Effects of Mindfulness-Oriented Recovery Enhancement Versus Social Support on Negative Affective Interference During Inhibitory Control Among Opioid-Treated Chronic Pain Patients: A Pilot Mechanistic Study

Abstract

Background Among opioid-treated chronic pain patients, deficient response inhibition in the context of emotional distress may contribute to maladaptive pain coping and prescription opioid misuse. Interventions that aim to bolster cognitive control and reduce emotional reactivity (e.g., mindfulness) may remediate response inhibition deficits, with consequent clinical benefits. Purpose To test the hypothesis that a mindfulness-based intervention, Mindfulness-Oriented Recovery Enhancement (MORE), can reduce the impact of clinically relevant, negative affective interference on response inhibition function in an opioid-treated chronic pain sample. Methods We examined data from a controlled trial comparing adults with chronic pain and long-term prescription opioid use randomized to either MORE (n = 27) treatment or to an active support group comparison condition (n = 30). Participants completed an Emotional Go/NoGo Task at pre- and post-treatment, which measured response inhibition in neutral and clinically relevant, negative affective contexts (i.e., exposure to pain-related visual stimuli). Results Repeated-measures analysis of variance indicated that compared with the support group, participants in MORE evidenced significantly greater reductions from pre- to post-treatment in errors of commission on trials with pain-related distractors relative to trials with neutral distractors, group × time × condition F(1,55) = 4.14, p = .047, η2partial = .07. Mindfulness practice minutes and increased nonreactivity significantly predicted greater emotional response inhibition. A significant inverse association was observed between improvements in emotional response inhibition and treatment-related reductions in pain severity by 3-month follow-up. Conclusions Study results provide preliminary evidence that MORE enhances inhibitory control function in the context of negative emotional interference.

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

“…In prescription opioid users with chronic pain conditions, treatment with MORE led to decreased errors of commission in an emotional Go/NoGo task when faced with pain-related distractors. Emotional response inhibition was furthermore correlated with the length of mindfulness practice as well as nonreactivity and reduced pain severity at follow-up [76].…”

Mindfulness and Behavior Change

“…These changes may help overcome prepotent motor responses, reduce the cognitive effort required for decision making about appetitive health behaviors, and diminish susceptibility to automatic behaviors in response to negative affect. 106 , 132 …”

The Relationship Between Mindfulness and Self-Compassion with Perceived Pain in Migraine Patients in Ilam, 2018

“…Regarding studies on mindfulness effects on pain scale of other patients, it is possible to refer to the study done by Ahmadi et al, which showed that in cancer patients mind-consciousness variance can result in increase of their life quality (56). In a systematic and meta-analysis review study done by Garland et al, it was shown that mindfulness-based stress reduction interventions (MBSR) reduce chronic pain of the patients (57). Furthermore, in the systematic and meta-analysis review study done by Ngamkham et al on the cancer patient group, the findings showed that mindfulness intervention results in pain reduction in this group of patients (58), which is consistent with the results of the present study indicating a meaningful statistical correlation between mindfulness and pain severity.…”