Evidence map›Paper›PMID 41687705›Full record

Trial reportThe journal of pain2026

Autonomic indices of negative emotion regulation predict treatment response in opioid-treated chronic low back pain.

Anna Parisi, Miranda Johnson, Aleksandra Zgierska, Bruce Barrett, Rob R Edwards, Eric L Garland

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in The journal of pain, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Anna ParisiDepartment of Social Work, George Mason University, Fairfax, VA, United States.
Miranda JohnsonMinneapolis Veterans Affairs Medical Center, Minneapolis, MN, United States.
Aleksandra ZgierskaPenn State College of Medicine, Department of Family and Community Medicine, Hershey, PA, United States; Penn State College of Medicine, Department of Public Health Sciences, Hershey, PA, United States; Penn State College of Medicine, Department of Anesthesiology and Perioperative Medicine, Hershey, PA, United States.
Bruce BarrettUniversity of Wisconsin-Madison, School of Medicine and Public Health, Department of Family Medicine and Community Health, Madison, WI, United States.
Rob R EdwardsHarvard Medical School, Brigham and Women's Hospital, Departments of Anesthesiology, Perioperative and Pain Medicine and Psychiatry, Chestnut Hill, MA, United States.
Eric L GarlandSanford Institute for Empathy and Compassion, University of California San Diego, La Jolla, CA, United States; Department of Psychiatry, University of California San Diego School of Medicine, La Jolla, CA, United States. Electronic address: egarland@health.ucsd.edu.

Funding

Optimizing Patient-Centered Opioid Tapering with Mindfulness-Oriented Recovery EnhancementR01DA058621 · NIDA · UNIVERSITY OF UTAH · PI Nina Cooperman, Eric Lee Garland · 2023 to 2026
$4.6M
Motivational Interviewing and Mindfulness-Oriented Recovery Enhancement for Tobacco Dependence and Other Drug use in Methadone TreatmentR01DA057631 · NIDA · RUTGERS BIOMEDICAL AND HEALTH SCIENCES · PI Nina Cooperman, Eric Lee Garland · 2022 to 2026
$3.8M
Implementation and Effectiveness of Mindfulness Oriented Recovery Enhancement as an Adjunct to Methadone Treatment for Opioid Use DisorderR01DA056537 · NIDA · RUTGERS BIOMEDICAL AND HEALTH SCIENCES · PI Nina Cooperman, Eric Lee Garland · 2022 to 2026
$3.4M
Analgesic and Opioid Sparing Brain Mechanisms of Mindfulness-Oriented Recovery Enhancement for Chronic Low Back PainR01AT011772 · NCCIH · UNIVERSITY OF UTAH · PI Eric Lee Garland, Fadel Zeidan · 2022 to 2026
$3.0M
NCCIH NIH HHS R01 AT011772NIDA NIH HHS R01 DA056537NIDA NIH HHS R01 DA057631NIDA NIH HHS R01 DA058621Patient-Centered Outcomes Research Institute OPD-1601-33860
6 · The paper itself

Abstract

Difficulties engaging in emotion regulation strategies, such as cognitive reappraisal, may contribute to heightened pain severity, functional interference and poorer treatment response among adults with chronic low back pain (CLBP) receiving long-term opioid therapy (LTOT). This study used high-frequency heart rate variability (HF-HRV) as a physiological index of negative emotion regulation capacity to examine its influence on psychological treatment outcomes in opioid-treated CLBP. Participants (N = 68) were adults with opioid-treated CLBP enrolled in the Salt Lake City site of a multisite randomized clinical trial comparing mindfulness-based therapy (MBT) and cognitive behavioral therapy (CBT) adjunctive to usual care. At baseline, participants completed an emotion regulation task involving passive viewing and cognitive reappraisal of negative affective stimuli while HF-HRV was recorded. They also completed the Brief Pain Inventory (BPI) to assess pain severity and functional interference. Participants were then randomized to 8 weeks of MBT (n = 41) or CBT (n = 27) and completed BPI assessments at 3-, 6-, 9-, and 12-month follow-ups. Linear mixed-effects models revealed that lower baseline reappraisal capacity, as indicated by blunted phasic HF-HRV during the emotional regulation task, significantly predicted higher pain severity and interference following treatment with MBT or CBT through 12-month follow-up. Findings suggest that attenuated ability to regulate autonomic responses during reappraisal of negative emotional stimuli may contribute to more refractory pain outcomes as long as a year later among individuals engaged in evidence-based psychological treatments. Enhancing emotion regulation strategies, like cognitive reappraisal, may strengthen autonomic functioning and improve pain-related outcomes. PERSPECTIVE: This study found that lower baseline cognitive reappraisal efficacy, indexed by blunted HF-HRV during an emotion regulation task, predicted worse response to psychological treatment for adults with opioid-treated CLBP. These findings point to the potential importance of cognitive reappraisal as a therapeutic target in chronic pain interventions.

Indexed as

Analgesics, OpioidAutonomic Nervous SystemChronic PainCognitive Behavioral TherapyEmotional RegulationHeart RateLow Back PainAdultCoping SkillsFemaleHumansMaleMiddle AgedMindfulnessOutcome Assessment, Health CareAnalgesics, OpioidChronic painCognitive reappraisalEmotional regulationHeart rate variability

Identifiers

PMID41687705
PMCPMC13529413

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.