Mindfulness-based relapse prevention for substance craving

Abstract

Craving, defined as the subjective experience of an urge or desire to use substances, has been identified in clinical, laboratory, and preclinical studies as a significant predictor of substance use, substance use disorder, and relapse following treatment for a substance use disorder. Various models of craving have been proposed from biological, cognitive, and/or affective perspectives, and, collectively, these models of craving have informed the research and treatment of addictive behaviors. In this article we discuss craving from a mindfulness perspective, and specifically how mindfulness-based relapse prevention (MBRP) may be effective in reducing substance craving. We present secondary analyses of data from a randomized controlled trial that examined MBRP as an aftercare treatment for substance use disorders. In the primary analyses of the data from this trial, Bowen and colleagues (2009) found that individuals who received MBRP reported significantly lower levels of craving following treatment, in comparison to a treatment-as-usual control group, which mediated subsequent substance use outcomes. In the current study, we extend these findings to examine potential mechanisms by which MBRP might be associated with lower levels of craving. Results indicated that a latent factor representing scores on measures of acceptance, awareness, and nonjudgment significantly mediated the relation between receiving MBRP and self-reported levels of craving immediately following treatment. The mediation findings are consistent with the goals of MBRP and highlight the importance of interventions that increase acceptance and awareness, and help clients foster a nonjudgmental attitude toward their experience. Attending to these processes may target both the experience of and response to craving.

The emerging role of Buddhism in clinical psychology: Toward effective integration.

“…Potential treatment applications for BDIs span almost the entire spectrum of psychological disorders including (for example) mood disorders (Hofmann, Sawyer, Witt, & Oh, 2010), anxiety disorders (Vøllestad, Nielson, & Nielson, 2011), substance use disorders (Witkiewitz, Bowen, Douglas, & Hsu, 2013), personality disorders (Soler et al, 2012), and schizophreniaspectrum disorders (Johnson et al, 2011). BDIs also effectuate improvements in psychological wellbeing, cognitive function, and emotion regulation capacity in sub-clinical and healthy-adult populations (e.g., Chiesa, Calati, & Serretti, 2011;Desbordes et al, 2012;Eberth, & Sedlmeier, 2012;Van Gordon, Shonin, Sumich, Sundin, & Griffiths, 2013).…”

Exploration des mécanismes potentiels sous-jacents aux troubles liés à l’utilisation d’une substance chez les personnes atteintes d’un trouble de la personnalité

“…Il reste bien sûr à démontrer que des traitements ciblant spécifiquement ces composantes pourraient mener vers une évolution favorable des comorbidités TP et TLUS. Récemment, des essais cliniques en psychothérapie visant à réduire l'impulsivité et les émotions négatives en utilisant l'approche « Mindfulness Based Relapse Prevention », se sont avérés prometteurs (Witkiewitz, Bowen, Douglas et Hsu, 2013). D'autres études menées chez des jeunes non diagnostiqués avec un trouble de personnalité indiquent même que des approches ciblant précocement certains traits spécifiques pourraient permettre de prévenir le développement d'une consommation de substances à risque (Conrod et al, 2013).…”

Mindfulness-Based Cognitive Therapy in Major depressive disorder - systematic review and metanalysis

“…It also leads individuals to accept experience as impermanent, recognizing that neither the positive state nor the negative state are long lasting and allowing them to realize that the effort exerted to achieve or hold on to a certain state of being is not only useless, but can cause suffering (52).…”