Mindfulness-Based Relapse Prevention: Efficacy and Mechanisms

基于正念的复发预防：功效和机制

• 批准号: 7737899
• 负责人: Gordon ALAN Marlatt
• 金额: $ 71.75万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7737899
• 关键词: Address; Adherence; Affect; Aftercare; Alcohol or Other Drugs use; Anger; Awareness; Behavior Therapy; Behavioral; Cognitive; Communities; Control Locus; Coping Skills; County; Data; Dependence; Development; Disease; Drug Use Disorder; Drug abuse; Drug usage; Evaluation; Expectancy; Foundations; Frequencies; General Population; Goals; High Prevalence; Individual; Inpatients; Intervention; Knowledge; Linguistics; Literature; Manuals; Measures; Mediating; Mediation; Mediator of activation protein; Meditation; Mission; Motivation; National Institute of Drug Abuse; Outcome; Outpatients; Participant; Pharmaceutical Preparations; Population; Preventive Intervention; Process; Protocols documentation; Questionnaires; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Recovery; Recruitment Activity; Relapse; Relative (related person); Research; Risk; Self Efficacy; Services; Signal Transduction; Social support; Societies; Staging; Structure; Subgroup; Substance abuse problem; Target Populations; Testing; Therapeutic; Time; Training; Treatment Efficacy; Treatment outcome; Work; Writing; active method; addiction; alcohol and other drug; alcohol craving; base; behavior change; common treatment; coping; craving; design; disorder later incidence prevention; drug relapse; emotion regulation; follow up assessment; impression; improved; innovation; mindfulness; mindfulness meditation; pilot trial; prevent; psychosocial; public health relevance; response; standard care; therapy design; treatment effect; treatment planning; treatment trial

DESCRIPTION (provided by applicant): The broad, long-term objective of the proposed randomized clinical trial is to evaluate the efficacy, moderators and mechanisms of change of two cognitive-behavioral aftercare treatments for alcohol and other drug (AOD) use disorders in preventing AOD relapse compared to standard aftercare (SA) offered in the community. The two cognitive-behavioral aftercare treatments are relapse prevention (RP; Daley & Marlatt, 2006) and Mindfulness-Based Relapse Prevention (MBRP), which integrates mindfulness meditation and RP aftercare components. The proposed research plan will address three specific aims. The first aim is to examine the efficacy of MBRP and RP compared to SA in preventing AOD relapse following intensive inpatient (IP) and outpatient (IOP) AOD treatment. Participants will be recruited from IP and IOP treatment and randomized to 8 weeks of MBRP, RP or SA. Treatment efficacy, as defined by reductions in AOD use and related consequences, will be evaluated at posttreatment and 3-, 6-, 9- and 12- month follow-up assessments. It is hypothesized that both MBRP and RP will result in significantly less AOD use and related consequences compared to SA. The second specific aim is to evaluate potential mediators of MBRP and RP treatment efficacy. It is proposed that the MBRP and RP interventions will be differentially effective in reducing AOD use and consequences based on the unique objectives of each treatment approach. It is therefore hypothesized that MBRP efficacy will be mediated by metacognitive processes, locus of control, mindfulness, thought suppression, ability to cope with craving and negative affect, experiential avoidance, emotion regulation and intensity of meditation practice. It is further hypothesized that RP efficacy will be mediated by negative affect, positive expectancies, self-efficacy and coping abilities. The final aim is to test potential moderators of treatment efficacy. It is hypothesized that participants with higher baseline levels of avoidant coping, experiential avoidance and lower levels of emotion regulation will benefit more from MBRP vs. RP treatments; whereas participants with lower self-efficacy and higher positive expectancies at baseline will benefit more from RP vs. MBRP treatments. In fulfilling these specific aims, the proposed research will address the NIDA mission for Stage II treatment research by examining the efficacy, moderators and differential mechanisms of change of various AOD aftercare treatments. PUBLIC HEALTH RELEVANCE: Given the high prevalence of alcohol and other drug (AOD) abuse in the general population and the high rates of relapse following AOD treatment, the proposed research will provide a valuable next step in evaluating the efficacy of two cognitive-behavioral treatments, relapse prevention and mindfulness-based relapse prevention, as aftercare treatments for AOD disorders in comparison to standard aftercare offered in the community. Further, the proposed research is designed to gain a better understanding of why these treatments work and for whom.

描述（由申请人提供）：拟议的随机临床试验的广泛，长期目标是评估两种对酒精和其他药物（AOD）两种认知行为行为的后果治疗的疗效，主持人和机制（AOD）使用障碍，以防止与社区提供的标准后期（SA）相比。两种认知行为的后果治疗方法是预防复发（RP； Daley＆Marlatt，2006）和基于正念的复发预防（MBRP），它整合了正念冥想和RP后期护理组件。拟议的研究计划将解决三个具体目标。与SA相比，与SA相比，在强化住院（IP）和门诊（IOP）AOD处理后，检查了MBRP和RP的功效。参与者将从IP和IOP治疗中招募，并随机分为MBRP，RP或SA的8周。治疗效率由AOD使用和相关后果的减少定义，将在治疗后以及3个，6个，9个月和12个月的随访评估中进行评估。假设与SA相比，MBRP和RP都会导致AOD的使用和相关后果明显较小。第二个具体目的是评估MBRP和RP治疗疗效的潜在介体。有人提出，基于每种治疗方法的独特目标，MBRP和RP干预措施将在减少AOD的使用和后果方面具有差异性。因此，假设MBRP疗效将由元认知过程，控制源，正念，思想抑制，能够应对渴望和负面影响，经验避免，情绪调节和冥想实践的强度。进一步假设RP功效将由负面影响，积极的期望，自我效能和应对能力介导。最终目的是测试治疗功效的潜在主持人。假设具有较高基线的回避应对水平，经验避免和较低情绪调节水平的参与者将从MBRP与RP治疗中受益更多；而基线时自我效能感和较高积极预期的参与者将从RP与MBRP治疗中受益更多。在实现这些特定目标时，拟议的研究将通过检查各种AOD AD Aftercare治疗的变化的功效，主持人和差异机制来解决NIDA的II阶段治疗研究。公共卫生相关性：鉴于酒精和其他药物（AOD）在普通人群中的高度流行以及AOD治疗后的较高复发率，拟议的研究将为评估两种认知行为治疗，复发预防和基于正念的预防疗法的认知性行为治疗的疗效，作为对AOD的顾客的顾客治疗，以提供对AOD的顾客的效力。此外，拟议的研究旨在更好地理解这些治疗原因以及为谁工作。