Substance use outcomes for mindfulness based relapse prevention are partially mediated by reductions in stress: Results from a randomized trial

Davis, Jordan P.; Berry, Daniel; Dumas, Tara M.; Ritter, Ellen M.; Smith, Douglas C.; Menard, Christopher; Roberts, Brent W.

doi:10.1016/j.jsat.2018.05.002

Cited by 49 publications

(42 citation statements)

References 48 publications

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“…Decrease in stress reactivity is one of the hypothesized mechanisms underlying the efficacy of mindfulness-based interventions in reducing relapse risk (Garland et al, 2010;Koob et al, 2014;Kober et al, 2017;Li et al, 2017;Priddy et al, 2018;Davis et al, 2018). It is possible our findings could be due to the insufficient efficacy of our intervention in improving stress coping and reducing stress reactivity, especially since both groups decreased their perceived stress scores to a similar degree.…”

Section: Discussionmentioning

confidence: 80%

“…Mindfulness-based interventions have been proposed as adjunctive treatments targeting relapse prevention in substance use disorders (Bowen, Chawla, & Marlatt, 2010). Improved emotion regulation, reduced stress reactivity, and decreased risk of relapse in high-risk situations have been hypothesized and documented as possible mechanisms, through which mindfulness-based interventions may impact substance use-related outcomes (Garland, Gaylord, Boettiger, & Howard, 2010;Koob et al, 2014;Kober, Brewer, Height, & Sinha, 2017;Li et al, 2017;Priddy et al, 2018;Davis et al, 2018). Several studies of mindfulness-based interventions, including Mindfulness-Based Relapse Prevention (MBRP), for a broad spectrum of substance use disorders have shown beneficial findings for reducing relapse risk, frequency and amount of substance misuse, craving, drug and alcohol-related consequences, mental health symptoms, and physical health problems (Bowen et al, 2009;Bowen et al, 2014;Witkiewitz & Bowen, 2010;Witkiewitz, Warner, et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

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Mindfulness-based relapse prevention for alcohol dependence: Findings from a randomized controlled trial

Zgierska

Burzinski

Mundt

et al. 2019

Journal of Substance Abuse Treatment

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OBJECTIVES: To assess the effects of mindfulness-based relapse prevention for alcohol dependence (MBRP-A) intervention on drinking and related consequences. METHODS: 123 alcohol-dependent adults in early recovery, recruited from outpatient treatment programs, were randomly assigned to MBRP-A (intervention plus usual-care; N=64) or Control (usual-care-alone; N=59) group. MBRP-A consisted of eight-weekly sessions and home practice. Outcomes were assessed at baseline, 8 weeks and 26 weeks (18 weeks post-intervention), and compared between groups using repeated measures analysis. RESULTS: Outcome analysis included 112 participants (57 MBRP-A; 55 Control) who provided follow-up data. Participants were 41.0±12.2 years old, 56.2% male, and 91% white. Prior to "quit date," they reported drinking on 59.4±34.8% (averaging 6.1±5.0 drinks/day) and heavy drinking (HD) on 50.4±35.5% of days. Their drinking reduced after the "quit date" (before enrollment) to 0.4±1.7% (HD: 0.1±0.7%) of days. At 26 weeks, the MBRP-A and control groups reported any drinking on 11.5±22.5% and 5.9±11.6% of days and HD on 4.5±9.3% and 3.2±8.7% of days, respectively, without between-group differences (ps≥0.05) in drinking or related consequences during the follow-up period. Three MBRP-A participants reported "relapse," defined as three

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Mindfulness-based relapse prevention for alcohol dependence: Findings from a randomized controlled trial

Zgierska

Burzinski

Mundt

et al. 2019

Journal of Substance Abuse Treatment

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“… This laboratory assessment was conducted as an extension of a large- scale clinical trial, and in consideration of participant burden, there is only one assessment time point with a relatively small sample. Davis et at., 2018 [ 33 ] Rolling MBRP + treatment normally provided by the residential facility: 8, 90- min classes that were held twice weekly. Members were enrolled as they entered the residential facility (as opposed to the standard 8- week cohort-based protocol).…”

Section: Resultsmentioning

confidence: 99%

“…An additional factor that MBIs appear to target is perceived stress. Many of the protocols we reviewed demonstrated that participants had more volitional control of stressful situations that may have previously led them to engage in substance use [23,32,33]. These findings could be linked to the process of non-judgmental awareness that all of the protocols encourage.…”

Section: Discussionmentioning

confidence: 97%

Mindfulness-based programs for substance use disorders: a systematic review of manualized treatments

Korecki

Schwebel

Votaw

et al. 2020

Subst Abuse Treat Prev Policy

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Background: Substance use disorders are prevalent and returning to substance use (i.e., relapse) following treatment is common, underscoring the need for effective treatments that will help individuals maintain long-term reductions in substance use. Mindfulness-based interventions (MBIs) have been increasingly developed and evaluated for the treatment of substance use disorders. The aim of this article was to update a systematic review conducted by Li et al. in 2017 on the outcomes of randomized control trials of MBIs for substance use disorders. In addition, we provided a session-by-session examination of the most widely used MBI protocols. Methods: We conducted a comprehensive literature search of the PubMed, PsycINFO, and Web of Science databases from January of 2016 through April of 2020. Studies were included based on the following criteria: 1) examined the effects of an MBI, 2) employed a randomized controlled trial design with repeated measures, including secondary data analyses of randomized controlled trials, and 3) enrolled participants seeking treatment for substance use disorders. Results: The search identified 902 publications and 30 studies were eligible for inclusion and data extraction. MBIs appear to be as effective as existing evidence-based treatments for substance use disorders at reducing the frequency and quantity of alcohol and drug use, substance-related problems, craving for substance use, and at increasing the rate of abstinence. Conclusions: Future directions include additional large scale randomized controlled trials, investigation of the most suitable settings and protocols, examination of patient populations that may benefit most from MBIs, and dissemination and implementation research.

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“…In the largest and most methodologically rigorous randomized controlled trial (RCT) of MBRP to date, MBRP as an aftercare treatment outperformed both standard relapse prevention and treatment‐as‐usual in reducing rates of heavy drinking and drug use 12 months following treatment (Bowen et al., ). Two RCTs have evaluated MBRP as a primary intervention in residential treatment and found that MBRP was significantly more effective than standard relapse prevention in reducing alcohol and drug use following treatment (Davis et al., ; Witkiewitz et al., ). Of note, there are several manualized interventions similar to MBRP, and recent meta‐analytic reviews of the various mindfulness‐based interventions for substance use disorders have each shown significant effects of mindfulness‐based interventions in reducing substance use (Li et al., ).…”

Section: Behavioral and Neurobiological Dysfunction In Audmentioning

confidence: 99%

Mindfulness‐Based Relapse Prevention and Transcranial Direct Current Stimulation to Reduce Heavy Drinking: A Double‐Blind Sham‐Controlled Randomized Trial

Witkiewitz

Stein

Votaw

et al. 2019

Alcoholism Clin & Exp Res

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Background: Mindfulness-based relapse prevention (MBRP) and transcranial direct current stimulation (tDCS) have independently shown benefits for treating alcohol use disorder (AUD). Recent work suggests tDCS may enhance mindfulness. The combination of MBRP and tDCS may provide synergistic benefits and may target both behavioral and neurobiological dysfunctions in AUD. The goal of this double-blind sham-controlled randomized trial was to examine the efficacy of a rolling group MBRP treatment combined with tDCS among individuals interested in reducing their drinking.Methods: Individuals who were interested in reducing their alcohol use (n = 84; 40.5% female; mean age = 52.3; 98.9% with current AUD) were randomized to receive active (2.0 milliamps) or sham (0.0 milliamps) anodal tDCS (5 cm 9 3 cm electrode) of the right inferior frontal gyrus with the 5 cm 9 3 cm cathodal electrode applied to the left upper arm, combined with 8 weeks of outpatient MBRP rolling group treatment. Assessments were conducted at baseline, posttreatment, and 2 months following treatment. The primary outcome was drinks per drinking day, and secondary outcomes were percent heavy drinking days, self-reported craving, alcohol cue reactivity in an alcohol cue task, and response inhibition in a stop signal reaction time task.Results: Results indicated significant reductions in drinks per drinking day over time, B (SE) = À0.535 (0.16), p = 0.001, and a significant dose effect for number of groups attended, B (SE) = À0.259 (0.11), p = 0.01. There were also significant effects of time and dose for number of groups attended on secondary outcomes of percent heavy drinking days and alcohol cue reactivity. There were no effects of active versus sham tDCS on primary or secondary outcomes.Conclusions: Findings from the current study provide initial support for the effectiveness of rolling group MBRP as an outpatient treatment for drinking reduction. The current study did not find additive effects of this tDCS protocol in enhancing MBRP among individuals with drinking reduction goals.

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Substance use outcomes for mindfulness based relapse prevention are partially mediated by reductions in stress: Results from a randomized trial

Cited by 49 publications

References 48 publications

Mindfulness-based relapse prevention for alcohol dependence: Findings from a randomized controlled trial

Mindfulness-based relapse prevention for alcohol dependence: Findings from a randomized controlled trial

Mindfulness-based programs for substance use disorders: a systematic review of manualized treatments

Mindfulness‐Based Relapse Prevention and Transcranial Direct Current Stimulation to Reduce Heavy Drinking: A Double‐Blind Sham‐Controlled Randomized Trial

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