The broad, long-term objectives of the proposed training plan and pilot study are to facilitate the PI's career development in brain imaging and to develop an interdisciplinary research team that seeks to investigate the gender dependent neurobiological underpinnings of mindfulness-based relapse prevention (MBRP) for substance use disorders (SUDs). Adding cutting edge brain imaging technology to the investigation of MBRP effects stands to vertically advance the goals of OppNet and propel MBRP towards recognition as an evidenced-based treatment option for SUDs. Neuroscience studies evince changes in the stress and reward neurocircuitry that perpetuates the chronic relapsing nature of SUDs (Koob et al., 2004). Through it's effects on craving, stress increases vulnerability to addiction in gender dependent ways (Sinha, 2008). The proposed research will draw upon the women's health research expertise of the PI and the expertise of mentors from the fields of addiction science and neuroimaging to investigate brain function in women with SUDs who have undergone treatment with MBRP. MBRP is an innovative treatment that incorporates mindfulness meditation with traditional cognitive- behavioral relapse prevention (Bowen et al., in press). When compared to patients in a standard aftercare program, MBRP demonstrated lower rates of substance use and greater decreases in craving postintervention (Bowen et al., 2009). To explore underlying mechanism of action including neurofunctional changes, a training plan that includes the use of functional magnetic resonance imaging (fMRI) to study craving-induced brain activation in women with SUDs is proposed. We propose studying only women to control for sex differences in the various dimensions of SUDs (Fox &Sinha, 2009).
The specific aims of the proposal are to: 1) receive training in neuroimaging, 2) investigate fMRI responses to script-guided imagery of a neutral- relaxing and a drug-related script in women with SUDs who completed MBRP treatment (n = 3) relative to those who received traditional Relapse Prevention (RP;n = 3), and 3) assess self- reported craving pre-post script-guided imagery in MBRP participants (n = 3) relative to RP participants (n = 3). We hypothesize that MBRP participants will show less fMRI signal in regions contributing to the stress and craving neurocircuitry such as the amygdala, insula, orbitofrontal and anterior cingulate cortices in response to a drug-related script than RP participants. We further hypothesize that MBRP participants will demonstrate less self-reported craving following a drug-related script than RP participants.
The public health consequences of alcohol and other drug (AOD) abuse are calamitous. An innovative treatment known as Mindfulness-Based Relapse Prevention (MBRP) offers promising aftercare for AOD, yet the fundamental mechanisms through which MBRP exerts is actions on reported craving and AOD are unknown. In an effort to vertically advance the field's understanding of neurobiological processes in addicts which will inform treatment modification or development, we are proposing training and a pilot study using fMRI to study craving-induced neurofunctional changes in addicts treated with MBRP.
| Bowen, Sarah; Witkiewitz, Katie; Clifasefi, Seema L et al. (2014) Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders: a randomized clinical trial. JAMA Psychiatry 71:547-56 |
| Witkiewitz, Katie; Lustyk, M Kathleen B; Bowen, Sarah (2013) Retraining the addicted brain: a review of hypothesized neurobiological mechanisms of mindfulness-based relapse prevention. Psychol Addict Behav 27:351-365 |
