Bio-Behavioral Indices of Emotion Regulation: Potential Targets for Treatment in Addiction

Abstract

Emotion regulation and the manner in which it is comprised play a key role in the motivation for drugs and alcohol. As such, the bio-behavioral processes underpinning aspects of emotion regulation behavior may provide expedient targets for treatment development. This review will examine some of the robust emotional, psychophysiological, and neurobiological adaptations that sub-serve affect regulation behaviors during early abstinence from addiction and assess their potential as targets for treatment development. During early abstinence from addiction, individuals report problems with emotional awareness and impulse control during distress as well as enhanced, persistent negative mood in the face of acute psychological stress. In line with this, psychophysiological research studies have used non-affective indices of emotional awareness to show poor interoceptive accuracy. Moreover, imaging research has highlighted hypofunctional prefrontal circuitry in regulatory brain regions and amygdala/insula adaptations that are also compatible with decrements in emotional awareness, enhanced provoked dysphoria and decreased impulse control. There is also some evidence to suggest that targeting these indices of emotion regulation behavior using mindfulness-based meditation and medication therapies may be effective in improving outcome. The biological construct of emotion regulation has helped to provide an important heuristic framework within which to develop novel treatment markers. However, there remains a need for more contextual and situational-based research to achieve a more holistic understanding of emotion regulation for improved clinical application.