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Objective: Few studies have evaluated moderators of mindfulness-based relapse prevention (MBRP) for substance use disorders (SUDs). We tested whether baseline patterns of scores for SUD symptom severity and depression and anxiety symptoms moderated the efficacy of MBRP. Method: We used a latent class moderation approach with data from a randomized trial of MBRP compared to cognitive–behavioral relapse prevention and treatment as usual (TAU; Bowen et al., 2014; N = 286, 71.8% male, 48.4% non-White, mean age = 38.44 years, SD = 10.92) and a randomized trial comparing MBRP to TAU (Bowen et al., 2009; N = 168, 63.7% male, 44.6% non-White, mean age = 40.45, SD = .28). Indicators for the latent class models were measures of SUD severity (Severity of Dependence Scale and Short Inventory of Problems), depression symptoms (Beck Depression Inventory), and anxiety symptoms (Beck Anxiety Inventory). Results: In both trials, 3 latent classes provided the best fit: a high–high class characterized by high SUD severity and depression and anxiety symptoms, a high–low class characterized by high SUD severity and low depression and anxiety symptoms, and a low–low class characterized by low SUD severity and depression and anxiety symptoms. In both trials, we found significant latent Class × Treatment interaction effects: There were significant and large effects of MBRP on substance use outcomes in the high–high and high–low classes, but no MBRP effect in the low–low class. Conclusion: MBRP may be an optimal treatment for preventing relapse among clients with severe levels of SUD symptoms and depression and anxiety symptoms, as well as clients with only severe SUD symptoms.
Mindfulness and drinking motives have both been linked to affect regulation, yet the relationship between mindfulness and drinking motives is poorly understood. The present study examined whether drinking motives, particularly mood regulatory motives, mediated the associations between facets of mindfulness and alcohol-related outcomes among college students (N = 297). We found 3 specific facets of mindfulness (describing, nonjudging of inner experience, and acting with awareness) to have negative associations with alcohol outcomes. Importantly, specific drinking motives mediated these associations such that lower levels of mindfulness were associated with drinking for distinct reasons (enhancement, coping, conformity), which in turn predicted alcohol use and/or alcohol problems. Our findings suggest that drinking motives, especially mood regulatory and negative reinforcement motives, are important to examine when studying the role of mindfulness in college student drinking behavior. (PsycINFO Database Record.
IntroductionMindfulness-based relapse prevention has shown promise as a treatment for substance use disorder but its efficacy according to racial/ethnic minority status and group composition is unknown. Method This is a secondary analysis of existing data (Bowen et al., 2014) testing individual race/ethnicity and racial/ethnic group composition as moderators of mindfulness-based relapse prevention (MBRP). Participants (N = 191; 29% female; 47% racial/ethnic minority; mean age = 39) with substance use disorder were randomized to MBRP or relapse prevention (RP). Outcomes were heavy drinking days (HDD) and drug use days (DUD) 12 months after treatment completion. Negative binominal regression models were conducted. Results Analyses accounted for drug of choice. Individual race/ethnicity was a significant moderator of substance use outcomes. White participants had lower HDD in MBRP than RP (IRR = 0, 95% CI: 0,0), whereas for minority participants, there was no treatment difference in HDD. Conversely, minorities had lower DUD in MBRP than RP (IRR = 0.03, 95% CI: 0.01, 0.10), whereas for whites there was no treatment difference in DUD. Group racial/ethnic composition was a significant moderator. Participants in groups with more than half whites had lower HDD in MBRP than RP (IRR = 0.01, 95% CI: 0, 0.09), whereas for participants in groups with more than half minorities there was no treatment difference in HDD. Exploratory analyses suggested MBRP resulted in better outcomes than RP when individual race/ethnic status was reflected in the group race/ethnicity (i.e., whites in groups with more than half whites or minorities in groups with more than half minorities). Conclusions Among whites, MBRP appears to be more effective than RP in preventing heavy drinking relapse. However, among racial/ethnic minorities, MBRP appears to more effective than RP in preventing drug use relapse. This suggests that the interaction between individual race/ethnicity and group composition may influence primary outcomes.