Mindfulness for Alcohol Abusing Offenders: Mechanisms and Outcomes

项目摘要 药物滥用和犯罪行为之间的恶性联系给社会带来了重大损失， 美国每年数十亿美元。迫切需要采取更有效的干预措施， 酗酒和滥用药物的刑事犯罪者复吸率和累犯率高。犯罪人的期间 监禁为制定和部署这种干预措施提供了独特机会。干预方面的进展 发展可以通过针对常见的特定认知和情感弱点来实现 滥用药物的犯罪分子。初步研究表明，冥想或正念 干预措施可为囚犯带来显著的心理和行为益处。但 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 方法上的一些限制。此外，到目前为止，还没有研究检查神经生物学 与该人群治疗成功相关的机制。NIAAA最近发起了一个项目， 解决这些问题（PA-15-299）。在这里，我们响应这一计划的呼吁，并建议进行严格的， 正念治疗酒精和物质使用障碍的综合纵向研究 女囚该项目将随机分配400多名女囚犯进行正念或复发 预防培训课程，并将两者与无治疗对照进行比较。正念 干预措施将针对酗酒罪犯两个关键神经心理缺陷， 罪犯：冲动和渴望。我们将测试关于治疗后神经变化的假设 来阐明变化的机制。我们将通过以下方式获得干预措施在“真实世界”的有效性估计值： 收集监狱中（行为报告）和释放后（酗酒复发和 反社会行为）。该项目利用了一个独特的，长期的合作伙伴关系， 团队和新墨西哥州和威斯康星州的矫正部门，允许收集 在监禁期间从囚犯获得的全面评估数据，包括使用移动的 MRI扫描仪，以及获得释放后的结果和复发数据。实现这些目标是一个 这是实施和评估针对高风险人群的有希望的正念干预的关键一步。 拟议的研究也将开始阐明的心理和神经生物学机制， 治疗因此，这些结果将大大推进一项旨在将日益增长的 将神经心理学缺陷的知识转化为更有针对性和有效的酒精治疗方法， 犯罪分子的药物滥用问题。

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.