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. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
RCT Entities:
OBJECTIVE: Despite the heightened urgency of the current prescription opioid crisis, few psychotherapies have been evaluated for chronic painpatients 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 painpatients receiving long-term opioid therapy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Authors: Kevin E Vowles; Katie Witkiewitz; Karen J Cusack; Wesley P Gilliam; Karen E Cardon; Sarah Bowen; Karlyn A Edwards; Mindy L McEntee; Robert W Bailey Journal: J Pain Date: 2019-11-21 Impact factor: 5.820
Authors: Benjamin J Morasco; Melissa H Adams; Elizabeth R Hooker; Patricia E Maloy; Erin E Krebs; Travis I Lovejoy; Somnath Saha; Steven K Dobscha Journal: J Gen Intern Med Date: 2022-03-16 Impact factor: 5.128
Authors: Kristen P Morie; Marc N Potenza; Mark Beitel; Lindsay M Oberleitner; Corey R Roos; Sarah W Yip; David E Oberleitner; Marina Gaeta; Declan T Barry Journal: Drug Alcohol Depend Date: 2020-10-24 Impact factor: 4.492
Authors: Justin Hudak; Kort C Prince; William R Marchand; Yoshio Nakamura; Adam W Hanley; Craig J Bryan; Brett Froeliger; Eric L Garland Journal: Prog Neuropsychopharmacol Biol Psychiatry Date: 2020-06-24 Impact factor: 5.067