American Journal of Psychiatry
January 10, 2024
Eric L Garland, Yoshio Nakamura, Craig J. Bryan et al.
OBJECTIVE. Evaluate the efficacy of Mindfulness-Oriented Recovery Enhancement (MORE) for past and current military personnel prescribed long-term opioid therapy (LTOT) for chronic pain. METHODS. In a clinical trial, 230 past and current U.S. military personnel prescribed LTOT were randomized (1:1) to MORE or supportive psychotherapy (in-person and then online via Zoom after onset of COVID-19)....
Psychological Medicine
April 1, 2023
Eric L Garland, Spencer T Fix, Justin Hudak et al.
51 citations
Neuropsychopharmacologic effects of long-term opioid therapy (LTOT) in the context of chronic pain may result in subjective anhedonia coupled with decreased attention to natural rewards. Yet, there are no known efficacious treatments for anhedonia and reward deficits associated with chronic opioid use. Mindfulness-Oriented Recovery Enhancement (MORE), a novel behavioral intervention combining...
Science Advances
October 14, 2022
Eric L Garland, Adam W. Hanley, Justin Hudak et al.
39 citations
Self-regulation is instantiated by theta oscillations (4 to 8 Hz) in neurons of frontal midline brain regions. Frontal midline theta (FMΘ) is inversely associated with default mode network (DMN) activation, which subserves self-referential processing. Addiction involves impaired self-regulation and DMN dysfunction. Mindfulness is an efficacious self-regulatory practice for treating addiction,...
JAMA Internal Medicine
February 28, 2022
E. Garland, Adam W. Hanley, Yoshio Nakamura et al.
Key Points Question Does a mindfulness-based intervention reduce comorbid chronic pain and opioid misuse in the primary care setting more than supportive psychotherapy? Findings In this randomized clinical trial that included 250 adults with both chronic pain and opioid misuse, 45.0% of participants receiving Mindfulness-Oriented Recovery Enhancement (MORE) were no longer misusing opioids after...
Journal of Consulting and Clinical Psychology
October 1, 2019
Eric L Garland, Adam W. Hanley, Michael R. Riquino et al.
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....
Annals of Behavioral Medicine
January 22, 2019
E. Garland, Myranda A Bryan, Sarah E. Priddy et al.
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...
Mindfulness
2018
Shirley Serfaty, Grace Gale, Matthew Beadman et al.
The psychological flexibility model (PFM) provides a framework for understanding and treating behavioural dysregulation in addictions. Rather than modulating the intensity of subjective experience, interventions based on, or consistent with, the PFM (PFM interventions) seek to alter the individual's relationship to internal states, such as craving, negative affect and drug-related thoughts,...
Psychotherapy and Psychosomatics
February 1, 2017
E. Garland, M. Howard, J. Zubieta et al.
opioid misuse as defined by a validated cutoff point on the Current Opioid Misuse Measure (COMM >12) [7] . We used heart rate (HR) to measure cue responsiveness and high-frequency heart rate variability (HRV) to index parasympathetic regulation of hedonic responses, including attention to emotional information [8] . Participants were paid USD 200 for completing the IRB-approved study; all...
Evidence-based Complementary and Alternative Medicine
2017
Brett Froeliger, Amanda R. Mathew, Patrick A. McConnell et al.
88 citations
The primary goal of this pilot feasibility study was to examine the effects of Mindfulness‐Oriented Recovery Enhancement (MORE), a behavioral treatment grounded in dual‐process models derived from cognitive science, on frontostriatal reward processes among cigarette smokers. Healthy adult (N = 13; mean (SD) age 49 ± 12.2) smokers provided informed consent to participate in a 10‐week study...
Neuroscience and Neuroeconomics
July 1, 2016
Eric L Garland, Matthew O. Howard, Sarah E. Priddy et al.
12 citations
Abstract: Dual-process models from neuroscience suggest that addiction is driven by dysregulated interactions between bottom-up neural processes underpinning reward learning and top-down neural functions subserving executive function. Over time, drug use causes atrophy in prefrontally mediated cognitive control networks and hijacks striatal circuits devoted to processing natural rewards in...
Mindfulness
April 1, 2015
Eric L Garland, Adam W. Hanley, Norman A. S. Farb et al.
Putatively, mindfulness meditation involves generation of a state of "nonappraisal", yet, little is known about how mindfulness may influence appraisal processes. We investigated whether the state and practice of mindfulness could enhance cognitive reappraisal. Participants (N = 44; M age = 24.44, SD = 4.00, range 19 - 38, 82.2% female) were randomized to either 1) mindfulness, 2) suppression,...
Journal of Behavioral Medicine
November 11, 2014
E. Garland, Brett Froeliger, M. Howard
Abstract Dysregulated processing of natural rewards may be a central pathogenic process in the etiology and maintenance of prescription opioid misuse and addiction among chronic pain patients. This study examined whether a Mindfulness-Oriented Recovery Enhancement (MORE) intervention could augment natural reward processing through training in savoring as indicated by event-related brain...
Journal of Consulting and Clinical Psychology
February 3, 2014
Eric L Garland, Eron G Manusov, Brett Froeliger et al.
Objective: Opioid pharmacotherapy is now the leading treatment for chronic pain, a problem that affects nearly one third of the U.S. population. Given the dramatic rise in prescription opioid misuse and opioid-related mortality, novel behavioral interventions are needed. The purpose of this study was to conduct an early-stage randomized controlled trial of Mindfulness-Oriented Recovery...
Evidence-based Complementary and Alternative Medicine
2012
Brett Froeliger, Eric L Garland, Rachel V Kozink et al.
Meditation practice alters intrinsic resting-state functional connectivity (rsFC) in the default mode network (DMN). However, little is known regarding the effects of meditation on other resting-state networks. The aim of current study was to investigate the effects of meditation experience and meditation-state functional connectivity (msFC) on multiple resting-state networks (RSNs). Meditation...
Frontiers in Integrative Neuroscience
2012
Brett Froeliger, Eric L Garland, Leslie A Modlin et al.
Mindfulness meditation involves attending to emotions without cognitive fixation of emotional experience. Over time, this practice is held to promote alterations in trait affectivity and attentional control with resultant effects on well-being and cognition. However, relatively little is known regarding the neural substrates of meditation effects on emotion and cognition. The present study...
Evidence-based Complementary and Alternative Medicine
2012
Brett Froeliger, Eric L Garland, F Joseph McClernon
Hatha yoga techniques, including physical postures (asanas), breathing exercises (pranayama), and meditation, involve the practice of mindfulness. In turn, yoga meditation practices may induce the state of mindfulness, which, when evoked recurrently through repeated practice, may accrue into trait or dispositional mindfulness. Putatively, these changes may be mediated by experience-dependent...