Restructuring Reward Mechanisms in Nicotine Addiction: A Pilot fMRI Study of Mindfulness‐Oriented Recovery Enhancement for Cigarette Smokers
Open accessAbstract
The primary goal of this pilot feasibility study was to examine the effects of Mindfulness‐Oriented Recovery Enhancement (MORE), a behavioral treatment grounded in dual‐process models derived from cognitive science, on frontostriatal reward processes among cigarette smokers. Healthy adult (N = 13; mean (SD) age 49 ± 12.2) smokers provided informed consent to participate in a 10‐week study testing MORE versus a comparison group (CG). All participants underwent two fMRI scans: pre‐tx and after 8‐weeks of MORE. Emotion regulation (ER), smoking cue reactivity (CR), and resting‐state functional connectivity (rsFC) were assessed at each fMRI visit; smoking and mood were assessed throughout. As compared to the CG, MORE significantly reduced smoking (d = 2.06) and increased positive affect (d = 2.02). MORE participants evidenced decreased CR‐BOLD response in ventral striatum (VS; d = 1.57) and ventral prefrontal cortex (vPFC; d = 1.7) and increased positive ER‐BOLD in VS (dVS = 2.13) and vPFC (dvmPFC = 2.66). Importantly, ER was correlated with smoking reduction (r’s = .68 to .91) and increased positive affect (r’s = .52 to .61). These findings provide preliminary evidence that MORE may facilitate the restructuring of reward processes and play a role in treating the pathophysiology of nicotine addiction.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Resting state functional connectivity between rACC and orbitofrontal cortex significantly increased in the MORE group relative to the comparison group.
“Furthermore, resting state functional connectivity between rACC and orbitofrontal cortex (OFC) significantly increased in the MORE group relative to the comparison group.”
From Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research (2018) · cites this paper as [34]
Increases in functional connectivity, striatal, and rACC savoring responses significantly predicted increases in positive affect and reductions in the quantity of cigarettes smoked over the course of treatment with MORE.
“These increases in functional connectivity, striatal, and rACC savoring responses significantly predicted increases in positive affect and reductions in the quantity of cigarettes smoked over the course of treatment with MORE”
From Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research (2018) · cites this paper as [34]
In a pilot study of MORE as a smoking cessation intervention, relative to a time matched comparison group, participants in MORE exhibited significant pre-post treatment reductions in ventral striatal responses to cigarette cues over time, and significant increases in ventral striatum and rostral anterior cingulate cortex during savoring of natural reward stimuli.
“Relative to a time matched comparison group, participants in MORE exhibited significant pre-post treatment reductions in ventral striatal responses to cigarette cues over time, and significant increases in ventral striatum and rostral anterior cingulate cortex (rACC) during savoring of natural reward stimuli.”
From Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research (2018) · cites this paper as [34]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Development and validation of brief measures of positive and negative affect: The PANAS scales.
Watson, D., Clark, L. A., & Tellegen, A. (1988) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.54.6.1063 · Cited by 32,433 · see citing works
Zhang, Q., Wang, C., Zheng, M., Li, Y., Li, J., Zhang, L., Shang, X., & Yan, C. (2014) · Cerebrovascular Diseases · doi:10.1159/000369778 · Cited by 11,609 · see citing works
Projections of Global Mortality and Burden of Disease from 2002 to 2030
Mathers, C. D., & Loncar, D. (2006) · PLoS Medicine · doi:10.1371/journal.pmed.0030442 · Cited by 11,386 · see citing works
The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire
HEATHERTON, T. F., KOZLOWSKI, L. T., FRECKER, R. C., & FAGERSTROM, K. (1991) · British Journal of Addiction · doi:10.1111/j.1360-0443.1991.tb01879.x · Cited by 10,738 · see citing works
A fast diffeomorphic image registration algorithm
Ashburner, J. (2007) · NeuroImage · doi:10.1016/j.neuroimage.2007.07.007 · Cited by 8,122 · see citing works
Koob, G. F., & Volkow, N. D. (2010) · Neuropsychopharmacology · doi:10.1038/npp.2009.110 · Cited by 5,340 · see citing works
Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., Walsh, E., Duggan, D., & Williams, J. M. G. (2008) · Assessment · doi:10.1177/1073191107313003 · Cited by 2,930 · see citing works
Goldstein, R. Z., & Volkow, N. D. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.10.1642 · Cited by 2,667 · see citing works
Analysis of functional MRI time‐series
Friston, K. J., Jezzard, P., & Turner, R. (1994) · Human Brain Mapping · doi:10.1002/hbm.460010207 · Cited by 1,835 · see citing works
The incentive sensitization theory of addiction: some current issues
Robinson, T. E., & Berridge, K. C. (2008) · Philosophical Transactions of the Royal Society B: Biological Sciences · doi:10.1098/rstb.2008.0093 · Cited by 1,717 · see citing works
Addiction and the brain antireward system
Koob, G. F., & Le Moal, M. (2008) · Annual Review of Psychology · doi:10.1146/annurev.psych.59.103006.093548 · Cited by 1,457 · see citing works
The glutamate homeostasis hypothesis of addiction
Kalivas, P. W. (2009) · Nature Reviews Neuroscience · doi:10.1038/nrn2515 · Cited by 1,350 · see citing works
A Meta-Analytic Review of Psychosocial Interventions for Substance Use Disorders
Dutra, L., Stathopoulou, G., Basden, S. L., Leyro, T. M., Powers, M. B., & Otto, M. W. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2007.06111851 · Cited by 1,287 · see citing works
Adaptive non‐local means denoising of MR images with spatially varying noise levels
Manjón, J. V., Pierrick Coupé, A., Martí‐Bonmatí, L., Collins, D. L., & Robles, M. (2009) · Journal of Magnetic Resonance Imaging · doi:10.1002/jmri.22003 · Cited by 1,088 · see citing works
Testing the integrity of a psychotherapy protocol: Assessment of adherence and competence
Waltz, J., Addis, M. E., Koerner, K., & Jacobson, N. S. (1993) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.61.4.620 · Cited by 873 · see citing works
Drug Addiction as a Pathology of Staged Neuroplasticity
Kalivas, P. W., & O’Brien, C. P. (2007) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301564 · Cited by 735 · see citing works
Mindfulness-Based Relapse Prevention for Substance Use Disorders: A Pilot Efficacy Trial
Bowen, S., Chawla, N., Collins, S. E., Witkiewitz, K., Hsu, S., Grow, J., Clifasefi, S., Garner, M., Douglass, A., Larimer, M. E., et al. (2009) · Substance Abuse · doi:10.1080/08897070903250084 · Cited by 715 · cited 1× · see citing works
“An emerging body of controlled trials indicates that mindfulness-based interventions (MBIs), includingMindfulness-Based Relapse Prevention [14] and MindfulnessOriented Recovery Enhancement (MORE) [15], may produce significant therapeutic effects among those struggling with drug addiction, including dependence on alcoh…”
BackgroundPrefrontal–striatal pathway underlies cognitive regulation of craving
Kober, H., Mende-Siedlecki, P., Kross, E. F., Weber, J., Mischel, W., Hart, C. L., & Ochsner, K. N. (2010) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1007779107 · Cited by 695 · see citing works
Statistical approach to segmentation of single-channel cerebral MR images
Rajapakse, J. C., Giedd, J. N., & Rapoport, J. L. (1997) · IEEE Transactions on Medical Imaging · doi:10.1109/42.563663 · Cited by 678 · see citing works
Fast and robust parameter estimation for statistical partial volume models in brain MRI
Tohka, J., Zijdenbos, A. P., & Evans, A. C. (2004) · NeuroImage · doi:10.1016/j.neuroimage.2004.05.007 · Cited by 670 · see citing works
Savoring: A New Model of Positive Experience
Bryant, F. B., & Veroff, J. (2007) · Cited by 568 · see citing works
Smoking withdrawal symptoms in two weeks of abstinence
Shiffman, S. M., & Jarvik, M. E. (1976) · Psychopharmacology · doi:10.1007/bf00634151 · Cited by 548 · see citing works
Jasinska, A. J., Stein, E. A., Kaiser, J., Naumer, M. J., & Yalachkov, Y. (2014) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2013.10.013 · Cited by 513 · see citing works
The principled control of false positives in neuroimaging
Bennett, C. M., Wolford, G. L., & Miller, M. B. (2009) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsp053 · Cited by 486 · see citing works
Garland, E. L., Manusov, E. G., Froeliger, B., Kelly, A., Williams, J. M., & Howard, M. O. (2014) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0035798 · Cited by 431 · see citing works
Self-citationCarroll, K. M. (2000) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(99)00049-6 · Cited by 386 · see citing works
Mindfulness training for smoking cessation: Results from a randomized controlled trial
Brewer, J. A., Mallik, S., Babuscio, T. A., Nich, C., Johnson, H. E., Deleone, C. M., Minnix-Cotton, C. A., Byrne, S. A., Kober, H., Weinstein, A. J., et al. (2011) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2011.05.027 · Cited by 383 · see citing works
Linking nucleus accumbens dopamine and blood oxygenation
Knutson, B., & Gibbs, S. E. B. (2007) · Psychopharmacology · doi:10.1007/s00213-006-0686-7 · Cited by 337 · see citing works
Addiction related alteration in resting-state brain connectivity
Ma, N., Liu, Y., Li, N., Wang, C.-X., Zhang, H., Jiang, X., Xu, H.-S., Fu, X., Hu, X. P., & Zhang, D. (2009) · NeuroImage · doi:10.1016/j.neuroimage.2009.08.037 · Cited by 322 · see citing works
Garland, E. L., Gaylord, S. A., Boettiger, C. A., & Howard, M. O. (2010) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2010.10400690 · Cited by 319 · see citing works
Self-citationGarland, E. L., Froeliger, B., & Howard, M. O. (2014) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2013.00173 · Cited by 268 · cited 4× · see citing works
“Study findings provide support for our dual-process model [12] and consistent with our hypotheses regarding frontostriatal mechanisms of mindfulness-centered regulation of addictive behavior.”
BackgroundResultInfluentialSelf-citationHong, L. E., Gu, H., Yang, Y., Ross, T. J., Salmeron, B. J., Buchholz, B., Thaker, G. K., & Stein, E. A. (2009) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.2 · Cited by 257 · see citing works
Emotion Refinement: A Theory Inspired by Chinese Poetics
Frijda, N. H., & Sundararajan, L. (2007) · Perspectives on Psychological Science · doi:10.1111/j.1745-6916.2007.00042.x · Cited by 242 · see citing works
Reinstatement of nicotine seeking is mediated by glutamatergic plasticity
Gipson, C. D., Reissner, K. J., Kupchik, Y. M., Smith, A. C. W., Stankeviciute, N. M., Hensley-Simon, M. E., & Kalivas, P. W. (2013) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1220591110 · Cited by 240 · see citing works
Garland, E. L., Froeliger, B., & Howard, M. O. (2014) · Psychopharmacology · doi:10.1007/s00213-014-3504-7 · Cited by 216 · see citing works
Self-citationGarland, E. L., Roberts-Lewis, A., Tronnier, C. D., Graves, R., & Kelley, K. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.11.012 · Cited by 173 · see citing works
Self-citationGender Differences in Craving and Cue Reactivity to Smoking and Negative Affect/Stress Cues
Saladin, M. E., Gray, K. M., Carpenter, M. J., LaRowe, S. D., DeSantis, S. M., & Upadhyaya, H. P. (2012) · American Journal on Addictions · doi:10.1111/j.1521-0391.2012.00232.x · Cited by 157 · see citing works
Self-citationGarland, E. L. (2016) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.13034 · Cited by 137 · cited 1× · see citing works
“In contrast to other MBIs, MORE integrates mindfulness training with reappraisal and savoring skills designed to decrease valuation of drug reward and amplify natural reward processing, thereby disrupting the cycle of craving, maladaptive affect, and cognition underpinning addictive behavior [15, 23].”
Self-citationGarland, E. L., Froeliger, B., & Howard, M. O. (2015) · Journal of Behavioral Medicine · doi:10.1007/s10865-014-9607-0 · Cited by 136 · see citing works
Self-citationMotzkin, J. C., Baskin-sommers, A. R., Newman, J. P., Kiehl, K. A., & Koenigs, M. R. (2014) · Human Brain Mapping · doi:10.1002/hbm.22474 · Cited by 105 · see citing works
Froeliger, B., McConnell, P. A., Stankeviciute, N. M., McClure, E. A., Kalivas, P. W., & Gray, K. M. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.09.021 · Cited by 90 · see citing works
Self-citationMindfulness training increases cooperative decision making in economic exchanges: Evidence from fMRI
Kirk, U., Gu, X., Sharp, C., Hula, A., Fonagy, P., & Montague, P. R. (2016) · NeuroImage · doi:10.1016/j.neuroimage.2016.05.075 · Cited by 71 · see citing works
Azizian, A., Nestor, L. J., Payer, D. E., Monterosso, J. R., Brody, A. L., & London, E. D. (2009) · Neuropsychopharmacology · doi:10.1038/npp.2009.186 · Cited by 69 · see citing works
Carpenter, M. J., Saladin, M. E., DeSantis, S. M., Gray, K. M., LaRowe, S. D., & Upadhyaya, H. P. (2009) · Addictive Behaviors · doi:10.1016/j.addbeh.2009.03.022 · Cited by 58 · see citing works
Self-citationGarland, E. L., Howard, M. O., Zubieta, J.-K., & Froeliger, B. (2017) · Psychotherapy and Psychosomatics · doi:10.1159/000453400 · Cited by 50 · see citing works
Self-citationMindfulness meditation modulates reward prediction errors in a passive conditioning task
Kirk, U., & Montague, P. R. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.00090 · Cited by 42 · see citing works
Smoking withdrawal shifts the spatiotemporal dynamics of neurocognition
Kozink, R. V., Lutz, A. M., Rose, J. E., Froeliger, B., & McClernon, F. J. (2010) · Addiction Biology · doi:10.1111/j.1369-1600.2010.00252.x · Cited by 41 · see citing works
Self-citationNicotine withdrawal modulates frontal brain function during an affective Stroop task
Froeliger, B., Modlin, L. A., Wang, L., Kozink, R. V., & McClernon, F. J. (2011) · Psychopharmacology · doi:10.1007/s00213-011-2522-y · Cited by 39 · see citing works
Self-citationMindfulness, Mechanisms and Meaning: Perspectives From the Cognitive Neuroscience of Addiction
McConnell, P. A., & Froeliger, B. (2015) · Psychological Inquiry · doi:10.1080/1047840x.2015.1076701 · Cited by 37 · see citing works
Self-citationEvidence for greater cue reactivity among low-dependent vs. high-dependent smokers
Watson, N. L., Carpenter, M. J., Saladin, M. E., Gray, K. M., & Upadhyaya, H. P. (2010) · Addictive Behaviors · doi:10.1016/j.addbeh.2010.02.010 · Cited by 36 · see citing works
Self-citationFroeliger, B., Modlin, L. A., Kozink, R. V., Wang, L., & McClernon, F. J. (2011) · Addiction Biology · doi:10.1111/j.1369-1600.2011.00410.x · Cited by 31 · see citing works
Self-citationFroeliger, B., Modlin, L., Kozink, R. V., Wang, L.-H., Garland, E., Addicott, M., & McClernon, F. (2012) · Psychiatry Research · doi:10.1016/j.pscychresns.2012.05.002 · Cited by 30 · see citing works
Self-citationDiggs, H. A., Froeliger, B., Carlson, J. M., & Gilbert, D. G. (2012) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2012.06.009 · Cited by 28 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- [15]Garland E. L. Mindfulness-Oriented Recovery Enhancement: Reclaiming a Meaningful Life from Addiction, Stress, and Pain 2013 Washington, DC, USA NASW Press
Cited by
Sorted by citations
Garland, E. L., & Howard, M. O. (2018) · Addiction Science & Clinical Practice · doi:10.1186/s13722-018-0115-3 · Cited by 300 · see citing works
Self-citationTrait mindfulness and health behaviours: a meta-analysis
Sala, M., Rochefort, C., Lui, P. P., & Baldwin, A. S. (2020) · Health Psychology Review · doi:10.1080/17437199.2019.1650290 · Cited by 199 · see citing works
Garland, E. L., Hanley, A. W., Riquino, M. R., Reese, S. E., Baker, A. K., Salas, K., Yack, B. P., Bedford, C. E., Bryan, M. A., Atchley, R., et al. (2019) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000390 · Cited by 167 · see citing works
Self-citationGarland, E. L. (2016) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.13034 · Cited by 137 · see citing works
Self-citationGarland, E. L., & Fredrickson, B. L. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2019.01.004 · Cited by 134 · see citing works
Self-citationGarland, E. L., Hanley, A. W., Kline, A., & Cooperman, N. A. (2019) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2019.07.007 · Cited by 105 · see citing works
Self-citationPriddy, S. E., Howard, M. O., Hanley, A. W., Riquino, M. R., Friberg-Felsted, K., & Garland, E. L. (2018) · Substance Abuse and Rehabilitation · doi:10.2147/sar.s145201 · Cited by 101 · see citing works
Self-citationGarland, E. L., Bryan, C. J., Finan, P. H., Thomas, E. A., Priddy, S. E., Riquino, M. R., & Howard, M. O. (2017) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2016.07.033 · Cited by 71 · see citing works
Self-citationHanley, A. W., de Vibe, M., Solhaug, I., Farb, N., Goldin, P. R., Gross, J. J., & Garland, E. L. (2021) · Stress and Health · doi:10.1002/smi.3035 · Cited by 56 · see citing works
Self-citationMindfulness in Treatment Approaches for Addiction — Underlying Mechanisms and Future Directions
Rosenthal, A., Levin, M. E., Garland, E. L., & Romanczuk-Seiferth, N. (2021) · Current Addiction Reports · doi:10.1007/s40429-021-00372-w · Cited by 54 · see citing works
Self-citationSmith, J. L., Allen, J. W., Haack, C., Wehrmeyer, K., Alden, K., Lund, M. B., & Mascaro, J. S. (2021) · Mindfulness · doi:10.1007/s12671-020-01502-7 · Cited by 37 · see citing works
Thomas, E. A., Mijangos, J. L., Hansen, P. A., White, S., Walker, D., Reimers, C., Beck, A. C., & Garland, E. L. (2019) · Integrative Cancer Therapies · doi:10.1177/1534735419855138 · Cited by 36 · see citing works
Self-citationHanley, A. W., & Garland, E. L. (2021) · Journal of Evidence-Based Social Work · doi:10.1080/26408066.2020.1833803 · Cited by 16 · see citing works
Self-citationRoos, C. R., Kiluk, B., Carroll, K. M., Bricker, J. B., Mun, C. J., Sala, M., Kirouac, M., Stein, E., John, M., Palmer, R., et al. (2024) · Annals of Medicine · doi:10.1080/07853890.2024.2315228 · Cited by 12 · see citing works
- Authors
- Froeliger, B., Mathew, A. R., McConnell, P. A., Eichberg, C., Saladin, M. E., Carpenter, M. J., & Garland, E. L.
- Affiliations
- Medical University of South Carolina (US)
- Northwestern University (US)
- University of Utah (US)
- Corresponding author
- Froeliger, B.
- ORCID
- Venue
- Evidence-Based Complementary and Alternative Medicine
- Publisher
- Wiley
- Published
- 2017-01
- Volume
- 2017
- Issue
- 1
- Pages
- 7018014-7018014
- ISSN
- 1741-427X (ISSN-L)
- 1741-4288
- PMC
- PMC5360937
- OpenAlex
- W2592095857
- Cited by
- 83
- References
- 53
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 8 · 2023: 12 · 2022: 5 · 2021: 12 · 2020: 9 · 2019: 14 · 2018: 8 · 2017: 3 · 2016: 1
- FWCI
- 6.82
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Evidence-based Complementary and Alternative Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute on Drug Abuse (R01DA0033459, T32DA007288, F32DA036947, R34DA037005)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- Mindfulness-Oriented Recovery Enhancement, nicotine dependence, smoking cessation, dual-process models, reward processing, ventral striatum, ventral prefrontal cortex, smoking cue reactivity, emotion regulation, positive affect, resting-state functional connectivity, frontostriatal circuits
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
