Negative Affective Processing Research Articles

Who follows through? Different factors predict initial commitment vs. Following through in a national survey of organ donor registration.

Little research has investigated factors that determine whether people falter in the face of an obstacle or successfully follow through on an initial commitment to act. We integrated multiple theories (the Reasoned Action Approach [RAA], Prototype Willingness Model, and anticipated regret theory) to test which factors predict initial commitment to register as an organ donor and to discover whether different factors predict initial commitment vs. following through with registration. Participants from a nationally representative UK sample (N = 1,008) reported their beliefs about organ donation and indicated their decision to register. An obstacle that participants could not foresee was that they had to complete registration in a second survey 3 days after making their initial commitment. Findings showed that 14.8% of participants followed through, 19.7% demonstrated initial commitment, and 65.5% declined to register. Linear discriminant function analysis derived two functions that distinguished these registration patterns. The first function discriminated participants who declined to register from the other groups. The declined group had lower scores on RAA variables compared to their counterparts. The second function distinguished participants who made an initial commitment to register from those who followed through. Follow-through was associated with less anticipated negative affect, more favorable descriptive norms, and stronger identification with organ donors. The present findings indicate that even modest friction leads to a large reduction in follow-through. Moreover, different factors influence initial commitment vs. following through. Whereas RAA variables predicted initial commitment, following through was a function of anticipated negative affect and social processes.

Unpacking affect maintenance and its association with depressive symptoms: integrating positive and negative affects

ABSTRACT Depression is associated with increased maintenance of negative affect (NA) and reduced – blunted and short-lived – maintenance of positive affect (PA). Studies have focused on factors associated with the maintenance of NA, specifically, the emotion regulation strategy of brooding and the capacity to hold negative affective experiences in working memory (WM). Despite its theoretical importance, less attention has been given to factors associated with the maintenance of PA in depression. This study aims to synthesise factors playing a role in the maintenance of both NA and PA. Specifically, we used self-reported assessment of PA and NA regulation and performance-based measures of NA and PA processing in WM to predict depressive symptoms severity. Participants (N = 219) completed the Affective Maintenance Task (AMT, Mikels et al., 2008), which provided performance-based measures of PA and NA maintenance, and filled out questionnaires assessing brooding, positive rumination and depressive severity. Brooding, positive rumination and AMT-based measures of positive (but not negative) affective information processing were independently associated with depressive symptoms. We highlight the unique contributions of PA processing, as well as of self-reported emotion regulation strategies in understanding depression maintenance.

The subjective amplitude of the diurnal rhythm matters – Chronobiological insights for neuroimaging studies

Multiple aspects of human psychophysiology, including mood and cognition, are subjected to diurnal rhythms. While the previous magnetic resonance imaging (MRI) studies have focused solely on the morningness-eveningness (ME) preference dichotomy, i.e. the circadian phase, the second key dimension of the diurnal rhythms, i.e. the strength of these preferences (amplitude; AM), has been completely overlooked. Uncovering the neural correlates of AM is especially important considering its link with negative emotionality. Structural T1-weighted neuroimaging data from 79 early (EC) and 74 late (LC) chronotypes were analysed to compare grey matter (GM) volume and cortical thickness. The study aimed to elucidate whether the subjective AM and its interaction with ME was a significant predictor of individual brain structure. Both GM volume and cortical thickness of the left primary visual cortex was negatively correlated with AM scores across the entire sample. Furthermore, EC and LC differed in their association between AM scores and the GM volume in the right middle temporal gyrus, with the positive and negative correlations reported respectively in the two groups. The current study underlines the importance of the visual system in circadian rhythmicity and provides possible neural correlates for AM-related differences in negative affect processing. Furthermore, the presence of the opposite correlations between brain anatomy and AM in the two groups suggests that the behavioural and neuronal chronotype differences might become more pronounced in individuals with extreme diurnal differences in mood and cognition, highlighting the necessity to additionally account for AM in neuroimaging studies.

Integrating Biobehavioral and Environmental Components of Developmental Psychopathology via Interpersonal Dynamics: An RDoC-Advancing Model

Although the Research Diagnostic Criteria (RDoC) framework proposes biological and environmental mechanisms intersect in the etiology of psychopathology, there is no guidance on how to define or measure experiences in the environment within the RDoC matrix. Interpersonal dynamics during caregiver–child interactions involve temporal coordination of interacting partners’ biobehavioral functioning; repeated experiences of signaling to caregivers and responding to caregivers’ signals shape children’s subsequent socioemotional and brain development. We begin with a review of the extant literature on caregiver-child dynamics, which reveals that RDoC’s units of analysis (brain circuits, physiology, behavior, and self-report) are inextricably linked with moment-to-moment changes in the caregiving environment. We then offer a proof-of-concept for integrating biobehavioral RDoC units and environmental components via caregiver-child dynamics. Our approach uses dynamic structural equation models to estimate within-dyad dynamics involving arousal, social, cognitive, and negative or positive affective processes based on second-by-second changes in parasympathetic activity (RSA) during a conflict discussion and a positive event-planning task. Our results illustrate variation in parent–child RSA synchrony, suggesting differences depending on the driver (i.e., child- or parent-led) and on the unique and intersecting domains involved (e.g., positive or negative affect valence systems). We conclude with recommendations for conducting robust, methodologically rigorous studies of interpersonal dynamics that advance the RDoC framework and provide a summary of the clinical implications of this research. Examining caregiver-child dynamics during and across multiple dyadic interaction paradigms that differentially elicit key domains of functioning can deepen understanding of how caregiver- and child-led interpersonal dynamics contribute to child psychopathology risk.

Mechanisms underlying capsulotomy for refractory obsessive-compulsive disorder: neural correlates of negative affect processing overlap with deep brain stimulation targets

Ablative procedures such as anterior capsulotomy are potentially effective in refractory obsessive-compulsive disorder (OCD). Converging evidence suggests the ventral internal capsule white matter tracts traversing the rostral cingulate and ventrolateral prefrontal cortex and thalamus is the optimal target for clinical efficacy across multiple deep brain stimulation targets for OCD. Here we ask which prefrontal regions and underlying cognitive processes might be implicated in the effects of capsulotomy by using both task fMRI and neuropsychological tests assessing OCD-relevant cognitive mechanisms known to map across prefrontal regions connected to the tracts targeted in capsulotomy. We tested OCD patients at least 6 months post-capsulotomy (n = 27), OCD controls (n = 33) and healthy controls (n = 34). We used a modified aversive monetary incentive delay paradigm with negative imagery and a within session extinction trial. Post-capsulotomy OCD subjects showed improved OCD symptoms, disability and quality of life with no differences in mood or anxiety or cognitive task performance on executive, inhibition, memory and learning tasks. Task fMRI revealed post-capsulotomy decreases in the nucleus accumbens during negative anticipation, and in the left rostral cingulate and left inferior frontal cortex during negative feedback. Post-capsulotomy patients showed attenuated accumbens-rostral cingulate functional connectivity. Rostral cingulate activity mediated capsulotomy improvement on obsessions. These regions overlap with optimal white matter tracts observed across multiple stimulation targets for OCD and might provide insights into further optimizing neuromodulation approaches. Our findings also suggest that aversive processing theoretical mechanisms may link ablative, stimulation and psychological interventions.

Dimensions of childhood maltreatment and adult risky behaviors: Differential affective and inhibitory control mechanisms

BackgroundWhile childhood maltreatment has been identified as a robust risk factor for a myriad of poor outcomes, significant gaps in our understanding still remain regarding mechanisms of this risk transmission across the lifespan. ObjectiveInformed by recent dimensional models, the objective of this study was to examine how unique dimensions of childhood maltreatment relate to adult risky behaviors via interactions between cognitive control and affective processes across Positive and Negative Valence Systems. Participants and settingOur sample consisted of 110 community adults (M/SDage = 31.92/10.58 years old, 52.7 % male). MethodsParticipants completed a neuropsychological test of inhibitory control and self-report measures of childhood maltreatment, recent adult risky behaviors, and indices of affective processing. ResultsModerated-mediation analyses revealed that childhood experiences of neglect and abuse exhibited distinct mechanisms of risk transmission related to adult risky behaviors. Specifically, disruptions in inhibitory control and reward-related processes were linked to adult risky behavior in the context of Childhood Deprivation (95%CI = −0.166/−0.002), whereas negative affective processes were associated with adult risky behavior in the context of Childhood Threat (95 % CI = 0.015/0.157). ConclusionsFindings provide empirical support for novel dimensional theories of childhood maltreatment and suggest that distinct regulatory processes are impacted by these early life experiences, which may confer risk into adulthood.

A Systematic Review and Narrative Synthesis of the Evidence Underpinning Theoretical Perspectives and Cultural Influences on Forgiveness in Palliative Care.

Background: The process of forgiveness is proposed to reduce patient and family conflict and suffering in the face of life-limiting illness. However, it is unclear which theoretical perspectives underpin the concept of forgiveness in palliative care, and how culture may influence it. Objectives: To identify and synthesize primary evidence that underpins the concept of forgiveness within palliative care, and identify theoretical perspectives, including cultural assumptions. Design: A systematic review of studies on forgiveness in palliative care regardless of design was prospectively registered on PROSPERO. Narrative synthesis was conducted and the modified Seven-Point Checklist and modified Status Assessment Tool applied to appraise study quality (level 1) and contributions to theory building (level 2). Data Sources: Reference chaining and hand-searching were conducted for 10 electronic databases from 1960 to June 30, 2020. Results: Thirty-nine studies were included. Seven provided a definition of forgiveness, and six studies reported a process model. Twelve patient studies scored "high" on quality level 1 and nine scored "high" on level 2. Conceptualization of forgiveness included a conscious decision to abandon negative thoughts, feelings, and behaviors associated with conflicts, to find positive outcomes through processing of negative affect and cognitive reframing of conflicts. The process of forgiveness develops through time paralleled by an attributional movement from an external to an internal locus of control. Theoretical perspectives of systems, exchange and choice, social constructionism, behaviorism, and humanism were identified. Cultural contexts impact forgiveness. Conclusion: The synthesized model is based on primary evidence of mixed quality. Future research needs better theoretical conceptualization utilizing cultural perspectives. Forgiveness interventions with consideration of cultural influences are encouraged.

Alpha-to-beta- and gamma-band activity reflect predictive coding in affective visual processing

Processing of negative affective pictures typically leads to desynchronization of alpha-to-beta frequencies (ERD) and synchronization of gamma frequencies (ERS). Given that in predictive coding higher frequencies have been associated with prediction errors, while lower frequencies have been linked to expectations, we tested the hypothesis that alpha-to-beta ERD and gamma ERS induced by aversive pictures are associated with expectations and prediction errors, respectively. We recorded EEG while volunteers were involved in a probabilistically cued affective picture task using three different negative valences to produce expectations and prediction errors. Our data show that alpha-to-beta band activity after stimulus presentation was related to the expected valence of the stimulus as predicted by a cue. The absolute mismatch of the expected and actual valence, which denotes an absolute prediction error was related to increases in alpha, beta and gamma band activity. This demonstrates that top-down predictions and bottom-up prediction errors are represented in typical spectral patterns associated with affective picture processing. This study provides direct experimental evidence that negative affective picture processing can be described by neuronal predictive coding computations.

Negative affective processing is associated with cognitive control in early childhood: An fNIRS study.

The association between emotion and cognition has recently gathered interest in the field of cognitive neuroscience. However, the neural mechanism of negative emotion processing and its association with cognitive control in early childhood remains unclear. In the present study, we compared the processing of three emotions (i.e., negative, neutral, and positive emotions) and investigated the association between negative emotion processing and cognitive control in children aged 4-6 years (N = 43). Results indicated that children revealed greater brain activation when processing negative emotions than processing neutral and positive emotions. We also found a significant negative association between brain activation during negative emotion processing and reaction times of cognitive control, which represented children with better cognitive control evoked higher brain activation when processing negative emotions. The current study proposes a neural mechanism underlying emotion processing and provides important insights into the risk and future behavioral outcomes of potential psychological disorders.

Orbitofrontal control of conduct problems? Evidence from healthy adolescents processing negative facial affect

Conduct problems (CP) in patients with disruptive behavior disorders have been linked to impaired prefrontal processing of negative facial affect compared to controls. However, it is unknown whether associations with prefrontal activity during affective face processing hold along the CP dimension in a healthy population sample, and how subcortical processing is affected. We measured functional brain responses during negative affective face processing in 1444 healthy adolescents [M = 14.39 years (SD = 0.40), 51.5% female] from the European IMAGEN multicenter study. To determine the effects of CP, we applied a two-step approach: (a) testing matched subgroups of low versus high CP, extending into the clinical range [N = 182 per group, M = 14.44 years, (SD = 0.41), 47.3% female] using analysis of variance, and (b) considering (non)linear effects along the CP dimension in the full sample and in the high CP group using multiple regression. We observed no significant cortical or subcortical effect of CP group on brain responses to negative facial affect. In the full sample, regression analyses revealed a significant linear increase of left orbitofrontal cortex (OFC) activity with increasing CP up to the clinical range. In the high CP group, a significant inverted u-shaped effect indicated that left OFC responses decreased again in individuals with high CP. Left OFC activity during negative affective processing which is increasing with CP and decreasing in the highest CP range may reflect on the importance of frontal control mechanisms that counteract the consequences of severe CP by facilitating higher social engagement and better evaluation of social content in adolescents.

Distinct Neural Processing of Acute Stress in Major Depression and Borderline Personality Disorder

BackgroundMajor depressive disorder (MDD) and borderline personality disorder (BPD) are highly prevalent and often comorbid psychiatric conditions, with abnormal processing of negative affect resulting from psychological stress. Characteristics of central processing of autonomic response to stress in each disorder are not clearly settled. MethodsWe obtained whole brain 3T fMRI with concurrent skin conductance, respiration rate, and heart rate variability measures in a cohort of MDD (N=19), BPD (N=19) patients, and healthy (N=20) individuals. Experiments were conducted in resting conditions, during a control mental arithmetic task, during highly stressful mental arithmetic, and in the period immediately following psychological stress. ResultsWidespread activation of central autonomic network (CAN) structures was observed during stress compared to a control task in the group of healthy participants, whereas CAN activation during stress was less intense in both BPD and MDD. Both patient groups displayed increased sympathetic and decreased parasympathetic activation compared to healthy subjects, as previously reported. The relationship between peripheral sympathetic or parasympathetic activity and simultaneous regional brain BOLD activity was similar in BPD patients and healthy subjects, and markedly different from that seen in MDD patients. LimitationsThe sample size, the fact it belonged to a single study site, and low grade affective symptomatology in both patient groups limit the generalizability of the present findings. ConclusionsThe diverging neurobiological signature in the homeostatic response to stress in MDD and BPD possibly represents a heuristically valuable candidate biomarker to help discern MDD and BPD patients.

Oscillatory EEG Signatures of Affective Processes during Interaction with Adaptive Computer Systems.

Affect monitoring is being discussed as a novel strategy to make adaptive systems more user-oriented. Basic knowledge about oscillatory processes and functional connectivity underlying affect during naturalistic human–computer interactions (HCI) is, however, scarce. This study assessed local oscillatory power entrainment and distributed functional connectivity in a close-to-naturalistic HCI-paradigm. Sixteen participants interacted with a simulated assistance system which deliberately evoked positive (supporting goal-achievement) and negative (impeding goal-achievement) affective reactions. Electroencephalography (EEG) was used to examine the reactivity of the cortical system during the interaction by studying both event-related (de-)synchronization (ERD/ERS) and event-related functional coupling of cortical networks towards system-initiated assistance. Significantly higher α-band and β-band ERD in centro-parietal and parieto-occipital regions and β-band ERD in bi-lateral fronto-central regions were observed during impeding system behavior. Supportive system behavior activated significantly higher γ-band ERS in bi-hemispheric parietal-occipital regions. This was accompanied by functional coupling of remote β-band and γ-band activity in the medial frontal, left fronto-central and parietal regions, respectively. Our findings identify oscillatory signatures of positive and negative affective processes as reactions to system-initiated assistance. The findings contribute to the development of EEG-based neuroadaptive assistance loops by suggesting a non-obtrusive method for monitoring affect in HCI.

Positive and Negative Affective Processes Associated With Firearm Acquisition and Ownership

Introduction: To examine positive and negative affective processes associated with firearm acquisition and firearm ownership. Methods: An online cross-sectional survey assessing firearm ownership, reasons for firearm ownership, intentions to acquire a firearm in the next 12 months, and positive and negative affective states was administered to 6,200 U.S. adults (49.0% male, 51.0% female). Results: Mean negative and positive affect were significantly elevated among protective firearm owners (i.e., those who kept firearms for the primary purpose of self-protection) and participants intending to acquire a firearm. Protective firearm owners intending to acquire another firearm reported significantly higher negative affect than all other subgroups. Within this subgroup, negative affect and positive affect were positively correlated. Among all other subgroups, negative and positive affect were either negatively correlated or uncorrelated. Discussion: The intention to acquire firearms and protective firearm ownership are associated with both positive and negative affectivity. Typical cognitive-affective processes may be disrupted among protective firearm owners intending to acquire another firearm.

Drinking Motives as Moderators of In-the-Moment Drinking Risks in Response to Trauma-Related Distress.

Trauma exposure and posttraumatic stress disorder (PTSD) symptomatology are linked to increased risk for problematic drinking, yet the factors that increase such risk remain largely unknown. Theoretical models suggest that affectively oriented drinking motives may be central to trauma-related drinking. Specifically, individual-level motivations to drink to regulate affect may be important for moderating drinking urges that occur acutely in response to trauma cues. Further, elevated distress associated with PTSD symptomatology may increase any affectively motivated, momentary drinking risks. However, research has yet to examine these dynamic affective processes. In a large experimental sample, the current study tested whether affective (i.e., coping and enhancement) drinking motives and PTSD symptomatology moderated individuals' drinking urge in response to a trauma cue in a laboratory cue reactivity paradigm. College drinkers (n=611, 53% female) were recruited and selected across levels of trauma exposure and PTSD symptomatology by a structured clinical interview. Participants were randomized to a personalized trauma or neutral cue, reporting on their urge to drink alcohol before and after cue exposure. Drinking motives were assessed at the end of the experimental session. Trauma cue associations with drinking urge were moderated by coping, but not enhancement, motives. Specifically, stronger coping motives were associated with increases in urge to drink alcohol following exposure to a trauma but not neutral cue. PTSD classification did not significantly moderate these associations. Coping motives may increase drinking urge immediately following exposure to trauma cues and may differentiate individuals most at risk for problematic drinking during trauma-associated distress. Findings support momentary negative affect processes driving dynamic, immediate trauma-related drinking risks.

A synthesis of the quantitative literature on autistic pupils' experience of barriers to inclusion in mainstream schools

Autistic pupils' full engagement with education can be limited by characteristics of their autism and features of the learning environment. We sought to identify which barriers to inclusion are most commonly and most frequently experienced and where gaps exist in the quantitative literature. In this systematic review, we followed the PRISMA guidelines to identify relevant literature and used the Research Domain Criteria (National Institute of Mental Health, 2017) framework to synthesise the findings. We then evaluated the strength and quality of the current literature in terms of the perspectives reflected in the data, characteristics of the participants and the methods used. Forty‐eight studies were found that contained quantitative data directly collected from autistic pupils relating to their mainstream school experience. Experiences of friendship, anxiety and sensory sensitivity have been explored in the literature, with findings suggesting that difficulties in these areas are common for autistic pupils. We found gaps in the research in the domains of cognitive systems, negative affect, positive affect, arousal and sensorimotor processes. Further quantitative research is needed that directly reflects the pupils' experience and more thoroughly covers the relevant focal domains in which barriers to inclusion for autistic pupils may be expected to occur.

Reduced task-dependent modulation of functional network architecture for positive versus negative affective touch processing in autism spectrum disorders

Individuals with autism spectrum disorders (ASD) experience impairments in social communication and interaction, and often show difficulties with receiving and offering touch. Despite the high prevalence of abnormal reactions to touch in ASD, and the importance of touch communication in human relationships, the neural mechanisms underlying atypical touch processing in ASD remain largely unknown. To answer this question, we provided both pleasant and unpleasant touch stimulation to male adults with and without ASD during functional neuroimaging. By employing generalized psychophysiological interaction analysis combined with an independent component analysis approach, we characterize stimulus-dependent changes in functional connectivity patterns for processing two tactile stimuli that evoke different emotions (i.e., pleasant vs. unpleasant touch). Results reveal that neurotypical male adults showed extensive stimulus-sensitive modulations of the functional network architecture in response to the different types of touch, both at the level of brain regions and large-scale networks. Conversely, far fewer stimulus-sensitive modulations were observed in the ASD group. These aberrant functional connectivity profiles in the ASD group were marked by hypo-connectivity of the parietal operculum and major pain networks and hyper-connectivity between the semantic and limbic networks. Lastly, individuals presenting more social deficits and a more negative attitude towards social touch showed greater hyper-connectivity between the limbic and semantic networks. These findings suggest that reduced stimulus-related modulation of this functional network architecture is associated with abnormal processing of touch in ASD.

The neural influence of autobiographical memory related to the parent-child relationship on psychological health in adulthood

The recollection of childhood memories is affected by the subjects involved, such as father and mother, and by the context. This study aimed to clarify the neural influence of autobiographical memory related to the parent-child relationship on psychological health in adulthood. Twenty-nine healthy volunteers participated in a functional magnetic resonance imaging experiment using a childhood memory recollection task, in which they appraised the emotion a parent would have provided in a given situation. Whole-brain univariate and psychophysiological interaction analyses were performed. Neuroimaging results indicated notable involvement of the caudal anterior cingulate cortex and precuneus in autobiographical memory related to the parent-child relationship, and their activities were closely associated with the level of depression and self-esteem, respectively. The functional connectivity results indicated increased connectivity between the caudal anterior cingulate cortex and fusiform gyrus for the father-positive condition compared to the mother-positive condition and there was a positive correlation between the strength of connectivity between the two regions and the anxiety level. Our findings suggest the processing of negative affect and the personalness of autobiographical memories are distinctly engaged depending on the parent in question and the situational valence. The present study illuminates the impact of autobiographical memory processes on various dimensions of psychological health.

Rhythm and blues: Influence of CLOCK T3111C on peripheral electrophysiological indicators of negative affective processing

Dysfunction in the circadian system has been linked to emotion regulation and mood disorders with genetic variation in clock genes as likely contributors. Here, we focused on endophenotypes of affective processing and investigated in two independent samples of healthy individuals (n1=99, n2=108) whether genotypes of a functional single nucleotide polymorphism (SNP) in the gene encoding CLOCK (CLOCK T3111C, rs1801260) differed in physiological responses to emotional stimuli. Both samples underwent an emotional startle paradigm with startle responses being measured via EMG. In the second sample, skin conductance responses as well as corrugator and zygomaticus activity were also assessed. In both samples, CLOCK T3111C was associated with overall startle responses to loud noise bursts with T/T homozygotes showing consistently more marked responses. However, in the all-female second sample, the effects of CLOCK on skin conductance responses to the same loud noise bursts depended on hormone status: similar to the startle results, in free-cycling women T/T homozygotes showed more pronounced skin conductance response (SCR) compared to C allele carriers. The opposite was true for women using combined oral contraceptives (COC). A further CLOCK × hormone status interaction effect was found for corrugator activity. In free-cycling women, T/T homozygotes presented with less corrugator activity to affective pictures compared to C allele carriers, while the opposite pattern emerged for COC users. The findings emphasize the potential role of CLOCK for affect and mood.

Expressive Writing and Marital Satisfaction: A Writing Sample Analysis

ObjectiveTo examine the relationship between marital satisfaction and two linguistic elements in the context of writing: use of personal pronouns and affective language.BackgroundExpressive writing (EW) is an effective way of identifying and processing thoughts and emotions. It also promotes individual, physical, and psychological health. However, much less literature has examined the relationship between EW and relationship health.MethodWe used the Linguistic Inquiry and Word Count (LIWC2007) to examine the writing of 78 married, heterosexual couples who were instructed to write freely on a topic they felt strongly about in their relationship. Multilevel modeling within SPSS was used to examine our research questions.ResultsFindings suggest a relationship between marital satisfaction and use of (a) first‐person plural pronouns (we, us, our, ours), (b) positive affective language, and (c) linguistic indicators of anger when writing about one's relationship.ConclusionThe results provide further impetus for examining relationship processes within an EW framework and, in particular, for examining the merits of EW as a potential intervention for couples.ImplicationsFindings suggest that expressive writing may be a potentially important indicator of mutuality (we‐ness), the ability to up‐regulate positive emotion, and negative affective processes (i.e., anger).

Mindfulness-oriented recovery enhancement reduces opioid misuse risk via analgesic and positive psychological mechanisms: A randomized controlled trial.

Despite the heightened urgency of the current prescription opioid crisis, few psychotherapies have been evaluated for chronic pain patients receiving long-term opioid analgesics. Current psychological pain treatments focus primarily on ameliorating negative affective processes, yet basic science suggests that risk for opioid misuse is linked with a dearth of positive affect. Interventions that modulate positive psychological processes may produce therapeutic benefits among patients with opioid-treated chronic pain. The aim of this study was to conduct a theory-driven mechanistic analysis of proximal outcome data from a Stage 2 randomized controlled trial of Mindfulness-Oriented Recovery Enhancement (MORE), an integrative intervention designed to promote positive psychological health. Patients with opioid-treated chronic pain (N = 95; age = 56.8 ± 11.7; 66% female) were randomized to 8 weeks of therapist-led MORE or support group (SG) interventions. A latent positive psychological health variable comprised of positive affect, meaning in life, and self-transcendence measures was examined as a mediator of the effect of MORE on changes in pain severity at posttreatment and opioid misuse risk by 3-month follow-up. Participants in MORE reported significantly greater reductions in pain severity by posttreatment (p = .03) and opioid misuse risk by 3-month follow-up (p = .03) and significantly greater increases in positive psychological health (p < .001) than SG participants. Increases in positive psychological health mediated the effect of MORE on pain severity by posttreatment (p = .048), which in turn predicted decreases in opioid misuse risk by follow-up (p = .02). Targeting positive psychological mechanisms via MORE and other psychological interventions may reduce opioid misuse risk among chronic pain patients receiving long-term opioid therapy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).