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Bautista TG, Ware OD, Macias Burgos MA, Rivas VD, Cruz-Carrillo Y, Davidson A, Mezhenska M, Sanchez M, Amaro H. Mixed-methods analysis of satisfaction during a 12-session mindfulness-based intervention for women with a substance use disorder and trauma symptomatology. Front Psychol 2024; 15:1359174. [PMID: 38939226 PMCID: PMC11210173 DOI: 10.3389/fpsyg.2024.1359174] [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: 12/20/2023] [Accepted: 05/16/2024] [Indexed: 06/29/2024] Open
Abstract
Satisfaction with an intervention influences the uptake of behavior changes and the long-term efficacy of the intervention. Therefore, it is crucial to assess satisfaction by participant profile when creating and adapting behavior interventions for minoritized populations. Qualitative and quantitative data on participant trauma symptom severity and intervention satisfaction were collected through self-report surveys from 54 women. The sample was 59.3% Hispanic, with an average age of 33.21 (SD = 10.42), who were in residential treatment for substance use disorders (SUDs) and participated in a 12-session mindfulness-based intervention. Qualitative responses were coded using thematic analysis, and an integrative mixed-methods approach was used to compare qualitative theme frequency between high-trauma (N = 28) and low-trauma (N = 26) groups at session 2 and session 11. High- and low-trauma groups were determined by interquartile ranges (bottom 25% = low; top 75% = high). In session 2, the low-trauma group reported significantly higher satisfaction (M = 4.20, SD = 0.55) than the high-trauma group (M = 3.77, SD = 0.89); t(43) = 1.90, p = 0.03. In session 11, there was no significant difference between groups. The mixed-methods analysis revealed that "trouble focusing" appeared more frequently in the high-trauma group than in the low-trauma group during session 2, but the theme was not present in either group at session 11, suggesting that this might pose an initial barrier for individuals with high trauma but subsides as the intervention progresses. This speaks to the importance of retention strategies tailored for participants with SUDs and high trauma while they adjust to the intervention. Assessing initial challenges with satisfaction may help facilitators intervene to increase participant satisfaction.
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Affiliation(s)
- Tara G. Bautista
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ, United States
| | - Orrin D. Ware
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Veronica D. Rivas
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ, United States
| | | | - Alec Davidson
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ, United States
| | - Mariia Mezhenska
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ, United States
| | - Mariana Sanchez
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
| | - Hortensia Amaro
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
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Barré T, Cherikh F, Carrieri P, Marcellin F. A call for mindfulness-based interventions for cannabis-use disorders. L'ENCEPHALE 2024; 50:118-120. [PMID: 37604715 DOI: 10.1016/j.encep.2023.06.015] [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: 05/31/2022] [Accepted: 06/14/2023] [Indexed: 08/23/2023]
Abstract
Cannabis use is being increasingly liberalized worldwide, and an increasing prevalence of cannabis-use disorder (CUD) is observed. The few current therapeutic options for CUD are only modestly effective. Mindfulness-based interventions offer promising prospects for the management of substance-use disorders. However, despite proliferating literature on mindfulness and substance use, few studies have explored mindfulness in terms of cannabis use and CUD. There are many possibilities for the implementation of mindfulness-based interventions for cannabis use reduction, especially for younger users, who are more vulnerable to cannabis-related harms. Accordingly, large controlled trials are needed to reliably assess the potential of such interventions.
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Affiliation(s)
- Tangui Barré
- Inserm, IRD, Sciences économiques et sociales de la santé et traitement de l'information médicale (SESSTIM), ISSPAM, Aix-Marseille université, Marseille, France.
| | - Faredj Cherikh
- Inserm, IRD, Sciences économiques et sociales de la santé et traitement de l'information médicale (SESSTIM), ISSPAM, Aix-Marseille université, Marseille, France; Addictology Unit, University Hospital of Nice, Archet 2 Hospital, Nice, France.
| | - Patrizia Carrieri
- Inserm, IRD, Sciences économiques et sociales de la santé et traitement de l'information médicale (SESSTIM), ISSPAM, Aix-Marseille université, Marseille, France.
| | - Fabienne Marcellin
- Inserm, IRD, Sciences économiques et sociales de la santé et traitement de l'information médicale (SESSTIM), ISSPAM, Aix-Marseille université, Marseille, France.
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Staton M, Tillson M, Levi MM, Dickson M, Webster M, Leukefeld C. Identifying and Treating Incarcerated Women Experiencing Substance Use Disorders: A Review. Subst Abuse Rehabil 2023; 14:131-145. [PMID: 38026785 PMCID: PMC10655602 DOI: 10.2147/sar.s409944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/02/2023] [Indexed: 12/01/2023] Open
Abstract
While research on substance use disorder (SUD) treatment among justice-involved populations has grown in recent years, the majority of corrections-based SUD studies have predominantly included incarcerated men or men on community supervision. This review 1) highlights special considerations for incarcerated women that may serve as facilitating factors or barriers to SUD treatment; 2) describes selected evidence-based practices for women along the cascade of care for SUD including screening and assessment, treatment and intervention strategies, and referral to services during community re-entry; and 3) discusses conclusions and implications for SUD treatment for incarcerated women.
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Affiliation(s)
- Michele Staton
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
| | - Martha Tillson
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
| | - Mary M Levi
- Department of Psychology, University of Kentucky, Lexington, KY, USA
| | - Megan Dickson
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
| | - Matt Webster
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
| | - Carl Leukefeld
- Department of Behavioral Science, University of Kentucky, Lexington, KY, USA
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
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Black DS, Kirkpatrick MG. Effect of a mindfulness training app on a cigarette quit attempt: an investigator-blinded, 58-county randomized controlled trial. JNCI Cancer Spectr 2023; 7:pkad095. [PMID: 37951593 PMCID: PMC10715839 DOI: 10.1093/jncics/pkad095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Cigarette smoking is the leading cause of preventable cancers. A majority of the 34 million people who currently smoke report wanting to quit. Mindfulness training apps offer a guided telehealth intervention to foster individuals' behavioral meditation practice. We present the main outcomes of a parallel-group randomized controlled trial that tested app-based mindfulness training vs attention control on smoking behavior. METHODS We enrolled adult residents from across California who smoked daily and were willing to make a quit attempt (N = 213). Participants completed daily sessions in 10-minute segments for 14 consecutive days. Participants then started a quit attempt and reported daily smoking for 28 days following the quit date using the timeline follow-back measure. RESULTS Seven-day point-prevalence abstinence for each week during the 4-week quit period ranged from 21.8% to 27.7% for app-based mindfulness training and 17.9% to 19.6% for controls. The intention-to-treat sample revealed that app-based mindfulness training outperformed controls on the proportion of abstinence days during the quit period (odds ratio = 2.00, 95% confidence interval = 1.03 to 3.87, P = .041). Although the 7-day point prevalence abstinence for week 4 favored app-based mindfulness training, significance was not reached (odds ratio = 1.65, 95% confidence interval = 0.84 to 3.23, P = .148). The mean number of cigarettes smoked per day among smokers was 4.95 for app-based mindfulness training vs 5.69 for controls (odds ratio = 0.81, 95% confidence interval = 0.71 to 0.92, P = .002), suggesting harm reduction in continued smokers. CONCLUSION A mindfulness training app prescribed for 2 weeks leading up to a quit date showed an advantage over controls for total abstinence days and fewer cigarettes smoked in a diverse sample consisting of urban and rural residents. These findings yield implications for the use of apps to reduce exposure to the carcinogenic properties of cigarette smoke.
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Affiliation(s)
- David S Black
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Norris Comprehensive Cancer Center, Cancer Control Research Division, Keck Medicine of USC, Los Angeles, CA, USA
| | - Matthew G Kirkpatrick
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Norris Comprehensive Cancer Center, Cancer Control Research Division, Keck Medicine of USC, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
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Killeen TK, Baker NL, Davis LL, Bowen S, Brady KT. Efficacy of mindfulness-based relapse prevention in a sample of veterans in a substance use disorder aftercare program: A randomized controlled trial. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 152:209116. [PMID: 37364669 DOI: 10.1016/j.josat.2023.209116] [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: 11/01/2022] [Revised: 05/13/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Complementary integrative medicine, such as mindfulness-based interventions, (MBI) have demonstrated efficacy in the treatment of depression, anxiety, substance use disorders (SUDs), and pain. Mindfulness-based relapse prevention (MBRP) is an aftercare intervention targeting SUD relapse that integrates cognitive-behavioral relapse prevention and mindfulness meditation practices, raising awareness of substance use triggers and reactive behavioral patterns. This study evaluated the efficacy of MBRP in reducing relapse in veterans following completion of an SUD treatment program. METHODS This study was a two-site, randomized controlled trial comparing MBRP to 12-step facilitation (TSF) aftercare in military veterans following completion of intensive treatment for SUDs. The 8 weeks of 90-minute, group-based MBRP or TSF sessions were followed by 3-, 6- and 10-month follow-up periods with assessments of alcohol/substance use and secondary outcomes of depression, anxiety, and mindfulness. RESULTS Forty-seven percent of veterans attended ≥75 % of sessions. Veterans in both the MBRP and TSF aftercare groups maintained reductions in alcohol and illicit substance use during the aftercare treatment. Nineteen participants (11 %; 19/174) reported returning to alcohol use during the study treatment period and the study found no difference between study groups [MBRP: 9 % vs. TSF 13 %; p = 0.42]. Thirteen participants (7.5 %; 13/174) reported a return to illicit substance use during study treatment [MBRP: 5.4 % vs. TSF 10.3 % p = 0.34]. The number of days of drinking and illicit substance use was not different between groups (alcohol, p = 0.53; illicit substance use, p = 0.28). CONCLUSION Although retention in treatment limits interpretation of the findings, both MBRP and TSF were effective in maintenance of treatment gains following an intensive treatment program for veterans with SUDs. Future studies should focus on strategies to improve treatment participation.
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Affiliation(s)
- Therese K Killeen
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St, Charleston, SC, 29425, United States of America.
| | - Nathaniel L Baker
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St, Charleston, SC, 29425, United States of America.
| | - Lori L Davis
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama Health System, 3701 Loop Rd, Tuscaloosa, AL 35404, United States of America.
| | - Sarah Bowen
- Department of Psychology, Pacific University, Graduate Psychology Health Prof. Building 2 297 (Hillsboro), 503-352-3614, UC Box A191, Portland, OR, United States of America.
| | - Kathleen T Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St, Charleston, SC, 29425, United States of America.
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Killeen TK, Wen CC, Neelon B, Baker N. Predictors of Treatment Completion among Women Receiving Integrated Treatment for Comorbid Posttraumatic Stress and Substance Use Disorders. Subst Use Misuse 2023; 58:500-511. [PMID: 36705433 DOI: 10.1080/10826084.2023.2170183] [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] [Indexed: 01/28/2023]
Abstract
Background: Retention in treatment for individuals with comorbid posttraumatic stress disorder (PTSD) and substance use disorders (SUD) is an area of concern in treatment outcome studies. The current study explores key variables related to retention in a group of women with comorbid PTSD and SUD enrolled in community SUD treatment randomized to eight weekly sessions of a trauma adapted mindfulness-based relapse prevention (TA-MBRP) or an integrated coping skills (ICS) group intervention. Methods: Two unadjusted and adjusted logistic discrete failure time (DFT) models were fit to examine associations between participants and the time (in weeks) to treatment completion status. Key covariates of interest, including time-varying PTSD Symptom Scale-Self Report (PSS) total score, time-varying Five Factors Mindfulness Questionnaire (FFMQ) total score, group assignment, baseline endorsements of substance use and demographics such as age, race and employment status were fit into the model. Results: In the adjusted PSS model, increased levels of PTSD symptom severity (PSS) scores at week 5 and 7 (PSS OR: 1:06: OR 1.13, respectively) were associated with higher odds of non-completion. In the FFMQ model, increased levels of FFMQ scores at week 6 (OR: 0:92) were associated with lower odds of non-completion. In both models, assignment to the ICS control group and unemployment were associated with lower odds of completion and baseline use of cocaine and sedatives were associated with higher odds of completion. Conclusion: Monitoring PTSD symptom severity and measures of mindfulness can inform providers on strategies to enhance retention early in treatment for individuals with comorbid PTSD/SUD.ClinicalTrials.gov # NCT02755103.
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Affiliation(s)
- Therese K Killeen
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Chun-Che Wen
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Brian Neelon
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Nathanial Baker
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
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Félix-Junior IJ, Donate APG, Noto AR, Galduróz JCF, Simionato NM, Opaleye ES. Mindfulness-based interventions in inpatient treatment for Substance Use Disorders: A systematic review. Addict Behav Rep 2022; 16:100467. [PMID: 36425879 PMCID: PMC9679543 DOI: 10.1016/j.abrep.2022.100467] [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: 09/08/2022] [Revised: 10/21/2022] [Accepted: 10/30/2022] [Indexed: 11/13/2022] Open
Abstract
Inpatient treatment for Substance Use Disorder (SUD), such as Therapeutic Communities and Residential Treatment has been used to test the effect of Mindfulness-Based Interventions (MBI) over different outcomes. Although there is evidence of the effectiveness of MBIs, little is known about the particularities that the place may have in the outcomes. The main objective of this Systematic Review was to evaluate the effectiveness of MBIs for SUDs performed in the inpatient context. PubMed, Web of Science and PsycInfo were used for the search. Quantitative and qualitative studies with no control, usual treatment or other active comparator intervention for SUDs inpatient treatment from 1980 to 2020 were included. From 21 selected studies, 18 were quantitative and 3 qualitative; 12 studies were RCT. Most samples were comprised with women. Based on characteristics of outcomes, we were able to divide them into: Substance Use and Associated Outcomes, Stress, Impulsivity e Evaluation of the MBI protocol. Results suggest that stress assessment is a determining factor for treatment success in these settings. Regarding substance use, although several outcomes have been assessed, the most remarkable results were craving reduction and improvement in treatment adherence. There is evidence that MBIs in inpatient settings benefited those who participated in the experimental groups on some outcomes, such as stress and substance use. Little is mentioned about the impact of the environment over the outcomes and short follow-ups were a relevant limitation of most of the studies. Future assessments must increase follow-up time and evaluate the relationship between the context and the MBI.
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Affiliation(s)
- Itamar José Félix-Junior
- Research Center on Health and Substance Use, Psychobiology Department, Universidade Federal de São Paulo, Brazil
| | - Ana Paula G Donate
- Research Center on Health and Substance Use, Psychobiology Department, Universidade Federal de São Paulo, Brazil
| | - Ana Regina Noto
- Research Center on Health and Substance Use, Psychobiology Department, Universidade Federal de São Paulo, Brazil
| | | | | | - Emérita Sátiro Opaleye
- Research Center on Health and Substance Use, Psychobiology Department, Universidade Federal de São Paulo, Brazil
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8
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Sanchez M, Amaro H. Cumulative exposure to traumatic events and craving among women in residential treatment for substance use disorder: The role of emotion dysregulation and mindfulness disposition. Front Psychol 2022; 13:1048798. [PMID: 36506948 PMCID: PMC9730726 DOI: 10.3389/fpsyg.2022.1048798] [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: 09/20/2022] [Accepted: 11/03/2022] [Indexed: 11/25/2022] Open
Abstract
Objective Strong evidence links exposure to traumatic life events with subsequent substance use disorders (SUD). Compared to men, women in SUD treatment are more likely to have a history of trauma, characterized in part by emotion dysregulation known to negatively influence treatment outcomes. Existing research has been conducted with predominantly male and non-Hispanic White samples, with an emphasis on adverse childhood experiences. Little is known about how exposure to cumulative traumatic events across the lifespan affects emotion dysregulation and how this may influence craving, particularly among racial and ethnic minoritized women with SUD. Mindfulness disposition may serve as a protective factor that could buffer the impact of trauma exposure and emotion dysregulation on substance use craving among underrepresented minoritized women with SUD. This study examined the association between cumulative exposure to traumatic events, emotion dysregulation, and mindfulness disposition on substance use craving in a sample of predominantly Hispanic and non-Hispanic Black women in residential treatment for SUD. Method Cross-sectional data were analyzed for a baseline sample of 241 women (56.96% Hispanic, 20.7% non-Hispanic White, 20.7% non-Hispanic Black; age: M = 32.11) entering a SUD residential treatment facility who agreed to participate in a parent randomized controlled trial. Results Findings indicated that greater cumulative exposure to traumatic events and emotion dysregulation were associated with higher levels of craving. Cumulative traumatic event exposure was indirectly associated with higher craving via lower levels in the mindfulness dimension of acting with awareness. Interaction effects also revealed greater exposure to traumatic events was associated with higher levels of craving among women with low and average (but not high) levels of mindfulness disposition. Conclusion These findings provide insight into the potential benefits of targeting emotion regulation and mindfulness-building strategies such as acting with awareness in interventions among racial-ethnically diverse women with SUD. These strategies may be particularly beneficial among those that have experienced extensive histories of trauma exposure. Overall, knowledge gained from the present study can be particularly valuable towards informing treatment models in minoritized groups that currently experience disparities in treatment utilization and outcomes.
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Affiliation(s)
- Mariana Sanchez
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States,*Correspondence: Mariana Sanchez,
| | - Hortensia Amaro
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States,Herbert Wertheim College of Medicine, Florida International University, Miami, FL, United States
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9
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Black DS, Kirkpatrick M. Test of daily app-based mindfulness meditation preceding a planned smoking quit attempt date on abstinence: Protocol for a randomized controlled trial recruiting across the 58 counties of California. Contemp Clin Trials 2022; 120:106855. [PMID: 35863695 DOI: 10.1016/j.cct.2022.106855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 11/19/2022]
Abstract
A majority of the 34 million people who currently smoke cigarettes report wanting to quit smoking yet most attempts to quit end in relapse. A mindfulness based intervention (MBI) is an intervention package used to reinforce an individual's practice of mindfulness meditation in daily life. MBIs delivered by phone app offer daily prompts to guide bouts of mindfulness meditation, that is, sustained attention to moment-by-moment experience without behavior reactivity. Daily bouts of mindfulness meditation offer individuals a replacement behavior for smoking during a quit attempt, and MBI app instruction aims to increase an individual's skill in non-reactivity when they experience cravings. Our study objective is to test the effect of an app-based MBI on abstinence during a scheduled quit attempt among people who currently smoke and who are willing to make a voluntary quit attempt on a selected near-term date. Our delivery of a smartphone app-based MBI occurs daily for the two weeks preceding a planned quit date. Study participants are randomized to a either a app-based MBI or an app-based psychoeducation control group and asked to self-administer their intervention two times a day in 10-min segments for 14 sequential days for a total of 280 min. This preparatory period capitalizes on time to help participants orient toward a near-term goal to quit smoking, practice mindfulness meditation, and increase the skill of non-reactivity during states of craving to smoke. We recruit people who smoke cigarettes from all 58 counties in California. We test the hypothesis that an app-based MBI will outperform a time-matched psychoeducation control on increasing smoking abstinence. Findings contribute knowledge to the addictions treatment field about whether MBIs delivered by app can increase smoking cessation in a geographically diverse sample.
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Affiliation(s)
- David S Black
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, United States of America.
| | - Matthew Kirkpatrick
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, United States of America
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10
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Ibañez GE, Sanchez M, Villalba K, Amaro H. Acting with awareness moderates the association between lifetime exposure to interpersonal traumatic events and craving via trauma symptoms: a moderated indirect effects model. BMC Psychiatry 2022; 22:287. [PMID: 35459133 PMCID: PMC9026679 DOI: 10.1186/s12888-022-03931-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 04/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND History of exposure to traumatic events (ETE) is common among women in substance use disorder (SUD) treatment and is related to craving. We examined whether ETE (i.e., emotional, physical, sexual abuse) in childhood, adulthood, or both is related to craving via trauma symptoms and how trait mindfulness might attenuate this association. METHODS Baseline data from a larger randomized clinical trial of a mindfulness-based intervention for women (N = 245) in SUD treatment were used. Inclusion criteria were: 18-65 years of age, SUD diagnosis, English fluency, no cognitive impairment, and willingness to be audio recorded and provide consent. Demographics and validated measures of ETE, posttraumatic stress symptoms, trait mindfulness, and substance use craving were collected via in-person interviews. Descriptive statistics, correlational analysis, and relative direct, indirect, and conditional indirect effects models were run. RESULTS Most participants identified as Hispanic (58.5%), had at least a high school education (52.2%), with a mean age of 32.2. Women reported ETE in childhood only (20.4%), adulthood only (17.5%), both childhood and adulthood (50.0%), and never (11.4%). Compared to women with ETE in both childhood and adulthood, those with exposure in adulthood only (β = -.10, 95% CI = -.20, -.02) or no exposure (β = -.11, 95% CI = -.23, -.03; [∆R2= .347, F(8, 245) = 15.7, p < .001) had lower craving via lower trauma symptomatology but no difference when compared to those with ETE only in childhood. Acting with awareness moderated this indirect effect (∆R2 = .04, F(3, 245) = 4.66, p = .004. At low levels of awareness, women with ETE during both childhood and adulthood reported higher craving via trauma symptomatology than women with no exposure or only adulthood exposure. CONCLUSIONS Low levels of acting with awareness may worsen trauma symptoms after ETE, which in turn may lead to more craving for women in substance use treatment. Despite a small moderating effect size, acting with awareness may have clinical significance due to the prevalence of trauma symptoms among women in SUD treatment.
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Affiliation(s)
- Gladys E Ibañez
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Florida, Miami, US.
| | - Mariana Sanchez
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Florida, Miami, US
| | - Karina Villalba
- Department of Population Health, College of Medicine, University of Central Florida, Florida, Miami, US
| | - Hortensia Amaro
- Herbert Wertheim College of Medicine and Robert Stempel College of Public Health, Florida International University, Florida, Miami, US
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11
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Persian Validation of the Mindful Attention Awareness Scale (MAAS) in Iranian Substance Abusers: Validity and Reliability. JOURNAL OF KERMANSHAH UNIVERSITY OF MEDICAL SCIENCES 2022. [DOI: 10.5812/jkums.121711] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: The Mindful Attention Awareness Scale (MAAS) is widely used as an evaluation tool for mindfulness. Objectives: The present study aimed to validate the Persian version of the MAAS in Iranian substance abusers. Methods: This descriptive-analytical, cross-sectional study was conducted in Tehran during April 2017-December 2018 on 753 male Iranian substance abusers. Data were collected using a demographic questionnaire, the Persian version of the MAAS, the Depression, Anxiety, and Stress Scale-21 (DASS-21), the General Self-efficacy Scale, the Aggression Scale, and the Quality of Mindfulness Scale. The study had two stages of exploratory factor analysis and confirmatory factor analysis (CFA). Data analysis was performed in SPSS version 22, and a single-factor structure was employed to analyze the internal consistency of the MAAS in LISREL version 8.8. Results: The CFA results indicated that the single-factor model had a good fit to the data. In addition, negative correlations were observed between the MAAS, DASS-21, and aggression, while a positive correlation was denoted with self-efficacy (P < 0.01). Conclusions: According to the results, the Persian version of the MAAS is a valid and reliable instrument for assessing the mindfulness of Iranian substance abusers. Our findings shed light on a new direction for future focus and exploration in this regard.
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12
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Loucks EB, Rosenkranz MA, Creswell JD. Harnessing Life's Slings and Arrows: The Science and Opportunities for Mindfulness Meditation During a Global Pandemic and Beyond. Psychosom Med 2021; 83:497-502. [PMID: 34117158 PMCID: PMC8740951 DOI: 10.1097/psy.0000000000000961] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
ABSTRACT We are at a difficult time in history with societal increases in stress, loneliness, and psychopathology, along with high rates of obesity, sedentary lifestyles, and chronic pain. Mindfulness interventions offer promise to address these societal issues. However, in order to make best use of the opportunities revealed by our current challenges, we must: (1) tackle these issues head-on with inclusive, innovative, and creative experimental designs and interventions, and (2) collectively adhere to rigorous, high quality methods so as to provide an evidence-based integration of mindfulness interventions into mainstream medicine and public health.We find there are several areas for which important advances are happening, including sampling socially diverse populations, examining mechanisms of action, pain management, and health behaviors. Furthermore, rigorous methods, including measurement, causal inference from control groups, delivery and scalability of mindfulness interventions, and effect modifiers to determine who mindfulness programs work best for are also gaining traction. This special issue on Mindfulness: Biobehavioral Mechanisms and Health Outcomes attends to many of these issues, several of which are highlighted in this editorial perspective.
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Affiliation(s)
- Eric B Loucks
- From the Department of Epidemiology, Brown University School of Public Health (Loucks); Mindfulness Center at Brown University (Loucks); Department of Psychiatry, University of Wisconsin-Madison (Rosenkranz); Center for Healthy Minds, University of Wisconsin-Madison (Rosenkranz); and Department of Psychology, Carnegie Mellon University (Creswell)
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Abstract
This commentary for this Special Issue on mindfulness highlights the progress and maturity of this growing field of scientific investigation and points the way toward important questions that require further study. Important methodological and implementation issues including the nature of proper comparison groups, the extension of mindfulness-based interventions to underserved populations, the assessment of baseline characteristics that predict beneficial outcomes, and how mindfulness might be combined with other health-promoting activities such as physical exercise are considered. New questions for future research were also showcased, including best practices for mobile interventions, the development and assessment of microinterventions, and the need for a more expansive framework to cultivate human flourishing. The learning of well-being is conceptualized as an urgent public health need that will require new approaches for global scaling.
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