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

Mindful moms: acceptability and impact of co-designed and digitally delivered video meditations for pregnant and parenting women with opioid use disorder

INTRODUCTION

Perinatal opioid use disorder (OUD) remains a public health epidemic. Stress, anxiety and depression are disproportionately high among this population and are associated with poor recovery outcomes. Mindfulness interventions show promise for supporting recovery for women. This paper reports results of a pilot study to evaluate initial efficacy and acceptability of digitally delivered mindfulness meditation videos to reduce stress and promote mindfulness among women in recovery.

METHODS

Women with lived experience of OUD were recruited from three outpatient programs that provided care to pregnant and parenting women with a history of opioid use in rural northern New England (2 maternity care settings that offered buprenorphine as part of their service menu and 1 academic substance use treatment setting). In a pre-post study design, participants were randomly assigned to receive four of 16 short meditation videos, each delivered by email in a survey link over a 2-week period (2 per week) Videos were co-designed in earlier work with representative end-users, guided by evidence-based mindfulness interventions. Assessment included the Perceived Stress Scale and the Mindfulness Attention Awareness Scale. Participants rated each video on usefulness, enjoyability, ability to lower anxiety, and intention to use in the future. Participants also provided open-ended feedback about the videos. Data were analyzed using descriptive statistics, paired t-tests, and generalized linear modeling.

RESULTS

A total of 20 women, ages 24-36 years, completed the pilot study. Most participants (95%) were white and non-Hispanic, reflecting the rural region. Marginal mean perceived stress scores decreased significantly from 21.49 to 19.85 [p = 0.05, d = 0.43] and mean mindfulness scores increased significantly from 3.47 to 3.76 [p = 0.04, d = 0.45]. Overall, the meditation videos were rated as highly acceptable and useful and a majority (80%) indicated intention to use the meditations in the future.

CONCLUSION

Digitally delivered meditation videos were highly acceptable and useful to participants and the low dose intervention reduced stress and improved mindfulness. Findings inform directions for future research with larger samples to evaluate the effectiveness of this accessible digital intervention to support women in recovery and strategies for broadly implementing the intervention.

Effectiveness of brief online mindfulness-based intervention on different types of mobile phone addiction: mechanisms of influence of trait mindfulness

Introduction

It is common for college students to suffer from mobile phone addiction, which can seriously affect their physical and mental health. The current study looked at the impact of a brief online mindfulness-based intervention (MBI) on mobile phone addiction to address this problem. The mechanisms behind the influence of trait mindfulness (TM) on this process were also investigated in the current study.

Methods

Subjects were split into two groups for a randomized controlled trial: an experimental group and a control group. During brief online MBI, online assessments of mobile social networking addiction (MSNA), mobile game addiction (MGA), mobile information acquisition addiction (MIAA), and mobile short-form video addiction (MSVA) as well as TM were completed. The present study examined the effectiveness of the brief online MBI with a two-factor repeated measures ANOVA and explored the effects of TM on the four types of mobile phone addiction with hierarchical linear modeling (HLM) after a brief online MBI.

Results

Results revealed that the experimental group receiving brief online MBI showed a significant decrease in MSNA, MGA, MIAA, and MSVA at the post-test level compared to the pre-test. TM negatively predicted MSNA, MGA, MIAA, and MSVA.

Discussion

The present study found that the brief online mindfulness-based intervention can effectively reduce four types of mobile phone addiction. In addition, the present study revealed that as the levels of TM increased, all four types of mobile phone addiction decreased.

Mindfulness facets are differentially related with reward processing stages in striatum and alcohol use in adolescence

Attenuated functional processing of non-drug rewards in striatal regions is an important mechanism in the transition from normal to hazardous alcohol use. Recent interventions seek to enhance nondrug reward processing through mindfulness, a mechanism that targets attention regulation and self-regulatory processes. It is yet unclear which specific aspects of mindfulness and which stages of reward processing are relevant preventive targets, particularly in adolescence, where alcohol use is often initiated and reward relating processing streams undergo continuous maturation. Fifty-four 14- and 16-year-old adolescents (54% female) completed the monetary incentive delay task (MID) during event-related functional magnetic resonance imaging. Alcohol use and dispositional mindfulness facets were measured using self-report instruments. Mindful Attention Regulation was positively associated with anticipatory reward processing in ventral striatum, whereas feedback-related processing in dorsal striatum was associated with the mindfulness facet Body-Listening. Only Attention Regulation was additionally associated with frequency of alcohol consumption and mediated the relationship between functional activation in ventral striatum during reward anticipation and alcohol use. Attention Regulation, beyond other mindfulness facets, might contribute to potentially triggering neural mechanisms of anticipatory, but not feedback-related reward processing and alcohol use, presenting a potential target for preventive efforts in combating transitions to substance-related disorders in adolescents.

Mindfulness and Readiness to Change in Individuals with Substance Abuse: The Mediating Role of Self-Compassion and Striving to Compensate for Inferiority

BACKGROUND

Motivation and readiness to change are critical first steps in preventing relapse into substance dependence. Therefore, examining their antecedents is essential for effective therapeutic interventions. This study aimed to investigate the relationship between self-compassion, mindfulness, striving to compensate for inferiority, and readiness to change in individuals with substance abuse.

METHODS

A cross-sectional correlational study design using structural equation modeling was employed. A total of 305 individuals with substance abuse, referred to outpatient rehabilitation centers in Ardakan City, Iran, were selected using a purposive sampling method. Data were collected using the Freiburg Mindfulness Questionnaire, the Striving to Avoid Inferiority Scale, the Self-Compassion Scale, and the Readiness to Change Scale. Data were then analyzed using correlation analysis and structural equation modeling.

RESULTS

Self-compassion exhibited a significant direct effect on striving to compensate for inferiority and readiness to change (p < 0.01). Additionally, striving to compensate for inferiority had a significant direct effect on readiness to change, while mindfulness showed a significant direct effect on self-compassion, readiness to change, and striving to compensate for inferiority (p < 0.01). Self-compassion mediated the relationship between mindfulness and readiness to change while striving to compensate for inferiority played a significant mediating role in the relationship between self-compassion, mindfulness, and readiness to change (p < 0.01).

CONCLUSION

These findings suggest that enhancing self-compassion, mindfulness, and striving to compensate for inferiority can significantly contribute to increasing readiness to change in individuals struggling with substance abuse.

Neuromodulation and mindfulness as therapeutic treatment in detoxified patients with alcohol use disorder

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).

Prevalence of substance use disorders and associations with mindfulness, impulsive personality traits and psychopathological symptoms in a representative sample of adolescents in Germany

Adolescence is a critical phase for the development of substance use disorders (SUDs). For Europe and Germany, there are limited data on problematic substance use from representative youth samples. Trait mindfulness is relevant in buffering against substance use-related problems and associated deficits in self-regulatory control. The objective of this study is to estimate 12-month prevalence rates for SUDs in a representative sample of adolescents in Germany and to examine associations with mindfulness and related factors such as stress, impulsivity, sensation seeking and symptoms of psychopathology. A sample of 4001 adolescents aged 12-18 years from Germany was surveyed based on DSM-IV diagnostic criteria for SUDs. Logistic regression analyses were used to examine associations with mindfulness-related variables. Criteria of at least one of the assessed SUDs were endorsed by 11.2% of the adolescents. Alcohol use disorders had the highest prevalence rate (10.1%) followed by cannabis use disorders (2.6%). For both substances, the criteria for abuse were met about twice as often as those for dependence. The prevalence of cigarette dependence was 1.7%, while the prevalence for e-cigarette dependence was only 0.1%. Prevalence rates were higher for male youth and increasing with age. SUD prevalence was also related to mindfulness, impulsivity and sensation seeking and externalizing symptoms of psychopathology. The statistically significant associations varied across different SUDs. SUDs appear highly prevalent among German adolescents. The results have public health implications with regard to treatment needs and prevention measures in the youth population in Germany.

Be more mindful: Targeting addictive responses by integrating mindfulness with cognitive bias modification or cue exposure interventions

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.

Psychological processes linking problematic smartphone use to sleep disturbance in young adults

OBJECTIVES

With such high rates of sleep and mental health problems among undergraduate students, understanding potential antecedents of these interrelated problems has emerged as a critical area of examination. One potential factor underlying these problems is problematic smartphone use, which is defined as excessive phone use, impulse control problems related to the use, and negative consequences stemming from these behaviors. Accordingly, the current study sought to examine how relative changes in problematic smartphone use might impact college students' sleep disturbance via their psychological functioning (ie, psychological inflexibility and anxiety symptoms).

METHODS

The 2-wave (baseline and 2-month follow-up) online sample consisted of 385 undergraduates (81% female; M = 20.0, SD = 1.6), who reported problematic smartphone use, psychological flexibility, anxiety symptoms, and sleep disturbance.

RESULTS

Controlling for baseline levels of sleep hygiene, age, and gender, our model demonstrated a significant indirect effect from problematic smartphone use to sleep disturbance. Specifically, relative increases from baseline to the 2-month follow-up in students' problematic smartphone use predicted subsequent increases in psychological inflexibility, which predicted increases in anxiety symptoms, which, in turn, predicted increases in sleep disturbance.

CONCLUSIONS

Given the ubiquity of college students' smartphone use, the potential for problematic use remains high. Results suggest that the negative consequences of problematic smartphone use not only can include college students' mental health but also their sleep. With such high levels of college students suffering from mental health and sleep problems, clinicians and college administrators should consider the potential sequelae of the problematic use of smartphones.

Lower Mindfulness is Associated with Problematic Social Media Use: A Meta-Analysis

Problematic social media use consists of use that interferes with individuals’ functioning, such as for example in failing to complete important tasks. A number of studies have investigated the association of trait mindfulness with problematic social media use. This meta-analysis synthesised research from 14 studies and a total of 5355 participants to examine the association between mindfulness and problematic social media use across studies. A lower level of mindfulness was associated with more problematic social media use, with a weighted effect size of r = -.37, 95% CI [-.42, -.33], k = 14, p < .001.

Effectiveness of web-based mindfulness program on college students with social network addiction

AIMS

In this study a web-based mindfulness cultivation program was implemented to investigate its effectiveness on the addiction symptoms and negative emotions of college students with social network addiction.

METHODS

A total of 66 students were recruited and randomly divided into the intervention group or the control group. Participants in the intervention group received a web-based mindfulness cultivation program including the group training and self-cultivating. The primary outcome was addiction level, and the secondary outcome was anxiety, depression and perceived stress. Repeated measures analysis of variance were utilized to analyze the differences between the control and intervention group over the course of the intervention and the follow-up.

RESULTS

There were significant interaction effects on addiction level (F = 39.39, P < .00), anxiety (F = 31.17, P < .00), depression (F = 37.93, P < .00) and perceived stress (F = 22.04, P < .00).

CONCLUSION

A web-based mindfulness cultivation program could improve the addiction level and negative emotions of college students with social network addiction.

Emotion dysregulation mediates the relationship between adverse childhood experiences and problematic gaming

Gaming disorder (i.e., gaming addiction) is a relatively common mental health disorder with a worldwide prevalence rate of 3.05%. In the present research, we examined whether emotion dysregulation mediates the relation between adverse childhood experiences and problematic gaming in two samples of current video game players. The first sample consisted of 1,262 students recruited from five universities across Canada. The second sample comprised 417 community adults residing in Canada. Both samples of participants completed an online survey which included measures of adverse childhood experiences, problematic gaming, and emotion dysregulation. A total of 45.64% (n = 576) in the university sample and 49.76% (n = 205) in the community sample met the threshold for problematic gaming. In the student sample, adverse childhood experiences were positively associated with problematic gaming. In contrast, there was no significant association between adverse childhood experiences and problematic gaming in the community sample. In both samples, adverse childhood experiences were positively associated with emotion dysregulation, and emotion dysregulation was positively associated with problematic gaming. Importantly for the present research, emotion dysregulation mediated the relationship between adverse childhood experiences and problematic gaming in both the university and community sample. Although adverse childhood experiences are distal and static risk factors for problematic gaming, emotion dysregulation is a more proximal and modifiable risk factor. The results suggest that increasing adaptive emotion regulation skills may decrease the risk of problematic gaming among individuals who have experienced an adverse childhood experience.

Effects of a brief mindfulness meditation practice on Pavlovian-to-instrumental transfer in alcohol use disorder - a pilot study

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.

Mindfulness for internet use disorder: a study protocol of a systematic review and meta-analysis

INTRODUCTION

Internet use disorder (IUD) is on the rise and is associated with detrimental health consequences. Growing evidence suggests that mindfulness-either as a trait or cultivated in mindfulness-based programmes (MBPs)-is promising in preventing and treating IUD. With this systematic review and meta-analysis, we will examine (1) the association between trait mindfulness (TM) and IUD and (2) the effectiveness of MBPs in reducing IUD.

METHODS AND ANALYSIS

In October 2022, we will screen Medline, PsycINFO, PSYINDEX, CINAHL, Web of Science, and the Cochrane Register of Controlled Trials without language or publication date restrictions. We will conduct backward and forward citation searches of included studies and relevant reviews. We will include studies that evaluate either (1) the association between TM and IUD or (2) the effectiveness of MBPs in reducing IUD. Two reviewers will independently screen records, select and extract data, and rate the risk of bias. In total, we will conduct three meta-analyses: a first meta-analysis will be on the correlation between TM and IUD, a second meta-analysis will be on between-group data examining the effectiveness of MBPs in reducing IUD in randomised controlled trials (RCTs), and a third meta-analysis will be on within-group pre-postdata examining the effectiveness of MBPs in reducing IUD in all kinds of intervention studies. For the second and third meta-analyses, the primary outcome will be changes in IUD. We will explore moderators and sources of between-study heterogeneity and pursue a narrative synthesis of results. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the overall quality of evidence across intervention studies.

ETHICS AND DISSEMINATION

Ethics approval is not required. Results will be published in a peer-reviewed journal and presented at (inter)national conferences.

PROSPERO REGISTRATION NUMBER

CRD42022350071.

Exploring the links between alexithymia and cognitive emotion regulation strategies in internet addiction: A network analysis model

Alexithymia and emotion regulation are closely related to internet addiction. However, no research has examined how the different components of alexithymia are associated with cognitive emotion regulation in the context of multi-strategy use in internet addiction. The current study aimed to investigate the relation between alexithymia and cognitive emotion regulation in individuals with internet addiction via network analysis. Participants included 560 students with Young’s Internet Addiction Test scores greater than 50 points; they were also asked to complete the Toronto Alexithymia Scale (TAS-20) and the Cognitive Emotion Regulation Questionnaire (CERQ). The results revealed two bridge nodes emerging within the combined alexithymia and cognitive emotion regulation network model: “catastrophizing” and “externally oriented thoughts.” These findings indicate a more specific relation between alexithymia and cognitive emotion regulation and provide empirical evidence for targeted prevention and targeted interventions for internet addiction.