Mindfulness-Oriented Recovery Enhancement Reduces Opioid Misuse Risk via Analgesic and Positive Psychological Mechanisms: A Randomized Controlled Trial

被引：113

作者：

Garland, Eric L. ^{[1
,2
]}

Hanley, Adam W. ^{[1
,2
]}

Riquino, Michael R. ^{[1
,2
]}

Reese, Sarah E. ^{[1
,2
]}

Baker, Anne K. ^{[1
,2
]}

Salas, Karen ^{[1
,2
]}

Yack, Brooke P. ^{[1
,2
]}

Bedford, Carter E. ^{[1
,2
]}

Bryan, Myranda A. ^{[1
,2
]}

Atchley, Rachel ^{[1
,2
]}

Nakamura, Yoshio ^{[1
,2
]}

Froeliger, Brett ^{[1
,3
,4
]}

Howard, Matthew O. ^{[5
]}

机构：

[1] Univ Utah, Ctr Mindfulness & Integrat Hlth Intervent Dev, Salt Lake City, UT 84112 USA

[2] Univ Utah, Coll Social Work, 395 South 1500 East, Salt Lake City, UT 84112 USA

[3] Univ Utah, Dept Anesthesiol, Salt Lake City, UT 84112 USA

[4] Med Univ South Carolina, Dept Neurosci, Charleston, SC USA

[5] Univ North Carolina Chapel Hill, Sch Social Work, Chapel Hill, NC USA

来源：

JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY | 2019年 / 87卷 / 10期

关键词：

mindfulness; opioid; pain; positive emotion; nondual awareness; TO-MEANING THEORY; OF-FIT INDEXES; CHRONIC PAIN; UNITED-STATES; HEDONIC DYSREGULATION; REWARD RESPONSIVENESS; PRESCRIPTION; ADDICTION; DEPENDENCE; DRUG;

D O I：

10.1037/ccp0000390

中图分类号：

B849 [应用心理学];

学科分类号：

040203 ;

摘要：

Objective: Despite the heightened urgency of the current prescription opioid crisis, few psychotherapies have been evaluated for chronic pain patients receiving long-term opioid analgesics. Current psychological pain treatments focus primarily on ameliorating negative affective processes, yet basic science suggests that risk for opioid misuse is linked with a dearth of positive affect. Interventions that modulate positive psychological processes may produce therapeutic benefits among patients with opioid-treated chronic pain. The aim of this study was to conduct a theory-driven mechanistic analysis of proximal outcome data from a Stage 2 randomized controlled trial of Mindfulness-Oriented Recovery Enhancement (MORE), an integrative intervention designed to promote positive psychological health. Method: Patients with opioid-treated chronic pain (N = 95; age = 56.8 +/- 11.7; 66% female) were randomized to 8 weeks of therapist-led MORE or support group (SG) interventions. A latent positive psychological health variable comprised of positive affect, meaning in life, and self-transcendence measures was examined as a mediator of the effect of MORE on changes in pain severity at posttreatment and opioid misuse risk by 3-month follow-up. Results: Participants in MORE reported significantly greater reductions in pain severity by posttreatment (p = .03) and opioid misuse risk by 3-month follow-up (p = .03) and significantly greater increases in positive psychological health (p < .001) than SG participants. Increases in positive psychological health mediated the effect of MORE on pain severity by posttreatment (p = .048), which in turn predicted decreases in opioid misuse risk by follow-up (p = .02). Conclusions: Targeting positive psychological mechanisms via MORE and other psychological interventions may reduce opioid misuse risk among chronic pain patients receiving long-term opioid therapy.

引用

页码：927 / 940

页数：14

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