Negative Mood Induction Increases Choice of Heroin Versus Food Pictures in Opiate-Dependent Individuals: Correlation With Self-Medication Coping Motives and Subjective Reactivity.

Lee Hogarth,Alexandra Bakou,Justin Mahlberg,Sharon Cashel,Lorna Hardy,Ahmed A Moustafa,Gabrielle Weidemann

doi:10.3389/fpsyt.2019.00274

Lee Hogarth, Alexandra Bakou + Show 5 more

Open Access

https://doi.org/10.3389/fpsyt.2019.00274

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Abstract

Acute growth in negative affect is thought to play a major role in triggering relapse in opiate-dependent individuals. Consistent with this view, three lab studies have demonstrated that negative mood induction increases opiate craving in opiate-dependent individuals. The current study sought to confirm these effects with a behavioral measure of heroin seeking, and test whether the effect is associated with self-reported opiate use to cope with negative affect and subjective reactivity to mood induction. Participants were heroin-dependent individuals engaged with treatment services (n = 47) and control participants (n = 25). Heroin users completed a questionnaire assessing reasons for using heroin: negative affect, social pressure, and cued craving. Baseline heroin choice was measured by preference to enlarge heroin versus food thumbnail pictures in two-alternative forced-choice trials. Negative mood was then induced by depressive statements and music before heroin choice was tested again. Subjective reactivity was indexed by negative and positive mood reported at the pre-induction to post-test timepoints. Heroin users chose heroin images more frequently than controls overall ( p = .001) and showed a negative mood-induced increase in heroin choice compared to control participants (interaction p < .05). Mood-induced heroin choice was associated with self-reported heroin use to cope with negative affect ( p < .05), but not social pressure ( p = .39) or cued craving ( p = .52), and with subjective mood reactivity ( p = .007). These data suggest that acute negative mood is a trigger for heroin seeking in heroin-dependent individuals, and this effect is pronounced in those who report using heroin to cope with negative affect, and those who show greater subjective reactivity to negative triggers. Interventions should seek to target negative coping motives to build resilience to affective triggers for relapse.

Highlights

According to negative reinforcement theory, negative affective states act as powerful triggers for drug use behavior, motivating drug use to cope with those states [e.g., Refs. [1,2,3]]
The main effect of block was significant in heroin users, F(1,45) = 6.96, p = .01, ηp2 = .134, but not controls, F(1,24) = .26, p = .62, ηp2 =
These results indicate that heroin users chose heroin images more frequently, and showed increased heroin choice following negative mood induction, compared to controls

Summary

Introduction

According to negative reinforcement theory, negative affective states act as powerful triggers for drug use behavior, motivating drug use to cope with those states [e.g., Refs. [1,2,3]]. Evidence for this proposal comes from lab studies where negative mood induction (including stress) increased various metrics of drug motivated behavior, including craving, choice, demand, consumption, and cognitive bias. Such mood induction effects have been extensively demonstrated for alcohol [4,5,6,7], tobacco [8,9,10], and cocaine [11,12,13,14]. The study by Childress and colleagues [21] recruited 10 opiatedependent clients who had been abstinent for 30 days, exposed them to guided self-hypnosis of a depressive scene, and found that subjective opiate craving increased from pre- to post-induction. This work provides preliminary support for the notion that acute negative mood is an important trigger for opiate seeking

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