Mindfulness meditation for substance use disorders: a systematic review

Psychotherapy research for compulsive buying-shopping disorder: Quo vadis?

Aim The aim of this position paper is to address the question of how psychotherapy research for compulsive buying-shopping disorder (CBSD) should develop further. Method: After a brief summary of existing psychotherapy research, this paper concentrates on the advantages and shortcomings of previous psychotherapy studies and offers recommendations for future psychotherapy research in the domain of CBSD. Results: Systematic reviews indicate that cognitive behavioural therapy is the most researched form of psychotherapy and presents a helpful intervention for reducing the symptom severity of CBSD. Notwithstanding the positive outcomes, the psychotherapy studies to date are limited by methodological shortcomings, which reduce their validity and generalizability. While research into the psychological mechanisms of offline and online CBSD has expanded considerably, psychotherapy research has not kept pace with this growth. Although the majority of individuals with CBSD engage in online shopping, the problematic usage of shopping websites has not been considered in any of the treatment studies to date. Conclusion: The application of the experimental medicine framework to psychotherapy research for CBSD may enhance the integration of findings on psychological mechanisms of CBSD with existing treatment concepts for CBSD. Moreover, it is necessary to consider the impact of technological factors and e-marketing in the context of treatment. There is a need for 1) proof-of-concept studies to test specific interventions that target specific psychological processes and mechanisms of CBSD, and 2) high-quality psychotherapy studies to test the efficacy and effectiveness of new treatment approaches in accordance with the scientific standards for randomised controlled trials.

Using the social cognitive theory to examine spontaneous attempts to quit illicit substance use

Rural areas in the US exhibit high rates of illicit substance use. This study aimed to investigate the Social Cognitive Theory factors associated with spontaneous attempts to quit illicit substance use in a sample of users. A cross-sectional survey was administered through face-to-face interviews. Data was collected from adult (≥ 18 years of age) current illicit substance users who were not receiving professional addiction treatment. Binary logistic regression analyses were utilized to answer the research question. Data from 230 illicit substance users met the eligibility criteria. The mean age was 38 years, whereas the average history of illicit substance use was 14 years. Users with a higher perceived value of quitting illicit substance use were significantly more likely to attempt to quit use spontaneously. Health behavior interventions that incorporate the perceived value of quitting illicit substance use can be effective in encouraging spontaneous attempts to quit illicit substance use.

Heterosexist Discrimination and Substance Use in Young Adult Sexual Minority Men: Examining the Moderating Role of Mindfulness

Purpose

Young sexual minority adults experience high rates of heterosexist discrimination. The use of substances has been documented as a form of coping with discrimination. While mindfulness has been used to address experiences of discrimination and the use of substances, respectively, few studies have explored whether mindfulness can lower the negative effects of discrimination on substance use. The purpose of this study is to examine the association between heterosexist discrimination and substance use in young adult sexual minority men (YASMM), and if dispositional mindfulness can moderate this relationship.

Methods

Logistic regression analysis was used to examine the association of heterosexist discrimination and cigarette, e-cigarette, and hazardous drinking in a sample of YASMM (18-35 years old; n = 325) from a national survey. A two-way interaction analysis was also implemented to evaluate if dispositional mindfulness moderated this relationship.

Results

Heterosexist discrimination was associated with increased odds of cigarette use (adjusted odds ratio [aOR] = 1.06; 95% confidence interval [CI]: 1.03, 1.08) and e-cigarette use (aOR = 1.03; 95% CI: 1.01, 1.05). Higher scores of dispositional mindfulness moderated the relationship between heterosexist discrimination and hazardous drinking, indicating a weakening effect with higher scores of dispositional mindfulness.

Conclusion

Mindfulness may decrease the negative effects of heterosexist discrimination on hazardous drinking among YASMM.Health Equity Implications: Researchers and practitioners should consider incorporating mindfulness as a component to their intervention to help YASMM deal with stressors engendered by discrimination, which may prevent hazardous drinking as a coping mechanism at a younger age.

Perspectives on Self-Management and Meditation: A Qualitative Study of Adolescents With Type 1 Diabetes Mellitus and Their Parents

BACKGROUND

One in three adolescents with type 1 diabetes mellitus (T1DM) experiences diabetes distress, which predicts poor self-management and glycemic control. Mindfulness-based interventions such as meditation have been associated with reduced psychological distress and health outcomes in different populations. This study explores the psychosocial barriers and facilitators of diabetes self-management and beliefs about meditation practices.

METHODS

Eight adolescents aged 15-19 who had been diagnosed with T1DM for more than a year were invited to participate in a 40-60-minute semi-structured one-on-one interview. Their parents were also invited to participate in the study. Three of the eight parents invited were able to participate in the study. Participants were asked about perceived psychosocial barriers and facilitators of diabetes self-management and their beliefs about meditation as a tool for addressing some of the psychosocial barriers to self-management. Data were analyzed using NVivo 10 (QSR International, Melbourne, Australia). Conventional content analysis was conducted based on an inductive coding approach.

RESULTS

Adolescents with T1DM had similar psychosocial challenges with managing T1DM, including high levels of diabetes distress and forgetfulness due to competing demands on their time. They also noted similar facilitators to effective self-management, such as the presence of family and peer support. Acceptance of T1DM diagnosis and personal commitment to self-management were also indicated as common facilitators of self-management. Adolescents with T1DM and parents of adolescents with T1DM believe that meditation can play a positive role in T1DM self-management by reducing diabetes distress and improving mental health and overall well-being.

CONCLUSION

Results suggest that adolescents with T1DM and parents of adolescents with T1DM believe peer and family support is crucial to diabetes self-management. They also noted that diabetes distress and forgetfulness are primary barriers to self-management. Participants also see a potential for meditation to help manage general stress and diabetes distress, thereby aiding self-management. Further research is needed to explore meditation-based interventions to reduce diabetes distress in adolescents diagnosed with T1DM. The findings from this study can inform the development and implementation of meditation-based interventions that integrate family and peer support to reduce diabetes distress and enhance self-management in adolescents with T1DM.

Mindfulness as a Moderator of the Association Between Anxiety and Alcohol Use Severity and Drinking Motives in Professional Firefighters

Objective: Firefighters are at risk of experiencing heightened anxiety and alcohol use perhaps due to occupational stress. Mindfulness is related to both anxiety and alcohol use; however, research on the relations of mindfulness with anxiety and alcohol use and drinking motives among firefighters is limited. This study examined (1) whether higher anxiety was positively related to alcohol use severity and drinking related motives (e.g., coping, enhancement, social, and conformity) and (2) whether higher mindfulness would moderate the association between anxiety symptom severity and alcohol use severity and alcohol use coping motives. Methods: Participants included urban firefighters (N = 679; Mage = 38.6; SD = 8.58; 93.5% male) who completed an online survey. Five hierarchical regression analyses were conducted to evaluate the main and interactive effects of anxiety symptom severity and mindfulness on all study outcomes (i.e., alcohol use severity and four drinking motives). Results: Anxiety symptom severity was significantly and negatively associated with mindfulness and, incrementally, positively associated with all alcohol use-related outcome variables. Mindfulness was negatively correlated with alcohol use severity and all alcohol use motives except social motives. Mindfulness moderated the effects of anxiety symptom severity on coping alcohol use motives only. Conclusion: Mindfulness moderated, or attenuated, the positive association between anxiety symptom severity and coping-oriented alcohol use motives among professional firefighters. Results have the potential to inform treatment development and wellness programming for the fire service.

The influence of mindfulness meditation combined with progressive muscle relaxation training on the clinical efficacy and quality of life of patients with sarcopenia receiving haemodialysis: a randomised controlled trial

OBJECTIVE

To study the effect of mindfulness meditation combined with progressive muscle relaxation training on the clinical efficacy and quality of life in patients with sarcopenia receiving maintenance haemodialysis (MHD).

METHODS

Eligible patients with sarcopenia in our hospital were randomly assigned to a control group (n = 24) and an intervention group (n = 25). The control group received conventional dialysis treatment, while the intervention group underwent mindfulness meditation combined with progressive muscle relaxation training during the interdialysis period in addition to conventional dialysis treatment. The effect of the intervention was evaluated after 12 weeks.

RESULTS

There were no significant differences in the baseline values of various parameters between the two groups. Exercise capacity (sit-to-stand test,handgrip,time to 10 sit-ups) significantly improved in the intervention group after 12 weeks (32.68 ± 8.32 vs 26.50 ± 6.83; 37.42 ± 10.12 vs 28.12 ± 8.51; 19.8 ± 5.40 vs 25.29 ± 7.18) (p < 0.05). In terms of the kidney disease quality of life (KDQOLTM) score, all other dimensions except sexual function, social functioning, burden of kidney disease and work status dimensions showed significant improvement compared to the baseline (p < 0.05). In the control group, only the dialysis staff encouragement (DSE) and patient satisfaction (PS) dimensions showed slight improvements compared to the baseline (p > 0.05). When compared with the control group, the intervention group showed significant improvements in 10 dimensions of exercise capacity and KDQOLTM scores for physical function, role-physical, general health, energy, symptom/problem list, sleep, DSE, pain, cognitive function, emotional well-being and patient PS after 12 weeks (61.30 ± 5.38 vs 42.98 ± 5.73; 57.50 ± 3.55 vs 50.70 ± 3.62) (p < 0.05). Some inflammatory markers, such as the levels of interleukin-6 and high-sensitivity C-reactive protein (30.29 ± 2.96 vs 17.65 ± 3.22; 8.93 ± 0.99 vs 3.02 ± 0.34), showed a decrease during the intervention, while albumin and prealbumin levels were significantly increased compared with the baseline (30.62 ± 1.65 vs 35.60 ± 1.68; 0.32 ± 0.05 vs 0.44 ± 0.07) (p < 0.05).

CONCLUSION

Combined intervention training can improve the motor ability and quality of life of patients with sarcopenia within a short period of time.

Brain changes following mindfulness: Reduced caudate volume is associated with decreased positive urgency

Mindfulness training has been shown to improve psychological health and general well-being. However, it is unclear which brain and personality systems may be affected by this practice for improving adaptive behavior and quality of life. The present study explores the effects of a 5-week mindfulness-based intervention (MBI) at the neuroanatomical level and its relationship with dispositional mindfulness and impulsivity. Sixty-six risky drivers were quasi-randomly assigned to a mindfulness training group (MT) or a control group (N). Participants underwent magnetic resonance imaging and completed the Five Facet Mindfulness Questionnaire (FFMQ) and the UPPS-P impulsivity scale twice, at baseline and after receiving the MBI. We observed that MBI changes dispositional mindfulness in the non-reactivity and observing facets. Further, we observed that the magnitude of change in impulsivity was associated with the change in dispositional mindfulness. Whole-brain voxel-wise analysis revealed that the volume of the right caudate nucleus of the MT group (n = 27) showed a reduction compared to that of the control group (n = 33), which increased in terms of the pre-post measurement (MT=-1.76 mm3; N = 6.31 mm3). We also observed that reduced caudate nucleus volume correlated with decreased positive urgency in the MT group. Taken together, our results show that MBI improves the skills of observing and non-reactivity to inner experience, while producing changes in the structure of the caudate nucleus. These structural changes are associated with a reduction in impulsivity levels, decreasing the tendency to act rashly in situations that generate positive emotions and thus facilitating more adaptive behavior.

Wellness in Nursing Education to Promote Resilience and Reduce Burnout: Protocol for a Holistic Multidimensional Wellness Intervention and Longitudinal Research Study Design in Nursing Education

BACKGROUND

The United States faces a nursing shortage driven by a burnout epidemic among nurses and nursing students. Nursing students are an integral population to fuel the nursing workforce at high risk of burnout and increased rates of perceived stress.

OBJECTIVE

The aim of this paper is to describe WellNurse, a holistic, interdisciplinary, multidimensional longitudinal research study that examines evidence-based interventions intended to reduce burnout and increase resilience among graduate and undergraduate nursing students.

METHODS

Graduate and undergraduate nursing students matriculated at a large public university in the northeastern United States are eligible to enroll in this ongoing, longitudinal cohort study beginning in March 2021. Participants complete a battery of health measurements twice each semester during the fourth week and the week before final examinations. The measures include the Perceived Stress Scale, the Satisfaction with Life Scale, the Oldenburg Burnout Inventory, the Brief Resilience Scale, and the Pittsburgh Sleep Quality Index. Participants are eligible to enroll in a variety of interventions, including mindfulness-based stress reduction, mindful eating, fitness training, and massage therapy. Those who enroll in specific, targeted interventions complete additional measures designed to target the aim of the intervention. All participants receive a free Fitbit device. Additional environmental changes are being implemented to further promote a culture that supports academic well-being, including recruiting a diverse student population through evidence-based holistic admissions, inclusive teaching design, targeted resilience and stress reduction workshops, and cultural shifts within classrooms and curricula. The study design protocol is registered at Open Science Framework (DOI 10.17605/OSF.IO/NCBPE).

RESULTS

The project was funded on January 1, 2022. Data collection started in March 2022. A total of 267 participants have been recruited. Results will be published after each semester starting in December 2023. WellNurse evaluation follows the Rapid Cycle Quality Improvement framework to continuously monitor ongoing project processes, activity outcomes, and progress toward reducing burnout and increasing resilience. Rapid Cycle Quality Improvement promotes the ability to alter WellNurse interventions, examine multiple interventions, and test their effectiveness among the nursing education population to identify the most effective interventions.

CONCLUSIONS

Academic nursing organizations must address student burnout risk and increase resilience to produce a future workforce that provides high-quality patient care to a diverse population. Findings from WellNurse will support evidence-based implementations for public baccalaureate and master's nursing programs in the United States.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/49020.

Impact of yoga and physical exercise on psychological wellbeing among substance abusers: a randomized controlled trial

OBJECTIVES

Substance use disorder is a pattern of recurrent use of illicit substances that leads to severe psychosocial imbalance and recurrent relapse. The study was to evaluate the efficacy of a yoga-based intervention as an add-on in enhancing psychological wellbeing, compared with physical exercise among substance abusers.

METHODS

In this randomized controlled study, 96 male participants with substance use disorder from a residential rehabilitation treatment center, Kathmandu, Nepal, were randomly allocated into two groups namely the yoga group (n=48, mean age ± SD=25.18 ± 6.43) and the physical exercise group (n=48, mean age ± SD=25.02 ± 5.02). The participants in the yoga group attended the 90 min yoga sessions for 12 weeks (six days per week) whereas the physical exercise group attended exercise sessions for the same duration. Above mentioned interventions were in addition to standard rehabilitation treatment. The study measured the Self-Control, Anxiety, Depression, Sleep parameters, and Mindfulness at the baseline and after 12 weeks of intervention.

RESULTS

A significant enhancement in self-control was observed in both the yoga (p<0.033, d=0.33) and the exercise group (p<0.038, d=0.32). Yoga group showed significant improvement in mindfulness score (p<0.017, d=0.37), whereas exercise group did not show any significant changes in mindfulness (p<0.169, d=0.21). The depression and anxiety scores reduced significantly in both yoga (p<0.044, d=0.31; p<0.025, d=0.35 resp.) and exercise (p<0.032, d=0.34. p<0.039, d=0.32. resp.) group. Furthermore, significant reduction was seen in sleep disturbance after yoga (p<0.001, d=0.52) and exercise (p<0.001, d=0.78) intervention. The sleep - somnolence score reduced significantly only in yoga group (p<0.020, d=0.36). The magnitude of improvement was higher in the yoga group than physical exercise group on self-control, mindfulness, depression, anxiety and some sleep parameters, however the between group differences could not reach to the level of significance.

CONCLUSIONS

The 12 week yoga intervention did not appear to be significantly more effective than the 12 week physical exercise program on psychological wellbeing in male participants with substance use disorder. However, greater improvement in psychological wellbeing was observed within the yoga group. In future, a multi-centric study with robust design, larger sample size and longer follow-up is required to conform the present results and to find out the difference between the impacts of yoga and physical exercise on psychological wellbeing in substance abusers.

An Overview of Mindfulness-Oriented Addiction and Pain Recovery

There is evidence that mindfulness-based interventions are effective as stress-reduction techniques in people with various stressor-related disorders. Research also shows overall improvement in mental health well-being in practitioners of mindfulness. However, there is limited literature probing the potential negative impacts of mindfulness practice. Relapse is a major challenge in substance use disorders (SUDs), particularly for people with chronic pain. There is an overlap between SUDs and chronic pain, which share common pathophysiological pathways that could contribute to poor pain control and mental instability. In this report, we discuss the possible effects of mindfulness on specified aspects of substance craving and chronic pain perception. We propose future directions for research in mindfulness practices to maximize the potential for relapse prevention and pain control.

Examining the Acceptability and Feasibility of the Compassionate Mindful Resilience (CMR) Programme in Adult Patients with Chronic Kidney Disease: The COSMIC Study Protocol

Kidney disease is often progressive, and patients experience diminished health-related quality of life. In addition, the impact of the coronavirus (COVID-19) pandemic, and its associated restrictions, has brought many additional burdens. It is therefore essential that effective and affordable systems are explored to improve the psychological health of this group that can be delivered safely during the COVID-19 pandemic. The aim of this study is to support a new service development project in partnership with the UK’s leading patient support charity Kidney Care UK by implementing the four-session Compassionate Mindful Resilience (CMR) programme, developed by MindfulnessUK, and explore its effectiveness for patients with stage 4 or 5 chronic kidney disease or have received a kidney transplant. The study will utilise a quasi-experimental, pretest/posttest design to measure the effect of the CMR programme on anxiety, depression, self-compassion, the ability to be mindful, wellbeing, and resilience, using pre- and posttests, alongside a qualitative exploration to explore factors influencing the feasibility, acceptability, and suitability of the intervention, with patients (and the Mindfulness Teacher) and their commitment to practice. Outcomes from this study will include an evidence-based mindfulness and compassion programme for use with people with kidney disease, which is likely to have applicability across other chronic diseases.

Comparing a mindfulness- and CBT-based guided self-help Internet- and mobile-based intervention against a waiting list control condition as treatment for adults with frequent cannabis use: a randomized controlled trial of CANreduce 3.0

BACKGROUND

Though Internet- and mobile-based interventions (IMIs) and mindfulness-based interventions (generally delivered in-situ) appear effective for people with substance use disorders, IMIs incorporating mindfulness are largely missing, including those targeting frequent cannabis use.

METHODS

This paper details the protocol for a three-arm randomized controlled trial comparing a mindfulness-based self-help IMI (arm 1) and cognitive-behavioral therapy (CBT)-based self-help IMI (arm 2) versus being on a waiting list (arm 3) in their effectiveness reducing cannabis use in frequent cannabis users. Predictors of retention, adherence and treatment outcomes will be identified and similarities between the two active intervention arms explored. Both active interventions last six weeks and consist of eight modules designed to reduce cannabis use and common mental health symptoms. With a targeted sample size of n = 210 per treatment arm, data will be collected at baseline immediately before program use is initiated; at six weeks, immediately after program completion; and at three and six months post baseline assessment to assess the retention of any gains achieved during treatment. The primary outcome will be number of days of cannabis use over the preceding 30 days. Secondary outcomes will include further measures of cannabis use and use of other substances, changes in mental health symptoms and mindfulness, client satisfaction, intervention retention and adherence, and adverse effects. Data analysis will follow ITT principles and primarily employ (generalized) linear mixed models.

DISCUSSION

This RCT will provide important insights into the effectiveness of an IMI integrating mindfulness to reduce cannabis use in frequent cannabis users.

TRIAL REGISTRATION

International Standard Randomized Controlled Trial Number Registry: ISRCTN14971662 ; date of registration: 09/09/2021.

Gender Differences in Transdiagnostic Predictors of Problematic Alcohol Consumption in a Large Sample of College Students in Ecuador

Background

Alcohol use is one of the main risk factors that leads to detrimental health effects and support for a transdiagnostic approach to alcohol use disorders is growing. However, the role of transdiagnostic predictors of problematic alcohol consumption in Ecuador are understudied.

Objective

The aim of this study was to examine gender differences in psychological stress and inflexibility as transdiagnostic predictors of problematic alcohol consumption in a large sample of college students in Ecuador.

Methods

A total of 7,905 college students (21.49 years, SD = 3.68; 53.75% females) were surveyed using the following standardized scales: Alcohol Use Disorders Identification Test, Perceived Stress Scale-14, and Acceptance and Action Questionnaire (AAQ-7). Macro Process for SPSS (models 4 and 7) was used to analyze mediation and moderation effects.

Results

Reported alcohol consumption was significantly higher in men than women students. On the other hand, women reported significantly higher levels of perceived stress and psychological inflexibility than men students. Gender, age, psychological stress, and inflexibility were significant predictors of alcohol consumption. Moreover, psychological inflexibility mediated the impact of stress on alcohol consumption, particularly in women (for men b = 0.065, 95% CI [0.048 to 0.083], for women b = 0.070, 95% CI [0.051 to 0.089]).

Discussion

Results of this study support psychological stress and psychological inflexibility as critical transdiagnostic variables related to increased rates of alcohol consumption among Ecuadorian college students. These conclusions contribute to the development of transdiagnostic comprehensive programs, which encompasses promotive, preventive, and treatment services that allow to alleviate the burden of alcohol, as well as to enrich the growing research on alcohol consumption in this population from a gender perspective.

Relationship between levels of mindfulness and substance use pattern

ABSTRACT Objective Evaluate the association between levels of mindfulness and sociodemographic characteristics and pattern of drug use of individuals seeking treatment in a University Service Specialized in Substance Use Disorders. Methods This is a cross-sectional study with 164 individuals over 18 years of age seeking treatment for the use of psychoactive substances in the June 2018-December 2019 period, using a questionnaire for sociodemographic data, the Mindful Attention Awareness Scale (MAAS) self-reporting instrument, and the Alcohol, Smoking, and Substance Involvement Screening Test. Results An association was found between low levels of mindfulness mainly with the individual risk of being a medium/high-risk user of sedative-hypnotic drugs (p = 0.020). A borderline association was also found between MAAS and the risk of the individual being a medium/high risk of alcohol (p = 0.053) and with a more severe pattern of substance use (p = 0.065). Conclusion Individuals seeking treatment for substance use presented impairments in the attentional aspect of mindfulness and levels of mindfulness seem to protect against behaviors related to substance use, especially against the use of high/moderate risk of sedative-hypnotics.

Performance of Academic Staff during COVID-19 Pandemic-Induced Work Transformations: An IPO Model for Stress Management

The COVID-19 pandemic has adversely affected all spheres of services-related business, including the higher education sector. As a pre-emptive measure, almost all traditional educational institutions have been transformed into virtual organizations. This pandemic-induced work transition has created stress among academic staff and has hampered their performance. The present study aims to examine the impact of leadership behaviors, e-training, and employment security on the stress management process, consequently improving employee performance during and after the pandemic. Based on the IPO (input–process–output) model, this study examines the effect of leadership behavior, e-training, and employment security on teaching staff’s tasks and adaptive and contextual performance, mediated by stress management. To test the conceptual model, data were collected from the teaching staff of Malaysian universities. The structural equation modeling technique was used for data analysis, while bootstrapping with the maximum likelihood estimator was used to confirm the mediational role of stress management. The study revealed that task- and relation-oriented leadership behavior, e-training, and employment security positively influence stress management and employee performance in virtual organizations. Moreover, stress management acts as a full mediator in the relationship between leadership behavior and employee performance, while partial mediation occurs between e-training, employment security, and employee performance. This study offers valuable insights into the literature by proposing leadership behavior, e-training, and employment security as input in the stress management process to attain the performance output of teaching staff. Higher education institutions should come forward to assist their teaching employees in managing their stress levels for better outcomes.

A Scoping Review of Drug Epidemic Models

The phenomenon of drug epidemics has been a global issue in the past decades, causing enormous damages to the physical and mental health of drug users and social well-being. Despite great efforts to curb drug epidemics at the governmental or social level, the total number of drug users has still been on the rise in recent years, along with illicit production and trafficking around the world. Inspired by dynamical epidemic models of infectious disease, a flourishment of promising results has been observed in the exploration of drug epidemic models. In this review, we aim to provide a scoping review of all existing drug epidemic modeling studies, and it has been shown that most studies focused on analyses of theoretical behaviors of the model systems, lacking emphasis on practical applications in real settings. We found that the drug epidemic models were characterized by a longer time scale, no incubation period, no significant prevention vaccines interfered, and population specificity. This review could assist policymakers and public health workers in gaining deeper insights into modeling tools, and help modelers improve their works, thus narrowing gaps between mathematical epidemiology and public health studies.

The effect of maladaptive schemas and psychological flexibility approaches on the addiction severity of drug addicts

PURPOSE

This study tested a model of the effect of maladaptive schemas on addiction severity and the mediating role of psychological flexibility between the two.

METHODS

The descriptive and methodological study was conducted with 661 opioid users. Data were collected using the questionnaire, including sociodemographic Characteristics, Addiction Profile Index, Young Schema Questionnaire 3 Short Form, Freiburg Mindfulness Inventory, Acceptance and Action Questionnaire-II and Cognitive Fusion Questionnaire. Data were analyzed using descriptive and correlational analysis and structural equation model.

RESULTS

The mean age was 27.43 ± 7.04 years. Of participants, 52.3% had a secondary school degree, 76.7% had no children, 90.8% were men, 69.3% single, 71.9% unemployed, and 71.4% lived with their parents. Relationship between schemas and addiction severity was 0.36 (p < 0.05), which was reduced to 0.10 by psychological flexibility (p < 0.05). Psychological flexibility affects addiction severity directly, but maladaptive schemas affect addiction severity through psychological flexibility.

CONCLUSIONS

Maladaptive schemas and psychological flexibility are constructs that need to be addressed in substance use treatment.

Exploring the Optimal Factor Structure of the Five Facet Mindfulness Questionnaire: Associations Between Mindfulness Facets and Dimensions of Psychopathology

Recent studies of the Five Facet Mindfulness Questionnaire (FFMQ) and its condensed version (FFMQ-SF) fail to replicate the initially proposed five-factor structure in clinical samples. Failure to adequately understand the dimensionality of common mindfulness measures within clinical samples, therefore, represents an important gap in the current literature. The increasing popularity of mindfulness-based interventions warrants further investigation of differential associations between facets of mindfulness and different forms of psychopathology. We examined (a) the underlying structure of the FFMQ and FFMQ-SF, and (b) associations between FFMQ and FFMQ-SF facets and dimensions of psychopathology (i.e., internalizing and substance use disorders) in two large clinical samples (N = 2,779). Results from bass-ackwards analyses suggested similarly defensible five- and six-factor model solutions in terms of fit. The five-factor model was optimal when factoring in parsimony. Exploratory structural equation modeling revealed that all FFMQ facets with the exception of observe were negatively associated with the internalizing factor. Associations with substance use disorders were more complex. In both samples, five-factor FFMQ and FFMQ-SF models were determined to best represent these data. Whereas deficits in all FFMQ facets with the exception of observe correspond with lower internalizing psychopathology, a more nuanced association was observed with substance use disorders.

Identifying App-Based Meditation Habits and the Associated Mental Health Benefits: Longitudinal Observational Study

Background

Behavioral habits are often initiated by contextual cues that occur at approximately the same time each day; so, it may be possible to identify a reflexive habit based on the temporal similarity of repeated daily behavior. Mobile health tools provide the detailed, longitudinal data necessary for constructing such an indicator of reflexive habits, which can improve our understanding of habit formation and help design more effective mobile health interventions for promoting healthier habits.

Objective

This study aims to use behavioral data from a commercial mindfulness meditation mobile phone app to construct an indicator of reflexive meditation habits based on temporal similarity and estimate the association between temporal similarity and meditation app users’ perceived health benefits.

Methods

App-use data from June 2019 to June 2020 were analyzed for 2771 paying subscribers of a meditation mobile phone app, of whom 86.06% (2359/2771) were female, 72.61% (2012/2771) were college educated, 86.29% (2391/2771) were White, and 60.71% (1664/2771) were employed full-time. Participants volunteered to complete a survey assessing their perceived changes in physical and mental health from using the app. Receiver operating characteristic curve analysis was used to evaluate the ability of the temporal similarity measure to predict future behavior, and variable importance statistics from random forest models were used to corroborate these findings. Logistic regression was used to estimate the association between temporal similarity and self-reported physical and mental health benefits.

Results

The temporal similarity of users’ daily app use before completing the survey, as measured by the dynamic time warping (DTW) distance between app use on consecutive days, significantly predicted app use at 28 days and at 6 months after the survey, even after controlling for users’ demographic and socioeconomic characteristics, total app sessions, duration of app use, and number of days with any app use. In addition, the temporal similarity measure significantly increased in the area under the receiver operating characteristic curve (AUC) for models predicting any future app use in 28 days (AUC=0.868 with DTW and 0.850 without DTW; P<.001) and for models predicting any app use in 6 months (AUC=0.821 with DTW and 0.802 without DTW; P<.001). Finally, a 1% increase in the temporal similarity of users’ daily meditation practice with the app over 6 weeks before the survey was associated with increased odds of reporting mental health improvements, with an odds ratio of 2.94 (95% CI 1.832-6.369).

Conclusions

The temporal similarity of the meditation app use was a significant predictor of future behavior, which suggests that this measure can identify reflexive meditation habits. In addition, temporal similarity was associated with greater perceived mental health benefits, which demonstrates that additional mental health benefits may be derived from forming reflexive meditation habits.

Mindfulness and Behavior Change

Initiating and maintaining behavior change is key to the prevention and treatment of most preventable chronic medical and psychiatric illnesses. The cultivation of mindfulness, involving acceptance and nonjudgment of present-moment experience, often results in transformative health behavior change. Neural systems involved in motivation and learning have an important role to play. A theoretical model of mindfulness that integrates these mechanisms with the cognitive, emotional, and self-related processes commonly described, while applying an integrated model to health behavior change, is needed. This integrative review (1) defines mindfulness and describes the mindfulness-based intervention movement, (2) synthesizes the neuroscience of mindfulness and integrates motivation and learning mechanisms within a mindful self-regulation model for understanding the complex effects of mindfulness on behavior change, and (3) synthesizes current clinical research evaluating the effects of mindfulness-based interventions targeting health behaviors relevant to psychiatric care. The review provides insight into the limitations of current research and proposes potential mechanisms to be tested in future research and targeted in clinical practice to enhance the impact of mindfulness on behavior change.

Mining the Mind: Linear Discriminant Analysis of MEG Source Reconstruction Time Series Supports Dynamic Changes in Deep Brain Regions During Meditation Sessions

Meditation practices have been claimed to have a positive effect on the regulation of mood and emotions for quite some time by practitioners, and in recent times there has been a sustained effort to provide a more precise description of the influence of meditation on the human brain. Longitudinal studies have reported morphological changes in cortical thickness and volume in selected brain regions due to meditation practice, which is interpreted as an evidence its effectiveness beyond the subjective self reporting. Using magnetoencephalography (MEG) or electroencephalography to quantify the changes in brain activity during meditation practice represents a challenge, as no clear hypothesis about the spatial or temporal pattern of such changes is available to date. In this article we consider MEG data collected during meditation sessions of experienced Buddhist monks practicing focused attention (Samatha) and open monitoring (Vipassana) meditation, contrasted by resting state with eyes closed. The MEG data are first mapped to time series of brain activity averaged over brain regions corresponding to a standard Destrieux brain atlas. Next, by bootstrapping and spectral analysis, the data are mapped to matrices representing random samples of power spectral densities in [Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text] frequency bands. We use linear discriminant analysis to demonstrate that the samples corresponding to different meditative or resting states contain enough fingerprints of the brain state to allow a separation between different states, and we identify the brain regions that appear to contribute to the separation. Our findings suggest that the cingulate cortex, insular cortex and some of the internal structures, most notably the accumbens, the caudate and the putamen nuclei, the thalamus and the amygdalae stand out as separating regions, which seems to correlate well with earlier findings based on longitudinal studies.

Mindfulness in Pregnancy: A Brief Intervention for Women at Risk

INTRODUCTION

The U.S. has the highest rate of preterm birth (PTB), of all developed countries, especially among African American women. Social determinants of health and inequalities in health outcomes are understudied areas. The intersectionality of race and socioeconomic status has been shown to contribute to chronic stress, stress has been shown to be associated with PTB, yet the mechanisms that affect pregnancy outcomes have not been explicit. Mindfulness-based Interventions that address stress reduction during pregnancy may improve quality of life during pregnancy, perhaps enhancing resilience, and be on the pathway to reducing the risk of negative pregnancy outcomes such as PTB.

METHODS

We over-enrolled African American women and those covered by Medicaid to reach women at higher risk for PTB and included women in substance use treatment. Participants were enrolled in a 6-week mindfulness in pregnancy (MIP) intervention at the obstetric clinic. Sociodemographic characteristics and psychosocial assessments were obtained at three time points.

RESULTS

We enrolled 35 women who self-identified as: non-white, Medicaid recipients, aged 25-35 years, with high school or less education. We found reductions in perceived stress, pregnancy specific stress, trait anxiety and depression and increases in mindfulness that sustained post-intervention at 2 and 7 months.

DISCUSSION

Social determinants and stress in particular have been associated with negative birth outcomes. This paper describes a brief intervention and results of MIP tailored to women who have significantly more stress due to race, poverty, homelessness, substance use treatment and other comorbid health risks including PTB.

Distress Tolerance as a Mechanism Linking Violence Exposure to Problematic Alcohol use in Adolescence

Adolescents exposed to violence are at elevated risk of developing most forms of psychopathology, including depression, anxiety, and alcohol abuse. Prior research has identified emotional reactivity and difficulties with emotion regulation as core mechanisms linking violence exposure with psychopathology. Scant research has examined behavioral responses to distress as a mechanism in this association. This study examined the association of violence exposure with distress tolerance-the ability to persist in the face of distress-and whether lower distress tolerance linked violence exposure with subsequent increases in depression, anxiety, and alcohol abuse problems during adolescence. Data were collected prospectively in a sample of 287 adolescents aged 16-17 (44.3% male; 40.8% White). At Time 1, participants provided self-report of demographics, violence exposure, and psychopathology, and completed a behavioral measure of distress tolerance, the Paced Auditory Serial Addition Task. Four months later, participants (n = 237) repeated the psychopathology assessments. Violence exposure was associated with lower distress tolerance (β = -.21 p = .009), and elevated concurrent psychopathology (β = .16-.45, p = .001-.004). Low distress tolerance was prospectively associated with greater likelihood of abusing alcohol over time (OR = .63, p = .021), and mediated the association between violence exposure and greater levels (β = .02, 95% CI [.001, .063]) and likelihood (OR = .03, 95% CI [.006, .065]) of alcohol use over time. In contrast, low distress tolerance was not associated concurrently or prospectively with internalizing symptoms. Results persisted after controlling for socio-economic status. Findings suggest that distress tolerance is shaped by early experiences of threat and plays a role in the association between violence exposure and development of problematic alcohol use in adolescence.

Treatment Disruption and Childcare Responsibility as Risk Factors for Drug and Alcohol Use in Persons in Treatment for Substance Use Disorders During the COVID-19 Crisis

The novel 2019 coronavirus (COVID-19) crisis has caused considerable upheaval in the U.S. healthcare system. The current study examined patient-reported experiences in substance use disorder (SUD) treatment during the early stages of the COVID-19 crisis.

Complementary and Alternative Medicine for Substance Use Disorders: A Scientometric Analysis and Visualization of Its Use Between 2001 and 2020

Background: This study aimed to identify frontiers for further studies via brief understanding in complementary and alternative medicine (CAM) for substance use disorders (SUDs). Materials and Methods: Publications on the use of CAM for treating SUDs were retrieved from the Web of Science Core Collection from 2001 to 2020 on July 12, 2020, and visualized by CiteSpace V. Results: A total of 3,807 publications were obtained. The USA, China, and England were the leading research centers. However, India and Pakistan have recently focused on assessing CAM for the treatment of SUDs. Frederick L Altice was found to be the most productive author. Addiction ranked first among the frequently cited journals, which exceeded 1,000. The most common CAM therapies were acupuncture and CAM psychotherapies, such as mindfulness meditation. Conclusion: CAM is gaining attention globally for treating SUDs. CAM psychotherapy and acupuncture are hotspots and deserve further study. Researchers should strengthen peer cooperation in this field.

Effectiveness of Interventions Based on Yogic Breathing Practices (IB-YBP) on Substance Use Disorders-A Systematic Review of the Randomized Control Trials and Quasi-Experimental Trials

Interventions based on Yogic Breathing Practices (IB-YBP) have shown promising results for substance use disorders (SUD). Research in this area is methodologically heterogeneous and only a few, but restricted, systematic reviews are available. The current systematic review aims to assess the effectiveness of IB-YBP for SUD. Materials and Methods: PubMed, Cochrane's Library, EBSCO-Medline, and Google Scholar databases were searched for the randomized- (RCTs) and quasi-randomized trials. Research involving participants with SUD, of either gender or any age, assessing the effectiveness of the IB-YBP either as a standalone intervention or as an adjuvant to standard treatment versus standard pharmacological/non-pharmacological treatment or no-intervention control were included. Studies having participants with co-morbid psychiatric illness and interventions not having IB-YBP as the predominant component were excluded. Results: The initial literature search yielded 396 articles and upon screening, only 14 studies were found eligible for this review. Most studies have researched IB-YBP as an adjunct to the standard treatment for SUD. Evidence for the effectiveness of IB-YBP is mostly available for tobacco and opioid use disorders, though only for short-term outcomes; however, literature is scarce for alcohol- and cocaine-use disorders. This review documented the effectiveness of the IB-YBP for substance use-related outcome parameters such as abstinence, quality of life (QoL), mood, craving, and withdrawal symptoms. Conclusion: IB-YBP may be an effective adjuvant to standard treatment for various SUD. However, more research is required to compare its effectiveness with standard treatment, and assessing its long-term efficacy, for it to be strongly recommended as a treatment strategy.

Mindfulness-Based Stress Reduction in the Management of Chronic Pain and Its Comorbid Depression

Context

Chronic pain (CP) is a common and serious medical condition, with an estimated 100 million people affected in the United States. In the 1990s, opioids were increasingly prescribed to manage chronic pain, and this practice contributed to the opioid epidemic of the 21st century. To combat this epidemic, multidisciplinary approaches to chronic pain management are being researched and implemented.

Objective

To evaluate the clinical effectiveness of an 8-week mindfulness-based stress reduction (MBSR) course implemented in a semi-rural population with chronic pain.

Methods

Participants were recruited from a community-based teaching hospital in Corvallis, Oregon, for a pre-post study. Participants aged 34 to 77 years who reported having chronic pain lasting for at least 1 year before enrollment were included. Participants took an 8-week group MBSR course in 2.5-hour weekly sessions taught by an experienced MBSR instructor. Techniques were self-practiced between sessions with a goal of 30 minutes per day, 6 days per week. Pre- and postsurvey measurements of pain, depression, and functional capacity were taken via online surveys using the patient health questionnaire (PHQ-9), the Pain Catastrophizing Scale (PCS), and a shortened version of the Modified Oswestry Disability Index (MO). Participants were asked about their satisfaction with the program content, instructor, timing, and location.

Results

Twenty-eight participants were included in the study. Paired t tests found significant improvements in PHQ-9, PCS, and MO percent scores from before to after the course. PHQ-9 scores decreased by a mean of 3.7 points (95% CI, −5.5, −1.8), PCS scores decreased by a mean of 4.6 points (95% CI: −7.2, −2.0), and MO percent score decreased by a mean of 9.4% (95% CI: −14.2%, −4.6%). Results showed an overall downward shift in the distribution of depression, disability, and pain scores after the course.

Conclusions

MBSR classes were found to benefit participants with chronic pain and depression in this setting, fostering significant improvement in participant perceptions of pain, mood, and functional capacity.

A Brief Report on an 8-Week Course of Mindfulness-based Care for Chronic Pain in the Treatment of Veterans With Back Pain: Barriers Encountered to Treatment Engagement and Lessons Learned

BACKGROUND

Chronic pain and associated symptoms are debilitating for veterans. Medical costs of treatments are high and current treatment options, most notably with opioid medications, have been associated with significant risk. Mindfulness-based interventions appear promising for chronic pain, but require additional testing in veteran care settings.

OBJECTIVE

This project was designed to test the feasibility of engaging and retaining veterans with chronic lower back pain in a new mindfulness protocol tailored for veterans, mindfulness-based care for chronic pain (MBCP). Clinical outcomes were also assessed.

DESIGN

An open pilot trial of an 8-week MBCP course that included meditation, gentle yoga, and psychoeducation.

SUBJECTS

Twenty-two veterans (mean age=49.77; 18% women) were recruited from a VA Medical Center in the Northeastern US. After screening for inclusion/exclusion criteria, 20 were eligible at baseline.

MEASURES

Veterans were assessed at baseline and postintervention for functional impairment, pain intensity and bothersomeness, depression, and mindfulness.

RESULTS

The average number of sessions completed was 5; only 4 (20%) attended all sessions. Eleven of the 20 participants (55%) attended 5 or more sessions and had complete preintervention and postintervention visits. Five of the 11 had a clinically meaningful decrease in pain intensity and in depressive symptoms, while 6 of 11 had a meaningful decrease in pain bothersomeness and functional impairment.

CONCLUSIONS

It was challenging to enroll and retain participants in this study, even with our intervention designed for veterans. We discuss possible adaptations and refinements in MBCP for veterans with chronic pain to enhance feasibility and improve upon these interventions.

Psychosocial treatment for incarcerated methamphetamine users: the Philippines experience

PURPOSE

The purpose of this study is to evaluate a psychosocial treatment program for prisoners incarcerated because of methamphetamine use. It compared the outcomes of prisoners who received the program while incarcerated, those who were released and received the treatment as part of community-based drug recovery program and a waitlist-control group (WC) with no treatment.

DESIGN/METHODOLOGY/APPROACH

A quasi-experimental design was use with pre- and post-test surveys administered to three groups: a WC group, a pre-release treatment-while-incarcerated (TWI) group, and a post-release outpatient treatment group (OP). Surveys measured recovery skills, life skills and substance use disorder (SUD) symptoms were administered before and after the intervention.

FINDINGS

Results revealed that at baseline OP and TWI had significant higher recovery skills compared to WC group. However, in terms of life skills, there was no significant difference observed among the WC, OP and TWI group at baseline. TWI had a significantly lower number of SUD symptoms compared to the WC group at baseline. As hypothesized, findings revealed significant changes in recovery and life skills among the OP and TWI group compared to the WC group. No significant change in SUD scores were observed for all groups.

RESEARCH LIMITATIONS/IMPLICATIONS

A major limitation of the study was the use of a quasi-experimental design because legal issues did not allow a randomized control trial. Future research using randomized controlled trial designs would provide more robust conclusions on the impact of the intervention. The study design was also limited to pre- and post-evaluation. Further studies are encouraged to look at longitudinal outcomes of appears on SUD symptoms and possibility of relapse.

PRACTICAL IMPLICATIONS

Given that there were no significant differences in outcomes between OP and TWI groups, results suggest that the program may serve either as a pre- or post-release program for incarcerated drug users. However, results also suggest that completion is higher when the program is used as a pre-release program. Delivering the program prior to release also reduces challenges related to attrition including conflict in schedules and the lack of resources for transportation.

SOCIAL IMPLICATIONS

The study suggests the value of psychosocial treatment as opposed to punitive approaches in dealing with drug use. In particular, delivering interventions prior to release can prepare participants for problems they may encounter during reintegration and prevent recidivism. In a country where drug-related killings are on the rise, the study presents an alternate and restorative justice approach.

ORIGINALITY/VALUE

The study addresses a dearth in the literature on psychosocial intervention for methamphetamine users. It also fills a vacuum in studies from developing countries such as the Philippines.

Mindfulness-Based Stress Reduction in the Management of Chronic Pain and Its Comorbid Depression

CONTEXT

Chronic pain (CP) is a common and serious medical condition, with an estimated 100 million people affected in the United States. In the 1990s, opioids were increasingly prescribed to manage chronic pain, and this practice contributed to the opioid epidemic of the 21st century. To combat this epidemic, multidisciplinary approaches to chronic pain management are being researched and implemented.

OBJECTIVE

To evaluate the clinical effectiveness of an 8-week mindfulness-based stress reduction (MBSR) course implemented in a semi-rural population with chronic pain.

METHODS

Participants were recruited from a community-based teaching hospital in Corvallis, Oregon, for a pre-post study. Participants aged 34 to 77 years who reported having chronic pain lasting for at least 1 year before enrollment were included. Participants took an 8-week group MBSR course in 2.5-hour weekly sessions taught by an experienced MBSR instructor. Techniques were self-practiced between sessions with a goal of 30 minutes per day, 6 days per week. Pre- and postsurvey measurements of pain, depression, and functional capacity were taken via online surveys using the patient health questionnaire (PHQ-9), the Pain Catastrophizing Scale (PCS), and a shortened version of the Modified Oswestry Disability Index (MO). Participants were asked about their satisfaction with the program content, instructor, timing, and location.

RESULTS

Twenty-eight participants were included in the study. Paired t tests found significant improvements in PHQ-9, PCS, and MO percent scores from before to after the course. PHQ-9 scores decreased by a mean of 3.7 points (95% CI, -5.5, -1.8), PCS scores decreased by a mean of 4.6 points (95% CI: -7.2, -2.0), and MO percent score decreased by a mean of 9.4% (95% CI: -14.2%, -4.6%). Results showed an overall downward shift in the distribution of depression, disability, and pain scores after the course.

CONCLUSIONS

MBSR classes were found to benefit participants with chronic pain and depression in this setting, fostering significant improvement in participant perceptions of pain, mood, and functional capacity.

Using mind control to modify cue-reactivity in AUD: the impact of mindfulness-based relapse prevention on real-time fMRI neurofeedback to modify cue-reactivity in alcohol use disorder: a randomized controlled trial

BACKGROUND

Alcohol Use Disorder is a severe mental disorder affecting the individuals concerned, their family and friends and society as a whole. Despite its high prevalence, novel treatment options remain rather limited. Two innovative interventions used for treating severe disorders are the use of real-time functional magnetic resonance imaging neurofeedback that targets brain regions related to the disorder, and mindfulness-based treatments. In the context of the TRR SFB 265 C04 "Mindfulness-based relapse prevention as an addition to rtfMRI NFB intervention for patients with Alcohol Use Disorder (MiND)" study, both interventions will be combined to a state-of-the art intervention that will use mindfulness-based relapse prevention to improve the efficacy of a real-time neurofeedback intervention targeting the ventral striatum, which is a brain region centrally involved in cue-reactivity to alcohol-related stimuli.

METHODS/DESIGN

After inclusion, N = 88 patients will be randomly assigned to one of four groups. Two of those groups will receive mindfulness-based relapse prevention. All groups will receive two fMRI sessions and three real-time neurofeedback sessions in a double-blind manner and will regulate either the ventral striatum or the auditory cortex as a control region. Two groups will additionally receive five sessions of mindfulness-based relapse prevention prior to the neurofeedback intervention. After the last fMRI session, the participants will be followed-up monthly for a period of 3 months for an assessment of the relapse rate and clinical effects of the intervention.

DISCUSSION

The results of this study will give further insights into the efficacy of real-time functional magnetic resonance imaging neurofeedback interventions for the treatment of Alcohol Use Disorder. Additionally, the study will provide further insight on neurobiological changes in the brain caused by the neurofeedback intervention as well as by the mindfulness-based relapse prevention. The outcome might be useful to develop new treatment approaches targeting mechanisms of Alcohol Use Disorder with the goal to reduce relapse rates after discharge from the hospital.

TRIAL REGISTRATION

This trial is pre-registered at clinicaltrials.gov (trial identifier: NCT04366505; WHO Universal Trial Number (UTN): U1111-1250-2964). Registered 30 March 2020, published 29 April 2020.

Somatic symptoms among prison inmates: contributions of emotion regulation, dispositional mindfulness, and duration of stay in prison

PURPOSE

The modern prison system is not only a necessity to keep the public safe but also a mode of punishment for crimes. The correctional role of prisons is hampered in situations of mental illness, given that mental illness in the prison or correctional setting is a serious security risk. Few studies have given attention to the modifiable factors that may influence the mental health status of prison inmates, especially in developing countries. The purpose of this paper is to investigate emotion regulation (ER), dispositional mindfulness and duration of stay as factors in somatic symptoms among prison inmates.

DESIGN/METHODOLOGY/APPROACH

Participants were 209 prison inmates drawn from a prison in Eastern Nigeria, who completed measures of ER (cognitive reappraisal and expressive suppression), mindfulness and somatization.

FINDINGS

Results of a hierarchical multiple regression indicated that cognitive reappraisal predicted somatic complaints but it was only among older prison inmates, while expressive suppression was not a significant predictor of somatic complaints. Dispositional mindfulness was a negative predictor of somatic complaints among younger and older prison inmates. Duration of stay in prison positively predicted somatic complaints among prison inmates in emerging adulthood only (younger inmates), but not among older inmates.

RESEARCH LIMITATIONS/IMPLICATIONS

Frequent use of cognitive reappraisal strategy of ER by prisoners may not always be productive in reducing somatic complaints, and the length of time in prison may influence somatic symptoms especially for younger prisoners. The possible benefits of incorporating mindfulness-based therapies in psychosocial interventions to reduce somatic complaints in correctional settings deserves further investigation.

ORIGINALITY/VALUE

To date, there is limited research on somatic complaints of prisoners in the developing societies, particularly the psychosocial factors that may contribute to mental health problems.

Mindfulness as a predictor of cognitive-behavioral therapy outcomes in inner-city adults with posttraumatic stress and substance dependence

The co-occurrence of posttraumatic stress disorder (PTSD) and substance use disorders (SUD) is highly prevalent and difficult-to-treat. Mindfulness, defined as nonjudgmental attention to and awareness of present-moment experiences, represents a targetable mechanism with potential to predict and improve treatment outcomes for PTSD/SUD populations. We hypothesized that greater self-reported mindfulness at baseline (pre-treatment) would predict (a) lower end-of-treatment PTSD severity and (b) greater longest sustained abstinence during a 12-week cognitive-behavioral treatment program. Participants included 53 inner-city adults meeting at least four current symptoms of DSM-5 PTSD and current (DSM-IV) substance dependence (51% women; 75.5% African American; Mage = 45.42, SD = 9.99). Hierarchical regression analysis results indicated that higher levels of baseline mindfulness predicted lower end-of-treatment PTSD severity but not longest sustained abstinence from the primary substance of choice. Post hoc exploration of end-of-treatment PTSD symptom clusters indicated that higher baseline mindfulness predicted lower intrusion, negative alterations in cognitions and mood, and arousal and reactivity symptoms but not avoidance symptoms. Clinical and research implications are discussed.

A pilot study of Vipassana meditation with female drug users at a rehabilitation centre, Thailand

Purpose

Substance abuse has become a major health issue in Thailand, contributing to high numbers of premature deaths and requiring considerable expenditure on treatment and rehabilitation programs. The purpose of this paper is to explore use of Vipassana meditation to reduce depression and improve empathy and self-awareness in drug dependent women at a rehabilitation centre.

Design/methodology/approach

Mixed methods were employed. Data were collected in a randomised controlled trial and focus group interviews with 24 intervention subjects and 22 controls.

Findings

Findings showed no significant differences in depression, empathy or mindfulness levels between intervention and control groups, but intervention subjects had a small decline in depression at one-month follow up. The focus group interviews showed that drug users had developed self-awareness, moral values and greater understanding of right and wrong acts.

Originality/value

Findings suggest that Vipassana meditation which is cultural appropriate for Thai culture and religion, should be incorporated into treatments in rehabilitation centres to increase successful outcomes.

The Effect of Mindfulness Meditation on Impulsivity and its Neurobiological Correlates in Healthy Adults

Interest has grown in using mindfulness meditation to treat conditions featuring excessive impulsivity. However, while prior studies find that mindfulness practice can improve attention, it remains unclear whether it improves other cognitive faculties whose deficiency can contribute to impulsivity. Here, an eight-week mindfulness intervention did not reduce impulsivity on the go/no-go task or Barratt Impulsiveness Scale (BIS-11), nor produce changes in neural correlates of impulsivity (i.e. frontostriatal gray matter, functional connectivity, and dopamine levels) compared to active or wait-list control groups. Separately, long-term meditators (LTMs) did not perform differently than meditation-naïve participants (MNPs) on the go/no-go task. However, LTMs self-reported lower attentional impulsivity, but higher motor and non-planning impulsivity on the BIS-11 than MNPs. LTMs had less striatal gray matter, greater cortico-striatal-thalamic functional connectivity, and lower spontaneous eye-blink rate (a physiological dopamine indicator) than MNPs. LTM total lifetime practice hours (TLPH) did not significantly relate to impulsivity or neurobiological metrics. Findings suggest that neither short- nor long-term mindfulness practice may be effective for redressing impulsive behavior derived from inhibitory motor control or planning capacity deficits in healthy adults. Given the absence of TLPH relationships to impulsivity or neurobiological metrics, differences between LTMs and MNPs may be attributable to pre-existing differences.

An Investigation of Moral Principles and Mental Training in the Pāli Nikāyas and Their Implications for Behaviour Modification and Mental Health

This article explicates the fundamental moral principles and mental training of Buddhism that have implications for behavioural transformation and mental health promotion. These techniques are considered to be effective for transforming the unwholesome thoughts and overcoming the afflictions (āsavas). It investigates some methods of mental training that can be designed to fit the behaviour of a practitioner. It also investigates the three key interdependent elements of mindfulness techniques and, in particular, how a simple practice of mindfulness (sati), full awareness (sampajañña), and proper attention (yoniso-manasikāra) can help us modify our behaviour and achieve mental health.

Abstinence Following a Motivation-Skill-Desensitization-Mental Energy Intervention for Heroin Dependence: A Three-year Follow-up Result of a Randomized Controlled Trial

The high rate of relapse among heroin users remains a significant public concern in China. In the present study, we utilized a Motivation-Skill-Desensitization-Mental Energy (MSDE) intervention and evaluated its effects on abstinence and mental health. Eighty-nine male heroin users in a drug rehabilitation center were enrolled in the study. The participants in the MSDE intervention group (n=46) received MSDE intervention, which included motivational interviewing, coping skills training, eye movement desensitization and reprocessing, and mindfulness-based psychotherapy. The participants in the control group (n=43) received a series of lectures on skills training. A significant increase in Contemplation Ladder score (P<0.001) and decreases in scores on the Obsessive Compulsive Drug Use Scale (P<0.001), Beck Depression Inventory (P<0.001), and Aggression Questionnaire (P=0.033) were found immediately after intervention. Compared to the control group, the MSDE intervention group reported significantly higher abstinence rates (P=0.027) and retention rates (P<0.001) at follow-up. Overall, the MSDE intervention, which uses a combined strategy for relapse prevention, could be a promising approach for preventing relapse among heroin users in China.

Mindfulness-based therapy modulates default-mode network connectivity in patients with opioid dependence

Recently, mindfulness-based programs have shown promising clinical effects in the treatment of substance-use disorders (SUD). While several studies linked mindfulness to decreased default mode network (DMN) connectivity in meditators, only a few studies investigated its effects in patients with SUD. This study aimed to detect changes in DMN connectivity in opiate dependent patients receiving mindfulness based therapy (MBT) during their first month of treatment. Data from 32 patients that were assigned to MBT or treatment as usual (TAU) groups was investigated using resting-state functional MRI at 1.5 T before and after four weeks of treatment. Independent Component Analysis was used to investigate distinct (anterior vs. posterior) DMN subsystems. Connectivity changes after treatment were related to measures of impulsivity, distress tolerance and mindfulness. Increased mindfulness scores after treatment were found in patients receiving MBT compared to TAU. Within the anterior DMN, decreased right inferior frontal cortical connectivity was detected in patients who received MBT compared to TAU. In addition, within the MBT-group decreased right superior frontal cortex connectivity was detected after treatment. Inferior frontal cortex function was significantly associated with mindfulness measures. The data suggest that MBT can be useful during abstinence from opiates. In opiate-dependent patients distinct functional connectivity changes within the DMN are associated with MBT.

Investigating the Feasibility of Brief Compassion Focused Therapy in Individuals in Treatment for Opioid Use Disorder

Opioid use disorder (OUD) is reaching epidemic proportions worldwide, and is notoriously difficult to treat. Compassion focused therapy (CFT) has emerged as therapeutic tool for treating individuals exhibiting high levels of self-criticism and low self-esteem, both of which are common in OUD. Until now, however, there had been no research investigating this therapy in patients with OUD. Before running a premature clinical trial, it is important to fully assess the feasibility and acceptability of this treatment in this group of individuals. We aimed to assess the feasibility of CFT treatment in individuals with OUD in a short group intervention, which was co-created by the research team, service users and a local drugs service. The intervention involved three 2-hour sessions held over 3 weeks, where participants engaged in compassion-orientated psychoeducation and self-compassionate exercises. Individuals were randomly assigned to either the CFT group (n = 15), the active control (relaxation) group (n = 12) or the waitlist control group (n = 11). Of 103 individuals approached, 45% attended a baseline visit suggesting the treatment was acceptable to this group. A relatively low attrition rate across the 3 groups was found for CFT (21.1%), with no difference in drop-out between the groups. Qualitative analysis of interviews with participants identified a desire for more sessions. Compassion focused therapy was thus feasible and well-tolerated in those with OUD, and a further trial to evaluate any clinical differences may be warranted.

Feasibility of a Mindfulness-Based Intervention for Caregivers of Veterans: A Pilot Study

Purpose: This pilot study aimed to assess the feasibility of conducting an 8-week mindfulness-based intervention with caregivers of veterans and to examine the effectiveness of the intervention to improve mindfulness using the Five Facet Mindfulness Questionnaire compared with waitlist controls. Design: In this randomized controlled trial, 23 caregivers of veterans were assigned to either the intervention or waitlist group. Method: Compliance with mindfulness instruction and attendance was assessed among those in the intervention. Wilcoxon signed-rank tests compared within group pre- and post-intervention scores and Mann-Whitney U tests compared difference scores (post-pre) by group type. Effect sizes were also calculated. Compliance variables were correlated with difference scores in the intervention group only. Findings: Of the 23 participants, 11 were assigned to the intervention; 100% of participants were retained. There was significant improvement from pre- to post-intervention in four of the five facets of mindfulness (p < .05) in the intervention group. Significant between-group differences (p < .05) were also observed in two of the five facets. Effect sizes ranged from small (.44) to large (.89). No significant improvement was observed in the waitlist control group. Conclusions: A mindfulness-based intervention is feasible and acceptable to improve mindfulness in caregivers of veterans.

Mindfulness-based weekend retreats for people bereaved by suicide (Panta Rhei): A pilot feasibility study

OBJECTIVES

This study investigates whether a programme of mindfulness-based weekend retreats (Panta Rhei) is able to improve mood states, mindfulness qualities, and self-compassion in family members and friends of suicide victims (suicide survivors).

DESIGN

Longitudinal prospective study.

METHODS

Sixty-one suicide survivors participated in a mindful-self-compassion retreat. The Five-Facet Mindfulness Questionnaire, the Profile of Mood States (POMS), and the Self-Compassion Scale were administered 4-6 days before and after the retreat.

RESULTS

A significant reduction in all dimensions of the POMS (except Vigor-Activity) and lower levels of overidentification were observed after the retreat.

CONCLUSIONS

Although further research is warranted, this study highlights the potential beneficial effect of brief mindfulness-based weekend retreats on the well-being of suicide survivors.

PRACTITIONER POINTS

Mindfulness-based weekend retreats seem to be effective in alleviating the psychological distress of suicide survivors in the short term. The benefit may depend on standard mindfulness practices and on more tailored interventions aimed at promoting acceptance of loss, forgiveness and rage management, and thus reducing rumination. Since there is no established treatment for this population, this type of intervention, which seems feasible and well accepted by participants, paves the way for future research in this area.

Psychological Determinants of Drug Abuse among Male Adolescents in Isfahan: A Structural Model

Background:

Drug abuse is one of the most prevalent public health problems around the world and Iran too. Drug abuse is influenced by various psychosocial factors. This study aimed to explain the relationship model of drug abuse based on perceived criticism, mindfulness, and emotion regulation in Isfahan male adolescents.

Methods:

This was a correlational cross-sectional study. A total of 350 male students were randomly selected from different high schools in Isfahan during the period of 2015–2016 academic year. Four questionnaires including the probability of drug abuse questionnaire, emotion regulation inventory, Mindful Attention Awareness Scale, and perceived criticism scale were employed. Data were analyzed using Chi-square and correlation coefficient, besides; Structural equation modeling was used to model the direct and indirect relationships between variables. In this regard, SPSS and AMOS softwares were used.

Results:

Out of the whole subjects, 49.7% had score above the median, indicating more likely to be drug abuser. There was a significant correlation between emotional reappraisal (r = −0.40), expressive suppression (r = −0.38), mindfulness (−0.57), and criticism (r = 0.57) with drug abuse among male adolescents (P < 0.001). Moreover, criticism through the emotional self-regulation had indirect effects on drug abuse. Totally 69% of the variance in drug abuse was explained by the study variables.

Conclusions:

In total, the results of this study revealed that high levels of drug abuse among students can be considered as a crucial issue, regarding the significant effects of psychological factors, adaptive emotion-regulation strategies, as well as school and family-based Psycho-social skills, are recommended.

Sex differences in stress-related alcohol use

Rates of alcohol use disorder (AUD) have increased in women by 84% over the past ten years relative to a 35% increase in men. This substantive increase in female drinking is alarming given that women experience greater alcohol-related health consequences compared to men. Stress is strongly associated with all phases of alcohol addiction, including drinking initiation, maintenance, and relapse for both women and men, but plays an especially critical role for women. The purpose of the present narrative review is to highlight what is known about sex differences in the relationship between stress and drinking. The critical role stress reactivity and negative affect play in initiating and maintaining alcohol use in women is addressed, and the available evidence for sex differences in drinking for negative reinforcement as it relates to brain stress systems is presented. This review discusses the critical structures and neurotransmitters that may underlie sex differences in stress-related alcohol use (e.g., prefrontal cortex, amygdala, norepinephrine, corticotropin releasing factor, and dynorphin), the involvement of sex and stress in alcohol-induced neurodegeneration, and the role of ovarian hormones in stress-related drinking. Finally, the potential avenues for the development of sex-appropriate pharmacological and behavioral treatments for AUD are identified. Overall, women are generally more likely to drink to regulate negative affect and stress reactivity. Sex differences in the onset and maintenance of alcohol use begin to develop during adolescence, coinciding with exposure to early life stress. These factors continue to affect alcohol use into adulthood, when reduced responsivity to stress, increased affect-related psychiatric comorbidities and alcohol-induced neurodegeneration contribute to chronic and problematic alcohol use, particularly for women. However, current research is limited regarding the examination of sex in the initiation and maintenance of alcohol use. Probing brain stress systems and associated brain regions is an important future direction for developing sex-appropriate treatments to address the role of stress in AUD.

“Create in Me a Clean Heart”: The Role of Spirituality in Desistance From Substance Use

Although the impact of religion on behavior is robust and well-examined in many areas, the role spirituality plays in changes in drug use over time has received relatively little attention. Using a life-course theoretical framework, this relationship is examined through growth curve modeling techniques. Specifically, multilevel analyses are estimated testing within-person relationships between substance use desistance and spirituality. The Pathways to Desistance longitudinal data are analyzed and leading criminological predictors are included, to determine if spirituality has a unique impact on substance use net of these criminological factors, and if these impacts vary across gender. Results from these analyses suggest that the impact of spirituality on desistance varies by gender, with spirituality significantly increasing the odds of desistance from marijuana use for females, but not males.

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

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-consecutive HD days, during the study. Subgroup analysis indicated that greater adherence to session attendance and weekly home practice minutes were associated with improved outcomes.

CONCLUSIONS

MBRP-A as an adjunct to usual-care did not show to improve outcomes in alcohol-dependent adults in early recovery compared to usual-care-alone; a return to drinking and relapse to HD were rare in both groups. However, greater adherence to MBRP-A intervention may improve long-term drinking-related outcomes.