Mindfulness for Alcohol Abusing Offenders: Mechanisms and Outcomes

项目总结 药物滥用和犯罪行为之间的有害联系给社会带来了重大代价，总计 每年在美国有数十亿美元。迫切需要更有效的干预措施来抵消 酗酒和滥用药物罪犯的复吸率和累犯率较高。犯罪者的期间 监禁为制定和部署这种干预措施提供了独特的机会。干预研究进展 可以通过针对常见的特定认知和情感弱点来实现发展 在滥用物质的犯罪分子中。初步研究表明，冥想或正念 干预可能会给囚犯带来显著的心理和行为上的好处。然而， 干预效果的机制和程度尚不清楚，因为这些先前的研究一直受到 方法限制的数量。此外，到目前为止，还没有研究检查神经生物学 与这一人群的治疗成功有关的机制。NIAAA最近进行了一个程序调用，以 解决这些问题(PA-15-299)。在这里，我们响应这个项目的号召，并建议进行严格的和 正念治疗酒精和药物使用障碍的综合纵向研究 女性囚犯。该项目将随机分配400多名女性囚犯进行正念或复发 预防培训课程，并将两者与没有治疗的对照组进行比较。正念 将量身定做干预措施，以解决酗酒罪犯的两个关键神经心理缺陷 违规者：冲动和渴望。我们将通过治疗来检验有关神经随时间变化的假说。 以阐明变化的机制。我们将通过以下方式获得对干预的“现实世界”效果的估计 在监狱内(执行报告)和获释后(酗酒复发和酗酒)收集结果衡量标准 反社会行为)。该项目利用了两个研究机构之间独特的、长期的合作伙伴关系 团队以及新墨西哥州和威斯康星州惩教部门允许收集 囚犯在服刑期间的全面评估数据，包括移动电话的脑部成像数据 核磁共振扫描仪，以及访问释放后的结果和复发数据。完成这些目标是一个 为这一高危人群实施和评估有前景的正念干预的关键步骤。 这项拟议的研究还将开始阐明精神障碍的心理和神经生物学机制。 治疗。因此，这些结果将极大地推进寻求将日益增长的 将神经心理缺陷的知识转化为更有针对性和更有效的酒精和 罪犯中的药物滥用问题。

PROJECT SUMMARY The pernicious link between substance abuse and criminal behavior imposes major costs to society, totaling billions of dollars in the U.S. annually. There is a critical need for more effective interventions to counteract the high rates of relapse and recidivism in alcohol and substance abusing criminal offenders. Periods of offender incarceration provide a unique opportunity to develop and deploy such interventions. Progress in intervention development could be achieved by targeting specific cognitive and affective vulnerabilities that are common among substance abusing criminal offenders. Preliminary studies suggest that meditative or mindfulness interventions may confer significant psychological and behavioral benefits to inmates. However, the mechanisms and extent of intervention efficacy are unclear, as these previous studies have been beset by a number of methodological limitations. Moreover, to date no study has examined the neurobiological mechanisms that relate to treatment success in this population. NIAAA has recently made a program call to address these issues (PA-15-299). Here we answer this program call and propose to undertake a rigorous and comprehensive longitudinal study of mindfulness treatment of alcohol and substance use disorders among female inmates. This project will randomly assign over 400 female inmates to a mindfulness or relapse prevention training course, and both will be compared against a no treatment control. The mindfulness intervention will be tailored to address two key neuropsychological deficits in alcohol abusing criminal offenders: impulsivity and craving. We will test hypotheses about the neural changes over time with treatment to elucidate mechanisms of change. We will obtain estimates of “real-world” efficacy of the intervention by collecting outcome measures in prison (conduct reports) and following release (alcohol use relapse and antisocial behavior). This project takes advantage of a unique, longstanding partnership between the research team and the states of New Mexico and Wisconsin Correction Departments that allows collection of comprehensive assessment data from inmates during incarceration, including brain imaging data with a mobile MRI scanner, as well as access to post-release outcomes and relapse data. Completion of these aims is a critical step for implementing and evaluating a promising mindfulness intervention for this high-risk population. The proposed research will also begin to elucidate the psychological and neurobiological mechanisms of the treatment. These results will thus significantly advance a program of research seeking to translate the growing knowledge of neuropsychological deficits into more targeted and effective treatments for alcohol and substance abuse problems in criminal offenders.