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Effectiveness of Mindfulness for Anger Expression on Men in Treatment for Substance Use Disorders: a Randomized Controlled Trial

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Abstract

Mindfulness is effective in managing cravings and preventing relapse in substance use disorders (SUD), but its effectiveness in managing anger is unclear. We aim to assess the effects of mindfulness-based relapse prevention (MBRP) on anger in men treated in therapeutics communities for SUD in Brazil. The sample size was designed to a minimum of 160 participants; 223 were randomized to MBRP or treatment as usual. After eight sessions of MBRP, the level of mindfulness and anger expression measures were assessed. Generalized estimated equations showed that MBRP group had a decreased effect on the anger expression index, reducing the anger expression-in and anger expression-out and increasing anger control-in and anger control-out compared to control. Mediation analysis showed that the level of mindfulness mediated group effects on anger expression index. MBRP protocol has shown benefits for anger management among inpatients with SUD.

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Data Availability

The dataset is available on https://repositoriodedados.unifesp.br/dataset.xhtml?persistentId=doi:10.5072/FK2/XLMPSS.

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Acknowledgements

We are grateful for the voluntary participation by the participants in this study as well as by the employees of the institutions that have made it possible. We are also grateful to our colleagues from NEPSIS for their relevant contributions in the design of the study, and the discussion of results. Finally, we are grateful to AFIP (Associação Fundo de Incentivo à Pesquisa) for the infrastructure support. This manuscript is part of the study conducted by Itamar José Félix Junior for his PhD at Universidade Federal de São Paulo.

Funding

ARN was supported by Grant #2015/19472–5 from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) from 2016 to 2022. IJFJ receives scholarship #2019/01767–0 from FAPESP. The agency did not have any role regarding decision about analysis and discussion within this manuscript.

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Author notes

  1. Ana Paula Gonçalves Donate

    Present address: Centre for Alcohol and Drug Research, Department of Psychology and Behavioral Sciences, Program of Business and Social Sciences, Aarhus University, 8000, Aarhus, Denmark

Authors and Affiliations

  1. NEPSIS Research Center for Health and Substance Use, Psychobiology Department, Universidade Federal de São Paulo. Rua Botucatu, 862, 1º Andar, Ed. Ciências Biomédicas. CEP, São Paulo, 04023-062, Brazil

    Itamar José Félix-Junior, Emérita Sátiro Opaleye, Ana Paula Gonçalves Donate, André Bedendo, Mayra Pires Alves Machado & Ana Regina Noto

  2. Department of Health Sciences, University of York, Area 2, Seebohm Rowntree Building Heslington, York, YO10 5DD, UK

    André Bedendo

  3. Psychobiology Department, Universidade Federal de São Paulo. Rua Botucatu, 862, 1º Andar, Ed. Ciências Biomédicas. CEP, São Paulo, 04023-062, Brazil

    José Carlos Fernandes Galduróz

  4. School of Graduate Psychology, Pacific University, Health Prof. Building 2 297UC Box A191, Hillsboro, OR, 503-352-3614, USA

    Sarah Bowen

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  1. Itamar José Félix-Junior
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Contributions

Itamar José Félix-Junior: conceptualization, methodology, investigation, writing—original draft, formal analysis. Emérita Sátiro Opaleye: conceptualization, Methodology, supervision, writing—original draft. Ana Paula Gonçalves Donate: investigation, writing—review and editing, formal analysis. André Bedendo: methodology, formal analysis, writing—review and editing. Mayra Pires Alves Machado: writing—review and editing. José Carlos Fernandes Galduróz: writing—review and editing. Sarah Bowen: writing—review and editing. Ana Regina Noto: conceptualization, methodology, supervision, project administration, funding acquisition, review and editing.

Corresponding author

Correspondence to Emérita Sátiro Opaleye.

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All procedures performed in this study were following the ethical standards of the institution (Ethics Committee in Research of Universidade Federal de São Paulo, approval number: 3.183.805) and with the 1964 Helsinki declaration.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

Conflict of Interest

ARN is the director of the Brazilian center that conducts MBRP training with financial incentives. ESO was an MBRP teacher in this center until 2019. MPAM and SB are teachers of Mindfulness and MBRP with financial incentives. IJFJ, APGD, AB and JCFG have declared no conflicts of interest.

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Félix-Junior, I.J., Opaleye, E.S., Donate, A.P.G. et al. Effectiveness of Mindfulness for Anger Expression on Men in Treatment for Substance Use Disorders: a Randomized Controlled Trial. Int J Ment Health Addiction (2023). https://doi.org/10.1007/s11469-023-01113-y

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