Elucidating the Association between Trait Mindfulness and Alcohol Use Behaviors among College Students

Mindfulness facets are differentially related with reward processing stages in striatum and alcohol use in adolescence

Attenuated functional processing of non-drug rewards in striatal regions is an important mechanism in the transition from normal to hazardous alcohol use. Recent interventions seek to enhance nondrug reward processing through mindfulness, a mechanism that targets attention regulation and self-regulatory processes. It is yet unclear which specific aspects of mindfulness and which stages of reward processing are relevant preventive targets, particularly in adolescence, where alcohol use is often initiated and reward relating processing streams undergo continuous maturation. Fifty-four 14- and 16-year-old adolescents (54% female) completed the monetary incentive delay task (MID) during event-related functional magnetic resonance imaging. Alcohol use and dispositional mindfulness facets were measured using self-report instruments. Mindful Attention Regulation was positively associated with anticipatory reward processing in ventral striatum, whereas feedback-related processing in dorsal striatum was associated with the mindfulness facet Body-Listening. Only Attention Regulation was additionally associated with frequency of alcohol consumption and mediated the relationship between functional activation in ventral striatum during reward anticipation and alcohol use. Attention Regulation, beyond other mindfulness facets, might contribute to potentially triggering neural mechanisms of anticipatory, but not feedback-related reward processing and alcohol use, presenting a potential target for preventive efforts in combating transitions to substance-related disorders in adolescents.

The Association Between Mindfulness Facets and Substance Use via Emotional Psychopathology and Coping Motives in Argentinian College Students

Background: Prior studies suggest that lower levels of mindfulness contribute to the motivation of using alcohol to cope with distress. Research examining this possibility is scarce or limited to alcohol, but not marijuana, related outcomes. Objectives: We examined separate models (for alcohol and for marijuana) to determine the associations between trait mindfulness (describing, acting with awareness, non-judging, non-reactivity) and alcohol and marijuana outcomes (use indicators and negative consequences) via emotional psychopathology (i.e., a latent variable assessing symptoms of depression and anxiety) and alcohol/marijuana coping motives. Results: The final analytic sample consisted of 456 participants (Mean age = 22.96 ± 3.12 years; 66.2% women) for the alcohol model; and 232 participants (Mean age = 22.96 ± 3.01 years; 66.2% women) for the marijuana model. Two path models were conducted, such that indirect paths were examined for each trait mindfulness facet on alcohol/marijuana outcomes (e.g., describing → emotional psychopathology → alcohol coping motives → binge drinking frequency). Within the comprehensive alcohol model, describing, acting with awareness, non-judging and non-reactivity were associated with less binge drinking frequency and lower number of alcohol-related negative consequences via lower severity of emotional psychopathology symptoms and lower endorsement of drinking to cope motives. For the marijuana model, describing, acting with awareness, and non-judging of inner experience were associated with less marijuana quantity (grams) consumed and lower number of marijuana-related negative consequences via lower severity of emotional psychopathology symptoms and lower endorsement of marijuana coping motives. Conclusions: Prevention and intervention programs of alcohol and marijuana in Argentina may benefit from improving mindfulness skills and targeting emotional psychopathology and motives to use drugs, to prevent or reduce negative drug-related consequences.

Drunkorexia and trait mindfulness among college students

Objective: Combined alcohol and disordered eating (drunkorexia) are alcohol fueled weight management behaviors. Mindfulness negatively relates to both disordered eating and alcohol use. Participants: Participants (n = 344, average age 20) were primarily female (85.2%, n = 293), and Caucasian (82.6%, n = 284). Methods: Students reported drunkorexia and mindfulness. Results: Drunkorexia behaviors were negatively correlated with Acting with Awareness (AA; full attention to a present moment; r = -.21, p < .001) and Nonjudgment (NJ; understanding and leniency toward oneself; r = -.22, p < .001). Drunkorexia motivations are significantly correlated with AA (r = -.13, p = .01) and NJ (r = -.18, p = .001). Structural equation modeling revealed higher levels of NJ related to higher levels of drunkorexia. Conclusion: The objective was to determine a potential relationship between drunkorexia behaviors and motivations, and trait mindfulness. Findings suggest a nonjudgmental disposition relates to lower levels of drunkorexia.

Effect of fear of missing out on learning burnout in medical students: a moderated mediation

Introduction

Learning burnout has a significant negative impact on students' academic performance and professional development, which has been exacerbated by the growing trend of problematic smartphone use, such as smartphone addiction, among young people. Recently, the literature on excessive social media use has revealed a critical role of fear of missing out. Objective The purpose of this study was to examine how fear of missing out affects smartphone addiction and its subsequent effect on learning burnout in college students.

Methods

In Study 1, 352 medical students were recruited to complete a cross-sectional survey. In Study 2, 2,948 college students were recruited to complete a cross-sectional survey. Further in Study 3, 30 medical students were recruited into a mindfulness-based intervention program.

Results

Study 1 preliminarily confirmed that fear of missing out was positively correlated with learning burnout. Study 2 then revealed a moderated mediation model showing that fear of missing out may increase smartphone addiction, which in turn affects their sleep quality and finally leads to learning burnout. This chain mediation model was moderated by the participants' level of mindfulness. To confirm the promoting role of mindfulness, Study 3 further confirmed that mindfulness training indeed can improve smartphone addiction and reduce learning burnout in medical students.

Discussion

Theoretical and practical contributions were discussed, highlighting the effects of fear of missing out on smartphone addiction and a moderating role of mindfulness training.

How Does Trait Mindfulness Weaken the Effects of Risk Factors for Adolescent Smartphone Addiction? A Moderated Mediation Model

As a psychological resource of individuals, trait mindfulness is valuable in facilitating individuals to maintain attention intensity, increase efficiency, and alleviate stress and depression. It can also buffer against the risk factors of addictive behaviors. However, applied research combining trait mindfulness and smartphone addiction with the use of psychological resources is relatively scarce and needs further examination. We constructed a moderated mediation model based on compensatory Internet use and conservation of resources theory (OCR) to examine the effects of social anxiety on adolescent smartphone addiction and to describe how trait mindfulness "works" and "in what contexts it works better". We analyzed 1570 adolescent subjects through a multistage stratified sampling method. Our findings revealed that social anxiety positively predicted smartphone addiction, while trait mindfulness was negatively associated with it. Furthermore, trait mindfulness mitigated smartphone addiction by reducing social anxiety, suggesting a mediating effect of social anxiety on this relationship. Meanwhile, the mediating effect was more pronounced among adolescents with left-behind experience; we found that left-behind experience partially moderated the relationship between social anxiety and smartphone addiction. Adolescents with left-behind experience had more significant compensatory media use with a higher risk of smartphone addiction. This study highlights the potential protective role of trait mindfulness in the development and maintenance of adolescent smartphone addiction. It provides empirical support for applying resource conservation theory and stress buffering theory in this context.

The Relationship between Mindfulness and Readiness to Change in Alcohol Drinkers

Mindfulness is a multi-faceted construct that involves paying attention to thoughts and emotions without automatically reacting and being critical of them. Recent research has suggested that mindfulness might play an important role in reducing problematic alcohol use. Further, Readiness to Change (RTC) is related to motivation to change drinking behaviours. The RTC scale identifies motivation to change drinking behaviours including Precontemplation, Contemplation, and Action stages. The current study investigated, for the first time, the relationship between mindfulness (and its facets) and RTC in relation to drinking behaviours. Undergraduate students from Western Sydney University (N = 279) were screened for drinking levels using the Alcohol Use Disorder Identification Test (AUDIT) and then completed the Readiness to Change Questionnaire (RCT) and the Five Facets Mindfulness Questionnaire (FFMQ), which includes the following facets: Acting with Awareness, Non-Judging of Inner Experience, Non-Reactivity to Inner Experience, Describing, and Observing. Results show that overall, mindfulness and its facets negatively correlated with RTC. Multiple regression analysis further showed that Awareness and Non-Judgement facets negatively predicted RTC. These findings provide insight into how the facets of mindfulness interact with the drinking motives of individuals and their intentions to change drinking behaviours. Based on these findings, we recommend the incorporation of mindfulness techniques in interventions targeting problematic drinking.

Transcranial Direct Current Stimulation Provides no Additional Benefit to Improvements in Self-Reported Craving Following Mindfulness-Based Relapse Prevention

Objectives

Mindfulness-Based Relapse Prevention (MBRP) and transcranial direct current stimulation (tDCS) have each demonstrated efficacy in improving outcomes in those with alcohol use disorder (AUD), however a recent study that combined MBRP with tDCS found tDCS provided no additional benefit to MBRP for AUD. Differences in treatment adherence between active versus sham tDCS groups may have contributed to this result. The current study examined whether treatment adherence interacted with tDCS condition in predicting post-treatment mindfulness and craving.

Methods

This study was a secondary data analysis from a randomized sham-controlled trial comparing MBRP paired with tDCS. Linear regression analyses were conducted examining the interaction between tDCS condition and two measures of treatment adherence (i.e., number of groups attended, number of tDCS administrations) on post-treatment mindfulness and craving.

Results

There was no effect of treatment adherence by tDCS condition in predicting mindfulness, however the interaction between treatment adherence and tDCS condition significantly predicted post-treatment craving. There was a significant negative association between treatment adherence and post-treatment craving in the sham group, but there was no association in the active tDCS group.

Conclusions

MBRP coupled with sham stimulation led to significant reductions in self-reported craving when patients attended more sessions and received a greater number of sham tDCS administrations, while no relationship was observed between treatment adherence and craving among those who received active tDCS. This result provides tentative evidence that, rather than improve the effects of MBRP on craving, this active tDCS protocol provides no additional benefit to MBRP in reducing craving.

Pre-registration

This study was registered with clinicaltrials.gov (NCT02861807).

Psychometric Properties of the Chinese Version of the Brief-Mindful Self-Care Scale: A Translation and Validation Study

Objective: This study aimed to translate the Brief-Mindful Self-Care Scale (B-MSCS) into Chinese and validate its reliability and validity among hospice nurses. Methods: A total of 510 hospice nurses were recruited from three provinces in China. The reliability of the translated scale was measured by internal consistency, split-half reliability, and test-retest reliability. The validity of the translated scale was evaluated by expert consultation, exploratory factor analysis, and confirmatory factor analysis. Results: The Cronbach's α value of the Chinese version of B-MSCS was 0.920, and the Cronbach's α value of the dimensions ranged from 0.850 to 0.933. The split-half reliability and test-retest reliability were 0.770 and 0.723, respectively. Furthermore, the content validity index of the scale (S-CVI) was 0.946. The 6-factor structure, supported by the eigenvalues, total variance explained, and scree plot were obtained by using exploratory factor analysis. Moreover, as a result of the confirmatory factor analysis, the model fitting indexes were all in the acceptable range. Conclusion: The Chinese version of B-MSCS had suitable reliability and validity among hospice nurses. The developed scale will evaluate the level of mindful self-care of Chinese hospice nurses, providing an opportunity for development of targeted educational plans. Each item is a direct guide for hospice nurses to develop their mindful self-care practice.

Does mindfulness reduce the effects of risk factors for problematic smartphone use? Comparing frequency of use versus self-reported addiction

BACKGROUND

There is growing concern regarding problematic smartphone overuse. Practiced mindfulness, the state of being aware of the present moment, may protect against problematic smartphone use by reducing the strength of risk factors.

PURPOSE

We hypothesized that trait mindfulness can reduce the impact of risk factors on a) objective smartphone use and b) subjective problematic smartphone use.

METHODS

Our sample (n = 135, M_age = 19.15, 68% female) consisted of college students from a large university. Participants completed self-report measures of boredom proneness, impulsivity, technology-related anxiety (nomophobia), trait mindfulness, smartphone use frequency, and problematic use.

RESULTS

Higher mindfulness was significantly associated with lower boredom proneness, impulsivity, and problematic use (F = 12.12, p < .01). Hierarchical regression revealed that the positive relationships between nomophobia, and problematic use decreased as mindfulness levels increased. A similar protective effect was observed for boredom proneness, although the effect dissipated as impulsivity rose. A second regression revealed no significant predictors of weekly smartphone use.

CONCLUSIONS

Effects of nomophobia and boredom proneness on problematic smartphone use diminish with increased mindfulness, but impulsivity may interfere with this. Risk and protective factors for 'addiction' appear unrelated to smartphone use frequency. Future research should examine benefits of mindfulness-based interventions in promoting emotional and cognitive self-regulation, focusing on those who use smartphones in dysfunctional ways.

Mindful Awareness: Can a Neuro-Developmentally Timed Approach Prevent Youth Substance Misuse

Youth substance use remains a significant public health issue. Although there are numerous evidence-based substance use preventive interventions, room for program improvement remains. Mindfulness practice, due to its feasibility of implementation, capacity to promote neuro-networks associated with delayed substance use initiation and progression to substance use disorders, and efficacy in promoting protective and reducing risk factors associated with substance use, may constitute one strategy for increasing the effectiveness of substance use preventive interventions. However, mindfulness-based approaches to substance use prevention have yet to be systematically tested with youth. In this conceptual paper, we first define mindfulness and its potential, through practice, to strengthen neuro-circuitry associated with substance use disorders. We then review evidence supporting the effectiveness of mindfulness-based preventive interventions to promote protective factors and reduce risk factors known to predict youth substance use. Thus, a case is made for neuro-developmentally timed, mindfulness-based substance use preventive interventions, with the ultimate goal of preventing future substance misuse and associated health consequences.

On the role of mindfulness and compassion skills in students' coping, well-being, and development across the transition to college: A conceptual analysis

In this paper, we aim to integrate the current conceptual approaches to stress and coping processes during the college transition with the potential role of mindfulness and compassion (MC) skills on students' well-being and development. First, we provide an overview of the issues and challenges emerging adults are facing during the transition to college, drawing on the revised version of the transactional stress model by Lazarus and Folkman (1984). Second, we introduce a conceptual model of adaptive stress and coping processes enhanced by MC skills to positively impact the appraisal and coping resources and emerging adults' mental health. Specifically, MC skills may play an important role in promoting a healthy stress response by strengthening emerging adults' socioemotional competencies and supporting the development of adaptive appraisal and coping resources, including processes antecedent and consequent to a coping encounter. In particular, MC skills were hypothesized to enhance (a) preparedness to cope, (b) productive stress response through adaptive appraisals and skillful deployment of coping resources, and (c) healthy postcoping reflections. Therefore, MC skills may be a useful preventive tool to strengthen emerging adults' ability to adjust to a new academic environment and fulfil the developmental tasks of this period.

Mindfulness buffers the effects of cue-induced craving on alcohol demand in college drinkers

Alcohol consumption among young adult college students represents a significant public health problem. The presence of alcohol-related cues in drinkers' environments can trigger powerful alcohol cravings, which may influence drinking outcomes. Less is known about how this cue-induced craving influences behavioral economic demand for alcohol. In addition, research has suggested that trait mindfulness may be an important buffer of the effects of internal states of craving on drinking decisions. Based on this literature, we hypothesized that cue-induced cravings would be associated with increased alcohol demand, an effect that would be attenuated among drinkers who have higher levels of mindfulness. Young adult college student drinkers (n = 69) completed a laboratory-based cue-induced craving assessment, a self-report assessment of trait mindfulness, and an alcohol purchase task. Findings revealed that cue-induced craving was related to higher alcohol demand. Consistent with the study hypothesis, acceptance, a component of mindfulness, buffered the effects of cue-induced craving on alcohol demand. Results raise the possibility that mindfulness-based interventions may be useful in helping disrupt the link between internal states of craving and drinking decisions in young adult college student drinkers.

Mindfulness as a mediator of the association between adverse childhood experiences and alcohol use and consequences

One-third of college students report past-year heavy episodic drinking, making college student alcohol use an important area for continued research. Research has consistently linked early experiences of adversity to problematic substance use in adolescence and adulthood. Given the negative health consequences associated with heavy episodic drinking, it is imperative to identify mechanisms that contribute to this relation. Low levels of mindfulness have been linked to early adversity as well as impulsivity and alcohol use, therefore, the current study aims to examine the mediating role of mindfulness in the relation between early adversity and current alcohol use and consequences. Undergraduate students (N = 385) at a Midwestern university completed an online questionnaire assessing experiences of childhood adversity, trait mindfulness, and current alcohol use and related consequences. Results indicated that increased adverse experiences and lower levels of mindfulness predicted both increased alcohol consumption and consequences (ps < 0.025), with mindfulness mediating the relationships. Mindfulness is a predictor of alcohol outcomes and appears to mediate the relation between early adversity and alcohol use and consequences. Findings suggest that students with a history of adversity are more likely to exhibit lower levels of mindfulness, which may lead to an increase in alcohol consumption and consequences in early adulthood. Targeted alcohol intervention efforts that incorporate mindfulness skills may be particularly beneficial for those who have experienced early adversity.

Mindfulness Facets, Social Anxiety, and Drinking to Cope with Social Anxiety: Testing Mediators of Drinking Problems

This cross-sectional study tested social anxiety symptoms, trait mindfulness, and drinking to cope with social anxiety as potential predictors and/or serial mediators of drinking problems. A community-based sample of individuals with co-occurring social anxiety symptoms and alcohol dependence were recruited. Participants (N = 105) completed measures of social anxiety, drinking to cope with social anxiety, and alcohol use and problems. As well, participants completed the Five Facet Mindfulness Questionnaire, which assesses mindfulness facets of accepting without judgment, acting with awareness, not reacting to one's internal experiences, observing and attending to experiences, and labeling and describing. As predicted, the relationship between social anxiety symptoms and drinking problems was mediated by social anxiety coping motives across each of the models. Further, the relationship between specific mindfulness facets (acting with awareness, accepting without judgment, and describe) and drinking problems was serially mediated by social anxiety symptoms and drinking to cope with social anxiety. This research builds upon existing studies that have largely been conducted with college students to evaluate potential mediators driving drinking problems. Specifically, individuals who are less able to act with awareness, accept without judgment, and describe their internal experiences may experience heightened social anxiety and drinking to cope with that anxiety, which could ultimately result in greater alcohol-related problems.

How to think about your drink: Action-identification and the relation between mindfulness and dyscontrolled drinking

Cross-sectional and intervention research have shown that mindfulness is inversely associated with difficulties in controlling alcohol use. However, little is known regarding the mechanisms through which mindfulness is related to increased control over drinking. One potential mechanism consists of the way individuals represent their drinking behaviour. Action identification theory proposes that self-control of behaviour is improved by shifting from high-level representations regarding the meaning of a behaviour to lower-level representations regarding "how-to" aspects of a behaviour. Because mindfulness involves present-moment awareness, it may help to facilitate such shifts. We hypothesized that an inverse relation between mindfulness and dyscontrolled drinking would be partially accounted for by the way individuals mentally represent their drinking behaviour - i.e., reduced levels of high-level action identification and increased levels of low-level action identification. One hundred and twenty five undergraduate psychology students completed self-report measures of mindful awareness, action identification of alcohol use, and difficulty in controlling alcohol use. Results supported the hypothesis that high-level action identification partially mediates the relation between mindfulness and dyscontrolled drinking but did not support a mediating role for low-level action identification. These results suggest that mindfulness can improve self-control of alcohol by changing the way we think about our drinking behaviour.

A meta-analysis of the relationship between trait mindfulness and substance use behaviors

BACKGROUND

The relationship between trait mindfulness and substance use behaviors has been inconsistent across studies. The current meta-analysis aimed at quantifying the magnitude of this relationship, and at determining how this relationship varies in context of (1) mindfulness facets, (2) substance type, (3) sample characteristics, and (4) substance use severity.

METHODS

Using electronic databases, the literature search yielded 303 articles, but only 39 articles met inclusion criteria to be included in this meta-analysis. The relationship was quantified as a Pearson's r correlation coefficient for all studies.

RESULTS

Findings indicated a small, negative, and significant trait mindfulness-substance use behaviors relationship (r=-0.13). This relationship varied across substance type, clinical status of the sample, and substance use severity. Mindfulness facet was not a significant moderator; however, only particular facets (e.g., acting with awareness, non-judgment, and non-reactivity) were consistently associated with substance use behaviors.

CONCLUSIONS

This meta-analysis quantified the trait mindfulness-substance use behaviors relationship, which can be used as future effect size estimates. Findings also indicated that the trait mindfulness-substance use behaviors relationship was more robust: (1) for alcohol and tobacco use compared to marijuana use behaviors; (2) for problematic compared to non-problematic substance use behaviors; and (3) with inpatient compared to outpatient and non-clinical samples. Further work should continue to examine if acting with awareness, non-judgment, and non-reactivity mindfulness facets are more robustly associated with substance use behaviors. Failure to consider these factors, or collapsing across these factors, could explain the smaller or inconsistently reported associations across previous studies.