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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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Carney LM, Park CL, Russell B. Alcohol-related Consequences: Factor Structure and Associations With Trait Mindfulness and Drinking Motivations. Int J Behav Med 2024:10.1007/s12529-024-10300-7. [PMID: 38834911 DOI: 10.1007/s12529-024-10300-7] [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] [Accepted: 05/20/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND This study aimed to determine if motivations to use alcohol (coping and social motivations) mediate the relationship between trait mindfulness and a variety of alcohol-related consequences and to determine if the relationship between motivations to use alcohol and alcohol-related consequences is moderated by alcohol use. We determined the factor structure of positive and negative consequences of alcohol use and used this structure as outcomes across eight moderated mediation models. METHODS Data were obtained from 296 undergraduate students to confirm the alcohol-related consequences factor structure and to test eight moderated-mediation models. RESULTS Four alcohol-related consequences scales (romantic/sexual, positive, mild negative, and severe negative consequences) were confirmed. The motive of drinking to cope significantly mediated the relationship between trait mindfulness and all four of the alcohol-related consequences scales. Drinking to socialize did not significantly mediate the relationship between trait mindfulness and all of the alcohol-related consequences scales. CONCLUSIONS The identified four-factor structure suggests that alcohol-related consequences should be assessed in a more specific manner. Additionally, different motivations for alcohol use relate differentially to trait mindfulness and different alcohol-related consequences; drinking to cope is particularly problematic for this population. Future research on the usefulness of promoting mindfulness to reduce problematic drinking appears warranted.
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Affiliation(s)
- Lauren M Carney
- Dept. of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Crystal L Park
- Dept. of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA
| | - Beth Russell
- Dept. of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA
- Dept. of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Rd, Storrs, USA
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Gústafsson BJ, Puljević C, Davies EL, Barratt MJ, Ferris J, Winstock A, Piatkowski T. Sweating for Sobriety: Exploring the Relationship Between Exercise Engagement and Substance Use Disorders. J Psychoactive Drugs 2024:1-11. [PMID: 38299228 DOI: 10.1080/02791072.2024.2311143] [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: 09/12/2023] [Accepted: 01/08/2024] [Indexed: 02/02/2024]
Abstract
Despite various interventions available for substance use disorders, relapse rates remain substantial and, therefore, alternative strategies for attenuating dependence are needed. This study examined the associations between exercise frequency, illicit substance use, and dependence severity among a large sample of people who use drugs. The study utilized data from the Global Drug Survey 2018 (N = 57,110) to investigate the relationship between exercise frequency, illicit substance use, and substance dependence severity. Binomial regressions were employed to examine the relationship between exercise and SDS scores for 9 drugs. Greater exercise frequency correlated with reduced severity of substance dependence for specific drugs: cannabis (χ2 = 14.75, p < .001), MDMA (χ2 = 4.73, p = .029), cocaine (χ2 = 8.37, p = .015), amphetamine powder (χ2 = 6.39, p = .041), and methamphetamine (χ2 = 15.17, p < .001). These findings suggest a potential link between exercise and reduced substance use dependency. Further research is needed to understand the complex dynamics between exercise and substance use, considering potential bidirectional relationships and concurrent factors.
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Affiliation(s)
- Baldur Jón Gústafsson
- School of Law, Department of Criminology and Sociology, Middlesex University, London, UK
| | - Cheneal Puljević
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Emma L Davies
- Centre for Psychological Research, Oxford Brookes University, Oxford, UK
| | - Monica J Barratt
- Social and Global Studies Centre and Digital Ethnography Research Centre, RMIT University, Melbourne, Australia
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Jason Ferris
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Adam Winstock
- South London and Maudsley NHS Trust/Kings College London, London, UK
- Global Drug Survey, London, UK
| | - Timothy Piatkowski
- School of Applied Psychology, Griffith University, Mount Gravatt, Australia
- Griffith Centre for Mental Health, Griffith University, Brisbane, Australia
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Herczyk JM, Zullig KJ, Davis SM, Mallow J, Hobbs GR, Davidov DM, Lander LR, Theeke L. Association of Loneliness and Mindfulness in Substance Use Treatment Retention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6571. [PMID: 37623157 PMCID: PMC10454177 DOI: 10.3390/ijerph20166571] [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: 06/30/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Elevated mental illness prevalence complicates efforts designed to address the opioid crisis in Appalachia. The recovery community acknowledges that loneliness impacts mood and engagement in care factors; however, the predictive relationship between loneliness and retention in medication-assisted outpatient treatment programs has not been explored. Our objectives were to identify associations between mental health factors and retention in treatment and elucidate treatment retention odds. Data were collected from eighty participants (n = 57 retained, n = 23 not retained) of a mindfulness-based relapse prevention (MBRP) intervention for individuals receiving medication for opioid use disorder (MOUD) in Appalachia. Loneliness, depression, and anxiety did not differ between the retained and not retained, nor did they predict not being retained; however, mindfulness was significantly lower among those not retained in treatment compared to those retained (OR = 0.956, 95% CI (0.912-1.00), and p < 0.05). Preliminary findings provide evidence for mindfulness training integration as part of effective treatment, with aims to further elucidate the effectiveness of mindfulness therapies on symptom reduction in co-occurring mental health disorders, loneliness, and MOUD treatment retention.
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Affiliation(s)
- Johnathan M. Herczyk
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA
| | - Keith J. Zullig
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA
| | - Stephen M. Davis
- Department of Health Policy, Management and Leadership, School of Public Health, West Virginia University, Morgantown, WV 26506, USA
| | - Jennifer Mallow
- School of Nursing, West Virginia University, Morgantown, WV 26506, USA
| | - Gerald R. Hobbs
- Department of Statistics, West Virginia University, Morgantown, WV 26506, USA
| | - Danielle M. Davidov
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA
| | - Laura R. Lander
- Department of Behavioral Medicine and Psychiatry, Rockefeller Neurosciences Institute, School of Medicine, West Virginia University, Morgantown, WV 26506, USA
| | - Laurie Theeke
- School of Nursing, The George Washington University, Washington, DC 20052, USA
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Denier N, Soravia LM, Moggi F, Stein M, Grieder M, Federspiel A, Kupper Z, Wiest R, Bracht T. Associations of thalamocortical networks with reduced mindfulness in alcohol use disorder. Front Psychiatry 2023; 14:1123204. [PMID: 37484679 PMCID: PMC10358776 DOI: 10.3389/fpsyt.2023.1123204] [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: 12/13/2022] [Accepted: 06/12/2023] [Indexed: 07/25/2023] Open
Abstract
Background Increased mindfulness is associated with reduced alcohol consumption in patients with alcohol use disorder (AUD) after residential treatment. However, the underlying neurobiological mechanism of mindfulness in AUD is unclear. Therefore, we investigate the structural and functional alterations of the thalamocortical system with a focus on the mediodorsal thalamic nucleus (MD-TN), the default mode and the salience network (DMN/SN) which has previously been associated with mindfulness in healthy subjects. We hypothesized lower mindfulness and reduced structural and functional connectivity (FC) of the thalamocortical system, particularly in the DMN/SN in AUD. We assumed that identified neurobiological alterations in AUD are associated with impairments of mindfulness. Methods Forty-five abstinent patients with AUD during residential treatment and 20 healthy controls (HC) were recruited. Structural and resting-state functional MRI-scans were acquired. We analysed levels of mindfulness, thalamic volumes and network centrality degree of the MD-TN using multivariate statistics. Using seed-based whole brain analyses we investigated functional connectivity (FC) of the MD-TN. We performed exploratory correlational analyses of structural and functional DMN/SN measurements with levels of mindfulness. Results In AUD we found significantly lower levels of mindfulness, lower bilateral thalamic and left MD-TN volumes, reduced FC between MD-TN and anterior cingulum/insula and lower network centrality degree of the left MD-TN as compared to HC. In AUD, lower mindfulness was associated with various reductions of structural and functional aspects of the MD-TN. Conclusion Our results suggest that structural and functional alterations of a network including the MD-TN and the DMN/SN underlies disturbed mindfulness in AUD.
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Affiliation(s)
- Niklaus Denier
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Leila M. Soravia
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
- Clinic Suedhang, Kirchlindach, Switzerland
| | - Franz Moggi
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Maria Stein
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Bern, Bern, Switzerland
| | - Matthias Grieder
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Andrea Federspiel
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Zeno Kupper
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
- Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland
| | - Tobias Bracht
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
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Gordon LT, Price L. State Mindfulness and Misinformation Susceptibility. Psychol Rep 2023:332941231164073. [PMID: 36947009 DOI: 10.1177/00332941231164073] [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: 03/23/2023]
Abstract
Two experiments examined whether brief mindful meditation exercises and belief in task utility impacted memory in the misinformation paradigm. Participants watched a fictionalized crime video, received post-event misinformation about the video, and completed a cued recall memory test. They were randomly assigned to complete either a brief mindfulness exercise or unrelated task prior to encoding the video (E1) or prior to the final cued recall test (E2). Further, half of the participants in each group were informed that their assigned task was beneficial to memory performance. In Experiment 1, information about task benefits reduced misinformation reports on the final recall test, regardless of the task. The brief mindfulness exercise increased self-reported mindfulness scores in both experiments. While no group differences in memory were found, correlational analyses across the two experiments suggest that individuals who achieve more intense states of mindfulness may have lower susceptibility to misinformation and better event memory when meditation occurs prior to encoding. The results suggest that brief mindfulness exercises can reliably increase state experiences of mindfulness and have potential for use as experimental manipulations. However, the intensity of a self-guided mindfulness experience can vary across individuals, so it is important to consider individual differences when considering the application of the exercises.
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Shrier LA, Harris SK. Associations of Momentary Mindfulness With Affect and Cannabis Desire in a Trial of Cannabis Use Interventions With and Without Momentary Assessment. J Adolesc Health 2023; 72:126-129. [PMID: 36272891 PMCID: PMC10870980 DOI: 10.1016/j.jadohealth.2022.09.002] [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: 03/07/2022] [Revised: 08/23/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Mindfulness, awareness resulting from attending to the present without judgment, has been associated with improved health. When considered as a time-varying momentary state, mindfulness is associated with other momentary states such as affect. We examined whether momentary mindfulness, specifically mindful attention and awareness (MAA), changed after counseling interventions to reduce cannabis use that included ecological momentary assessment (EMA) and explored associations with negative affect, positive affect, and cannabis desire. METHODS Outpatients 15-24 years using cannabis ≥3x/week were randomized to one of the three interventions, each including two motivational enhancement therapy (MET) sessions. For two interventions, MET was followed by 2 weeks of EMA (with/without messaging). Momentary MAA, negative affect, positive affect, and cannabis desire were assessed over 1 week of EMA at baseline and 3-month follow-up (N = 1,971 reports, 68 participants). We examined changes in momentary MAA from baseline to follow-up overall and by group (MET + EMA, MET-only) using generalized linear mixed effects models. We tested associations of momentary MAA with momentary affect and cannabis desire using generalized estimating equations. RESULTS Momentary MAA increased from baseline to follow-up after MET counseling plus EMA (β = 0.237), but did not change with MET counseling alone. Higher momentary MAA was associated with lower negative affect (β = -0.526) and cannabis desire (β = -0.521), but not with positive affect. DISCUSSION Among youth using cannabis frequently, momentary MAA was increased 3 months after interventions with EMA after counseling and was inversely associated with momentary negative affect and momentary cannabis desire. Mindfulness may be a useful target for momentary intervention.
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Affiliation(s)
- Lydia A Shrier
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
| | - Sion Kim Harris
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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