Psychological assessment
December 1, 2018
Adam W Hanley, Yoshio Nakamura, Eric L Garland
125 citations
Two new questionnaires, the Nondual Awareness Dimensional Assessment-Trait (NADA-T) and the Nondual Awareness Dimensional Assessment-State (NADA-S), were developed to measure nondual awareness—a sense of oneness or absence of self-other boundaries. Principal component analysis with 528 participants identified two dimensions of the NADA-T: self-transcendence and bliss. Further analyses in three independent samples (totaling 725 participants) showed both dimensions reflect a single overarching nondual awareness construct. The NADA-T correlated with interdependent self-construals and dispositional mindfulness.
Mindfulness
May 1, 2020
Adam W Hanley, Michael Dambrun, Eric L Garland
66 citations
Five sessions of mindfulness training, compared with an active listening control, led healthy young adults to report a decreased sense of body boundary dissolution and a more allocentric (less self-centered) spatial frame of reference. The effect on spatial frame of reference was mediated by the reduction in perceived body boundaries. The findings suggest that even brief mindfulness practice can shift the experience of self, relaxing the boundary between self and environment and extending the spatial frame of reference beyond the physical body.
Journal of pain and symptom management
September 1, 2023
Benjamin R Lewis, Eric L Garland, Kevin Byrne et al.
60 citations
Psilocybin-assisted group therapy appears safe and feasible for treating depression in cancer patients. In an open-label pilot trial, twelve participants with a depressive disorder received one high-dose (25 mg) psilocybin session within a three-week group program. Depression scores on the HAM-D scale decreased substantially from an average of 21.5 at baseline to 10.09 at two weeks and 14.83 at six months. Six of twelve participants met remission criteria (HAM-D below 7) at two weeks, and no serious adverse events occurred. The group format may reduce therapist time while maintaining possible efficacy, warranting further study.
Psychological medicine
April 1, 2023
Eric L Garland, Spencer T Fix, Justin P Hudak et al.
51 citations
Long-term opioid therapy for chronic pain can lead to anhedonia, or reduced ability to experience pleasure from natural rewards. A behavioral intervention called Mindfulness-Oriented Recovery Enhancement (MORE) was tested in 63 veterans on long-term opioid therapy for chronic pain, who were randomly assigned to eight weeks of MORE or a supportive group therapy. MORE increased brain and physiological responses to natural reward cues and reduced subjective anhedonia more than the control. The reduction in anhedonia was linked to increased brain activity during savoring of rewards. MORE may be an effective treatment for anhedonia in chronic opioid users and those at risk for opioid use disorder.
JAMA psychiatry
April 1, 2024
Nina A Cooperman, Shou-En Lu, Adam W Hanley et al.
39 citations
Adding a telehealth mindfulness-based program called Mindfulness-Oriented Recovery Enhancement (MORE) to standard methadone treatment reduced the risk of returning to drug use by 42% and the risk of dropping out of methadone treatment by 59% over 16 weeks among people with opioid use disorder and chronic pain. Participants receiving MORE also had fewer days of drug use, better methadone adherence, and greater reductions in pain and depression than those receiving standard care alone. Anxiety did not differ significantly between groups. The findings suggest that telehealth MORE is a feasible and effective supplement to methadone treatment.
Science advances
October 14, 2022
Eric L Garland, Adam W Hanley, Justin Hudak et al.
39 citations
Theta oscillations (4 to 8 Hz) in frontal midline brain regions, which support self-regulation, are inversely linked to default mode network activity involved in self-referential processing. Addiction involves impaired self-regulation and default mode network dysfunction. In a mechanistic study of 165 long-term opioid users, Mindfulness-Oriented Recovery Enhancement increased frontal midline theta during meditation compared to supportive psychotherapy. Theta during meditation was associated with self-transcendent experiences such as ego dissolution and bliss. Increased theta mediated the treatment's effect on reducing opioid misuse, suggesting mindfulness-induced theta stimulation may reset default mode network dysfunction to inhibit addictive behavior.
The Clinical journal of pain
February 1, 2024
Myrella Paschali, Asimina Lazaridou, Jason Sadora et al.
25 citations
A systematic review and meta-analysis of 18 randomized controlled trials and other studies found that mindfulness-based interventions (such as mindfulness meditation, mindfulness-based stress reduction, and acceptance and commitment therapy) have a large beneficial effect on reducing pain intensity in adults with chronic low back pain. The authors caution that findings should be interpreted carefully due to high variability in study methods, small sample sizes, inclusion of studies with high risk of bias, and reliance on pre-post treatment differences without assessing long-term maintenance. More large-scale randomized trials are needed for reliable effect estimates.
The journal of pain
July 1, 2024
Patrick H Finan, Carly Hunt, Michael L Keaser et al.
18 citations
A pilot mechanistic randomized controlled trial tested a positive emotion-enhancing intervention called Savoring Meditation against a Slow Breathing control in 44 patients with rheumatoid arthritis. Savoring significantly reduced experimental pain intensity ratings relative to rest and increased cerebral blood flow in the ventromedial prefrontal cortex, as well as connectivity between that region and the caudate during painful stimulation. Participants in the Savoring condition also reported significantly increased positive emotions and reduced anhedonic symptoms from pre- to post-intervention. The findings suggest that Savoring recruits reward-enhancing corticostriatal circuits in the face of pain, warranting future work on clinical pain outcomes.
Mindfulness
January 1, 2023
Eric L Garland, R Lynae Roberts, Adam W Hanley et al.
14 citations
A new measure, the Mindful Reappraisal of Pain Sensations Scale (MRPS), was developed and validated across multiple studies. The scale captures how mindfulness helps people shift from catastrophic pain appraisals to viewing pain as a harmless sensory signal. In samples of opioid-treated chronic pain patients, the MRPS showed a single-factor structure and good convergent and divergent validity. Mindfulness training via Mindfulness-Oriented Recovery Enhancement (MORE) increased MRPS scores more than supportive psychotherapy. Changes in MRPS scores statistically mediated the effect of MORE on reducing chronic pain severity through 9-month follow-up, indicating the MRPS measures a key analgesic mechanism involving attentional disengagement and interoceptive exposure.
Journal of integrative and complementary medicine
September 1, 2024
Adam W Hanley, Ayaka Lingard, Eric L Garland
7 citations
A 2-hour single-session version of Mindfulness-Oriented Recovery Enhancement (One MORE) improved chronic pain patients' pain catastrophizing, pain intensity, pain interference, physical function, sleep, anxiety, and depression through a 3-month follow-up. The intervention also increased mindfulness, positive reappraisal, savoring, and self-transcendence. These results from a waitlist-controlled randomized trial with 40 participants suggest that a brief, scalable, low-cost nonpharmacologic treatment may help address the logistical barriers of longer 8-week mindfulness-based interventions for chronic pain.
Biological psychiatry. Cognitive neuroscience and neuroimaging
April 1, 2025
Saampras Ganesan, Fernando A Barrios, Ishaan Batta et al.
6 citations
Meditation practices, which have shown therapeutic benefits for conditions like depression, pain, addiction, and anxiety, have been studied with neuroimaging over the past decade. However, existing neuroscientific models are based on small, heterogeneous datasets, limiting generalizability and replicability. The ENIGMA-Meditation consortium is the first worldwide collaborative effort to conduct systematic meta- and mega-analyses of globally distributed neuroimaging data using standardized methods. This framework aims to improve statistical power and address multidomain heterogeneity in meditation practice types, experience, and experimental design. The consortium will generate rigorous neuroscientific insights into the mechanisms underlying meditation's therapeutic effects on psychological and cognitive attributes.
medRxiv
January 1, 2025
Benjamin R Lewis, John Hendrick, Kevin Byrne et al.
3 citations
preprint
Adding a single 25 mg dose of psilocybin to an 8-week mindfulness-based stress reduction (MBSR) program reduced depression and burnout symptoms more than MBSR alone in frontline physicians and nurses who worked during the COVID-19 pandemic. In a randomized trial with 25 participants, those receiving psilocybin-assisted therapy plus MBSR showed larger decreases in depressive symptoms at two weeks and six months, and greater improvements in burnout, demoralization, and connectedness. No serious adverse events occurred; only mild to moderate side effects were reported. The findings suggest that combining psilocybin with mindfulness training may be a promising treatment for depression and burnout in healthcare workers.
Journal of pain and symptom management
January 3, 2026
Karolina L Bryl, Adam W Hanley, Raymond E Baser et al.
1 citation
Chronic pain is common among cancer survivors but often goes untreated. Existing treatments carry risks or offer limited relief, and non-drug options have shown only modest benefits. Mindfulness-Oriented Recovery Enhancement (MORE), an intervention that targets the neurocognitive mechanisms of chronic pain, has helped people without cancer but had not been tested in cancer survivors. This pilot trial enrolled 60 cancer survivors with moderate-to-severe pain (average age 60; 75% female) and randomly assigned them to one of three MORE formats (16, 8, or 2 hours) or a waitlist. MORE proved feasible, with high enrollment (71%) and assessment completion (91%), and acceptable, with high adherence and satisfaction.
Drug and alcohol dependence
June 2, 2025
Anna Parisi, Lisa Taylor-Swanson, Jennifer L Stewart et al.
1 citation
People with chronic pain who misuse opioids report lower awareness of internal bodily signals compared to those who take opioids as prescribed. In a study of 372 adults on long-term opioid therapy, lower scores on attention regulation and trusting one's body were linked to higher opioid misuse, even after accounting for pain severity. Among 250 participants at elevated risk, an 8-week mindfulness-based program (MORE) produced greater increases in interoceptive awareness than supportive group therapy, and these increases explained reductions in opioid misuse over nine months. The findings suggest that boosting interoceptive awareness may help reduce opioid misuse.
Journal of addiction medicine
Babak Tofighi, Christina Marini, Joshua D Lee et al.
1 citation
Among 72 patients prescribed buprenorphine for opioid use disorder in office-based opioid treatment, 90.3% reported practicing at least one category of meditation-based intervention (MBI) on at least a daily (39.6%) or weekly (41.7%) basis. The most common type was spiritual meditation (67.7%), followed by nonmantra meditation (61.3%), mindfulness meditation (54.8%), and mantra meditation (29.0%). Interest in MBI was motivated by improving general health and well-being (73.4%), treatment outcomes (60.9%), and relationships (60.9%). Perceived benefits included reduced anxiety or depression (70.3%), pain (62.5%), substance use (60.9%), cravings (57.8%), and withdrawal symptoms (51.6%). The findings suggest high acceptability for adopting MBI in this population.