title: Mindfulness-based relapse prevention for substance craving.
abstract: Craving, defined as the subjective experience of an urge or desire to use substances, has been identified in clinical, laboratory, and preclinical studies as a significant predictor of substance use, substance use disorder, and relapse following treatment for a substance use disorder. Various models of craving have been proposed from biological, cognitive, and/or affective perspectives, and, collectively, these models of craving have informed the research and treatment of addictive behaviors. In this article we discuss craving from a mindfulness perspective, and specifically how mindfulness-based relapse prevention (MBRP) may be effective in reducing substance craving. We present secondary analyses of data from a randomized controlled trial that examined MBRP as an aftercare treatment for substance use disorders. In the primary analyses of the data from this trial, Bowen and colleagues (2009) found that individuals who received MBRP reported significantly lower levels of craving following treatment, in comparison to a treatment-as-usual control group, which mediated subsequent substance use outcomes. In the current study, we extend these findings to examine potential mechanisms by which MBRP might be associated with lower levels of craving. Results indicated that a latent factor representing scores on measures of acceptance, awareness, and nonjudgment significantly mediated the relation between receiving MBRP and self-reported levels of craving immediately following treatment. The mediation findings are consistent with the goals of MBRP and highlight the importance of interventions that increase acceptance and awareness, and help clients foster a nonjudgmental attitude toward their experience. Attending to these processes may target both the experience of and response to craving.
authors.affiliation: Department of Psychology, Washington State University-Vancouver, USA. Electronic address: katie.witkiewitz@wsu.edu.
authors.forename: Katie
authors.initials: K
authors.lastname: Witkiewitz
authors.affiliation: Center for the Study of Health and Risk Behaviors, Department of Psychiatry, University of Washington, Box 354944, 1100 NE 45th St, Suite 300, Seattle, WA 98105, USA. Electronic address: swbowen@uw.edu.
authors.forename: Sarah
authors.initials: S
authors.lastname: Bowen
authors.affiliation: Department of Psychology, University of Washington, Box 351525, Seattle, WA 98195, USA. Electronic address: hacdougl@uw.edu.
authors.forename: Haley
authors.initials: H
authors.lastname: Douglas
authors.affiliation: Department of Psychology, University of Washington, Box 351525, Seattle, WA 98195, USA. Electronic address: shsinhsu@gmail.com.
authors.forename: Sharon H
authors.initials: SH
authors.lastname: Hsu
mesh_terms: D000328:Adult; D001288:Attention / Q000502:physiology; D001364:Awareness / Q000502:physiology; D016739:Behavior, Addictive / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D019122:Meditation / Q000379:methods* / Q000523:psychology; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D055502:Secondary Prevention; D057566:Self Report; D019966:Substance-Related Disorders / Q000517:prevention & control* / Q000523:psychology; D013997:Time Factors