Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders: a randomized clinical trial.
Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders: a randomized clinical trial.
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DOI：
10.1001/jamapsychiatry.2013.4546
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发表时间：
2014-05
期刊：
影响因子：
25.8
通讯作者：
Larimer, Mary E.
中科院分区：
文献类型：
--
作者：
Bowen, Sarah;Witkiewitz, Katie;Clifasefi, Seema L.;Grow, Joel;Chawla, Neharika;Hsu, Sharon H.;Carroll, Haley A.;Harrop, Erin;Collins, Susan E.;Lustyk, M. Kathleen;Larimer, Mary E.
药物滥用治疗后复发的情况非常普遍，这凸显了改进善后护理干预措施的必要性。基于正念的复发预防（MBRP）是一种基于团体的心理社会善后护理，整合了基于正念的干预措施和认知行为复发预防（RP）方法的循证实践。旨在评估在 12 个月的随访期间，与 RP 和照常治疗（TAU [12 步编程和心理教育]）相比，MBRP 在减少复发方面的长期疗效。 2009 年 10 月至 2012 年 7 月期间，共有 286 名符合资格的个人在私人非营利性治疗机构成功完成了物质使用障碍的初步治疗，他们被随机分配至 MBRP、RP 或 TAU 术后护理组，并接受为期 12 个月的监测。经医学证明可以继续接受护理的参与者年龄在 18 至 70 岁之间； 71.5% 为男性，42.1% 为少数民族。参与者被随机分配到每周 8 次的 MBRP、认知行为 RP 或 TAU 小组会议。主要结局包括吸毒和酗酒复发以及过去 90 天内物质使用频率。在基线以及 3、6 和 12 个月的随访点评估变量。使用的措施包括自我报告复发情况以及尿液分析药物和酒精筛查。与 TAU 相比，分配至 MBRP 和 RP 的参与者报告称，药物滥用和酗酒复发的风险显着降低，并且在使用药物的参与者中，在 6 个月的随访中，药物滥用和酗酒的天数显着减少。认知行为 RP 在首次使用药物的时间上表现出优于 MBRP 的优势。在 12 个月的随访中，与 RP 和 TAU 相比，MBRP 参与者报告物质使用天数显着减少，重度饮酒也显着减少。对于物质使用障碍初次治疗后处于善后护理的个体，与 TAU 相比，RP 和 MBRP 显着降低了吸毒和酗酒的复发风险。复发预防延迟了 6 个月随访时首次使用药物的时间，与 TAU 参与者相比，饮酒的 MBRP 和 RP 参与者报告的酗酒天数也显着减少。在 12 个月的随访中，MBRP 在减少药物使用和酗酒方面比 RP 和 TAU 具有更多益处。有针对性的正念练习可以通过加强监测和巧妙应对与渴望或负面影响相关的不适的能力来支持长期结果，从而支持长期结果。 ClinicalTrials.gov 标识符：NCT01159535
Relapse is highly prevalent following substance abuse treatments, highlighting the need for improved aftercare interventions. Mindfulness-based relapse prevention (MBRP), a group-based psychosocial aftercare, integrates evidence-based practices from mindfulness-based interventions and cognitive-behavioral relapse prevention (RP) approaches. To evaluate the long-term efficacy of MBRP in reducing relapse compared with RP and treatment as usual (TAU [12-step programming and psychoeducation]) during a 12-month follow-up period. Between October 2009 and July 2012, a total of 286 eligible individuals who successfully completed initial treatment for substance use disorders at a private, nonprofit treatment facility were randomized to MBRP, RP, or TAU aftercare and monitored for 12 months. Participants medically cleared for continuing care were aged 18 to 70 years; 71.5% were male and 42.1% were of ethnic/racial minority. Participants were randomly assigned to 8 weekly group sessions of MBRP, cognitive-behavioral RP, or TAU. Primary outcomes included relapse to drug use and heavy drinking as well as frequency of substance use in the past 90 days. Variables were assessed at baseline and at 3-, 6-, and 12-month follow-up points. Measures used included self-report of relapse and urinalysis drug and alcohol screenings. Compared with TAU, participants assigned to MBRP and RP reported significantly lower risk of relapse to substance use and heavy drinking and, among those who used substances, significantly fewer days of substance use and heavy drinking at the 6-month follow-up. Cognitive-behavioral RP showed an advantage over MBRP in time to first drug use. At the 12-month follow-up, MBRP participants reported significantly fewer days of substance use and significantly decreased heavy drinking compared with RP and TAU. For individuals in aftercare following initial treatment for substance use disorders, RP and MBRP, compared with TAU, produced significantly reduced relapse risk to drug use and heavy drinking. Relapse prevention delayed time to first drug use at 6-month follow-up, with MBRP and RP participants who used alcohol also reporting significantly fewer heavy drinking days compared with TAU participants. At 12-month follow-up, MBRP offered added benefit over RP and TAU in reducing drug use and heavy drinking. Targeted mindfulness practices may support long-term outcomes by strengthening the ability to monitor and skillfully cope with discomfort associated with craving or negative affect, thus supporting long-term outcomes. clinicaltrials.gov Identifier: NCT01159535
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影响因子：
3
作者：
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