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

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.

Keywords: coping motives; heroin-seeking behavior; negative mood induction; opiate dependence; vulnerability.

Figures

Figure 1
Figure 1
Task used to test the effect of mood induction on heroin choice in opiate-dependent and control participants. Images of heroin and food were obtained online and were not copyrighted.
Figure 2
Figure 2
(A) Mean percent (and SEM) choice of heroin versus food pictures in the baseline and test blocks of the task (see Figure 1). Opiate-dependent participants showed a higher rate of heroin choice overall compared to control participants, and showed a mood induced increase in heroin choice at test, whereas controls did not. (B) Subjective negative and positive mood states reported at pre-induction and post-test timepoints (see Figure 1). Opiate-dependent participants showed no overall change in subjective mood states, whereas control participants showed an increase in negative mood and a decrease in positive mood following mood induction. (C) Scatterplot and regression slope relating the mood-induced change in percent heroin choice to self-reported opiate use to cope with negative affect in opiate-dependent participants. (D) Scatterplot and regression slope relating the mood-induced change in percent heroin choice to self-reported change in negative mood in opiate-dependent participants.

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