Department of Psychology.
J Consult Clin Psychol. 2010 Jun;78(3):362-374. doi: 10.1037/a0019172.
A strong relation between negative affect and craving has been demonstrated in laboratory and clinical studies, with depressive symptomatology showing particularly strong links to craving and substance abuse relapse. Mindfulness-based relapse prevention (MBRP), shown to be efficacious for reduction of substance use, uses mindfulness-based practices to teach alternative responses to emotional discomfort and lessen the conditioned response of craving in the presence of depressive symptoms. The goal in the current study was to examine the relation between measures of depressive symptoms, craving, and substance use following MBRP.
Individuals with substance use disorders (N = 168; mean age 40.45 years, SD = 10.28; 36.3% female; 46.4% non-White) were recruited after intensive stabilization, then randomly assigned to either 8 weekly sessions of MBRP or a treatment-as-usual control group. Approximately 73% of the sample was retained at the final 4-month follow-up assessment.
Results confirmed a moderated-mediation effect, whereby craving mediated the relation between depressive symptoms (Beck Depression Inventory) and substance use (Timeline Follow-Back) among the treatment-as-usual group but not among MBRP participants. MBRP attenuated the relation between postintervention depressive symptoms and craving (Penn Alcohol Craving Scale) 2 months following the intervention (f(2) = .21). This moderation effect predicted substance use 4 months following the intervention (f(2) = .18).
MBRP appears to influence cognitive and behavioral responses to depressive symptoms, partially explaining reductions in postintervention substance use among the MBRP group. Although results are preliminary, the current study provides evidence for the value of incorporating mindfulness practice into substance abuse treatment and identifies a potential mechanism of change following MBRP.
实验室和临床研究表明，消极情绪与渴望之间存在密切关系，其中抑郁症状与渴望和物质滥用复发之间的关联尤为紧密。基于正念的复发预防（MBRP）已被证明可有效减少物质使用，它通过正念实践来教授对情绪不适的替代反应，并减轻在抑郁症状存在下对渴望的条件反射。本研究的目的是检验 MBRP 后抑郁症状、渴望和物质使用之间的关系。
在强化稳定后，招募了患有物质使用障碍的个体（N=168；平均年龄 40.45 岁，标准差 10.28；36.3%为女性；46.4%为非白人），然后随机分配到 8 周的 MBRP 或常规治疗对照组。大约 73%的样本在最终的 4 个月随访评估中被保留。
结果证实了一种调节中介效应，即在常规治疗组中，渴望中介了抑郁症状（贝克抑郁量表）和物质使用（时间线随访）之间的关系，但在 MBRP 参与者中则不然。MBRP 减轻了干预后抑郁症状与渴望（宾夕法尼亚酒精渴望量表）之间的关系，这种调节作用在干预后 2 个月（f(2) =.21）预测了物质使用。4 个月后（f(2) =.18）。
MBRP 似乎影响了对抑郁症状的认知和行为反应，部分解释了 MBRP 组中干预后物质使用减少的原因。尽管结果是初步的，但本研究为将正念实践纳入物质滥用治疗提供了证据，并确定了 MBRP 后潜在的变化机制。
