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Liu X, Zhang Y, Cheng H, Dong H, You Y, Wu Y, Yang C, Jing L. Mindfulness-based relapse prevention targeting psychological craving and trait mindfulness in young Chinese women with methamphetamine dependence: a randomized controlled trial. Front Psychiatry 2024; 15:1339517. [PMID: 39415885 PMCID: PMC11481037 DOI: 10.3389/fpsyt.2024.1339517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 09/09/2024] [Indexed: 10/19/2024] Open
Abstract
Methods We recruited 58 MA-dependent young adult females from a compulsory isolation drug rehabilitation center in Sichuan Province and randomly divided them into an MBRP group (n = 29) and a control group (n = 29) according to their degree of psychological craving. The MBRP group received 2 hours of MBRP training twice a week for 4 weeks, alongside routine treatment at the drug rehabilitation center. Meanwhile, the control group solely received routine treatment at the drug rehabilitation center without any additional interventions. The assessment was conducted before and immediately after the intervention, with the Compulsive Drug Use Scale (OCDUS) used to assess craving and the Five-Factor Mindfulness Scale (FFMQ) used to assess trait mindfulness. Also, a "mental feedback monitoring balance" instrument was used to assess concentration and relaxation during some training sessions. This randomized trial was conducted to evaluate the effectiveness of decreasing psychological craving and increasing trait mindfulness. Results At baseline, there were no significant differences in total or dimension scores for FFMQ or OCDUS between the two groups (all P > 0.05). After the intervention, the repeated measures ANOVA showed a significant time main effect on changes in observing, non-judging, and non-reacting scores (all P < 0.05), and a significant interaction effect between time and group on both FFMQ total score and OCDUS score (P < 0.01 or P < 0.05). Mental feedback monitoring indicated significant improvement in concentration and relaxation after breath meditation exercises (P < 0.05 or P < 0.001). Additionally, the MBRP group showed improved relaxation during the body scan exercise (P < 0.01). Conclusion MBRP training can improve the trait mindfulness of MA addicts and reduce psychological cravings effectively.
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Affiliation(s)
- Xuan Liu
- School of Psychology, Chengdu Medical College, Chengdu, China
| | - Yidan Zhang
- School of Psychology, Chengdu Medical College, Chengdu, China
| | - Hongxin Cheng
- School of Psychology, Chengdu Medical College, Chengdu, China
| | - Honglin Dong
- School of Psychology, Chengdu Medical College, Chengdu, China
| | - Yuting You
- School of Psychology, Chengdu Medical College, Chengdu, China
| | - Yuxi Wu
- Sichuan Women’s Compulsory Isolation Drug Treatment Center, Deyang, Sichuan, China
| | - Chunli Yang
- Sichuan Women’s Compulsory Isolation Drug Treatment Center, Deyang, Sichuan, China
| | - Lushi Jing
- School of Psychology, Chengdu Medical College, Chengdu, China
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Richard D, Rousseau D, Umapathy K, Pandya H, Rousis G, Peeples P. Exploring the Impact of a Trauma-informed Yoga and Mindfulness Curriculum for Multiple Populations: A Pilot Study. Explore (NY) 2024; 20:54-61. [PMID: 37365081 DOI: 10.1016/j.explore.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 05/11/2023] [Accepted: 05/31/2023] [Indexed: 06/28/2023]
Abstract
Individuals with trauma experience negative mental health impacts and are at risk of poor cardiovascular outcomes. Unmanaged, these conditions may worsen, compromising healing and wellbeing. Yoga, particularly trauma-informed, may improve outcomes. The current pilot study explores the impact of a novel trauma-informed yoga and mindfulness curriculum on wellbeing in two parts. The first examined mental health (stress, mood) outcomes in four trauma-impacted populations: adults who were incarcerated (INC), individuals in recovery from substance use disorders (SU), veterans (VA), and vulnerable youth (YTH) assessing both the impact of individual class participation and impact of attending at least four curriculum sessions. For the subgroup of incarcerated individuals, impact by theme was examined. After curriculum sessions, stress was reduced, and mood improved. Across multiple sessions both the largest decreases in stress and greatest increase in mood occurred after participant in the first session. Further, a specific exploration of curriculum class impact by theme for participants who were incarcerated indicated no difference in impact by theme. The second part of this study explored cardiovascular outcomes for the population of those in recovery from substance use. Reductions in systolic blood pressure occurred immediately after the first curriculum session, and diastolic blood pressure reduced over three consecutive sessions.
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Affiliation(s)
- D Richard
- University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, United States.
| | - D Rousseau
- Boston University, 1010 Commonwealth Avenue, Rm 510, Boston, MA 02215, United States.
| | - K Umapathy
- University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, United States.
| | - H Pandya
- SS&C Technologies, 9000 Southside Blvd, Building 700, Jacksonville FL 32256, United States
| | - G Rousis
- University of South Florida, 4202 E., Fowler Avenue, PCD 4118 G, Tampa, FL 33620, United States.
| | - P Peeples
- The Peeples Collaborative, 1327 Walnut Street, Jacksonville, FL, United States
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Chang KS, Lee LH, Chen SL, Chen YC, Yang CI. Factors influencing the effects of the mindfulness-based interventions of patients with substance abuse: A qualitative systematic review and meta-synthesis. Heliyon 2023; 9:e18911. [PMID: 37649842 PMCID: PMC10462840 DOI: 10.1016/j.heliyon.2023.e18911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 07/12/2023] [Accepted: 08/02/2023] [Indexed: 09/01/2023] Open
Abstract
Objective This article aims to provide the experiences of mindfulness treatments from the perspectives of patients with a history of substance abuse. Data source Peer-reviewed articles on 5 databases, namely, PubMed, PsychINFO, Medline, CINAHL and the Cochrane Library, between the year of 2000 and 2023. Study Inclusion and Exclusion Criteria Studies were included if they were published in the English language and reported on qualitative studies that directly engaged patients with experiences of substance abuse and mindfulness treatments. Data extraction After our initial search, 5355 studies were reviewed by title and abstract, consequently, 10 studies were included. Data synthesis Meta-ethnography were used in this study. Data were obtained from the quotations from participants and text under the heading "results" or "findings" from the included 10 studies. Results Effective mindfulness-based interventions (MBI) influence recovery from substance abuse. Four themes were identified as factors influencing the MBI treatment effect. They were (1) engaging in mindfulness: entry and retention, (2) perceived benefits of MBIs, (3) implementation of treatment group and (4) maintenance of treatment effect. Conclusion This article examines the scientific literature to date and presents the evidence on the factors that influentially impact the effect of MBIs in patients with substance abuse. The findings of this study should be helpful in guiding clinical practice, policy, and future research focused on the treatment effect of MBIs for person with substance use.
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Affiliation(s)
- Ko-Shih Chang
- Department of Cardiology, Yuan Rung Hospital, Changhua, Taiwan
| | - Li-Hung Lee
- Department of Nursing, Hung Kuang University, Taichung, Taiwan
| | - Shu-Ling Chen
- Department of Nursing, Hung Kuang University, Taichung, Taiwan
| | - Yu-Chun Chen
- Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Cheng-I Yang
- Department of Nursing, Hung Kuang University, Taichung, Taiwan
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Thekkumkara S, Jagannathan A, Muliyala KP, Joseph A, Murthy P. Feasibility testing of a peer support programme for prisoners with common mental disorders and substance use. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2023. [PMID: 37038899 DOI: 10.1002/cbm.2287] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 03/16/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The prevalence of mental disorders and substance use among prisoners is high. Convicted prisoners of 'good behaviour' can be part of a peer support system in prisons. AIM To evaluate the feasibility of a peer support programme for prisoners with common mental disorders and substance use in prison. METHOD The study used a mixed method research design, with a quasi-experimental approach (single group pre-post without control). It was conducted in two phases: Phase I. Thirty-five peers/convicted prisoners were recruited through advertisements on the prisoners' community radio station. Volunteers with good behaviour reports were given training over 5 days to recognise mental and substance use disorders and provide basic peer support in prison; their attitudes and knowledge were tested before and after the training. PHASE II Feasibility of the peer support programme was tested by (i) recording the number of cases identified and referred, (ii) pre- and post-evaluation of well-being, coping, and symptom severity of those supported and (iii) evaluating qualitatively the experience of the peer supporters and service users. RESULTS Thirty-five peer supporters identified 49 cases over 3 months. These cases showed significant improvement in well-being (Z -1.962; p < 0.050) and reduction in symptom severity (Z -1.913; 0.056). There was a significant improvement in the peers supporters' self-esteem from pre- to post-training (t -3.31; p < 0.002), improvement in their benevolence (t -4.37; p < 0.001) and a significant reduction in their negative attitudes to mental illness (Z -3.518; p < 0.001). A thematic model of peer support encompassed self-experienced benefits for the peer supporter, wider recognition of peer supporters in the prison, challenges to this kind of support, experience of training and visions for future work. CONCLUSION The peer support programme was experienced positively by the peer-supporters and supported. Common mental disorders, substance use and suicidality were recognised and appropriately referred. A full-scale evaluation of this promising programme is warranted.
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Affiliation(s)
| | | | | | - Ambi Joseph
- MSW, Social Worker, Thiruvananthapuram, Kerala, India
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Effects of a Mindfulness and Physical Activity Programme on Anxiety, Depression and Stress Levels in People with Mental Health Problems in a Prison: A Controlled Study. Healthcare (Basel) 2023; 11:healthcare11040555. [PMID: 36833089 PMCID: PMC9956396 DOI: 10.3390/healthcare11040555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/26/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023] Open
Abstract
Recent studies in the general population have shown an inverse relationship between mindfulness and symptoms of anxiety and depression, as well as the benefits of physical activity on these symptoms. These relationships have not yet been studied in a population with severe mental disorder (SMD) in prison, where symptoms of anxiety and depression and impulsive behaviours have a high incidence. A controlled study was developed to assess the benefits of a mindfulness-based protocol whereby elements of Acceptance and Commitment Therapy were evaluated and compared to an adapted sport program. Twenty-two inmates from the "El Acebuche" prison aged between 23 and 58 years old participated in this study, which included a pre-, post-, and follow-up; the majority of participants had SMD and were distributed in both conditions. The DASS-21 was obtained for its evaluation. The results of the Mann-Whitney U test for independent samples indicated a significant reduction in the levels of stress and depression in the mindfulness intervention group compared to the control group in which no significant changes were observed, providing evidence on the effect of this practice in prison contexts.
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Wang M, Chen Y, Xu Y, Zhang X, Sun T, Li H, Yuan C, Li J, Ding ZH, Ma Z, Sun Y. A Randomized Controlled Trial Evaluating the Effect of Tai Chi on the Drug Craving in Women. Int J Ment Health Addict 2022; 22:1-13. [PMID: 36119946 PMCID: PMC9469824 DOI: 10.1007/s11469-022-00917-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 10/27/2022] Open
Abstract
This study was conducted in the purpose of investigating the effect of Tai Chi on drug craving for women with drug disorders. One hundred and twelve women were recruited from a drug rehabilitation center in China, and 47 and 48 were finally analyzed in the control group and exercise group, respectively. The exercise group underwent a 3-month Tai Chi training, whereas the control group experienced no exercise intervention during the same time period. The drug craving was measured by the visual analog scale. In data analysis, repeated-measures were utilized to test the differences between the control and exercise group over the course of the experiment time. The mean of the craving score significantly dropped from pre-test (control: mean = 5.38, SD = 3.04; exercise: mean = 4.68, SD = 2.93) to post-test (control: mean = 4.03, SD = 2.73; exercise: mean = 1.91, SD = 1.90) in both groups (control group: t = 3.84, df = 46, p < 0.001; exercise group: t = 5.941, df = 47, p < 0.001), with more decrease witnessed in the exercise group. Repeated-measures analysis with a Huynh-Feldt correction showed the significant effect of time (F = 27.383, p < 0.001) as well as the study group by time interaction (F = 3.52, p = 0.024). Tai Chi can ameliorate the drug craving in women and it could be a supportive treatment for drug addiction.
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Affiliation(s)
- Mu Wang
- Institute of Intelligent Machines, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hubin Building, Science Island, Shushan, Hefei, 230031 Anhui People’s Republic of China
- University of Science and Technology of China, Hefei, 230026 People’s Republic of China
| | - Yanyan Chen
- Institute of Intelligent Machines, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hubin Building, Science Island, Shushan, Hefei, 230031 Anhui People’s Republic of China
| | - Yubing Xu
- Institute of Intelligent Machines, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hubin Building, Science Island, Shushan, Hefei, 230031 Anhui People’s Republic of China
| | - Xiaoyu Zhang
- Institute of Intelligent Machines, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hubin Building, Science Island, Shushan, Hefei, 230031 Anhui People’s Republic of China
- University of Science and Technology of China, Hefei, 230026 People’s Republic of China
| | - Ting Sun
- Institute of Intelligent Machines, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hubin Building, Science Island, Shushan, Hefei, 230031 Anhui People’s Republic of China
| | - Huazhi Li
- Women Specific Drug Rehabilitation Center, Hefei, Anhui People’s Republic of China
| | - Cunfeng Yuan
- Drug Rehabilitation Administration of the Ministry of Justice of the People’s Republic of China, Beijing, People’s Republic of China
| | - Jin Li
- Women Specific Drug Rehabilitation Center, Hefei, Anhui People’s Republic of China
| | - Zeng-Hui Ding
- Institute of Intelligent Machines, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hubin Building, Science Island, Shushan, Hefei, 230031 Anhui People’s Republic of China
| | - Zuchang Ma
- Institute of Intelligent Machines, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hubin Building, Science Island, Shushan, Hefei, 230031 Anhui People’s Republic of China
| | - Yining Sun
- Institute of Intelligent Machines, Hefei Institute of Physical Science, Chinese Academy of Sciences, Hubin Building, Science Island, Shushan, Hefei, 230031 Anhui People’s Republic of China
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Soler-Prieto C, Martín FM. El Uso de Técnicas de Neutralización en Condenados por Crimen Organizado. Diferencias entre Integrantes del Núcleo y la Periferia. ANUARIO DE PSICOLOGÍA JURÍDICA 2022. [DOI: 10.5093/apj2022a8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Thekkumkara SN, Jagannathan A, Muliyala KP, Murthy P. Psychosocial Interventions for Prisoners with Mental and Substance Use Disorders: A Systematic Review. Indian J Psychol Med 2022; 44:211-217. [PMID: 35656427 PMCID: PMC9125461 DOI: 10.1177/02537176211061655] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PURPOSE OF THE REVIEW The prevalence of mental and substance use disorders is three to five times higher than that of the general population. Psychosocial interventions are effective in identifying and managing mental health and substance use disorders. This article aims to review the randomized control studies which have used nonpharmacological interventions alone or in combination with pharmacological interventions for managing mental and substance use disorders in prison/correctional settings. COLLECTION AND ANALYSIS OF DATA Studies included were randomized control trials and pilot randomized studies that assessed the impact of psychosocial interventions for prisoners with mental disorders and substance use disorders. A comprehensive search for articles was done by the primary author (Sreekanth Nair Thekkumkara) in the following databases: PubMed, ProQuest, PsychArticles, and Google Scholar (search engine), for the period June 1, 2000, to December 31, 2020. RESULTS AND CONCLUSIONS The 21 studies included in the review had a sample size of 34 to 759. The settings of all the interventions were the prison and different types of psychosocial interventions were provided across the studies. The average duration of intervention ranged between 10 min and 120 min with the frequency of one to six sessions per week for 1 to 36 months. All the 21 Randomized Control Trials (RCTs) were nonIndian studies. Overall, the results of the included studies showed significant improvement postintervention (motivational intervention, interpersonal therapy, cognitive behavior therapy, positive psychology intervention, music therapy, and acceptance and commitment therapy) on primary outcome measures such as symptom severity of depression, anxiety, and substance abuse prisoners. Positive effects were observed on secondary outcome measures such as motivation, aggression, follow up rates, and recidivism. A limited number of studies have focused on evaluating psychosocial interventions in prison settings. Most of the interventions were tested in prisoners with substance use disorder alone or in those with dual diagnoses and in high-income countries.
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Affiliation(s)
- Sreekanth Nair Thekkumkara
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Aarti Jagannathan
- Dept. of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Krishna Prasad Muliyala
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pratima Murthy
- Professor of Psychiatry, Director National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Sun S, Goldberg SB, Loucks EB, Brewer JA. Mindfulness-based interventions among people of color: A systematic review and meta-analysis. Psychother Res 2022; 32:277-290. [PMID: 34098859 PMCID: PMC8648858 DOI: 10.1080/10503307.2021.1937369] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022] Open
Abstract
Objective In the United States, people of color (POC) are disproportionately affected by various sources of stress and prevalent mental and physical health issues that may benefit from Mindfulness-based Interventions (MBIs). However, effects of MBIs for POC are unclear. This meta-analysis examines the efficacy of MBIs through randomized controlled trials (RCTs) that included predominately POC (≥75% of the sample). Method: Random effects models were used to synthesize effect sizes. A total of 24 RCT samples were analyzed. Results: Samples were on average 94.4% POC and predominantly from low-income backgrounds (total N = 2,156). At post-treatment, MBIs yielded small but statistically superior outcomes to active controls (Hedges' g = 0.11) and inactive controls (g = 0.26). Compared to active controls, MBIs' effects on well-being were smaller than their effects on other outcome types. Compared to inactive controls, MBIs that focused on non-clinical populations and had higher proportion of POC had larger effect sizes. Attrition rates of MBIs did not differ from other active conditions in outpatient settings. Conclusion: Findings provide modest, preliminary empirical support for MBIs among POC. We discuss main findings, limitations, and implications for future MBI research for health promotion among POC.
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Affiliation(s)
- Shufang Sun
- Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Mindfulness Center, Brown University, Providence, RI, USA
| | - Simon B. Goldberg
- Department of Counseling Psychology, University of Wisconsin-Madison, Madison, WI, USA
- Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI, USA
| | - Eric B. Loucks
- Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Mindfulness Center, Brown University, Providence, RI, USA
| | - Judson A. Brewer
- Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Mindfulness Center, Brown University, Providence, RI, USA
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Han A. Effects of mindfulness-based interventions on psychological distress and mindfulness in incarcerated populations: A systematic review and meta-analysis. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2022; 32:48-59. [PMID: 35170107 DOI: 10.1002/cbm.2230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND As incarcerated populations report significantly higher prevalence rates for psychological distress than community populations, it is important to have an evidence-based perspective on what reduces psychological distress among people in prison or jail. AIMS To examine effects of mindfulness-based interventions (MBIs) on psychological distress, including anxiety, depressive symptoms, stress and overall psychological distress, and on mindfulness in incarcerated populations. METHODS This systematic review and meta-analysis of randomised controlled trials (RCTs) involved a comprehensive search within the PubMed, CINAHL, PsycINFO, and SCOPUS databases to identify relevant RCTs. The quality of the included RCTs was assessed using the Cochrane Collaboration risk of bias tool. Depending on I2 statistic values for heterogeneity, either a random effects model or fixed effects model was used. Subgroup analyses for each outcome were conducted to see whether effects differed when compared MBIs to active control groups, provided with other comparable interventions, or passive control groups, provided with no intervention (i.e., treatment as usual [TAU] control groups or waiting list controls). RESULTS Thirteen RCTs met the eligibility criteria. Meta-analyses showed moderate effects of MBIs on depressive symptoms and overall psychological distress, large effects on stress, and small effects on anxiety and mindfulness. The overall risk of bias across studies was unclear. Fewer studies were conducted to compare effects of MBIs to other interventions than TAU. CONCLUSIONS Future high-quality studies comparing MBIs to other active interventions are needed to understand better whether the former are comparable or superior to other evidence-based treatments in decreasing distress and improving mindfulness in incarcerated populations and/or in which circumstances one may be preferable to the other.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Goldberg SB, Pace B, Griskaitis M, Willutzki R, Skoetz N, Thoenes S, Zgierska AE, Rösner S. Mindfulness-based interventions for substance use disorders. Cochrane Database Syst Rev 2021; 10:CD011723. [PMID: 34668188 PMCID: PMC8527365 DOI: 10.1002/14651858.cd011723.pub2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Substance use disorders (SUDs) are highly prevalent and associated with a substantial public health burden. Although evidence-based interventions exist for treating SUDs, many individuals remain symptomatic despite treatment, and relapse is common.Mindfulness-based interventions (MBIs) have been examined for the treatment of SUDs, but available evidence is mixed. OBJECTIVES To determine the effects of MBIs for SUDs in terms of substance use outcomes, craving and adverse events compared to standard care, further psychotherapeutic, psychosocial or pharmacological interventions, or instructions, waiting list and no treatment. SEARCH METHODS We searched the following databases up to April 2021: Cochrane Drugs and Alcohol Specialised Register, CENTRAL, PubMed, Embase, Web of Science, CINAHL and PsycINFO. We searched two trial registries and checked the reference lists of included studies for relevant randomized controlled trials (RCTs). SELECTION CRITERIA RCTs testing a MBI versus no treatment or another treatment in individuals with SUDs. SUDs included alcohol and/or drug use disorders but excluded tobacco use disorders. MBIs were defined as interventions including training in mindfulness meditation with repeated meditation practice. Studies in which SUDs were formally diagnosed as well as those merely demonstrating elevated SUD risk were eligible. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS Forty RCTs met our inclusion criteria, with 35 RCTs involving 2825 participants eligible for meta-analysis. All studies were at high risk of performance bias and most were at high risk of detection bias. Mindfulness-based interventions (MBIs) versus no treatment Twenty-four RCTs included a comparison between MBI and no treatment. The evidence was uncertain about the effects of MBIs relative to no treatment on all primary outcomes: continuous abstinence rate (post: risk ratio (RR) = 0.96, 95% CI 0.44 to 2.14, 1 RCT, 112 participants; follow-up: RR = 1.04, 95% CI 0.54 to 2.01, 1 RCT, 112 participants); percentage of days with substance use (post-treatment: standardized mean difference (SMD) = 0.05, 95% CI -0.37 to 0.47, 4 RCTs, 248 participants; follow-up: SMD = 0.21, 95% CI -0.12 to 0.54, 3 RCTs, 167 participants); and consumed amount (post-treatment: SMD = 0.10, 95% CI -0.31 to 0.52, 3 RCTs, 221 participants; follow-up: SMD = 0.33, 95% CI 0.00 to 0.66, 2 RCTs, 142 participants). Evidence was uncertain for craving intensity and serious adverse events. Analysis of treatment acceptability indicated MBIs result in little to no increase in study attrition relative to no treatment (RR = 1.04, 95% CI 0.77 to 1.40, 21 RCTs, 1087 participants). Certainty of evidence for all other outcomes was very low due to imprecision, risk of bias, and/or inconsistency. Data were unavailable to evaluate adverse events. Mindfulness-based interventions (MBIs) versus other treatments (standard of care, cognitive behavioral therapy, psychoeducation, support group, physical exercise, medication) Nineteen RCTs included a comparison between MBI and another treatment. The evidence was very uncertain about the effects of MBIs relative to other treatments on continuous abstinence rate at post-treatment (RR = 0.80, 95% CI 0.45 to 1.44, 1 RCT, 286 participants) and follow-up (RR = 0.57, 95% CI 0.28 to 1.16, 1 RCT, 286 participants), and on consumed amount at post-treatment (SMD = -0.42, 95% CI -1.23 to 0.39, 1 RCT, 25 participants) due to imprecision and risk of bias. The evidence suggests that MBIs reduce percentage of days with substance use slightly relative to other treatments at post-treatment (SMD = -0.21, 95% CI -0.45 to 0.03, 5 RCTs, 523 participants) and follow-up (SMD = -0.39, 95% CI -0.96 to 0.17, 3 RCTs, 409 participants). The evidence was very uncertain about the effects of MBIs relative to other treatments on craving intensity due to imprecision and inconsistency. Analysis of treatment acceptability indicated MBIs result in little to no increase in attrition relative to other treatments (RR = 1.06, 95% CI 0.89 to 1.26, 14 RCTs, 1531 participants). Data were unavailable to evaluate adverse events. AUTHORS' CONCLUSIONS In comparison with no treatment, the evidence is uncertain regarding the impact of MBIs on SUD-related outcomes. MBIs result in little to no higher attrition than no treatment. In comparison with other treatments, MBIs may slightly reduce days with substance use at post-treatment and follow-up (4 to 10 months). The evidence is uncertain regarding the impact of MBIs relative to other treatments on abstinence, consumed substance amount, or craving. MBIs result in little to no higher attrition than other treatments. Few studies reported adverse events.
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Affiliation(s)
- Simon B Goldberg
- Department of Counseling Psychology, University of Wisconsin, Madison, WI, USA
| | | | - Matas Griskaitis
- Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Reinhard Willutzki
- Private medical practice for Psychiatry and Psychotherapy, Zürich, Switzerland
| | - Nicole Skoetz
- Cochrane Cancer, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Sven Thoenes
- Department of Psychology, Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Aleksandra E Zgierska
- Departments of Family and Community Medicine, Pennsylvania State University College of Medicine, Hershey, PA, USA
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Somohano VC, Shank T, Manuel J, Mallik D, Rehder K, Bowen S. The Role of Pretreatment Expectancy on Substance Use Outcomes in Women Mandated to Mindfulness-Based Relapse Prevention. J Altern Complement Med 2021; 27:1147-1155. [PMID: 34516782 DOI: 10.1089/acm.2021.0123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: More than one-third of justice-involved individuals meet the criteria for substance use disorder (SUD). Many studies show that treatment expectancy predicts longitudinal SUD outcomes; however, results are inconsistent, and the role of treatment expectancy on SUD outcomes for individuals mandated to a mindfulness-based intervention (MBI) is unknown. Mindfulness-based relapse prevention (MBRP) has shown efficacy with justice-involved populations; however, enrollment in MBRP is typically voluntary. The current study assessed whether pretreatment expectancy predicted SUD- and affect-related outcomes in a sample of women (n = 54) mandated to MBRP as part of their residential SUD programming. Method: The authors employed a quasiexperimental design and administered measures at pre-, mid-, and postcourse. Results: Following mandatory participation in MBRP, significant reductions in craving and substance use were observed. However, contrary to hypotheses, higher pretreatment expectancy predicted greater substance dependence at postcourse. Conclusions: Positive treatment expectancy within the context of an MBI was not related to favorable posttreatment outcomes; in fact, it was related to higher postcourse substance dependence. This suggests that MBIs may be suitable for mandated individuals who may not have voluntarily chosen to participate in such an intervention, and thus may have lower expectancy for the treatment. This finding needs to be replicated in a larger sample to warrant a firmer conclusion.
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Affiliation(s)
| | - Taylor Shank
- School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
| | - Jacob Manuel
- School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
| | - Debesh Mallik
- School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
| | - Kristoffer Rehder
- VA Portland Health Care System, Portland, OR, USA.,School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
| | - Sarah Bowen
- School of Graduate Psychology, Pacific University, Hillsboro, OR, USA
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Wimberly AS, Ware OD, Bazell A, Sibinga EMS. Stress Among a Sample of Returning Citizens Living with HIV and Substance Use Disorder: A Mixed Methods Analysis. Community Ment Health J 2021; 57:884-897. [PMID: 32642816 DOI: 10.1007/s10597-020-00667-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 06/19/2020] [Indexed: 10/23/2022]
Abstract
This mixed-methods study asks: among a sample of returning citizens living with HIV and substance use disorder, how is stress experienced; and what are the leading stressors and stress-coping strategies? Data is from a parent study that randomized 36 people to a yoga intervention and 36 people to treatment as usual. Qualitative analysis found that securing basic life needs was more acute in early reentry, and challenges with HIV acceptance were greater among those with a more recent HIV diagnosis. Social support was the most widely employed coping strategy but many lacked social networks. Post-program, multiple regression found older age(β = - 0.38, p < .05), greater income(β = - 0.002, p < .01), shorter incarceration(β = .03, p < .01) and randomization to yoga(β = 6.92, p < .01) predicted lower levels of stress. Results indicate that reentry needs for people living with HIV and substance use disorder include basic life needs, social supports, and stress-coping interventions that address physical and mental stress symptoms (such as yoga).
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Affiliation(s)
| | - Orrin D Ware
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | - Alicia Bazell
- School of Social Work, University of Maryland, Baltimore, MD, USA
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Clark EM, Ma L, Knott CL, Williams BR, Park CL, Schulz EK, Ghosh D. A longitudinal examination of social support as a mediator of the personality-health relationship in a national sample of African Americans. JOURNAL OF BLACK PSYCHOLOGY 2020; 46:607-637. [PMID: 34354319 DOI: 10.1177/0095798420966826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study investigates whether social support mediates the relationship between personality traits and health among African Americans over a five-year period, filling a gap in the literature on longitudinal tests of the personality-health association. Data were collected from a national probability sample of African American adults (N = 200). Personality was assessed at Time 1 (T1), social support was assessed 2.5 years later (T2), and physical functioning was examined 5 years (T3) after T1. Telephone surveys included measures of the Five Factor Model personality traits (T1), social support (T2), and physical functioning (T3). Results suggested that relationships between the T1 personality traits and T3 physical functioning were not mediated by T2 social support. Secondary analyses found that among all T1 personality traits, higher openness and lower neuroticism uniquely predicted higher T2 social support. Further, among T1 personality traits, higher conscientiousness uniquely predicted better T3 physical functioning. This information may be useful to healthcare providers and community members in developing prevention and intervention strategies for African Americans.
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Vujanovic AA, Smith LJ, Green C, Lane SD, Schmitz JM. Mindfulness as a predictor of cognitive-behavioral therapy outcomes in inner-city adults with posttraumatic stress and substance dependence. Addict Behav 2020; 104:106283. [PMID: 31927220 PMCID: PMC7024008 DOI: 10.1016/j.addbeh.2019.106283] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/19/2019] [Accepted: 12/24/2019] [Indexed: 02/06/2023]
Abstract
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.
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Affiliation(s)
| | | | - Charles Green
- University of Texas Health Science Center at Houston, United States
| | - Scott D Lane
- University of Texas Health Science Center at Houston, United States
| | - Joy M Schmitz
- University of Texas Health Science Center at Houston, United States
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Spinelli C, Paradis-Gagné E, Per M, Fleischmann MH, Manova V, Wallace A, Khoury B. Evaluating the Use of Mindfulness and Yoga Training on Forensic Inpatients: A Pilot Study. Front Psychiatry 2020; 11:614409. [PMID: 33362615 PMCID: PMC7758348 DOI: 10.3389/fpsyt.2020.614409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 11/19/2020] [Indexed: 11/13/2022] Open
Abstract
Forensic inpatients (i. e., individuals found not responsible for a criminal offense on account of mental illness) represent an often marginalized and difficult-to-treat population. This has led to the need for research exploring the effectiveness of novel interventions. A Canadian forensic hospital has developed an 8-weeks mindfulness and yoga training program (MTP). This pilot study examined the potential effects of this program on patients' mindfulness, stress, and use of cognitive and emotion regulation strategies. A sample of 13 forensic inpatients (male = 92%) participating in the MTP program completed self-report measures assessing dispositional mindfulness, perceived stress, and use of cognitive emotion regulation strategies at baseline, post-intervention, and a 3-months follow-up. Repeated measure ANOVAs found a significant increase in the describe facet of mindfulness (p = 0.03) with a large effect size (ηp 2 = 0.26) and a significant decrease in stress (p = 0.003) with a large effect size (ηp 2 = 0.39). Pairwise comparisons revealed medium to large significant changes between baseline and post-intervention for both the describe facet (p = 0.03, Hedge's g = 0.55) and stress (p = 0.003, Hedge's g = 0.70). However, comparisons were insignificant between baseline and follow-up. No significant main effects were found on the use of cognitive emotion regulation strategies. This pilot study offers preliminary support for the use of the MTP as an adjunctive therapy in forensic inpatient treatment. Further investigation is needed into the long-term impacts of this training.
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Affiliation(s)
- Christina Spinelli
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | | | - Megan Per
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Matthew H Fleischmann
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Viktoriya Manova
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Aimée Wallace
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Bassam Khoury
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
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