Mindfulness Based Relapse Prevention for Stimulant Users

描述（由申请人提供）：目前研究的广泛，长期目标是通过用创新的基于冥想的策略增强传统的复发预防治疗来改善兴奋剂使用障碍的治疗，以促进情绪调节技能。基于抑郁症的正念认知疗法（Segal，Teasdale，&威廉姆斯，2002），Marlatt及其同事最近开发了一种用于治疗物质使用人群的手动干预：基于正念的复发预防（MBRP）。本研究的具体目的是：（1）进行一项初步随机临床试验，以评估招募和保留个体进行大规模研究的可行性，并确定MBRP相对于接受应急管理（CM）的兴奋剂使用者的健康教育（艾德）对照组的效应量。将在基线、治疗结束和治疗后1个月对MBRP和艾德受试者进行评估。2)测试MBRP与艾德相比对负面情绪、兴奋剂使用和医疗结果的影响。3)评估MBRP与艾德对受试者HIV风险行为的不同影响，以及4）检查MBRP的潜在作用机制，包括减少应激反应和唤醒的生物指标，如血压和心率。我们假设MBRP在减少负面情绪和兴奋剂使用方面比艾德更有效。此外，我们预计MBRP将产生更大的减少艾滋病毒的风险行为，压力反应，和唤醒，这些变化将与物质使用的结果。MBRP结合了特定的以物质为中心的认知治疗技术，并额外强调了正念技能。通过提供应对技巧，以解决影响调节和应激反应，兴奋剂复发的两个重要因素，MBRP可能提供一个有前途的增强策略，治疗兴奋剂使用者。 公共卫生相关性：与公共卫生的相关性：拟议的研究具有相当大的公共卫生意义，因为它将提供基于正念的复发预防的基础信息，作为对兴奋剂依赖的干预，这是一个具有广泛影响的严重药物问题。如果证明有效，该方案可用于治疗成瘾和减少受治疗者中的兴奋剂使用，从而有效地减少药物滥用和相关后果，如犯罪活动、社会混乱和由于不安全性活动频率增加而增加的艾滋病毒传播/感染风险，这是兴奋剂使用者中特别突出的问题。拟议的项目将确定一个创新的干预方案，以前未经测试的兴奋剂依赖的个人的临床效用。

DESCRIPTION (provided by applicant): The broad, long-term objective of the current research is to improve treatment for stimulant use disorders by augmenting traditional relapse prevention therapy with innovative meditation-based strategies to promote affect regulation skills. Based on Mindfulness-Based Cognitive Therapy for depression (Segal, Teasdale, & Williams, 2002), Marlatt and colleagues recently developed a manualized intervention for the treatment of substance using populations: Mindfulness Based Relapse Prevention (MBRP). The specific aims of this research are 1) To conduct a pilot randomized clinical trial to assess the feasibility of recruiting and retaining individuals for a large scale study and to determine the effect size of MBRP relative to a health education (ED) control group in stimulant users receiving contingency management (CM). Both MBRP and ED participants will be assessed at baseline, treatment-end, and 1 month post-treatment. 2) To test the impact of MBRP compared to ED on negative affect, stimulant use, and healthcare outcomes. 3) To evaluate the differential effects of MBRP versus ED on HIV-risk behavior of participants, and 4) To examine potential mechanisms of action of MBRP, including reductions in stress reactivity and biological indicators of arousal such as blood pressure and heart rate. We hypothesize that MBRP will be more efficacious than ED in reducing negative affect and stimulant use. Further, we expect that MBRP will produce greater reductions in HIV-risk behaviors, stress reactivity, and arousal, and these changes will be associated with substance use outcomes. MBRP incorporates specific substance-focused cognitive therapy techniques with an additional emphasis on mindfulness skills. By providing coping skills to address affect regulation and stress reactivity, two important factors in stimulant relapse, MBRP may provide a promising augmenting strategy for the treatment of stimulant users. PUBLIC HEALTH RELEVANCE: Relevance to Public Health: The proposed research is of considerable public health significance in that it will provide foundational information on Mindfulness Based Relapse Prevention as an intervention for stimulant dependence, a serious drug problem with extensive impacts. If proven effective, the protocol could be useful in treating addiction and in reducing stimulant use among treated individuals, thereby efficiently reducing drug abuse and related consequences such as criminal activity, social disruption, and elevated risk of HIV transmission/infection due to increased frequency of unsafe sexual activities, a particularly prominent problem among stimulant users. The proposed project will determine clinical utility of an innovative intervention protocol previously untested in stimulant-dependent individuals.