The relation of metacognitions to emotion, impulsivity and craving in patients diagnosed with opoid use disorder

Objective: In this study we aimed to compare patients diagnosed with opioid use disorder and healthy adults in terms of metacognition, impulsivity and emotion; investigate their relations with substance craving in patients and apply these findings to our clinical practice for prevention and treatment purposes. Method: This study was conducted in University of Akdeniz Alcohol and Substance Addiction Treatment and Research Center. 100 patients who were diagnosed with opioid use disorder according to Diagnostic and Statistical Manual of Mental Disorders- 5 (DSM-5) between the age of 18-40 were included in the study. Also 100 healthy individuals that has no history of substance use were matched according to age, gender and education levels as control group. All participants were given semi-structured Sociodemographic Data Forms, and self-reported Clinical Interview for DSM Disorders (SCID-I), Barratt Impulsiveness Scale-11 (BIS-11), Metacognition Questionnare-30 (MCQ-30) and Hospital Anxiety and Depression Scale (HADS). Additionally Substance Craving Scale (SCS) was applied to the patient group. Our study had cross-sectional and descriptive properties and data was analyzed using SPSS 22 (SPSS/IBM, Chicago, IL, USA). Results: When compared in terms of metacognition, impulsivity and emotion, the patient group had significantly higher scores on all platforms than the control group. Opioid users had higher levels of impulsivity, metacognitive distortions and negative emotions. Upon investigation of the patient group, all fields of impulsivity were positively correlated with Cognitive Confidence and Need for Control while negatively correlated with Cognitive Self-Consciousness. The same relation was also concurred with anxiety levels and metacognitive distortions. Substance craving had a direct positive correlation with negative emotions and impulsivity, furthermore metacognitions were also indirectly related with craving via impulsivity levels. Discussion: Findings of this study revealed that metacognitions to be of importance in the treatment of opioid use disorder. Furthermore impulsivity, negative emotions and craving also had substantial relationship with metacognitions in this patient population. Multi dimensional treatment approaches that include not only cognitive but metacognitive fields should be incorporated in the rehabilitation of opioid users. More wide-ranging prospective studies are needed in order to reveal the role of metacognition in other cognitive, emotional and behavioral fields of opiod and substance use. Keywords: Opioid Use Disorder, Metacognition, Impulsivity, Depression, Anxiety, Craving