Abstract: Substance Use Outcomes for Mindfulness-Based Relapse Prevention Are Partially Mediated By Reductions in Stress: Results from a Randomized Controlled Trial (Society for Social Work and Research 23rd Annual Conference - Ending Gender Based, Family and Community Violence)

Schedule:

Friday, January 18, 2019: 2:15 PM

Golden Gate 3, Lobby Level (Hilton San Francisco)

* noted as presenting author

Jordan Davis, PhD, Assistant Professor, University of Southern California, Los Angeles, CA

Doug Smith, PhD, Associate Professor, University of Illinois at Urbana-Champaign, Urbana, IL

Brent Roberts, Professor, University of Illinois at Urbana-Champaign, IL

Tara Dumas, assistant professor, Huron University, ON, Canada

Daniel Berry, assistant professor, University of Minnesota-Twin Cities, MN

Background: Mindfulness Based Relapse Prevention (MBRP) has demonstrated efficacy in alleviating substance use, stress, and craving but how MBRP works for marginalized young adults has not been investigated. The current NIH-funded randomized controlled trial tested the hypothesis that MBRP would reduce stress, craving, and substance use among young adults in residential treatment relative to treatment-as-usual plus 12-step/self-help meetings (TAU). Further, we examined whether reduced stress during treatment was a potential mechanism of change operating in MBRP.

Method: Seventy-nine primarily Caucasian young adults were randomly assigned to MBRP (n = 44) or TAU (n =35). Individuals assigned to MBRP received eight additional mindfulness sessions and those assigned to TAU received an equal amount of additional 12-step/self-help. The eight MBRP sessions were administered twice per week (90 min each). All participants were followed-up bi-monthly over the course of 6 months assessing self-reported measures of stress, craving, and substance use. Bi-linear spine structural equation models were used to assess intervention effects during the treatment and post-treatment phase.

Results: At treatment completion young adults receiving MBRP had lower substance use (d = -.58), craving (d = -.58), and stress (d = -.77). These results were maintained at study completion with diverging trajectories between MBRP and TAU groups manifesting effect sizes ranging from small (Craving; d = -.28) to rather large (substance use: d = -1.1; stress: d = -1.3). Reduced stress during treatment partially mediated observed outcome differences between MBRP and TAU for substance use (β_indirect = -.45 [-.79, -.11]).

Conclusions: This is the first study to provide support for changes in stress as an active mechanism contributing to lower substance use. Overall, findings suggest that MBRP is an appropriate and integrative therapy designed to reduce stress, negative emotion, and substance use among a sample of marginalized young adults.