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
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
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DOI：
10.1093/abm/kay096
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发表时间：
2019-10-01
影响因子：
3.8
通讯作者：
Howard, Matthew O.
中科院分区：
文献类型：
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作者：
Garland, Eric L.;Bryan, Myranda A.;Howard, Matthew O.
背景：在接受阿片类药物治疗的慢性疼痛患者中，情绪困扰背景下的反应抑制不足可能导致适应不良的疼痛应对和处方阿片类药物滥用。旨在加强认知控制和减少情绪反应的干预措施（例如，正念）可以补救反应抑制缺陷，从而具有临床益处。目的为了检验基于正念的干预，正念导向恢复增强（MORE），可以减少临床相关，在阿片类药物治疗的慢性疼痛样本中，对反应抑制功能的负性情感干扰。长期处方阿片类药物使用随机分配到MORE（n = 27）治疗组或积极支持组比较条件（n = 30）。参与者在治疗前和治疗后完成了情绪Go/NoGo任务，该任务测量了在中性和临床相关的负面情感背景下的反应抑制（即，暴露于疼痛相关的视觉刺激）。结果重复测量方差分析表明，与支持组相比，MORE中的参与者证明，相对于使用中性干扰物的试验，使用疼痛相关干扰物的试验的委托错误从治疗前到治疗后显著减少，组x时间x条件F（1，55）= 4.14，p = 0.047，η（2）（部分）= 0.07。正念练习分钟数和无反应性的增加显著预测了更大的情绪反应抑制。一个显着的负相关性之间的改善，情绪反应抑制和治疗相关的减少疼痛严重程度3个月follow-up.Conclusions研究结果提供了初步证据，更多的增强抑制控制功能的背景下，消极的情绪干扰。
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 x time x condition F(1,55) = 4.14, p = .047, eta(2)(partial) = .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.