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.
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.
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.
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.
JMIR research protocols
April 23, 2026
Kennedi Childs, Carter Minnick, Geraldine Martorella et al.
Chronic musculoskeletal pain often becomes entangled with a person's sense of self, making treatment difficult. Mindfulness-based interventions may help by promoting self-transcendence, a potential mechanism for lasting pain relief. This protocol describes a three-arm randomized controlled trial with 173 adults who have chronic musculoskeletal pain. Participants will receive either traditional mindful breathing instruction, mindful breathing plus direct pointing instruction, or be placed on a waitlist. Self-transcendence will be measured using self-reports, EEG theta activity, and fNIRS default mode network activity. Pain intensity and functional interference will be tracked from baseline through a three-month follow-up. Data collection runs from October 2024 to May 2027; no results are yet available.