Approach Coping and Substance Use Outcomes Following Mindfulness-Based Relapse Prevention Among Individuals with Negativ
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ORIGINAL PAPER
Approach Coping and Substance Use Outcomes Following Mindfulness-Based Relapse Prevention Among Individuals with Negative Affect Symptomatology Corey Roos 1 & Sarah Bowen 2 & Katie Witkiewitz 3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Objectives Mindfulness-based relapse prevention (MBRP) for substance use disorders (SUDs) appears to be particularly effective among individuals with high levels of co-occurring affective symptoms. We sought to understand whether changes in approach and avoidance coping may explain the effects of MBRP among this subpopulation. Methods The sample included 286 individuals with SUDs randomized to MBRP, relapse prevention (RP), or treatment as usual (TAU) as an aftercare treatment. We conducted conditional indirect effect models with treatment condition as the predictor, baseline affective symptoms as the moderator, changes in approach and avoidance coping over time from baseline through 6 months post-treatment as mediators, and substance use and substance-related problems at 12 months post-treatment as the outcome. Affective symptomatology at baseline was modeled as a latent factor indicated by depression, anxiety, and PTSD symptoms. Change in approach and avoidance coping were modeled using latent growth curve analyses. Results We found significant conditional indirect effects of MBRP, such that the interaction of MBRP vs. TAU by affective symptoms predicted increases in approach coping, which in turn predicted fewer heavy drinking days and substance-related problems at month 12. Follow-up analyses showed that increases in approach coping mediated the therapeutic effect of MBRP on these outcomes among those with high, but not low or moderate, affective symptoms. We did not find indirect or conditional indirect effects when comparing RP with TAU, or when avoidance coping was the mediator. Conclusions The pronounced therapeutic effects of MBRP among individuals with SUD and relatively higher negative affective symptoms may be due to increases in approach coping over time. Keywords Mindfulness-based relapse prevention . Substance use disorder . Conditional indirect effects . Approach coping . Latent growth curve models
Mindfulness-based relapse prevention (MBRP) (Bowen et al. 2011) is a manual-guided, group-delivered behavioral Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12671-020-01456-w) contains supplementary material, which is available to authorized users. * Corey Roos [email protected] 1
Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, Ste Suite 6C, New Haven, CT 06510, USA
2
School of Professional Psychology, Pacific University, 190 SE 8th Avenue, Hillsboro, OR 97123, USA
3
Department of Psychology, University of New Mexico, MSC 03-2220, Albuquerque, NM 87131, USA
intervention for reducing the risk and severity of substance use relapse among individuals with substance use disorders (SUDs). As a mindfulness-based intervention, a cornerstone
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