Clinical Psychopharmacology Unit; Research Department of Clinical, Educational and Health Psychology, University College London, United Kingdom.
Int J Neuropsychopharmacol. 2017 Nov 1;20(11):936-947. doi: 10.1093/ijnp/pyx064.
Like other complex psychosocial interventions, mindfulness-based treatments comprise various modality-specific components as well as nonspecific therapeutic ingredients that collectively contribute to efficacy. Consequently, the isolated effects of mindfulness strategies per se remain unclear.
Using a randomized double-blind design, we compared the isolated effects of 11-minutes of "supervised" mindfulness instruction against a closely matched active control (relaxation) on subjective, physiological, and behavioral indices of maladaptive alcohol responding in drinkers at risk of harm from alcohol use (n = 68). Simple follow-up instructions on strategy use were provided, but practice was unsupervised and not formally monitored.
Both groups showed acute reductions in craving after training, although a trend group x time interaction (P = .056) suggested that this reduction was greater in the relaxation group (d = 0.722 P < .001) compared with the mindfulness group (d = 0.317, P = .004). Furthermore, upregulation of parasympathetic activity was found after relaxation (d = 0.562; P < .001) but not mindfulness instructions (d = 0.08; P > .1; group x time interaction: P = .009). By contrast, only the mindfulness group showed a reduction in past-week alcohol consumption at 7-day follow-up (-9.31 units, d = 0.593, P < .001), whereas no significant reduction was seen in the relaxation group (-3.00 units, d = 0.268, P > .1; group x time interaction: P = .026).
Very brief mindfulness practice can significantly reduce alcohol consumption among at-risk drinkers, even with minimal encouragement to use this strategy outside of the experimental context. The effects on consumption may therefore represent a lower bound of efficacy of "ultra-brief" mindfulness instructions in hazardous drinkers, at least at short follow-up intervals.
与其他复杂的心理社会干预措施一样，基于正念的治疗方法包含各种特定模式的组成部分以及非特异性治疗成分，这些成分共同促成了疗效。因此，正念策略本身的孤立效果仍然不清楚。
我们采用随机双盲设计，比较了 11 分钟“监督”正念指导对有风险的酒精使用伤害的饮酒者的不良酒精反应的主观、生理和行为指标的孤立影响，与密切匹配的积极对照组（放松）相比（n = 68）。提供了关于策略使用的简单后续说明，但实践是无人监督的，也没有正式监测。
两组在训练后都表现出渴望的急性降低，尽管趋势组 x 时间交互作用（P =.056）表明，放松组的这种降低更大（d = 0.722，P <.001），与正念组相比（d = 0.317，P =.004）。此外，放松后发现副交感神经活动上调（d = 0.562；P <.001），但正念指令后未上调（d = 0.08；P >.1；组 x 时间交互作用：P =.009）。相比之下，只有正念组在 7 天随访时显示出过去一周饮酒量减少（-9.31 个单位，d = 0.593，P <.001），而放松组没有显著减少（-3.00 个单位，d = 0.268，P >.1；组 x 时间交互作用：P =.026）。
非常简短的正念练习可以显著减少高危饮酒者的饮酒量，即使在实验环境之外使用这种策略的鼓励最小。因此，在短期随访间隔内，至少在消耗方面，“超简短”正念指令对危险饮酒者的疗效可能代表“最低下限”。
