Abstract
Objectives
Mindfulness-based relapse prevention (MBRP) is an effective group-based aftercare treatment for substance use disorders (SUDs), yet few studies have examined moderators of MBRP efficacy. This secondary data analysis evaluated individual gender and group gender composition (e.g., proportion of women relative to men in each therapy group) as treatment moderators of MBRP.
Methods
The analysis sample included 186 individuals with SUDs randomized to MBRP or relapse prevention (RP) as an aftercare treatment. Outcomes included number of heavy drinking days and drug use days at the 12-month follow-up.
Results
There were no treatment moderation effects for models with heavy drinking days as the outcome (all ps > .05). Group gender composition, but not individual gender, moderated the effect of treatment condition on drug use days (p < .01). Individuals who received MBRP had significantly fewer drug use days at 12 months than those who received RP, but only among individuals in therapy groups comprising one-third or more women (p < 0.0001). Specifically, all women and men who received MBRP in groups with one third or more women were abstinent from drugs at month 12, whereas those in RP groups with one third or more women had an average of about eight drug use days at month 12 (corresponding to a large between-treatment condition effect size).
Conclusions
Group-based MBRP may be more efficacious than group-based RP, particularly when women compose at least one third of the therapy group. Further research is warranted on gender and group gender composition as moderators of MBRP.
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Funding
During the preparation of this manuscript, Corey Roos and Elena Stein were supported by a training grant through the National Institute on Alcohol Abuse and Alcoholism (grant number T32 AA0018108).
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All authors contributed to the study conceptualization and design. CRR conducted the data analyses and wrote the initial drafts of the results and discussion sections. ES wrote the initial drafts of the introduction and method sections. KW and SB contributed to the oversight of the data analyses and study execution and the writing and editing of the final manuscript.
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This paper is a secondary analysis of data from a clinical trial. The original clinical trial was approved by the University of Washington Institutional Review Board. All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All participants enrolled in the study gave their informed consent prior to their inclusion in the study.
Conflict of Interest
Drs Bowen and Witkiewitz conduct MBRP trainings for which they receive monetary incentives, although the findings presented in this article have not yet been presented as part of these trainings. No other authors have conflicts, and there has been no significant financial support for this work that could have influenced its outcome.
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Roos, C., Stein, E., Bowen, S. et al. Individual Gender and Group Gender Composition as Predictors of Differential Benefit from Mindfulness-Based Relapse Prevention for Substance Use Disorders. Mindfulness 10, 1560–1567 (2019). https://doi.org/10.1007/s12671-019-01112-y
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DOI: https://doi.org/10.1007/s12671-019-01112-y