Developing MBSR for Application in Alcoholism Treatment

描述(由申请人提供)：在酒精依赖者开始戒酒后，再次饮酒是常见的结果。这种复发主要发生在涉及个人内部或人际压力的情况下。作为回应，本申请(根据NIAAA的“行为和综合治疗发展计划”计划公告(PA06-486)提交)建议在酒精中毒治疗中适应、应用和评估基于正念的压力减轻(MBSR)，这是一种公认的压力减轻干预措施。MBSR强调发展超然的观察和对意识内容的认识，已被证明在提高应对压力的能力和增强应对和心理健康方面有效。然而，文献中没有评估MBSR在酒精依赖者中的独特效果的对照临床研究。该项目将分两个阶段进行。在第一阶段(1a阶段活动)中，将改编一份以团体为基础进行MBSR的8节治疗手册，以便在酒精依赖男子和妇女10节治疗照常(TAU)的范围内使用。在第二阶段(1b阶段活动)，将进行一项试点临床试验，以检查在TAU中加入MBSR对酒精依赖门诊患者的影响。参加TAU MBSR的患者的结果将与接受TAU加一系列健康和生活方式讲座(TAU HLL)的患者的结果进行比较。这项研究中出现的积极发现将作为更大规模的第二阶段对照临床试验的基础，以进一步评估MBSR在酒精中毒治疗中的作用，并确定其作用机制 MBSR可能会起到这样的作用。这项研究的长期目标是减少治疗后再次饮酒，这将为正在接受酒精依赖治疗的人提供显著的健康益处。

DESCRIPTION (provided by applicant): Relapses to drinking are common outcomes following the initiation of abstinence among alcohol dependent individuals. Such relapses predominantly occur in situations involving either intrapersonal or interpersonal stress. In response, the present application (submitted under NIAAA's "Behavioral and Integrative Treatment Development Program" Program Announcement {PA06-486}) proposes the adaptation, application, and evaluation of Mindfulness-based Stress Reduction (MBSR), a well-established stress reduction intervention, in alcoholism treatment. MBSR, with its emphasis on the development of detached observation and awareness of the contents of consciousness, has been shown to be efficacious in increasing the ability to cope with stress and in enhancing coping and psychological well-being. However, there are no controlled clinical studies in the literature evaluating the unique effects of MBSR among persons with alcohol dependence. The project will be conducted in two phases. In Phase I (Stage 1a activity), an 8- session treatment manual for conducting group-based MBSR will be adapted for use in the context of a standardized 10-session treatment-as-usual (TAU) for alcohol dependent men and women. In Phase II (Stage 1b activity), a pilot clinical trial will be conducted to examine the effects of adding MBSR to TAU for alcohol dependent outpatients. The outcomes of patients participating in TAU + MBSR will be compared to the outcomes for patients receiving TAU plus a series of Health and Lifestyle Lectures (TAU + HLL). Positive findings emerging from this research will serve as foundation for a larger, Stage 2 controlled clinical trial to further evaluate MBSR in alcoholism treatment and to determine the mechanisms of action by which MBSR may operate to effect such benefits. The long-term goal of this research is to decrease relapse to drinking following treatment, which will provide significant health benefits to persons being treated for alcohol dependence.