Biopsychosocial Assessment of a Mindfulness-Oriented Intervention for Stress-Precipitated Alcohol Dependence: A Pilot Randomized Controlled Trial

Background: The risk chain of stress-precipitated alcohol dependence relapse may be malleable to targeted behavioral therapies. Data is presented from a pilot-test of a mindfulness-oriented recovery enhancement (MORE) intervention designed to target cognitive, affective, and physiological mechanisms implicated in stress-precipitated alcohol dependence. Methods: Fifty-three alcohol-dependent adults (mean age = 40.3, SD = 9.4) recruited from a long-term therapeutic community were randomly assigned to either 10 weeks of mindfulness training or an alcohol dependence support group (ASG). A majority of participants were male (79.2%), African American (60.4%), and had earned <$0,000 in the year before entering the TC (52.8%). Repeated measures analyses of variance were used to explore the differential effects of treatment on clinical self-report measures, a psychophysiological cue-reactivity protocol, and a dot-probe task designed to measure alcohol attentional bias. Results: 37 participants completed the interventions. Relative to ASG (n = 19), MORE (n = 18) resulted in medium-large effect size reductions in perceived stress and thought suppression, increased heart rate variability (HRV) recovery from alcohol cues, and significant effects on alcohol attentional bias (AB). Among MORE participants, decreases in thought suppression were correlated with reduced AB, improved ability to inhibit appetitive alcohol responses, and greater HRV recovery. Conclusion: Mindfulness training appears to effect cognitive, affective, and physiological risk mechanisms implicated in alcohol dependence relapse. MORE holds promise as an alternative, targeted treatment for vulnerable alcohol dependent adults.