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Mindfulness training applied to addiction therapy: insights into the neural mechanisms of positive behavioral change

Authors Garland E, Howard M, Priddy S, McConnell P, Riquino M, Froeliger B

Received 23 January 2016

Accepted for publication 18 February 2016

Published 27 July 2016 Volume 2016:5 Pages 55—63

DOI https://doi.org/10.2147/NAN.S89257

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Weirui Guo

Peer reviewer comments 2

Editor who approved publication: Dr Annabel Chen


Eric L Garland,1,2 Matthew O Howard,3 Sarah E Priddy,1 Patrick A McConnell,4 Michael R Riquino,1 Brett Froeliger4

1College of Social Work, 2Hunstsman Cancer Institute, University of Utah, Salt Lake City, UT, USA; 3School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 4Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA


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 service of compulsive seeking of drug-related reward. In essence, mindfulness-based interventions (MBIs) can be conceptualized as mental training programs for exercising, strengthening, and remediating these functional brain networks. This review describes how MBIs may remediate addiction by regulating frontostriatal circuits, thereby restoring an adaptive balance between these top-down and bottom-up processes. Empirical evidence is presented suggesting that MBIs facilitate cognitive control over drug-related automaticity, attentional bias, and drug cue reactivity, while enhancing responsiveness to natural rewards. Findings from the literature are incorporated into an integrative account of the neural mechanisms of mindfulness-based therapies for effecting positive behavior change in the context of addiction recovery. Implications of our theoretical framework are presented with respect to how these insights can inform the addiction therapy process.

Keywords: mindfulness, frontostriatal, savoring, cue reactivity, hedonic dysregulation, reward, addiction

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