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Mindfulness-Oriented Recovery Enhancement remediates hedonic dysregulation in opioid users: Neural and affective evidence of target engagement

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Science Advances  16 Oct 2019:
Vol. 5, no. 10, eaax1569
DOI: 10.1126/sciadv.aax1569

Figures

  • Fig. 1 Experiment 1: Treatment effects on centroparietal LPP during opioid cue-reactivity.

    (A) Experiment 1: Treatment by time effects on centroparietal LPP during opioid cue-reactivity. (B) Experiment 1: Change in centroparietal LPP (in μV) index of opioid cue-reactivity (opioid cue − neutral cue) from pretreatment to posttreatment (n = 40).

  • Fig. 2 Experiment 2: Treatment effects on centroparietal LPP during down-regulation of opioid cue-reactivity.

    (A) Experiment 2: Treatment by time effects on centroparietal LPP during down-regulation of opioid cue-reactivity. (B) Experiment 2: Change in centroparietal LPP (in μV) index of regulation of opioid cue-reactivity (regulate-view) from pretreatment to posttreatment (n = 24).

  • Fig. 3 Experiment 3: Treatment effects on centroparietal LPP during up-regulation of natural reward.

    (A) Experiment 3. Treatment by time effects on centroparietal LPP during up-regulation of natural reward. (B) Experiment 3: Change in LPP (in μV) index of regulation of natural reward cue-reactivity (regulate − view) from pretreatment to posttreatment (n = 29).

  • Fig. 4 Experiment 4: Treatment effects on positive affect and craving ratings across view and regulate conditions of the natural reward cue-reactivity task.

    (A) Experiment 4: Change in positive affect ratings (log transformed) across view and regulate conditions of the natural reward cue-reactivity task from pretreatment to posttreatment (n = 64). (B) Experiment 4: Change in craving ratings (log-transformed) during up-regulation of natural reward cue-reactivity (regulate − view) from pretreatment to posttreatment (n = 64). (C) Experiment 4: Associations between treatment-related changes in positive affect reactivity and decreases in craving during up-regulation of responding to natural reward (n = 64). Note that several cases had identical change scores and are therefore represented by a single data point in the scatterplot.

  • Fig. 5 Path analysis demonstrating that the effect of MORE on reducing opioid misuse by 3-month follow-up is mediated by increased positive affective reactivity to natural reward cues.

Tables

  • Table 1 Demographic and clinical characteristics of the chronic opioid using samples (N = 135).

    MeasureSample 1 (n = 40)Sample 2 (n = 31)Sample 3 (n = 64)
    Age (mean ± SD)55.4 (11.1)57.8 (11.3)56.7 (10.9)
    Female, n (%)23 (57.5)4 (12.9)42 (65.6)
    Race, n (%)
      White or Caucasian36 (90.0)25 (80.6)53 (82.8)
      Hispanic or Latino1 (2.5)1 (3.2)3 (4.7)
      Black or African American01 (3.2)3 (4.7)
      Asian01 (3.2)0
      American Indian/Native Alaskan02 (6.5)0
      Native Hawaiian/Pacific Islander1 (2.5)01 (1.6)
      Other001 (1.6)
      Not reported2 (5)1 (3.2)3 (4.7)
    Primary pain location, n (%)
      Back pain22 (55.0)19 (61.3)30 (46.9)
      Hip/leg/foot pain3 (7.5)2 (6.4)8 (12.5)
      Joint pain3 (7.5)5 (16.1)6 (9.4)
      Neck/shoulder pain6 (15.0)1 (3.2)4 (6.3)
      Other pain location6 (15.0)4 (12.9)16 (25.0)
    Average pain severity (0–10)5.2 (1.5)5.26 (1.7)5.13 (1.5)
    Primary opioid type, n (%)
      Hydrocodone10 (25.0)8 (25.8)20 (31.3)
      Oxycodone8 (20.0)9 (29.0)19 (29.7)
      Tramadol10 (25.0)10 (32.3)10 (15.6)
      Morphine4 (10.0)3 (9.7)8 (12.5)
      Methadone or buprenorphine8 (20.0)1 (3.2)2 (3.1)
      Fentanyl002 (3.1)
      Other002 (4.7)
    Duration of opioid use in years
    (mean ± SD)
    10.3 (8.5)8.3 (5.7)10.9 (7.1)
    Morphine equivalent daily dose
    (mean ± SD)
    84.1 (102.4)62.3 (131.5)71.4 (96.6)

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