Do Mindfulness and/or Thought Suppression Mediate Treatment Effects on Cardiac Vagal Control in Substance Abusers treated with Mindfulness-Based Relapse Prevention, Relapse Prevention or Treatment as Usual?

Abstract

Thought suppression, or the effort to reduce or stop thinking about a particular thought (i.e., target thought of anticipated pleasant sensations associated with drug), is involved with many effective therapeutic strategies for substance use disorders such as cognitive behavioral therapy, but paradoxically associated with rebound effects, or an increased occurrence of the target thought (Rassin, 2005). Mindfulness stands in contrast to thought suppression by fostering a non-judgmental attitude towards and acceptance of thoughts. For example, Mindfulness-Based Relapse Prevention (MBRP) treatment for substance use aims to increase tolerance of negative physical, emotional, and cognitive states. Initial research with MBRP aftercare treatment for substance use disorders suggests efficacy as MBRP program completers engage in less substance use than Treatment as Usual (TAU) completers and show decreases in craving (Bowen, et al., 2009). Additionally, MBRP is associated with favorable psychophysiological outcomes when compared to cognitive behavioral therapy. Thus, the current project compares the effects of thought suppression and mindfulness on psychophysiological reactivity to stress in MBRP to Relapse Prevention (RP, cognitive behavioral therapy) and TAU. Mediation models assessing if thought suppression and mindfulness mediated the effect of treatment (MBRP, RP, TAU) onto psychophysiological outcomes suggest that MBRP is positively related to mindfulness and negatively related to thought suppression, where RP is negatively related to mindfulness and positively related to thought suppression. However, no significant overall mediation models were found. Future research should continue to identify contributors to health outcomes following treatment for substance use disorders.