VR's efficacy will be tested in a subsequent Phase 2 trial. TRIAL REGISTRATION ClinicalTrials.gov NCT05034276; https://classic.clinicaltrials.gov/ct2/show/NCT05034276.
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Affiliation(s)
- Eric L. Garland
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Salt Lake City, Utah, USA
| | - Marc Recasens
- BEHAVR, LLC, DBA RealizedCare, Elizabethtown, Kentucky, USA
| | - Bayley J. Taple
- BEHAVR, LLC, DBA RealizedCare, Elizabethtown, Kentucky, USA
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Gary W. Donaldson
- Pain Research Center, Department of Anesthesiology, University of Utah, Salt Lake City, Utah, USA
| | - Risa B. Weisberg
- BEHAVR, LLC, DBA RealizedCare, Elizabethtown, Kentucky, USA
- Department of Psychiatry, Chobanian and Avedisian School of Medicine, Boston University, Boston, Massachusetts, USA
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Roos CR, Bricker J, Kiluk B, Trull TJ, Bowen S, Witkiewitz K, Kober H. A smartphone app-based mindfulness intervention to enhance recovery from substance use disorders: Protocol for a pilot feasibility randomized controlled trial. Contemp Clin Trials Commun 2024; 41:101338. [PMID: 39233850 PMCID: PMC11372603 DOI: 10.1016/j.conctc.2024.101338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 06/21/2024] [Accepted: 07/23/2024] [Indexed: 09/06/2024] Open
Abstract
Background Poor long-term recovery outcomes after treatment (e.g., readmission to inpatient treatment) are common among individuals with substance use disorders (SUDs). In-person mindfulness-based treatments (MBTs) are efficacious for SUDs and may improve recovery outcomes. However, existing MBTs for SUD have limited public health reach, and thus scalable delivery methods are needed. A digitally-delivered MBT for SUDs may hold promise. Methods We recently developed Mindful Journey, a smartphone app-based adjunctive MBT for improving long-term recovery outcomes. In this paper, we present details on the app and describe the protocol for a single-site pilot feasibility randomized controlled trial of Mindful Journey. In this trial, individuals (n = 34) in an early phase of outpatient treatment for SUDs will be randomized to either treatment-as-usual (TAU) plus Mindful Journey, or TAU only. The trial will focus on testing the feasibility (e.g., engagement) and acceptability of the app (e.g., perceived usability and helpfulness for recovery), as well as feasibility of study procedures (e.g., assessment completion). The trial will incorporate ecological momentary assessment before and after treatment to assess mechanisms in real-time, including mindfulness, craving, difficulties with negative emotion regulation, and savoring. To examine the sensitivity to change of outcomes (substance use, substance-related problems, and psychological distress) and mechanism variables (noted above), we will test within-treatment-condition changes over time. Discussion The proposed pilot trial will provide important preliminary data on whether Mindful Journey is feasible and acceptable among individuals with SUDs. Trial registration ClinicalTrials.gov NCT05109507.
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Affiliation(s)
- Corey R Roos
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | | | - Brian Kiluk
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Timothy J Trull
- Department of Psychological Sciences, University of Missouri, USA
| | - Sarah Bowen
- Department of Psychology, Pacific University, USA
| | - Katie Witkiewitz
- Center on Alcohol, Substance Use, and Addiction, Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Hedy Kober
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
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Rosenthal A, Haslacher D, Garbusow M, Pangratz L, Apfel B, Soekadar S, Romanczuk-Seiferth N, Beck A. Neuromodulation and mindfulness as therapeutic treatment in detoxified patients with alcohol use disorder. BMC Psychiatry 2024; 24:635. [PMID: 39334026 PMCID: PMC11438385 DOI: 10.1186/s12888-024-06085-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 09/14/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Alcohol use disorder (AUD) poses a significant global health challenge. Traditional management strategies often face high relapse rates, leading to a need for innovative approaches. Mindfulness-based relapse prevention (MBRP) has emerged as a promising intervention to enhance cognitive control, reduce cue-related craving and improve interoceptive processing. Neuroimaging studies suggest that mindfulness training can modulate brain networks associated with these factors, potentially improving treatment outcomes for AUD. Neuroimaging studies suggest that mindfulness training can modulate brain networks linked to these brain functions, potentially improving treatment outcomes for AUD. However, it is unclear how MBRP links to neurophysiological measures such as frontal midline theta oscillations (FMΘ) and whether the beneficial effects of MBRP can be increased by enhancing FMΘ. Here, we will use two different forms of neuromodulation to target and enhance these oscillations, and evaluate their impact on the effectiveness of MBRP. METHODS This study will employ a four-arm randomized controlled trial to evaluate the synergistic effects of MBRP augmented with transcutaneous vagus nerve stimulation (tVNS) or closed-loop amplitude-modulated transcranial alternating current stimulation (CLAM-tACS) on cognitive control, cue reactivity and interoceptive processing in AUD patients. Participants will undergo six weekly group MBRP sessions and daily individual mindfulness practices. Assessments will include an inhibition task, cue-induced craving task, and heartbeat discrimination task, alongside heart rate variability and 32-channel EEG recordings. Participants will be assessed pre and post treatment, with a three-month follow-up to evaluate long-term effects on abstinence and alcohol consumption. DISCUSSION This study will not only elucidate the causal link between FMΘ and efficacy of MBRP, but contribute to a better understanding of how combined psychological and neuromodulation interventions can improve treatment outcomes for AUD, potentially leading to more effective therapeutic strategies. This study also seeks to explore individual differences in response to treatment, which could inform future approaches to AUD management. TRIAL REGISTRATION This study received approval by the Charité-Universitätsmedizin Berlin Institutional Review Board (EA1/030/23, 10.11.2023). It was registered on ClinicalTrials.gov (NCT06308484).
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Affiliation(s)
- Annika Rosenthal
- Institute for Mental Health and Behavioral Medicine, Department of Psychology, HMU Health and Medical University Potsdam, 14471, Potsdam, Germany.
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany.
| | - D Haslacher
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
| | - M Garbusow
- Department of Psychology, MSB Medical School Berlin, 14197, Berlin, Germany
| | - L Pangratz
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
| | - B Apfel
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
| | - S Soekadar
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
| | | | - A Beck
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Charité Mitte, 10117, Berlin, Germany
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Li X, Kass G, Wiers CE, Shi Z. The Brain Salience Network at the Intersection of Pain and Substance use Disorders: Insights from Functional Neuroimaging Research. CURRENT ADDICTION REPORTS 2024; 11:797-808. [PMID: 39156196 PMCID: PMC11329602 DOI: 10.1007/s40429-024-00593-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2024] [Indexed: 08/20/2024]
Abstract
Purpose of Review The brain's salience network (SN), primarily comprising the anterior insula and anterior cingulate cortex, plays a key role in detecting salient stimuli and processing physical and socioemotional pain (e.g., social rejection). Mounting evidence underscores an altered SN in the etiology and maintenance of substance use disorders (SUDs). This paper aims to synthesize recent functional neuroimaging research emphasizing the SN's involvement in SUDs and physical/socioemotional pain and explore the therapeutic prospects of targeting the SN for SUD treatment. Recent Findings The SN is repeatedly activated during the experience of both physical and socioemotional pain. Altered activation within the SN is associated with both SUDs and chronic pain conditions, characterized by aberrant activity and connectivity patterns as well as structural changes. Among individuals with SUDs, functional and structural alterations in the SN have been linked to abnormal salience attribution (e.g., heightened responsiveness to drug-related cues), impaired cognitive control (e.g., impulsivity), and compromised decision-making processes. The high prevalence of physical and socioemotional pain in the SUD population may further exacerbate SN alterations, thus contributing to hindered recovery progress and treatment failure. Interventions targeting the restoration of SN functioning, such as real-time functional MRI feedback, neuromodulation, and psychotherapeutic approaches, hold promise as innovative SUD treatments. Summary The review highlights the significance of alterations in the structure and function of the SN as potential mechanisms underlying the co-occurrence of SUDs and physical/socioemotional pain. Future work that integrates neuroimaging with other research methodologies will provide novel insights into the mechanistic role of the SN in SUDs and inform the development of next-generation treatment modalities.
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Affiliation(s)
- Xinyi Li
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 USA
| | - Gabriel Kass
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 USA
| | - Corinde E. Wiers
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 USA
| | - Zhenhao Shi
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104 USA
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Li X, Ni X, Zhang J. The Chain-Mediating Effects of Mindfulness and Sense of Control on Corporate Employees' Mental Health Problems. Behav Sci (Basel) 2024; 14:654. [PMID: 39199050 PMCID: PMC11351485 DOI: 10.3390/bs14080654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 07/23/2024] [Accepted: 07/23/2024] [Indexed: 09/01/2024] Open
Abstract
Based on the chain-mediating role of mindfulness and sense of control, this study examines the mediating role of mindfulness and sense of control on employees' mental health. A total of 720 questionnaires were collected from employees of select enterprises and institutions in China; 53 invalid questionnaires were excluded, with a response rate of 93%, leaving 667 employees as the study sample (average age = 38 years, 71.8% female). The study findings show that: (1) Work-family conflict had a significant positive correlation with mental health problems and a significant negative correlation with mindfulness and sense of control. (2) The influence on the mental health state was due to the mediating effect of mindfulness, sense of control, and the chain-mediating effect of mindfulness and sense of control. The study adopted self-report scales for measuring mindfulness and a sense of control; therefore, further experimental methods must be included in the future to explore these results. This study shows that mindfulness and sense of control can reduce the impact of work-family conflict on mental health problems. Additionally, the chain-mediating effect of mindfulness and sense of control plays an important role in mental health problems.
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Affiliation(s)
- Xiaoran Li
- School of Public Administration, Gansu University of Political Science and Law, Lanzhou 730070, China;
| | - Xiaoli Ni
- Institute of Social Psychology, School of Humanities and Social Sciences, Xi’an Jiaotong University, Xi’an 710049, China;
| | - Juguo Zhang
- School of Public Administration, Gansu University of Political Science and Law, Lanzhou 730070, China;
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Young AS, Reboussin BA, Riehm K, Mojtabai R, Green KM, O'Gorman ET, Susukida R, Amin-Esmaeili M, Crum RM. Associations between mental health & substance use treatment and alcohol use progression and recovery among US women drinkers. PLoS One 2024; 19:e0306820. [PMID: 38976705 PMCID: PMC11230554 DOI: 10.1371/journal.pone.0306820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 06/24/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Alcohol use has profound public health impact on women; however, modifiable factors that may influence alcohol use progression/recovery, including health service utilization, are understudied in women. OBJECTIVE To investigate the association between mental health (MH) and substance use (SU) treatment with alcohol use progression and recovery among women who currently use alcohol or have in the past. METHODS This study is a secondary data analysis of prospective data from waves 1 (2001-2002) and 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; a US-nationally representative sample of adults). The analytic sample was limited to women who reported past or current alcohol use at wave 1 (N = 15,515). Latent transition analysis (LTA) examined whether receiving SU/MH treatment in the year prior to wave 1 was associated with transitioning between three empirically-derived stages of alcohol involvement (no, moderate, and severe problems classes), between Waves 1 and 2 adjusting for possible confounders using propensity score weight. RESULTS Compared to White female drinkers, female drinkers who were from Black, Hispanic, or other races were less likely to receive SU/MH treatment (p-values ≤. 001). SU/MH treatment in the year prior to wave 1 was associated with transitioning from the moderate problems class to the no problems class between Waves 1 and 2 (p-value = .04). CONCLUSION Receipt of SU or MH treatment among women, was associated with a higher likelihood of remission from moderate alcohol use problems to no problems over time. Future research, including investigation into treatment characteristics (e.g., frequency, duration, type) should further explore why women initially experiencing severe alcohol use problems did not experience similar remission.
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Affiliation(s)
- Andrea S Young
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Kira Riehm
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Ramin Mojtabai
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Kerry M Green
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, Maryland, United States of America
| | - Emily T O'Gorman
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Ryoko Susukida
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Masoumeh Amin-Esmaeili
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Rosa M Crum
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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Wardle MC, Webber HE, Yoon JH, Heads AM, Stotts AL, Lane SD, Schmitz JM. Behavioral therapies targeting reward mechanisms in substance use disorders. Pharmacol Biochem Behav 2024; 240:173787. [PMID: 38705285 DOI: 10.1016/j.pbb.2024.173787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/04/2024] [Accepted: 05/02/2024] [Indexed: 05/07/2024]
Abstract
Behavioral therapies are considered best practices in the treatment of substance use disorders (SUD) and used as first-line approaches for SUDs without FDA-approved pharmacotherapies. Decades of research on the neuroscience of drug reward and addiction have informed the development of current leading behavioral therapies that, while differing in focus and technique, have in common the overarching goal of shifting reward responding away from drug and toward natural non-drug rewards. This review begins by describing key neurobiological processes of reward in addiction, followed by a description of how various behavioral therapies address specific reward processes. Based on this review, a conceptual 'map' is crafted to pinpoint gaps and areas of overlap, serving as a guide for selecting and integrating behavioral therapies.
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Affiliation(s)
- Margaret C Wardle
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Heather E Webber
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Jin H Yoon
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Angela M Heads
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Angela L Stotts
- Department of Family and Community Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, United States of America
| | - Scott D Lane
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Joy M Schmitz
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States of America.
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Mumba MN, Mugoya GT, Allen RS, Glenn AL, Richman J, Ghera A, Butler A, Rogers B, Granger TA, Davis LL. The methods and baseline characteristics of a multi-site randomized controlled trial evaluating mindfulness-based relapse prevention in conjunction with peer support to improve adherence to medications for opioid use disorders. Front Psychiatry 2024; 15:1330672. [PMID: 38974917 PMCID: PMC11224476 DOI: 10.3389/fpsyt.2024.1330672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/09/2024] [Indexed: 07/09/2024] Open
Abstract
Introduction Medications for opioid use disorders (MOUD) remain the gold standard for treating OUD, but treatment initiation and adherence remain challenging. Exclusive utilization of pharmacotherapy as a treatment modality for OUD is sub-optimal, and a combination of psychotherapies and pharmacotherapies is recommended. General trends indicate the benefits of peer mentoring and MBRP separately. Therefore, we hypothesize that the combined effect of MBRP and Peer mentoring will produce synergistic improvements in MOUD adherence compared to an enhanced twelve-step facilitation (TSF). Methods This paper describes the methods and baseline characteristics of a multi-site randomized controlled trial evaluating the effectiveness of a combination of MBRP and peer support (MiMP) compared to an enhanced TSF in improving adherence to MOUD. Both MiMP and TSF are 12-week manualized protocols that utilize licensed therapists. The interventions are delivered in weekly group sessions that last about 75-90 minutes per session. The primary outcome is MOUD adherence. Secondary and exploratory outcomes include relapse, cravings, depression, anxiety, stress, quality of life, and pain catastrophizing. Results The participants' ages ranged from 21 years to 77 years, with a mean age of 44.5 (SD ± 11.5 years). There was an almost equal distribution of gender and place of residence. Overall, 51.9% (n=54) of participants identified as female and 48.1% (n=50) were male. Similarly, 51.9% (n=54) of participants resided in urban areas, while 48.1% (n=50) resided in rural areas. Participants identified as either black or white, with over three-quarters identifying as white (77.9%, n= 81) and 22.1% (n= 23) as black. Most participants randomized to the 12-step facilitation group were white (93.1%). Relationships and employment status were well distributed between categories. Over half of the participants reported some college or higher education. Over 90% of the participants made less than $75,000 per year. Some participants indicated that they had both public and private health insurance. Discussion and conclusion This study is innovative in several ways including combining MBRP and peer support, addressing comorbid mental health issues among individuals with OUD, utilizing manualized protocols, and evaluating of both physiological and self-reported measures in assessing cortisol reactivity as a predictor of relapse and treatment outcomes.
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Affiliation(s)
- Mercy Ngosa Mumba
- Capstone College of Nursing, University of Alabama, Tuscaloosa, AL, United States
- Tuscaloosa VA Medical Center, Tuscaloosa, AL, United States
| | - George Tongi Mugoya
- Tuscaloosa VA Medical Center, Tuscaloosa, AL, United States
- Department of Educational Studies in Psychology, Research Methodology, and Counseling, University of Alabama, Tuscaloosa, AL, United States
| | - Rebecca S. Allen
- Department of Psychology, University of Alabama, Tuscaloosa, AL, United States
| | - Andrea L. Glenn
- Department of Psychology, University of Alabama, Tuscaloosa, AL, United States
| | - Joshua Richman
- Department of Surgery, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, United States
- Birmingham VA Health Care System, Birmingham, AL, United States
| | - Anchal Ghera
- Tuscaloosa VA Medical Center, Tuscaloosa, AL, United States
- Birmingham VA Health Care System, Birmingham, AL, United States
| | - Austin Butler
- Capstone College of Nursing, University of Alabama, Tuscaloosa, AL, United States
| | - Blossom Rogers
- Capstone College of Nursing, University of Alabama, Tuscaloosa, AL, United States
| | - Teresa Ann Granger
- Tuscaloosa VA Medical Center, Tuscaloosa, AL, United States
- Department of Educational Studies in Psychology, Research Methodology, and Counseling, University of Alabama, Tuscaloosa, AL, United States
| | - Lori L. Davis
- Tuscaloosa VA Medical Center, Tuscaloosa, AL, United States
- Birmingham VA Health Care System, Birmingham, AL, United States
- Department of Psychiatry, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, United States
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10
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Sease TB, Cox CR, Wiese AL, Sandoz EK, Knight K. The impact of State of Surrender on the relationship between engagement in substance use treatment and meaning in life presence: a pilot study. Front Psychol 2024; 15:1331756. [PMID: 38952826 PMCID: PMC11216303 DOI: 10.3389/fpsyg.2024.1331756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 06/03/2024] [Indexed: 07/03/2024] Open
Abstract
The current study examined the construct of State of Surrender (SoS)-defined as a willingness to accept, without resistance, what is to come-and investigated SoS as a statistical mediator of the relationship between engagement in substance use treatment and meaning in life (MIL). Using a cross-sectional design, participants were 123 people involved with the legal system participating in a 6-month residential treatment program for substance use. Results showed that measures of treatment engagement, including treatment participation, counselor rapport, and peer support, were all positively associated with SoS scores (R 2s ≥ 21.16). Moreover, while controlling for time spent in treatment, SoS statistically mediated the positive association between aspects of treatment engagement and MIL. State of Surrender may be a targetable process in substance use treatment that aids in recovery by orienting clients toward what they find meaningful in life. Future directions and practical considerations are discussed.
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Affiliation(s)
- Thomas B. Sease
- Institute of Behavioral Research, College of Science and Engineering, Texas Christian University, Fort Worth, TX, United States
| | - Cathy R. Cox
- Department of Psychology, Texas Christian University, Fort Worth, TX, United States
| | - Amanda L. Wiese
- Institute of Behavioral Research, College of Science and Engineering, Texas Christian University, Fort Worth, TX, United States
| | - Emily K. Sandoz
- Department of Psychology, University of Louisiana at Lafayette, Lafayette, LA, United States
| | - Kevin Knight
- Institute of Behavioral Research, College of Science and Engineering, Texas Christian University, Fort Worth, TX, United States
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11
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Harp NR, Wager TD, Kober H. Neuromarkers in addiction: definitions, development strategies, and recent advances. J Neural Transm (Vienna) 2024; 131:509-523. [PMID: 38630190 DOI: 10.1007/s00702-024-02766-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/12/2024] [Indexed: 04/28/2024]
Abstract
Substance use disorders (SUDs) are the most costly and prevalent psychiatric conditions. Recent calls emphasize a need for biomarkers-measurable, stable indicators of normal and abnormal processes and response to treatment or environmental agents-and, in particular, brain-based neuromarkers that will advance understanding of the neurobiological basis of SUDs and clinical practice. To develop neuromarkers, researchers must be grounded in evidence that a putative marker (i) is sensitive and specific to the psychological phenomenon of interest, (ii) constitutes a predictive model, and (iii) generalizes to novel observations (e.g., through internal cross-validation and external application to novel data). These neuromarkers may be used to index risk of developing SUDs (susceptibility), classify individuals with SUDs (diagnostic), assess risk for progression to more severe pathology (prognostic) or index current severity of pathology (monitoring), detect response to treatment (response), and predict individualized treatment outcomes (predictive). Here, we outline guidelines for developing and assessing neuromarkers, we then review recent advances toward neuromarkers in addiction neuroscience centering our discussion around neuromarkers of craving-a core feature of SUDs. In doing so, we specifically focus on the Neurobiological Craving Signature (NCS), which show great promise for meeting the demand of neuromarkers.
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Affiliation(s)
- Nicholas R Harp
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Tor D Wager
- Department of Psychological & Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Hedy Kober
- Department of Psychiatry, Yale University, New Haven, CT, USA.
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12
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Carmo C, Iacob V, Brás M, Fernandes J. Effects of a Mindfulness-Based Intervention on Male Portuguese Prisoners. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2024; 68:677-692. [PMID: 35723515 DOI: 10.1177/0306624x221106333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Mindfulness-based interventions (MBIs) in prison environments have revealed positive benefits for prisoners' physical and psychological health. This study aimed to verify the efficacy of an MBI program in decreasing depressive symptoms, anxiety, stress, negative effects, and increasing positive affects, self-esteem, and mindfulness state and capacity in prisoners. The sample comprised 44 Portuguese male prisoners, who were divided into two groups: the mindfulness training group (n = 22) and the control group (n = 22). The mindfulness training group demonstrated increased self-esteem and mindfulness capacities. Qualitative analysis showed the usefulness of the training for inmates, not only in their daily prison life, but also post-release and the importance of breathing in coping with anxious and stressful situations. These findings suggest the benefits of MBI in prison settings and propose that these interventions may hold the potential to improve prisoners' reintegration into society.
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Affiliation(s)
- Cláudia Carmo
- Universidade do Algarve, Campus de Gambelas, Faro, Portugal
| | - Vivien Iacob
- Universidade do Algarve, Campus de Gambelas, Faro, Portugal
| | - Marta Brás
- Universidade do Algarve, Campus de Gambelas, Faro, Portugal
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13
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Cheng L, Luo M, Ge J, Fu Y, Gan Q, Chen Z. Effects of brief mindfulness training on smoking cue-reactivity in tobacco use disorder: Study protocol for a randomized controlled trial. PLoS One 2024; 19:e0299797. [PMID: 38648252 PMCID: PMC11034654 DOI: 10.1371/journal.pone.0299797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/26/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND The prevalence of Tobacco Use Disorder (TUD) represents a significant and pressing global public health concern, with far-reaching and deleterious consequences for individuals, communities, and healthcare systems. The craving caused by smoking cue is an important trigger for relapse, fundamentally hindering the cessation of cigarette smoking. Mindfulness interventions focusing on cue-reactivity was effective for the treatment of related dependence. Brief mindfulness training (BMT) meets the short-term needs for intervention but the effects still need to be examined. The objective of the present study is to investigate the impact of BMT intervention on smoking cue-reactivity among Chinese college students with TUD, to uncover the dynamic models of brain function involved in this process. METHOD A randomized control trial (RCT) based on electroencephalography (EEG) was designed. We aim to recruit 90 participants and randomly assign to the BMT and control group (CON) with 1:1 ratio. A brief mindfulness training will be administered to experimental group. After the intervention, data collection will be conducted in the follow-up stage with 5 timepoints of assessments. EEG data will be recorded during the smoking cue-reactivity task and 'STOP' brief mindfulness task. The primary outcomes include subjective reports of smoking craving, changes in EEG indicators, and mindfulness measures. The secondary outcomes will be daily smoking behaviours, affect and impulsivity, as well as indicators reflecting correlation between mindfulness and smoking cue-reactivity. To evaluate the impact of mindfulness training, a series of linear mixed-effects models will be employed. Specifically, within-group effects will be examined by analysing the longitudinal data. Additionally, the effect size for all statistical measurements will be reported, offering a comprehensive view of the observed effects. DISCUSSION The current study aims to assess the impact of brief mindfulness-based intervention on smoking cue-reactivity in TUD. It also expected to enhance our understanding of the underlying processes involved in brain function and explore potential EEG biomarkers at multiple time points. TRIAL REGISTRATION Trial registration number: ChiCTR2300069363, registered on 14 March 2023. Protocol Version 1.0., 10 April 2023.
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Affiliation(s)
- Linlin Cheng
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
| | - Miaoling Luo
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
| | - Jie Ge
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
- Students Counseling and Mental Health Center, Kunming University of Science and Technology, Kunming, China
| | - Yu Fu
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
| | - Quan Gan
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
- Faculté de médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Zhuangfei Chen
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
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14
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Christopher M, Bowen S, Witkiewitz K, Grupe D, Goerling R, Hunsinger M, Oken B, Korecki T, Rosenbaum N. A multisite feasibility randomized clinical trial of mindfulness-based resilience training for aggression, stress, and health in law enforcement officers. BMC Complement Med Ther 2024; 24:142. [PMID: 38575888 PMCID: PMC10993469 DOI: 10.1186/s12906-024-04452-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 03/22/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Law enforcement officers (LEOs) are exposed to significant stressors that can impact their mental health, increasing risk of posttraumatic stress disorder, burnout, at-risk alcohol use, depression, and suicidality. Compromised LEO health can subsequently lead to aggression and excessive use of force. Mindfulness training is a promising approach for high-stress populations and has been shown to be effective in increasing resilience and improving mental health issues common among LEOs. METHODS This multi-site, randomized, single-blind clinical feasibility trial was intended to establish optimal protocols and procedures for a future full-scale, multi-site trial assessing effects of mindfulness-based resilience training (MBRT) versus an attention control (stress management education [SME]) and a no-intervention control, on physiological, attentional, and psychological indices of stress and mental health. The current study was designed to enhance efficiency of recruitment, engagement and retention; optimize assessment, intervention training and outcome measures; and ensure fidelity to intervention protocols. Responsiveness to change over time was examined to identify the most responsive potential proximate and longer-term assessments of targeted outcomes. RESULTS We observed high feasibility of recruitment and retention, acceptability of MBRT, fidelity to assessment and intervention protocols, and responsiveness to change for a variety of putative physiological and self-report mechanism and outcome measures. CONCLUSIONS Results of this multi-site feasibility trial set the stage for a full-scale, multi-site trial testing the efficacy of MBRT on increasing LEO health and resilience, and on decreasing more distal outcomes of aggression and excessive use of force that would have significant downstream benefits for communities they serve. TRIAL REGISTRATION ClinicalTrials.gov, NCT03784846 . Registered on December 24th, 2018.
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Affiliation(s)
- Michael Christopher
- School of Graduate Psychology, Pacific University, 190 SE 8thAve, Suite 260, Hillsboro, OR, 97123, USA.
| | - Sarah Bowen
- School of Graduate Psychology, Pacific University, 190 SE 8thAve, Suite 260, Hillsboro, OR, 97123, USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, 2001 Redondo S Dr, Albuquerque, NM, 87106, USA
| | - Daniel Grupe
- Center for Healthy Minds, University of Wisconsin Madison, 625 West Washington Ave, Madison, WI, 53703, USA
| | - Richard Goerling
- School of Graduate Psychology, Pacific University, 190 SE 8thAve, Suite 260, Hillsboro, OR, 97123, USA
| | - Matthew Hunsinger
- School of Graduate Psychology, Pacific University, 190 SE 8thAve, Suite 260, Hillsboro, OR, 97123, USA
| | - Barry Oken
- Department of Neurology, Oregon Center for Complementary and Alternative Medicine in Neurological Disorders, Oregon Health & Science University, 3181 Sam Jackson Park Road, Portland, OR, 97239, USA
| | - Tyrus Korecki
- Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Los Angeles, CA, 90095, USA
| | - Nils Rosenbaum
- Behavioral Sciences Department, Albuquerque Police Department, 400 Rome, NW, Albuquerque, NM, 87102, USA
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15
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Xue T, Sheng J, Gao H, Gu Y, Dai J, Yang X, Peng H, Gao H, Lu R, Shen Y, Wang L, Wang L, Shi Y, Li Z, Cui D. Eight-month intensive meditation-based intervention improves refractory hallucinations and delusions and quality of life in male inpatients with schizophrenia: a randomized controlled trial. Psychiatry Clin Neurosci 2024; 78:248-258. [PMID: 38318694 DOI: 10.1111/pcn.13641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/10/2023] [Accepted: 12/25/2023] [Indexed: 02/07/2024]
Abstract
AIM This study investigated the impact of an 8-month daily-guided intensive meditation-based intervention (iMI) on persistent hallucinations/delusions and health-related quality of life (QoL) in male inpatients with schizophrenia with treatment-refractory hallucinations and delusions (TRHDs). METHODS A randomized controlled trial assigned 64 male inpatients with schizophrenia and TRHD equally to an 8-month iMI plus general rehabilitation program (GRP) or GRP alone. Assessments were conducted at baseline and the third and eighth months using the Positive and Negative Syndrome Scale (PANSS), 36-Item Short Form-36 (SF-36), and Five Facet Mindfulness Questionnaire (FFMQ). Primary outcomes measured PANSS reduction rates for total score, positive symptoms, and hallucinations/delusions items. Secondary outcomes assessed PANSS, SF-36, and FFMQ scores for psychotic symptoms, health-related QoL, and mindfulness skills, respectively. RESULTS In the primary outcome, iMI significantly improved the reduction rates of PANSS total score, positive symptoms, and hallucination/delusion items compared with GRP at both the third and eighth months. Treatment response rates (≥25% reduction) for these measures significantly increased in the iMI group at the eighth month. Concerning secondary outcomes, iMI significantly reduced PANSS total score and hallucination/delusion items, while increasing scores in physical activity and mindfulness skills at both the third and eighth months compared with GRP. These effects were more pronounced with an 8-month intervention compared with a 3-month intervention. CONCLUSIONS An iMI benefits patients with TRHDs by reducing persistent hallucinations/delusions and enhancing health-related QoL. Longer iMI duration yields superior treatment outcomes.
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Affiliation(s)
- Ting Xue
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Jialing Sheng
- The First Minzheng Mental Health Center, Shanghai, China
| | - Hui Gao
- The First Minzheng Mental Health Center, Shanghai, China
| | - Yan Gu
- The First Minzheng Mental Health Center, Shanghai, China
| | - Jingjing Dai
- The First Minzheng Mental Health Center, Shanghai, China
| | - Xianghong Yang
- The First Minzheng Mental Health Center, Shanghai, China
| | - Hong Peng
- The First Minzheng Mental Health Center, Shanghai, China
| | - Hongrui Gao
- The First Minzheng Mental Health Center, Shanghai, China
| | - Ruping Lu
- The First Minzheng Mental Health Center, Shanghai, China
| | - Yi Shen
- The First Minzheng Mental Health Center, Shanghai, China
| | - Li Wang
- The First Minzheng Mental Health Center, Shanghai, China
| | - Lijun Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Yuan Shi
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Zezhi Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Donghong Cui
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
- Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
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16
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Garland EL, Jinpa T. Mindfulness-induced self-transcendence promotes universal love with consequent effects on opioid misuse. Behav Res Ther 2024; 175:104494. [PMID: 38395015 DOI: 10.1016/j.brat.2024.104494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024]
Abstract
In addition to its health benefits, mindfulness has been theorized in classical contemplative frameworks to elicit self-transcendent experiences as a means of promoting universal love and compassion. Increasing feelings of love may be especially clinically relevant for the treatment of opioid misuse, in that addictive use of opioids dysregulates neurobiological processes implicated in the experience of love. Here we tested these hypotheses in a secondary analysis (n = 187) of data from a randomized clinical trial of Mindfulness-Oriented Recovery Enhancement (MORE) versus supportive psychotherapy for comorbid opioid misuse and chronic pain. At pre- and post-treatment, participants completed a measure of state self-transcendence immediately following a laboratory-based mindfulness task. Through 9-month follow-up, we assessed changes in universal love and opioid misuse. Participants also completed ecological momentary assessments of opioid craving during the 8-week study interventions and for the following month. Compared to supportive psychotherapy, participants in MORE reported significantly greater increases in mindfulness-induced self-transcendence, which mediated the effect of MORE on increased feelings of universal love. In turn, increases in universal love significantly predicted decreased opioid craving and lower odds opioid misuse through 1- and 9-month follow-ups, respectively. Findings suggest mindfulness-induced self-transcendence may promote feelings of universal love, with possible downstream benefits on reducing addictive behavior.
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Affiliation(s)
- Eric L Garland
- Center on Mindfulness and Integrative Health Intervention Development, University of Utah, USA.
| | - Thupten Jinpa
- School of Religious Studies, McGill University, Canada
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17
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Dionisi T, Di Sario G, De Mori L, Spagnolo G, Antonelli M, Tarli C, Sestito L, Mancarella FA, Ferrarese D, Mirijello A, Vassallo GA, Gasbarrini A, Addolorato G. Current treatments of alcohol use disorder. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2024; 175:127-152. [PMID: 38555114 DOI: 10.1016/bs.irn.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Emerging treatments for alcohol dependence reveal an intricate interplay of neurobiological, psychological, and circumstantial factors that contribute to Alcohol Use Disorder (AUD). The approved strategies balancing these factors involve extensive manipulations of neurotransmitter systems such as GABA, Glutamate, Dopamine, Serotonin, and Acetylcholine. Innovative developments are engaging mechanisms such as GABA reuptake inhibition and allosteric modulation. Closer scrutiny is placed on the role of Glutamate in chronic alcohol consumption, with treatments like NMDA receptor antagonists and antiglutamatergic medications showing significant promise. Complementing these neurobiological approaches is the progressive shift towards Personalized Medicine. This strategy emphasizes unique genetic, epigenetic and physiological factors, employing pharmacogenomic principles to optimize treatment response. Concurrently, psychological therapies have become an integral part of the treatment landscape, tackling the cognitive-behavioral dimension of addiction. In instances of AUD comorbidity with other psychiatric disorders, Personalized Medicine becomes pivotal, ensuring treatment and prognosis are closely defined by individual characteristics, as exemplified by Lesch Typology models. Given the high global prevalence and wide distribution of AUD, a persistent necessity exists for development and improvement of treatments. Current research efforts are steadily paving paths towards more sophisticated, effective typology-based treatments: a testament to the recognized imperative for enhanced treatment strategies. The potential encapsulated within the ongoing research suggests a promising future where the clinical relevance of current strategies is not just maintained but significantly improved to effectively counter alcohol dependence.
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Affiliation(s)
- Tommaso Dionisi
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, IRCCS "A. Gemelli" University Polyclinic Foundation, Rome, Italy
| | - Giovanna Di Sario
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, IRCCS "A. Gemelli" University Polyclinic Foundation, Rome, Italy
| | - Lorenzo De Mori
- Department of Neuroscience, Section of Psychiatry, Catholic University of Rome, Rome, Italy
| | - Giorgia Spagnolo
- Clinical Psychology Unit, IRCCS "A. Gemelli" University Polyclinic Foundation, Rome, Italy
| | - Mariangela Antonelli
- Internal Medicine and Alcohol Related Disease Unit, Columbus-Gemelli Hospital, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Claudia Tarli
- Internal Medicine and Alcohol Related Disease Unit, Columbus-Gemelli Hospital, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luisa Sestito
- Internal Medicine and Alcohol Related Disease Unit, Columbus-Gemelli Hospital, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Antonio Mancarella
- Internal Medicine and Alcohol Related Disease Unit, Columbus-Gemelli Hospital, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Daniele Ferrarese
- Clinical Psychology Unit, IRCCS "A. Gemelli" University Polyclinic Foundation, Rome, Italy
| | - Antonio Mirijello
- Unit of Internal Medicine, IRCCS "Casa Sollievo della Sofferenza" Foundation, San Giovanni Rotondo, Italy
| | | | - Antonio Gasbarrini
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, IRCCS "A. Gemelli" University Polyclinic Foundation, Rome, Italy; Department of Medical and Surgical Sciences, Università Cattolica di Roma, Rome, Italy
| | - Giovanni Addolorato
- Internal Medicine and Alcohol Related Disease Unit, Columbus-Gemelli Hospital, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Medical and Surgical Sciences, Università Cattolica di Roma, Rome, Italy.
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18
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Hayashi Y. Problematic mobile phone use as impulsive choice: Development and empirical verification of a reinforcer-pathology model. J Exp Anal Behav 2024; 121:189-200. [PMID: 38148676 DOI: 10.1002/jeab.900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 11/18/2023] [Indexed: 12/28/2023]
Abstract
Problematic mobile phone use is characterized by its "impulsive" nature; users engage in it despite their negative attitude toward it. From a behavioral-economic perspective, this attitude-behavior discrepancy is generated by competing contingencies that involve smaller-sooner social reinforcers associated with mobile phone use and larger-later prosocial reinforcers potentially compromised by phone use. Based on this conceptualization, the reinforcer-pathology model of problematic mobile phone use is proposed, which posits that such phone use stems from excessive delay discounting of the social and prosocial reinforcers and/or excessive demand for the social reinforcers. A secondary data analysis of previously published studies was conducted, with the novel addition of principal component analysis and hierarchical cluster analysis of these data. The results generated evidence that supports the reinforcer-pathology model proposed in this article. Based on the theoretical analyses and accumulated empirical evidence, theory-driven prevention and intervention strategies for problematic mobile phone use are proposed. Overall, the reinforcer-pathology model of problematic mobile phone use provides a comprehensive framework for understanding and addressing this growing issue.
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19
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Uebelacker LA, Braun TD, Taylor LE, Saper R, Baldwi M, Abrantes A, Tremont G, Toribio A, Kirshy S, Koch R, Lorin L, Van Noppen D, Anderson B, Roseen EJ, Stein MD. Evaluation of intervention components to maximize yoga practice among people with chronic pain taking opioid agonist therapy: A factorial experiment using the multiphase optimization strategy framework. Contemp Clin Trials 2024; 137:107411. [PMID: 38103784 PMCID: PMC10922864 DOI: 10.1016/j.cct.2023.107411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/01/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Chronic pain affects up to half of individuals taking opioid agonist therapy (OAT; i.e., methadone and buprenorphine) for opioid use disorder (OUD), and yoga-based interventions may be useful for decreasing pain-related disability. Whereas more yoga practice (i.e., higher "dosage") may improve pain-related outcomes, it can be challenging for people with chronic pain taking OAT to attend class regularly and sustain a regular personal yoga practice. Therefore, we plan to optimize a yoga-based intervention (YBI) package in order to support class attendance and personal practice, thus maximizing the yoga dose received. STUDY DESIGN Using the Multiphase Optimization Strategy (MOST) framework, we will conduct a factorial experiment to examine four intervention components that may be added to a weekly yoga class as part of a YBI. Components include: 1) personal practice videos featuring study yoga teachers, 2) two private sessions with a yoga teacher, 3) daily text messages to inspire personal practice, and 4) monetary incentives for class attendance. The primary outcome will be minutes per week engaged in yoga (including class attendance and personal practice). We plan to enroll 192 adults with chronic pain who are taking OAT for OUD in this 2x2x2x2 factorial experiment. CONCLUSION Results of the study will guide development of an optimized yoga-based intervention package that maximizes dosage of yoga received. The final treatment package can be tested in a multisite efficacy trial of yoga to reduce pain interference in daily functioning in people with chronic pain who are taking OAT. TRIAL REGISTRATION Pre-registration of the study was completed on ClinicalTrials.gov (identifier: NCT04641221).
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Affiliation(s)
- Lisa A Uebelacker
- Alpert Medical School of Brown University, Providence, RI, United States of America; Butler Hospital, Providence, RI, United States of America.
| | - Tosca D Braun
- Alpert Medical School of Brown University, Providence, RI, United States of America; Butler Hospital, Providence, RI, United States of America.
| | - Lynn E Taylor
- University of Rhode Island, Kingston, RI, United States of America
| | - Robert Saper
- Cleveland Clinic, Cleveland, OH, United States of America
| | - Marielle Baldwi
- Boston University Chobanian & Avedision School of Medicine, Boston, MA, United States of America; Boston Medical Center, Boston, MA, United States of America
| | - Ana Abrantes
- Alpert Medical School of Brown University, Providence, RI, United States of America; Butler Hospital, Providence, RI, United States of America
| | - Geoffrey Tremont
- Alpert Medical School of Brown University, Providence, RI, United States of America; The Boston University School of Public Health, Boston, MA, United States of America
| | - Alisha Toribio
- Boston University Chobanian & Avedision School of Medicine, Boston, MA, United States of America; Boston Medical Center, Boston, MA, United States of America
| | - Shannon Kirshy
- Butler Hospital, Providence, RI, United States of America
| | - Ryan Koch
- Butler Hospital, Providence, RI, United States of America
| | - Lucy Lorin
- Boston University Chobanian & Avedision School of Medicine, Boston, MA, United States of America; Boston Medical Center, Boston, MA, United States of America
| | | | | | - Eric J Roseen
- Boston University Chobanian & Avedision School of Medicine, Boston, MA, United States of America; Boston Medical Center, Boston, MA, United States of America
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20
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Loreto BBL, Sordi AO, de Castro MN, Ornell F, Guarnieri EP, Roza TH, Schuch JB, Cima MDS, Pechansky F, Grevet EH, Grassi-Oliveira R, von Diemen L, Kessler FHP. Proposing an integrative, dynamic and transdiagnostic model for addictions: dysregulation phenomena of the three main modes of the predostatic mind. Front Psychiatry 2024; 14:1298002. [PMID: 38274436 PMCID: PMC10808830 DOI: 10.3389/fpsyt.2023.1298002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/28/2023] [Indexed: 01/27/2024] Open
Abstract
Several theories have been proposed to explain the complex diagnostic aspects related to addiction disorders and their development. Recent frameworks tend to focus on dimensional perspectives of symptoms rather than categorical systems, since substance use disorders are frequently comorbid with other psychiatric and especially personality disorders. However, useful transdiagnostic models that could integrate clinical evaluation derived from neuroscientific theories are lacking. In the present manuscript, the authors propose a model based on a new paradigm, in an attempt to better explain this complex, multifaceted phenomenon. The new paradigm presupposes that emotions and behavior are a response to risk prediction. Individuals make choices and engage in actions to manage potential risks/rewards in order to seek or maintain homeostasis in their internal and external environments - a mechanism that the authors call predostatic (predictive mechanism with homeostatic purpose). The model considers three main modes of the predostatic mind: (1) Alarm Mode, activated by high and/or imminent risk prediction; (2) Seek Mode, activated by long-term risk or reward prediction; and (3) Balance Mode, a self-regulating state of mind related to low risk prediction, a soothing system and a calm state. Addiction is seen as a chronic dysregulation of organism systems leading to internalizing or externalizing phenomena mainly related to the Seek and Alarm Modes, which are persistently activated by reward and risk prediction, respectively, thus hindering Balance. Addiction neuroscience research has shown that chronic drug use or engagement in addictive behaviors can lead to neuroadaptations in the brain reward circuitry, disrupting normal balance and the regulation of reward processes. This dysregulation can contribute to persistent drug-seeking/addictive behaviors despite negative consequences. This newly proposed dynamic and integrative model, named dysregulation based on externalizing and internalizing phenomena of the three main modes of the predostatic mind (DREXI3), proposes six dysregulation dimensions with basic emotional and behavioral symptoms, such as neurophysiological alterations, impulsivity, compulsion, cognitive impairment/psychosis, mood, and anxiety/anger. In this paper, the authors explain the rationale behind DREXI3 and present some hypothetical clinical examples to better illustrate the use of the model in clinical practice. The development of this innovative model could possibly guide tailored treatment interventions in the addiction field.
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Affiliation(s)
- Bibiana Bolten Lucion Loreto
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Anne Orgler Sordi
- Addiction and Forensic Psychiatry Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Melina Nogueira de Castro
- Addiction and Forensic Psychiatry Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Felipe Ornell
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Eduardo Pegoraro Guarnieri
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | - Jaqueline Bohrer Schuch
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Marcos da Silveira Cima
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Flavio Pechansky
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Eugênio Horácio Grevet
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Rodrigo Grassi-Oliveira
- Department of Clinical Medicine, Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
| | - Lisia von Diemen
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Felix Henrique Paim Kessler
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Mange J, Mauny N, Montcharmont C, Legrand E, Lemercier-Dugarin M, Mortier A, Duvivier M, Leveneur J, Lacherez C, Cabé N, Le Berre AP. A prevention program for binge drinking among students based on mindfulness and implementation intention (ALCOMEDIIT): a randomized controlled trial. Trials 2024; 25:1. [PMID: 38169391 PMCID: PMC10759352 DOI: 10.1186/s13063-023-07887-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The emergence of new problematic alcohol consumption practices among young people requires new dynamics in prevention strategies. In this context, the ADUC project (Alcohol and Drugs at the University of Caen) aims to develop a better understanding of alcohol consumption, and in particular the practice of binge drinking (BD) in students, in order to develop relevant and adapted prevention tools. The ALCOMEDIIT study (Rin Normandie and IRESP funding; Agreement 20II31-00 - ADUC part 3) is a randomized controlled trial that focuses on the specific determinant of impulsivity. The main objective of this experiment is to assess a program for the prevention of BD practices based on motivational interviewing (MI) associated with implementation intention (II) and mindfulness meditation (MBM) in a student environment. METHODS This study will include 170 healthy subjects who will be students at the university, alcohol users, with a BD score > 1 in the month preceding the inclusion but not presenting any specific disorder. The trial will be proposed by e-mail and students who meet the inclusion criteria will join either a control group which will benefit from a MI or an experimental group which will additionally benefit from an initiation to MBM with II (initial visit T0). In order to measure the effectiveness of the prevention program in terms of BD decrease, a follow-up at 1 month (T1) as well as a follow-up at 6 months (T6; exploratory) will be proposed to all participants. The total duration of this research protocol is 21 months. DISCUSSION The purpose of this study is to evaluate the interest of associating mindfulness meditation practices and implementation of self-regulation strategies to optimize their use, with a motivational interview in an innovative prevention program aiming at reducing alcohol use and BD practice in the student population. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05565989, September 30, 2022. https://clinicaltrials.gov/study/NCT05565989 Protocol version 2.0 (September 2022) No. ID-RCB 2022-A00983-40.
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Affiliation(s)
- Jessica Mange
- Laboratoire de Psychologie Caen Normandie (LPCN, UR 7452), University of Caen Normandy, Esplanade de la Paix, 14032, Caen, cedex 5, France.
| | - Nicolas Mauny
- Laboratoire de Psychologie Caen Normandie (LPCN, UR 7452), University of Caen Normandy, Esplanade de la Paix, 14032, Caen, cedex 5, France
| | - Charlotte Montcharmont
- Laboratoire de Psychologie Caen Normandie (LPCN, UR 7452), University of Caen Normandy, Esplanade de la Paix, 14032, Caen, cedex 5, France
| | - Eve Legrand
- Laboratoire Parisien de Psychologie Sociale (LAPPS), University Paris Nanterre, Nanterre, France
| | - Maud Lemercier-Dugarin
- Laboratoire de Psychologie Caen Normandie (LPCN, UR 7452), University of Caen Normandy, Esplanade de la Paix, 14032, Caen, cedex 5, France
| | - Arnaud Mortier
- Laboratoire de Psychologie Caen Normandie (LPCN, UR 7452), University of Caen Normandy, Esplanade de la Paix, 14032, Caen, cedex 5, France
- University of Caen Normandy, CNRS, LMNO UMR 6139, F-14000, Caen, France
| | - Martin Duvivier
- Laboratoire de Psychologie Caen Normandie (LPCN, UR 7452), University of Caen Normandy, Esplanade de la Paix, 14032, Caen, cedex 5, France
| | - Johnny Leveneur
- Information System and Communication Department, University of Caen Normandy, Caen, France
| | - Cédric Lacherez
- Information System and Communication Department, University of Caen Normandy, Caen, France
| | - Nicolas Cabé
- Normandie Univ, UNICAEN, PSL Université, EPHE, NSERM, U1077, CHU de Caen, GIP Cyceron, NIMH, 14000, Caen, France
| | - Anne-Pascale Le Berre
- Department of Addictology, Public Institution of Mental Health (EPSM) of Finistère Sud, Quimper, France
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Chen H, Kuitunen-Paul S, Weinstein AM, Petzold J. Editorial: Addiction and the brain: current knowledge, methods, and perspectives. Front Psychiatry 2023; 14:1343524. [PMID: 38173709 PMCID: PMC10761471 DOI: 10.3389/fpsyt.2023.1343524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Affiliation(s)
- Hao Chen
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Sören Kuitunen-Paul
- Department of Clinical Psychology and Psychotherapy, Technische Universität Chemnitz, Chemnitz, Germany
- Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Dresden, Germany
| | | | - Johannes Petzold
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Binkowska AA, Obarska K, Marcowski P, Szymczak K, Lewczuk K, Sollich K, Banaszak M, Woronowicz B, Nowicka M, Skorko M, Gola M. Evaluating the effectiveness of mobile app-based self-guided psychological intervention to reduce craving and lapse risk in problematic substance use and behaviors: Protocol for a randomized control trial in the general population. Contemp Clin Trials Commun 2023; 36:101180. [PMID: 37720591 PMCID: PMC10500479 DOI: 10.1016/j.conctc.2023.101180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/11/2023] [Accepted: 07/02/2023] [Indexed: 09/19/2023] Open
Abstract
Background The prevalence of substance and behavioral addiction is estimated between 10 and 15% of the global population and remains a severe public health concern. Moreover, addiction treatment has several barriers, such as a lack of access to professional treatment or stigmatization. Mobile health interventions emerge as a promising solution. Methods This two-armed randomized controlled trial (RCT) aims to assess the efficacy of a mobile app-based self-guided psychological intervention delivered via a smartphone app (Nałogometr) in reducing craving and lapse risk in problematic behaviors and substance use compared to a control condition. Participant recruitment and data collection will start in June 2022 and end in September 2022. Due to the nature of the study, i.e., a nationwide study of problematic substance use and behaviors, we will aim to recruit all individuals willing to participate. The four-week intervention condition includes short-term and long-term modules based mainly on mindfulness and cognitive behavioral therapy. Longitudinal data on several variables related to craving and lapse risk are collected daily using ecological momentary assessment (EMA). The primary outcomes of interest will be the self-reported number of lapses and craving level in daily EMA. Moreover, a questionnaire battery assessment is administered at baseline in the first week following onboarding, after five weeks, and after six months. The secondary outcome measures will include the severity of problematic substance use or behaviors, anxiety and depression, and life satisfaction. Results Results will be submitted for publication in peer-reviewed journals. Clinical trial registration [https://clinicaltrials.gov/], identifier [NCT054 34,429].
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Affiliation(s)
- Alicja Anna Binkowska
- PredictWatch, Upalna 1A/76, 15-668, Białystok, Poland
- DrugsTeam, NeuroCognitive Research Center, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Katarzyna Obarska
- PredictWatch, Upalna 1A/76, 15-668, Białystok, Poland
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | | | - Karol Szymczak
- PredictWatch, Upalna 1A/76, 15-668, Białystok, Poland
- Institute of Psychology, The Maria Grzegorzewska University, Warsaw, Poland
| | - Karol Lewczuk
- PredictWatch, Upalna 1A/76, 15-668, Białystok, Poland
- Institute of Psychology, Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Poland
| | | | - Maria Banaszak
- PredictWatch, Upalna 1A/76, 15-668, Białystok, Poland
- Monar Association, Warsaw, Poland
| | - Bohdan Woronowicz
- PredictWatch, Upalna 1A/76, 15-668, Białystok, Poland
- Consulting Center Akmed, Warsaw, Poland
| | | | - Maciej Skorko
- PredictWatch, Upalna 1A/76, 15-668, Białystok, Poland
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Mateusz Gola
- PredictWatch, Upalna 1A/76, 15-668, Białystok, Poland
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
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Jarrett O, London ED, Mahmoudie T, Suh J, Ghahremani D, Dean AC. Mindfulness and clinical correlates in methamphetamine use disorder. Drug Alcohol Depend 2023; 253:111029. [PMID: 38006669 DOI: 10.1016/j.drugalcdep.2023.111029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/30/2023] [Accepted: 11/10/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Mindfulness-based interventions are increasingly used for the treatment of substance use disorders, including methamphetamine use disorder (MUD). Literature indicates that trait mindfulness may play a key role in the effectiveness of these treatments on therapeutic outcome, yet no prior studies have tested for differences in trait mindfulness between individuals with MUD and healthy control participants. Such differences are important for treatment implementation. OBJECTIVES The goals of this study were to evaluate trait mindfulness and to determine its clinical correlates in individuals with MUD. METHODS A group of participants with MUD at varying lengths of abstinence from methamphetamine (< 1h to 90 days; mean 5.4 ± 12.5 days; N=95, 53 female, 42 male) and a healthy control group (N=65, 30 female, 35 male) completed the Mindfulness Attention Awareness Scale (MAAS). Group differences and relationships between trait mindfulness and several measures of drug use and psychiatric symptoms were evaluated. RESULTS In participants with MUD, trait mindfulness was 10% lower than in healthy controls (p < 0.001), but it was not significantly correlated with measures of drug use or craving. Across both groups, trait mindfulness was negatively correlated with state anxiety, depression, emotional dysregulation, impulsivity, and a history of childhood trauma, while it was positively correlated with self-compassion (ps < 0.001). CONCLUSION The deficit in trait mindfulness in MUD presents a capacity that can be targeted for improved treatment outcome with mindfulness-based therapies. Trait mindfulness is inversely related to mood dysregulation.
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Affiliation(s)
- Olivia Jarrett
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and human Behavior, David Geffen School of Medicine, USA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and human Behavior, David Geffen School of Medicine, USA; Department of Molecular and Medical Pharmacology, USA; Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Tarannom Mahmoudie
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and human Behavior, David Geffen School of Medicine, USA
| | - Jaymee Suh
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and human Behavior, David Geffen School of Medicine, USA
| | - Dara Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and human Behavior, David Geffen School of Medicine, USA; Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA
| | - Andy C Dean
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and human Behavior, David Geffen School of Medicine, USA; Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA.
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25
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Demina A, Petit B, Meille V, Trojak B. Mindfulness interventions for craving reduction in substance use disorders and behavioral addictions: systematic review and meta-analysis of randomized controlled trials. BMC Neurosci 2023; 24:55. [PMID: 37853315 PMCID: PMC10583418 DOI: 10.1186/s12868-023-00821-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 09/11/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND High-quality evidence is still required to affirm the efficacy of mindfulness-based interventions (MBIs) in craving reduction. MBIs may be particularly appropriate for this purpose given the neurobiological mechanisms of addiction with automatic behavior in response to the negative affect. In this systematic review and meta-analysis, we aimed to study the efficacy of MBIs in craving reduction and to synthetize the newly published data. METHODS We searched four databases and three clinical trial registries for randomized controlled trials (RCTs) up to August 2023, including studies with MBIs in all types of substance use disorders or behavioral addictions. We chose as our outcome of interest the change from the baseline of craving measures at posttreatment. Standardized mean difference was used as an effect size estimator. RESULTS We included 17 RCTs with 1228 participants. The overall effect size was estimated at -0.70 (95% CI -1.15, -0.26) in favor of MBIs. CONCLUSION Due to the high inconsistency (I2 = 92%), we were unable to conclude that there is a medium to large effect size. Overall risk of bias was high for most studies, and the GRADE approach detected a low quality of evidence. Previous clinical and fundamental research suggest that MBIs have a promising potential in addiction medicine. However, further investigation of whether MBIs effectively reduce craving is needed, and innovative solutions for resolving methodological limitations in MBI research are warranted. TRIAL REGISTRATION PROSPERO registration ID CRD42020221141.
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Affiliation(s)
- Anastasia Demina
- Dijon University Hospital, Bâtiment Marion 14 rue Paul Gaffarel, 21079, BP77908, Dijon Cedex, France.
- INSERM U1093, CAPS, Université de Bourgogne, UFR STAPS, BP 27877, F-21078, Dijon, France.
| | - Benjamin Petit
- Dijon University Hospital, Bâtiment Marion 14 rue Paul Gaffarel, 21079, BP77908, Dijon Cedex, France
| | - Vincent Meille
- Dijon University Hospital, Bâtiment Marion 14 rue Paul Gaffarel, 21079, BP77908, Dijon Cedex, France
| | - Benoit Trojak
- Dijon University Hospital, Bâtiment Marion 14 rue Paul Gaffarel, 21079, BP77908, Dijon Cedex, France
- INSERM U1093, CAPS, Université de Bourgogne, UFR STAPS, BP 27877, F-21078, Dijon, France
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Gallo GG, Curado DF, Machado MPA, Espíndola MI, Scattone VV, Noto AR. A randomized controlled trial of mindfulness: effects on university students' mental health. Int J Ment Health Syst 2023; 17:32. [PMID: 37833796 PMCID: PMC10571349 DOI: 10.1186/s13033-023-00604-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The development of mental health disorders is common in the university population, and mindfulness-based interventions (MBIs) seem to be effective in addressing them in different contexts. Thus, this study investigated the impact of an 8-week MBI adapted to university students from the Mindfulness-Based Relapse Prevention (MBSR) on different symptoms related to mental health problems, specifically symptoms of anxiety, depression, stress and insomnia. METHODS University students (n = 136) were randomized into MBI group (n = 71) or wait-list group (n = 65). All participants completed self-administered questionnaires before and after the intervention, and the experimental group answered questionnaires weekly during intervention. Generalized mixed models were used to assess the effects of the intervention. RESULTS There were improvements in the symptoms of stress (B = 5.76, p < 0.001), depression (B = 1.55, p < 0.01) and insomnia (B = 1.35, p = 0.020) from the beginning of the intervention to the final assessment when it was compared to the control group. No effect was found in respect of trait anxiety. The MBI was found to be effective in reducing important symptoms related to university students' mental health, possibly grounding further research on the intervention's potential of preventing the development of mental disorders. TRIAL REGISTRATION The research was registered in the Brazilian Registry of Clinical Trials (ReBEC) - number RBR-63qsqx, approved at 09/16/2019.
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Affiliation(s)
- Giovana Gonçalves Gallo
- Departamento de Psicobiologia, NEPSIS - Núcleo de Pesquisa em Saúde de Uso de Substâncias - MBRP Brasil - Centro Brasileiro de Pesquisa e Formação em Prevenção de Recaídas Baseada em Mindfulness (MBRP), Universidade Federal de São Paulo, São Paulo, 04023-062, SP, Brazil.
| | - Daniela Fernandez Curado
- Departamento de Psicobiologia, NEPSIS - Núcleo de Pesquisa em Saúde de Uso de Substâncias - MBRP Brasil - Centro Brasileiro de Pesquisa e Formação em Prevenção de Recaídas Baseada em Mindfulness (MBRP), Universidade Federal de São Paulo, São Paulo, 04023-062, SP, Brazil
| | - Mayra Pires Alves Machado
- Departamento de Psicobiologia, NEPSIS - Núcleo de Pesquisa em Saúde de Uso de Substâncias - MBRP Brasil - Centro Brasileiro de Pesquisa e Formação em Prevenção de Recaídas Baseada em Mindfulness (MBRP), Universidade Federal de São Paulo, São Paulo, 04023-062, SP, Brazil
| | - Marília Ignácio Espíndola
- Departamento de Psicobiologia, NEPSIS - Núcleo de Pesquisa em Saúde de Uso de Substâncias - MBRP Brasil - Centro Brasileiro de Pesquisa e Formação em Prevenção de Recaídas Baseada em Mindfulness (MBRP), Universidade Federal de São Paulo, São Paulo, 04023-062, SP, Brazil
| | - Vitor Villar Scattone
- Departamento de Psicobiologia, NEPSIS - Núcleo de Pesquisa em Saúde de Uso de Substâncias - MBRP Brasil - Centro Brasileiro de Pesquisa e Formação em Prevenção de Recaídas Baseada em Mindfulness (MBRP), Universidade Federal de São Paulo, São Paulo, 04023-062, SP, Brazil
| | - Ana Regina Noto
- Departamento de Psicobiologia, NEPSIS - Núcleo de Pesquisa em Saúde de Uso de Substâncias - MBRP Brasil - Centro Brasileiro de Pesquisa e Formação em Prevenção de Recaídas Baseada em Mindfulness (MBRP), Universidade Federal de São Paulo, São Paulo, 04023-062, SP, Brazil
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Gocet Tekin E, Yilmaz FB, Satici SA. Impulsivity and substance misuse among Turkish people: Serial mediating effect of emotion dysregulation and general anxiety disorder. J Ethn Subst Abuse 2023:1-18. [PMID: 37812504 DOI: 10.1080/15332640.2023.2263742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Substance misuse is an alarming issue worldwide that causes serious problems at both the individual and societal levels, placing a burden on public health systems and economies. Understanding the predictors of substance misuse may help prevent it and may be an adjunct to treatment. The present study examined the relationship among impulsivity, emotion dysregulation, generalized anxiety disorder, and substance misuse. A total of 462 participants age between 18 and 74 years (M = 33.67, SD = 12.91) from 49 cities across Türkiye, completed the measures of impulsivity, emotion dysregulation, generalized anxiety disorder, and substance misuse. Structural equation modeling indicated that impulsivity, emotion dysregulation, and generalized anxiety have a significant predictive role in substance misuse. Further, emotion dysregulation and generalized anxiety disorder mediate the relationship between impulsivity and substance misuse. These findings suggest that noticing and treating impulsivity, emotion dysregulation, and generalized anxiety may minimize the effects of substance misuse.
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Larsen JK, Hollands GJ, Garland EL, Evers AWM, Wiers RW. Be more mindful: Targeting addictive responses by integrating mindfulness with cognitive bias modification or cue exposure interventions. Neurosci Biobehav Rev 2023; 153:105408. [PMID: 37758008 DOI: 10.1016/j.neubiorev.2023.105408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/01/2023] [Accepted: 09/22/2023] [Indexed: 09/29/2023]
Abstract
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.
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Affiliation(s)
- Junilla K Larsen
- Behavioural Science Institute, Radboud University, PO Box 9104, 6500 HE Nijmegen, the Netherlands.
| | - Gareth J Hollands
- EPPI Centre, UCL Social Research Institute, University College London, UK
| | - Eric L Garland
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Salt Lake City, USA
| | - Andrea W M Evers
- Health, Medical and Neuropsychology Unit, Leiden University, NL, and Medical Delta, Leiden University, TU Delft and Erasmus University, UK
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam and Centre for Urban Mental Health, University of Amsterdam, the Netherlands
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Richner KA, Sande-Martin B, Soetjoadi I, McChargue DE. Trait mindfulness weakens the relationship between Snapchat use and alcohol-related outcomes. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2200-2207. [PMID: 34469256 DOI: 10.1080/07448481.2021.1965147] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 06/03/2021] [Accepted: 07/22/2021] [Indexed: 06/13/2023]
Abstract
Objective:Previous studies identified Snapchat as the most likely social media platform for depictions of excessive drinking and consequences. We sought to further examine this relationship and the possible protective impact of trait mindfulness.Method:A sample of 838 college students completed a survey assessing self-reported alcohol use, alcohol-related consequences, trait mindfulness, and individual and peer alcohol-related Snapchat posts.Results:Viewing more peer's Snapchats was associated with increased alcohol-related consequences, except at high levels of trait mindfulness. When controlling for the individual's Snapchat posts, the significant relationship between peer's Snapchats and consequences remained at low levels of trait mindfulness but not for moderate levels. The protective effect of high levels of trait mindfulness endured.Conclusion:Increasing trait mindfulness may help buffer the negative influence of viewing peer's alcohol-related Snapchats on alcohol-related consequences. Further examining how trait mindfulness interacts with peer norms offers important avenues for future research.
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Affiliation(s)
- Kailey A Richner
- Department of Psychology, University of Nebraska, Lincoln, NE, USA
| | | | - Irenea Soetjoadi
- Department of Psychology, University of Nebraska, Lincoln, NE, USA
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Hospital MM, Contreras-Pérez ME, Alessi SM, Langwerden RJ, Morris SL, Wagner EF. Mindfulness as an early intervention for hazardous alcohol use among non-treatment seeking Latine emerging adults: A mini-review. Addict Behav 2023; 145:107759. [PMID: 37276788 DOI: 10.1016/j.addbeh.2023.107759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/17/2023] [Accepted: 05/24/2023] [Indexed: 06/07/2023]
Abstract
The age cohort referred to as emerging adults (ages 18-29 years old) demonstrates the most hazardous alcohol use in the United States (U.S.) Approximately one-third of emerging adults regularly engage in heavy episodic drinking (4/5 drinks in two hours females/males). Compared to their non-Latine White peers, Latine emerging adults in the U.S. report lower rates of heavy episodic drinking (HED) yet are at greater risk of developing a substance use disorder and experience more severe negative consequences from drinking alcohol. Despite their high-risk status, Latine emerging adults are less likely to seek treatment and have less access to innovative health-promoting resources, further exacerbating health inequities. Research has shown that practicing mindfulness can interrupt habituated cognitions, intrusive thinking, and automatic behaviors associated with hazardous drinking. However, Latine representation in MBI trials is minimal. This mini-review explores the potential value of mindfulness as an early intervention for hazardous alcohol use among Latine emerging adults. The review provides future directions for research, highlighting the need to design culturally and developmentally tailored MBIs that can provide a respectful, non-judgmental, and discrimination-free environment that appeals to Latine emerging adults. Additionally, conclusions are drawn regarding the possible benefits of pairing MBI with contingency management strategies to decrease attrition rates in MBI trials.
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Affiliation(s)
- Michelle M Hospital
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA; Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA; Department of Biostatistics, Florida International University, Miami, FL 33199, USA.
| | - María Eugenia Contreras-Pérez
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA; Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA; School of Social Work, Florida International University, Miami, FL 33199, USA.
| | - Sheila M Alessi
- Department of Medicine and the Calhoun Cardiology Center - Behavioral Health Division, University of Connecticut School of Medicine, Farmington, CT 06030-3944, USA.
| | - Robbert J Langwerden
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA; Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA.
| | - Staci Leon Morris
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA; Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA; School of Social Work, Florida International University, Miami, FL 33199, USA.
| | - Eric F Wagner
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA; Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA; School of Social Work, Florida International University, Miami, FL 33199, USA.
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Killeen TK, Baker NL, Davis LL, Bowen S, Brady KT. Efficacy of mindfulness-based relapse prevention in a sample of veterans in a substance use disorder aftercare program: A randomized controlled trial. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 152:209116. [PMID: 37364669 DOI: 10.1016/j.josat.2023.209116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 05/13/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Complementary integrative medicine, such as mindfulness-based interventions, (MBI) have demonstrated efficacy in the treatment of depression, anxiety, substance use disorders (SUDs), and pain. Mindfulness-based relapse prevention (MBRP) is an aftercare intervention targeting SUD relapse that integrates cognitive-behavioral relapse prevention and mindfulness meditation practices, raising awareness of substance use triggers and reactive behavioral patterns. This study evaluated the efficacy of MBRP in reducing relapse in veterans following completion of an SUD treatment program. METHODS This study was a two-site, randomized controlled trial comparing MBRP to 12-step facilitation (TSF) aftercare in military veterans following completion of intensive treatment for SUDs. The 8 weeks of 90-minute, group-based MBRP or TSF sessions were followed by 3-, 6- and 10-month follow-up periods with assessments of alcohol/substance use and secondary outcomes of depression, anxiety, and mindfulness. RESULTS Forty-seven percent of veterans attended ≥75 % of sessions. Veterans in both the MBRP and TSF aftercare groups maintained reductions in alcohol and illicit substance use during the aftercare treatment. Nineteen participants (11 %; 19/174) reported returning to alcohol use during the study treatment period and the study found no difference between study groups [MBRP: 9 % vs. TSF 13 %; p = 0.42]. Thirteen participants (7.5 %; 13/174) reported a return to illicit substance use during study treatment [MBRP: 5.4 % vs. TSF 10.3 % p = 0.34]. The number of days of drinking and illicit substance use was not different between groups (alcohol, p = 0.53; illicit substance use, p = 0.28). CONCLUSION Although retention in treatment limits interpretation of the findings, both MBRP and TSF were effective in maintenance of treatment gains following an intensive treatment program for veterans with SUDs. Future studies should focus on strategies to improve treatment participation.
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Affiliation(s)
- Therese K Killeen
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St, Charleston, SC, 29425, United States of America.
| | - Nathaniel L Baker
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St, Charleston, SC, 29425, United States of America.
| | - Lori L Davis
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama Health System, 3701 Loop Rd, Tuscaloosa, AL 35404, United States of America.
| | - Sarah Bowen
- Department of Psychology, Pacific University, Graduate Psychology Health Prof. Building 2 297 (Hillsboro), 503-352-3614, UC Box A191, Portland, OR, United States of America.
| | - Kathleen T Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St, Charleston, SC, 29425, United States of America.
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Tofighi B, Marini C, Lee JD, Garland EL. Patient Perceptions of Integrating Meditation-based Interventions in Office-based Opioid Treatment with Buprenorphine: A Mixed-methods Survey. J Addict Med 2023; 17:517-520. [PMID: 37788602 PMCID: PMC10533745 DOI: 10.1097/adm.0000000000001160] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
INTRODUCTION Recent findings support the provision of meditation-based interventions (MBIs) in primary care. However, the acceptability of MBI among patients prescribed medications for opioid use disorder (eg, buprenorphine) in primary care remains unclear. This study assessed experiences and preferences for adopting MBI among patients prescribed buprenorphine in office-based opioid treatment (OBOT). METHODS This 23-item, semistructured cross-sectional survey was administered by study staff to patients enrolled in OBOT (N = 72) and consisted of demographic and clinical characteristics, perceptions, experiences with MBI, and preferred strategies to access MBI to support their treatment on buprenorphine. RESULTS Most participants reported practicing at least 1 category of MBI (90.3%) on at least a daily (39.6%) or weekly (41.7%) basis including (1) spiritual meditation (eg, centering prayer; 67.7%); (2) nonmantra meditation (eg, comfortable posture; 61.3%); (3) mindfulness meditation (eg, mindfulness-based stress reduction; 54.8%); and (4) mantra meditation (eg, transcendental meditation; 29.0%). Interest in MBI was motivated by improving one's general health and well-being (73.4%), treatment outcomes with medications for OUD (eg, buprenorphine; 60.9%), and relationships with others (60.9%). Perceived clinical benefits of MBI included reduced anxiety or depression symptoms (70.3%), pain (62.5%), illicit substance or alcohol use (60.9%), cravings for illicit substances (57.8%), and opioid-related withdrawal symptoms (51.6%). CONCLUSIONS Findings from this study indicate high acceptability for adopting MBI among patients prescribed buprenorphine in OBOT. Further research is needed to assess the efficacy of MBI to improve clinical outcomes among patients initiating buprenorphine in OBOT.
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Affiliation(s)
- Babak Tofighi
- New York University School of Medicine, Department of Population Health
- Bellevue Hospital Center Division of General Internal Medicine
- Center for Drug Use and HIV Research
- Nathan Kline Institute for Psychiatric Research
| | - Christina Marini
- New York University School of Medicine, Department of Population Health
| | - Joshua D. Lee
- New York University School of Medicine, Department of Population Health
- Bellevue Hospital Center Division of General Internal Medicine
- Center for Drug Use and HIV Research
| | - Eric L. Garland
- University of Utah, Center on Mindfulness and Integrative Health Intervention Development, College of Social Work
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Jovanova M, Cosme D, Doré B, Kang Y, Stanoi O, Cooper N, Helion C, Lomax S, McGowan AL, Boyd ZM, Bassett DS, Mucha PJ, Ochsner KN, Lydon-Staley DM, Falk EB. Psychological distance intervention reminders reduce alcohol consumption frequency in daily life. Sci Rep 2023; 13:12045. [PMID: 37491371 PMCID: PMC10368637 DOI: 10.1038/s41598-023-38478-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 07/09/2023] [Indexed: 07/27/2023] Open
Abstract
Modifying behaviors, such as alcohol consumption, is difficult. Creating psychological distance between unhealthy triggers and one's present experience can encourage change. Using two multisite, randomized experiments, we examine whether theory-driven strategies to create psychological distance-mindfulness and perspective-taking-can change drinking behaviors among young adults without alcohol dependence via a 28-day smartphone intervention (Study 1, N = 108 participants, 5492 observations; Study 2, N = 218 participants, 9994 observations). Study 2 presents a close replication with a fully remote delivery during the COVID-19 pandemic. During weeks when they received twice-a-day intervention reminders, individuals in the distancing interventions reported drinking less frequently than on control weeks-directionally in Study 1, and significantly in Study 2. Intervention reminders reduced drinking frequency but did not impact amount. We find that smartphone-based mindfulness and perspective-taking interventions, aimed to create psychological distance, can change behavior. This approach requires repeated reminders, which can be delivered via smartphones.
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Affiliation(s)
- Mia Jovanova
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA.
| | - Danielle Cosme
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Bruce Doré
- Desautels Faculty of Management, McGill University, Montreal, Canada
| | - Yoona Kang
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Ovidia Stanoi
- Department of Psychology, Columbia University, New York, USA
| | - Nicole Cooper
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Chelsea Helion
- Department of Psychology, Temple University, Philadelphia, USA
| | - Silicia Lomax
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Amanda L McGowan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Zachary M Boyd
- Mathematics Department, Brigham Young University, Provo, USA
| | - Dani S Bassett
- Department of Bioengineering, University of Pennsylvania, Philadelphia, USA
- Department of Electrical & Systems Engineering, University of Pennsylvania, Philadelphia, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
- Department of Psychiatry, University of Pennsylvania, Philadelphia, USA
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, USA
- The Santa Fe Institute, Santa Fe, USA
| | - Peter J Mucha
- Department of Mathematics, Dartmouth College, Hanover, USA
| | - Kevin N Ochsner
- Department of Psychology, Columbia University, New York, USA
| | - David M Lydon-Staley
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, USA
| | - Emily B Falk
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA.
- Department of Psychology, University of Pennsylvania, Philadelphia, USA.
- Wharton Marketing Department, University of Pennsylvania, Philadelphia, USA.
- Wharton Operations, Information and Decisions Department, University of Pennsylvania, Philadelphia, USA.
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Kun B, Alpay P, Bodó V, Molnár Á, Horváth A, Karsai S, Somlai RS, Takacs ZK, Kökönyei G. Differences in the associations between psychoactive substance use and alexithymia: A series of Meta-analyses. Clin Psychol Rev 2023; 103:102297. [PMID: 37290244 DOI: 10.1016/j.cpr.2023.102297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/18/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023]
Abstract
The present meta-analytic study examined the association between alexithymia and psychoactive substance use. Studies published from 1988 to August 20, 2022 were identified by a systematic search and 168 eligible studies were included in five meta-analyses. Results showed that (1) the correlation between substance use and alexithymia is small but significant (r = 0.177); (2) substance users have substantially higher alexithymia than nonusers (g = 0.545); (3) alexithymic participants have significantly but slightly higher levels of substance use than non-alexithymics (g = 0.242); (4) substance users are significantly but only slightly more likely to be alexithymic than nonusers (OR = 2.392); and (5) alexithymic individuals are not more likely to be substance users than non-alexithymics. Larger effects were observed among samples diagnosed with substance use disorder (SUD), and the use of depressants, alcohol, opiates, and illicit stimulants had stronger relation to alexithymia. We found a tendency for a larger association with problematic use as compared to other indicators (e.g., frequency and duration) of substance use. Among the components of alexithymia, difficulties in identifying feelings has the strongest association with substance use. Our findings support clinical practice by suggesting the improvement of emotion regulation in SUD.
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Affiliation(s)
- Bernadette Kun
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Pelin Alpay
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Viktória Bodó
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Ágnes Molnár
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Andrea Horváth
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Szilvia Karsai
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Róza Sára Somlai
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsofia K Takacs
- School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Gyöngyi Kökönyei
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; SE-NAP2 Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary; Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
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Lorenzetti V, Gaillard A, Beyer E, Kowalczyk M, Kamboj SK, Manning V, Gleeson J. Do mindfulness-based interventions change brain function in people with substance dependence? A systematic review of the fMRI evidence. BMC Psychiatry 2023; 23:407. [PMID: 37286936 DOI: 10.1186/s12888-023-04789-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/14/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Substance use disorders (SUDs) affect ~ 35 million people globally and are associated with strong cravings, stress, and brain alterations. Mindfulness-based interventions (MBIs) can mitigate the adverse psychosocial outcomes of SUDs, but the underlying neurobiology is unclear. Emerging findings were systematically synthesised from fMRI studies about MBI-associated changes in brain function in SUDs and their associations with mindfulness, drug quantity, and craving. METHODS PsycINFO, Medline, CINAHL, PubMed, Scopus, and Web of Science were searched. Seven studies met inclusion criteria. RESULTS Group by time effects indicated that MBIs in SUDs (6 tobacco and 1 opioid) were associated with changes in the function of brain pathways implicated in mindfulness and addiction (e.g., anterior cingulate cortex and striatum), which correlated with greater mindfulness, lower craving and drug quantity. CONCLUSIONS The evidence for fMRI-related changes with MBI in SUD is currently limited. More fMRI studies are required to identify how MBIs mitigate and facilitate recovery from aberrant brain functioning in SUDs.
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Affiliation(s)
- Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Level 5 Daniel Mannix Building, 115 Victoria Parade, Fitzroy, VIC, 3065, Australia.
| | - Alexandra Gaillard
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Level 5 Daniel Mannix Building, 115 Victoria Parade, Fitzroy, VIC, 3065, Australia
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | - Emillie Beyer
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Level 5 Daniel Mannix Building, 115 Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Magdalena Kowalczyk
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Level 5 Daniel Mannix Building, 115 Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Sunjeev K Kamboj
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Victoria Manning
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
- Turning Point, Eastern Health, Monash University, Melbourne, Australia
| | - John Gleeson
- Digital Innovations in Mental Health and Well-being Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
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Koenig HG. Person-Centered Mindfulness: A Culturally and Spiritually Sensitive Approach to Clinical Practice. JOURNAL OF RELIGION AND HEALTH 2023; 62:1884-1896. [PMID: 36823258 DOI: 10.1007/s10943-023-01768-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Mindfulness meditation is rapidly being integrated into many different forms of counseling and psychotherapy, and there is a growing evidence base for its effectiveness. It is important to understand the spiritual roots of mindfulness, and to apply it in a patient-centered manner, sensitive to the patient's own faith tradition rather than taking a one-size-fits-all approach, assuming that mindfulness-based practice is a purely secular approach. The philosophical underpinning of mindfulness lies squarely in the Buddhist faith tradition. Indeed, mindfulness is the 7th step on the Eightfold Path, which is the heart of Buddhist teachings. Many practitioners, however, may not realize that there are Western meditative techniques that are very similar to mindfulness and that have deep roots within Christian, Jewish, and Muslim faith traditions. Patient-centered mindfulness involves the use of mindfulness and other meditation methods that are based on the patient's own faith tradition, rather than applying Eastern forms of mindfulness claiming these are a secular approach appropriate for everyone regardless of religious beliefs, even if those beliefs are not consistent with the Buddhist religious or philosophical approach. In this article, I briefly examine the evidence for the clinical effectiveness of mindfulness meditation, and then go into greater depth on Hindu, Buddhist, Christian, Jewish, and Muslim forms of mindfulness or similar meditative practices, providing resources that will better equip clinicians and researchers to provide patient-centered culturally-sensitive care.
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Affiliation(s)
- Harold G Koenig
- Departments of Psychiatry and Medicine, Duke University Health System, Durham, NC, 27705, USA.
- Division of Psychiatry, Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
- School of Public Health, Ningxia Medical University, Yinchuan, People's Republic of China.
- Department of Psychiatry, Shiraz University of Medical Sciences, Shiraz, Iran.
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Davis JP, Pedersen ER, Borsari B, Bowen S, Owen J, Sedano A, Fitzke R, Delacruz J, Tran DD, Buch K, Saba S, Canning L, Bunyi J. Development of a mobile mindfulness smartphone app for post-traumatic stress disorder and alcohol use problems for veterans: Beta test results and study protocol for a pilot randomized controlled trial. Contemp Clin Trials 2023; 129:107181. [PMID: 37059261 PMCID: PMC10225328 DOI: 10.1016/j.cct.2023.107181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/04/2023] [Accepted: 04/08/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) are highly prevalent, and co-occurring among post-9/11 veterans. Mobile health (mHealth) applications, specifically those focused on mindfulness-based techniques, may be an effective avenue to intervene with veterans who cannot or will not seek care at traditional in-person settings. Thus, to address areas of improvement in mHealth for veterans, we developed Mind Guide and prepared it for testing in a pilot randomized controlled trial (RCT) with veterans. METHODS We have completed phase 1 (treatment development) and Phase 2 (beta test) of our mobile mHealth app, Mind Guide. In this paper we describe the methods for Phase 1 as well as results for our beta test (n = 16; inclusion criteria included screen for PTSD, AUD, a post-9/11 veteran, and not currently receiving treatment) for Mind Guide as well as outline procedures for our pilot RCT of Mind Guide (Phase 3). The PTSD Checklist, self-reported alcohol use, the Perceived Stress Scale, Penn Alcohol Craving Scale, and the Emotion Regulation Questionnaire were used. RESULTS Results of our beta test of Mind Guide show promising past 30 day effects on PTSD (d = -1.12), frequency of alcohol use (d = -0.54), and alcohol problems (d = -0.44), and related mechanisms of craving (d = -0.53), perceived stress (d = -0.88), and emotion regulation (d = -1.22). CONCLUSION Our initial beta-test of Mind Guide shows promise for reducing PTSD and alcohol related problems among veterans. Recruitment is ongoing for our pilot RCT in which 200 veterans will be recruited and followed up for 3 months. CLINICALTRIALS gov Identifier: NCT04769986.
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Affiliation(s)
- Jordan P Davis
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA.
| | - Eric R Pedersen
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, Los Angeles, CA, USA
| | - Brian Borsari
- Mental Health Service, San Francisco VA Health Care System, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | | | - Jason Owen
- National Center for PTSD, Veteran Affairs Palo Alto Healthcare System, Palo Alto, CA, USA
| | - Angeles Sedano
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA
| | - Reagan Fitzke
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, Los Angeles, CA, USA
| | - Joannalyn Delacruz
- Mental Health Service, San Francisco VA Health Care System, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Denise D Tran
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, Los Angeles, CA, USA
| | - Keegan Buch
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, Los Angeles, CA, USA
| | - Shaddy Saba
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA
| | - Liv Canning
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA
| | - John Bunyi
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Los Angeles, CA, USA
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Franco Corso SJ, O'Malley K, Subaiya S, Mayall D, Dakwar E. The role of non-ordinary states of consciousness occasioned by mind-body practices in mental health illness. J Affect Disord 2023; 335:166-176. [PMID: 37150220 DOI: 10.1016/j.jad.2023.04.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/13/2023] [Accepted: 04/29/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Research with hallucinogens suggests that non-ordinary states of consciousness (NOSCs), particularly mystical-type experiences, predict improvements in various affective disorders and substance use disorders (SUDs). Little is known, however, about the therapeutic potential of NOSCs induced by mind-body practices such as meditation, yoga and breathwork. METHODS We conducted a literature review in online databases (PubMed, Scopus, Google Scholar) and preprint databases (SSRN, bioRxiv) to identify studies of NOSCs induced by mind-body practices and their effects in affective disorders and SUDs. RESULTS A wide variety of mind-body practices involving physical movement (i.e., shamanic drumming, yoga) and hyper-focused immersive mental experiences (i.e., meditation, breathwork) have been reported in the literature. Preliminary evidence, mostly from qualitative studies and open label studies, suggest that mind-body practices produce NOSCs. Such experiences have been associated with short-term reduced levels of anxiety and depression, increased motivation to quit addictive behaviors, and enhanced self-awareness and spiritual well-being. LIMITATIONS Findings are limited by the scarcity of literature in this field. Further rigorous and methodologically sound empirical research is needed, including comparative studies of NOSCs occasioned by different methods. CONCLUSIONS Mind-body practices may represent a promising approach for treating mental health disorders. The NOSCs induced by such practices may lead to beneficial shifts in perceptions, values, beliefs, and behaviors. Given the challenges with hallucinogen-based therapies, mind-body practices may represent a more accessible and acceptable way of eliciting potentially helpful NOSCs in clinical practice.
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Affiliation(s)
- Silvia J Franco Corso
- Department of Psychiatry, Columbia University Vangelos College of Physicians and Surgeons, New York, NY, United States of America; Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America.
| | - Kate O'Malley
- Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America
| | - Saleena Subaiya
- Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America
| | - Danielle Mayall
- Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America
| | - Elias Dakwar
- Department of Psychiatry, Columbia University Vangelos College of Physicians and Surgeons, New York, NY, United States of America; Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America
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Verdejo-Garcia A, Rezapour T, Giddens E, Khojasteh Zonoozi A, Rafei P, Berry J, Caracuel A, Copersino ML, Field M, Garland EL, Lorenzetti V, Malloy-Diniz L, Manning V, Marceau EM, Pennington DL, Strickland JC, Wiers R, Fairhead R, Anderson A, Bell M, Boendermaker WJ, Brooks S, Bruno R, Campanella S, Cousijn J, Cox WM, Dean AC, Ersche KD, Franken I, Froeliger B, Gamito P, Gladwin TE, Goncalves PD, Houben K, Jacobus J, Jones A, Kaag AM, Lindenmeyer J, McGrath E, Nardo T, Oliveira J, Pennington CR, Perrykkad K, Piercy H, Rupp CI, Schulte MHJ, Squeglia LM, Staiger P, Stein DJ, Stein J, Stein M, Stoops WW, Sweeney M, Witkiewitz K, Woods SP, Yi R, Zhao M, Ekhtiari H. Cognitive training and remediation interventions for substance use disorders: a Delphi consensus study. Addiction 2023; 118:935-951. [PMID: 36508168 PMCID: PMC10073279 DOI: 10.1111/add.16109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022]
Abstract
AIMS Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training and remediation interventions are well suited to fill the gap for managing cognitive deficits in SUD. We aimed to reach consensus on recommendations for developing and applying these interventions. DESIGN, SETTING AND PARTICIPANTS We used a Delphi approach with two sequential phases: survey development and iterative surveying of experts. This was an on-line study. During survey development, we engaged a group of 15 experts from a working group of the International Society of Addiction Medicine (Steering Committee). During the surveying process, we engaged a larger pool of experts (n = 54) identified via recommendations from the Steering Committee and a systematic review. MEASUREMENTS Survey with 67 items covering four key areas of intervention development: targets, intervention approaches, active ingredients and modes of delivery. FINDINGS Across two iterative rounds (98% retention rate), the experts reached a consensus on 50 items including: (i) implicit biases, positive affect, arousal, executive functions and social processing as key targets of interventions; (ii) cognitive bias modification, contingency management, emotion regulation training and cognitive remediation as preferred approaches; (iii) practice, feedback, difficulty-titration, bias modification, goal-setting, strategy learning and meta-awareness as active ingredients; and (iv) both addiction treatment work-force and specialized neuropsychologists facilitating delivery, together with novel digital-based delivery modalities. CONCLUSIONS Expert recommendations on cognitive training and remediation for substance use disorders highlight the relevance of targeting implicit biases, reward, emotion regulation and higher-order cognitive skills via well-validated intervention approaches qualified with mechanistic techniques and flexible delivery options.
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Affiliation(s)
- Antonio Verdejo-Garcia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Tara Rezapour
- Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran
| | - Emily Giddens
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Arash Khojasteh Zonoozi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Parnian Rafei
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Jamie Berry
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, NSW, Australia
| | - Alfonso Caracuel
- Mind, Brain and Behavior Research Center, Universidad de Granada, Granada, Spain
| | | | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Eric L Garland
- Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City, UT, USA
| | - Valentina Lorenzetti
- Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioral Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Leandro Malloy-Diniz
- Mental Health Department, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Victoria Manning
- Turning Point Drug and Alcohol Centre and Monash Addiction Research Centre (MARC), Monash University, Melbourne, VIC, Australia
| | - Ely M Marceau
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - David L Pennington
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Reinout Wiers
- Addiction Development and Psychopathology (ADAPT) Laboratory, Department of Psychology, Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands
| | - Rahia Fairhead
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Alexandra Anderson
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Morris Bell
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Wouter J Boendermaker
- Addiction, Development, and Psychopathology (ADAPT) Laboratory, Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Samantha Brooks
- Research Centre for Brain and Behaviour, School of Psychology, Faculty of Health, Liverpool John Moores University, UK
| | - Raimondo Bruno
- School of Psychology, University of Tasmania, TAS, Hobart, Australia
| | - Salvatore Campanella
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles, Bruxelles, Belgium
| | - Janna Cousijn
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, the Netherlands
| | - W Miles Cox
- School of Human and Behavioural Sciences, Bangor University, Bangor, UK
| | - Andrew C Dean
- Department of Psychiatry and Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, CA, USA
| | - Karen D Ersche
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Ingmar Franken
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, the Netherlands
| | - Brett Froeliger
- Department of Psychiatry and Psychological Sciences, University of Missouri, Columbia, MO, USA
| | | | | | - Priscila D Goncalves
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Katrijn Houben
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Joanna Jacobus
- Department of Psychiatry, University of California San Diego, CA, USA
| | - Andrew Jones
- Department of Psychology, University of Liverpool, UK
| | - Anne M Kaag
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
| | | | - Elly McGrath
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Talia Nardo
- School of Psychological Sciences, Macquarie University, NSW, Australia
| | | | | | - Kelsey Perrykkad
- Cognition and Philosophy Laboratory, Monash Centre for Consciousness and Contemplative Studies, Monash University, Melbourne, VIC, Australia
| | - Hugh Piercy
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Claudia I Rupp
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Clinics of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Mieke H J Schulte
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Lindsay M Squeglia
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Petra Staiger
- School of Psychology, Deakin University, Melbourne, VIC, Australia
| | - Dan J Stein
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Jeff Stein
- Center for Health Behaviors Research, Fralin Biomedical Research Institute at Virginial Tech, VA, USA
| | - Maria Stein
- Department for Clinical Psychology and Psychotherapy, University of Bern, Switzerland
| | - William W Stoops
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
| | - Mary Sweeney
- Behavioral Pharmacology Research Unit, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Katie Witkiewitz
- Department of Psychology and Center on Alcohol, Substance Use and Addictions, University of New Mexico, NM, USA
| | - Steven P Woods
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Richard Yi
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Min Zhao
- Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hamed Ekhtiari
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
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Verma S. Substance Use Disorders and Role of Complementary and Integrative Medicine/Functional Medicine. Child Adolesc Psychiatr Clin N Am 2023; 32:217-241. [PMID: 37147038 DOI: 10.1016/j.chc.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Substance use disorders are a growing concern for all ages, including adolescents. Even though there is an increase in recreational substance use and a wider variety of drugs is available to this young population, treatment options remain scarce. Most medications have limited evidence in this population. Few specialists treat individuals struggling with addiction along with mental health disorders. As the evidence grows, these treatments are usually included in complementary and integrative medicine. This article discusses available evidence for many complementary and integrative treatment approaches while briefly describing existing psychotherapeutic and psychotropic medications.
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Affiliation(s)
- Shikha Verma
- Evolve-PC Residential Treatment Centers, CA; Department of Psychiatry and Behavioral Health, Rosalind Franklin University of Medicine and Science, IL.
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41
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Esteban J, Suárez-Relinque C, Jiménez TI. Effects of family therapy for substance abuse: A systematic review of recent research. FAMILY PROCESS 2023; 62:49-73. [PMID: 36564902 DOI: 10.1111/famp.12841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/29/2022] [Accepted: 11/02/2022] [Indexed: 06/17/2023]
Abstract
One of the most serious psychosocial problems worldwide is substance abuse because of its repercussions not only on the physical and psychological health of the abuser but also on their relational functioning. Among the well-established therapeutic approaches for the treatment of substance abuse is family therapy, which, in addition to influencing personal variables, promotes changes in family dynamics. The main objective of this study is to review the scientific literature published from 2010 to the present on the efficacy and effectiveness shown by family-based treatment approaches for substance use problems both in adolescent and adult samples. In addition, the effect on secondary variables such as family functioning and behavioral problems is evaluated. The empirical evidence accumulated in the last decade and reviewed in the present study indicates that the incorporation of family members in the treatment of substance abuse produces benefits by diminishing consumption and improving family functioning. Limitations of this study and of the research reviewed are discussed and directions for future research are provided.
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Affiliation(s)
- Jessica Esteban
- Facultad de Ciencias Sociales y Humanas, Campus de Teruel, Universidad de Zaragoza, Teruel, Spain
| | | | - Teresa I Jiménez
- Facultad de Ciencias Sociales y Humanas, Campus de Teruel, Universidad de Zaragoza, Teruel, Spain
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42
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LaBelle O, Hastings M, Vest N, Meeks M, Lucier K. The role of mindfulness, meditation, and peer support in recovery capital among Recovery Dharma members. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 145:208939. [PMID: 36880913 PMCID: PMC9992926 DOI: 10.1016/j.josat.2022.208939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/31/2022] [Accepted: 12/30/2022] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Recovery Dharma (RD) is a Buddhist-based peer support program for the treatment of addiction that incorporates mindfulness and meditation into meetings, program literature, and the recovery process, creating the opportunity to study these variables in a peer-support program context. Mindfulness and meditation are beneficial for people in recovery, yet we know little about their relationship to recovery capital, a positive indicator of recovery outcomes. We explored mindfulness and meditation (average length of sessions and average frequency per week) as predictors of recovery capital and examined perceived support in relation to recovery capital. METHODS The study recruited participants (N = 209) through the RD website, newsletter and social media pages for an online survey that included measures of recovery capital, mindfulness, perceived support, and questions about meditation practices (e.g., frequency, duration). Participants' mean age was 46.68 years (SD = 12.21), with 45 % female (5.7 % non-binary), and 26.8 % from the LGBTQ2S+ community. The mean time in recovery was 7.45 years (SD = 10.37). The study fitted univariate and multivariate linear regression models to determine significant predictors of recovery capital. RESULTS As anticipated, multivariate linear regressions indicated that mindfulness (β = 0.31, p < .001), meditation frequency (β = 0.26, p < .001), and perceived support from RD (β = 0.50, p < .001) were all significant predictors of recovery capital when controlling for age and spirituality. However, longer time in recovery and the average duration of meditation sessions did not predict recovery capital as anticipated. CONCLUSIONS Results indicate the importance of a regular meditation practice for recovery capital rather than engaging in prolonged sessions infrequently. The results also support previous findings, which point to the influence of mindfulness and meditation on positive outcomes for people in recovery. Further, peer support is associated with higher recovery capital in RD members. This study is the first examination of the relationship between mindfulness, meditation, peer support, and recovery capital in recovering people. The findings lay the groundwork for the continued exploration of these variables as they relate to positive outcomes both within the RD program and in other recovery pathways.
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Affiliation(s)
- Onawa LaBelle
- Department of Psychology, University of Windsor, Canada.
| | | | - Noel Vest
- School of Medicine, Stanford University, United States of America
| | - Matthew Meeks
- Department of Psychology, University of Windsor, Canada
| | - Krista Lucier
- Department of Psychology, University of Windsor, Canada
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Hamonniere T, Billieux J. Individually delivered mindfulness-based cognitive therapy in concomitant problematic substance use and emotional symptoms: A process-based case study. Clin Psychol Psychother 2023. [PMID: 36639943 DOI: 10.1002/cpp.2827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 12/21/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
The process-based approach assumes that transdiagnostic psychological processes are involved in the onset and maintenance of mental disorders. Case conceptualization is used to identify such psychological processes and to individualize the intervention accordingly. This approach is fundamentally different from syndrome-based approaches in which standardized treatments are administered for psychiatric diagnoses or symptoms. In the current case, we proposed a process-based conceptualization and treatment for a woman with concomitant problematic substance use and emotional symptoms. Our idiosyncratic process-based conceptualization showed that for this person, substance abuse consisted in a maladaptive coping strategy to deal with repetitive negative thinking and poor emotion regulation skills, for which we decided to use a mindfulness-based intervention. Treatment comprised 8 weeks of individually delivered mindfulness-based cognitive therapy sessions. A comprehensive assessment of psychiatric symptoms and psychological processes was conducted at baseline, post-intervention and 3-month follow-up. The post-treatment assessment revealed that psychological processes targeted by the intervention were improved, together with the mindfulness trait. At the symptom-based level, we observed a significant reduction in substance abuse and emotional symptoms. Treatment gains were maintained at follow-up. From a process-based perspective, this result implies that the intervention successfully targeted the psychological processes underlying the presenting symptoms. Adopting a process-based approach rather than symptom- or syndrome-based approaches is a valuable alternative in the conceptualization and treatment of complex cases presenting with multiple comorbidities.
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Affiliation(s)
| | - Joël Billieux
- Institute of Psychology, University of Lausanne (UNIL), Lausanne, Switzerland.,Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
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44
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Rosenthal A, Garbusow M, Romanczuk-Seiferth N, Beck A. Effects of a brief mindfulness meditation practice on Pavlovian-to-instrumental transfer in alcohol use disorder - a pilot study. Front Psychiatry 2023; 14:1134458. [PMID: 37168079 PMCID: PMC10164967 DOI: 10.3389/fpsyt.2023.1134458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/04/2023] [Indexed: 05/13/2023] Open
Abstract
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.
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Affiliation(s)
- Annika Rosenthal
- Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, Charité – Berlin University of Medicine, Berlin, Germany
- Department of Social and Preventive Medicine, University of Potsdam, Potsdam, Germany
- *Correspondence: Annika Rosenthal,
| | - Maria Garbusow
- Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, Charité – Berlin University of Medicine, Berlin, Germany
| | - Nina Romanczuk-Seiferth
- Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, Charité – Berlin University of Medicine, Berlin, Germany
- Department of Psychology, Clinical Psychology and Psychotherapy, MSB Medical School Berlin, Berlin, Germany
| | - Anne Beck
- Faculty of Health Sciences, Health and Medical University, University of Potsdam, Potsdam, Germany
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45
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Rosenthal A, Ebrahimi C, Wedemeyer F, Romanczuk-Seiferth N, Beck A. The Treatment of Substance Use Disorders: Recent Developments and New Perspectives. Neuropsychobiology 2022; 81:451-472. [PMID: 35724634 DOI: 10.1159/000525268] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 04/28/2022] [Indexed: 11/19/2022]
Abstract
Substance-related disorders are complex psychiatric disorders that are characterized by continued consumption in spite of harmful consequences. Addiction affects various brain networks critically involved in learning, reward, and motivation, as well as inhibitory control. Currently applied therapeutic approaches aim at modification of behavior that ultimately leads to decrease of consumption or abstinence in individuals with substance use disorders. However, traditional treatment methods might benefit from recent neurobiological and cognitive neuroscientific research findings. Novel cognitive-behavioral approaches in the treatment of addictive behavior aim at enhancement of strategies to cope with stressful conditions as well as craving-inducing cues and target erroneous learning mechanisms, including cognitive bias modification, reconsolidation-based interventions, mindfulness-based interventions, virtual-reality-based cue exposure therapy as well as pharmacological augmentation strategies. This review discusses therapeutic strategies that target dysregulated neurocognitive processes associated with the development and maintenance of disordered substance use and may hold promise as effective treatments for substance-related disorders.
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Affiliation(s)
- Annika Rosenthal
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia Ebrahimi
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Friederike Wedemeyer
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nina Romanczuk-Seiferth
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Anne Beck
- Department of Psychiatry and Neurosciences
- CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Health and Medical University, Campus Potsdam, Faculty of Health, Potsdam, Germany
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Félix-Junior IJ, Donate APG, Noto AR, Galduróz JCF, Simionato NM, Opaleye ES. Mindfulness-based interventions in inpatient treatment for Substance Use Disorders: A systematic review. Addict Behav Rep 2022; 16:100467. [PMID: 36425879 PMCID: PMC9679543 DOI: 10.1016/j.abrep.2022.100467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/21/2022] [Accepted: 10/30/2022] [Indexed: 11/13/2022] Open
Abstract
Inpatient treatment for Substance Use Disorder (SUD), such as Therapeutic Communities and Residential Treatment has been used to test the effect of Mindfulness-Based Interventions (MBI) over different outcomes. Although there is evidence of the effectiveness of MBIs, little is known about the particularities that the place may have in the outcomes. The main objective of this Systematic Review was to evaluate the effectiveness of MBIs for SUDs performed in the inpatient context. PubMed, Web of Science and PsycInfo were used for the search. Quantitative and qualitative studies with no control, usual treatment or other active comparator intervention for SUDs inpatient treatment from 1980 to 2020 were included. From 21 selected studies, 18 were quantitative and 3 qualitative; 12 studies were RCT. Most samples were comprised with women. Based on characteristics of outcomes, we were able to divide them into: Substance Use and Associated Outcomes, Stress, Impulsivity e Evaluation of the MBI protocol. Results suggest that stress assessment is a determining factor for treatment success in these settings. Regarding substance use, although several outcomes have been assessed, the most remarkable results were craving reduction and improvement in treatment adherence. There is evidence that MBIs in inpatient settings benefited those who participated in the experimental groups on some outcomes, such as stress and substance use. Little is mentioned about the impact of the environment over the outcomes and short follow-ups were a relevant limitation of most of the studies. Future assessments must increase follow-up time and evaluate the relationship between the context and the MBI.
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Affiliation(s)
- Itamar José Félix-Junior
- Research Center on Health and Substance Use, Psychobiology Department, Universidade Federal de São Paulo, Brazil
| | - Ana Paula G Donate
- Research Center on Health and Substance Use, Psychobiology Department, Universidade Federal de São Paulo, Brazil
| | - Ana Regina Noto
- Research Center on Health and Substance Use, Psychobiology Department, Universidade Federal de São Paulo, Brazil
| | | | | | - Emérita Sátiro Opaleye
- Research Center on Health and Substance Use, Psychobiology Department, Universidade Federal de São Paulo, Brazil
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Maynes TD, Nishikawara RK. Career counseling as relapse prevention: A theoretical look at social cognitive career theory in supporting recovery from substance use. JOURNAL OF EMPLOYMENT COUNSELING 2022. [DOI: 10.1002/joec.12202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
- Teresa D. Maynes
- Department of Educational & Counselling Psychology and Special Education University of British Columbia Vancouver Canada
| | - Ria K. Nishikawara
- Department of Educational & Counselling Psychology and Special Education University of British Columbia Vancouver Canada
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Nowakowski-Sims E, Ferrante S. Perspectives of Integrative Body-Mind-Spirit Interventions Among Women with Substance Use Disorder: A Qualitative Study. ALCOHOLISM TREATMENT QUARTERLY 2022. [DOI: 10.1080/07347324.2022.2145924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Stephen Ferrante
- School of Social Work, Barry University, Miami Shores, Florida, USA
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49
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Garland EL, Hanley AW, Hudak J, Nakamura Y, Froeliger B. Mindfulness-induced endogenous theta stimulation occasions self-transcendence and inhibits addictive behavior. SCIENCE ADVANCES 2022; 8:eabo4455. [PMID: 36223472 PMCID: PMC9555770 DOI: 10.1126/sciadv.abo4455] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 08/24/2022] [Indexed: 05/26/2023]
Abstract
Self-regulation is instantiated by theta oscillations (4 to 8 Hz) in neurons of frontal midline brain regions. Frontal midline theta (FMΘ) is inversely associated with default mode network (DMN) activation, which subserves self-referential processing. Addiction involves impaired self-regulation and DMN dysfunction. Mindfulness is an efficacious self-regulatory practice for treating addiction, but little is known about the mechanisms by which mindfulness reduces addictive behavior. In this mechanistic study of long-term opioid users (N = 165), we assessed meditation-induced FMΘ as a mediator of changes in opioid misuse. Relative to a supportive psychotherapy control, participants treated with Mindfulness-Oriented Recovery Enhancement (MORE) exhibited increased FMΘ during a laboratory-based meditation session. FMΘ during meditation was associated with self-transcendent experiences characterized by ego dissolution, nondual awareness, and bliss. MORE's effects on decreasing opioid misuse were mediated by increased FMΘ. Given the role of aberrant self-referential processing in addiction, mindfulness-induced endogenous theta stimulation might "reset" DMN dysfunction to inhibit addictive behavior.
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Affiliation(s)
- Eric L. Garland
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Salt Lake City, UT, USA
- Veterans Health Care Administration VISN 19 Whole Health Flagship site located at the VA Salt Lake City Health Care System, Salt Lake City, UT, USA
| | - Adam W. Hanley
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Salt Lake City, UT, USA
| | - Justin Hudak
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Salt Lake City, UT, USA
| | - Yoshio Nakamura
- Department of Anesthesiology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Brett Froeliger
- Department of Psychology, University of Missouri, Columbia, MO, USA
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Yang MJ, Ketcher D, Witkiewitz K, Unrod M, Baban S, Wetter DW, Vinci C. What Happens When You Smoke a Cigarette Mindfully? A Deductive Qualitative Study. Mindfulness (N Y) 2022; 13:2628-2640. [PMID: 37692535 PMCID: PMC10488318 DOI: 10.1007/s12671-022-01984-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 10/14/2022]
Abstract
Objectives The mindful smoking exercise instructs participants to pay attention to a range of experiences while smoking a cigarette with the expectation that it will modify the often automatic process of smoking. Given its theoretical value, mindfulness- and acceptance and commitment therapy-based smoking cessation interventions have usually included a mindful smoking exercise. However, its utility has not been empirically examined. Through qualitative analyses, the current study examined smokers' lived experience with mindful smoking during an 8-week telehealth group-based smoking cessation and alcohol modification trial. Method Participants were smokers who were present in group during the mindful smoking exercise. The recordings of sessions and follow-up interviews in which discussion on mindful smoking took place were transcribed and hand-coded for qualitative analysis. A thematic content analytic approach was used to identify themes. Results Participants (N=20) were 75% female (mean age=49.75, average cigarettes per day=16.35). Identified themes mapped onto both the theoretical rationale for mindful smoking (e.g., attention/awareness, decentering, similarity/difference between mindful versus automatic smoking) and cognitive-affective-behavioral responses (e.g., unpleasant/pleasant experience, shifts in desire to smoke, cognitive reappraisal). The most prominent themes were attention/awareness, similarity/difference between mindful versus automatic smoking, and unpleasant/pleasant experience; Dynamic interplay between themes was also observed and representative quotes are included. Conclusions Our findings indicate that intentionally paying attention to smoking led to the reporting of a heightened awareness of automatic behavior accompanied by noticing unpleasant aspects of smoking, potentially facilitating change in one's relationship to smoking. Theoretical implications of mindful smoking in the context of addiction are discussed.
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Affiliation(s)
- Min-Jeong Yang
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Dana Ketcher
- University of Minnesota Medical School, Duluth Campus, Duluth, MN, USA
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, NM, USA
- Center on Alcohol, Substance Use & Addictions, University of New Mexico, Albuquerque, NM, USA
| | - Marina Unrod
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Sana Baban
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - David W. Wetter
- Department of Population Health Sciences and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Christine Vinci
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
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