Abstract
Objectives
Mindfulness-Based Relapse Prevention (MBRP) and transcranial direct current stimulation (tDCS) have each demonstrated efficacy in improving outcomes in those with alcohol use disorder (AUD); however, a recent study that combined MBRP with tDCS found tDCS provided no additional benefit to MBRP for AUD. Differences in treatment adherence between active versus sham tDCS groups may have contributed to this result. The current study examined whether treatment adherence interacted with tDCS condition in predicting post-treatment mindfulness and craving.
Methods
This study was a secondary data analysis from a randomized sham-controlled trial comparing MBRP paired with tDCS. Linear regression analyses were conducted examining the interaction between tDCS condition and two measures of treatment adherence (i.e., number of groups attended, number of tDCS administrations) on post-treatment mindfulness and craving.
Results
There was no effect of treatment adherence by tDCS condition in predicting mindfulness; however, the interaction between treatment adherence and tDCS condition significantly predicted post-treatment craving. There was a significant negative association between treatment adherence and post-treatment craving in the sham group, but there was no association in the active tDCS group.
Conclusions
MBRP coupled with sham stimulation led to significant reductions in self-reported craving when patients attended more sessions and received a greater number of sham tDCS administrations, while no relationship was observed between treatment adherence and craving among those who received active tDCS. This result provides tentative evidence that, rather than improve the effects of MBRP on craving, this active tDCS protocol provides no additional benefit to MBRP in reducing craving.
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Data Availability
The data that support the findings of this study are available on request from the corresponding author (BG). The data are not publicly available because participants did not consent to public data sharing.
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Funding
This research was sponsored by grants from the National Institute on Alcohol Abuse and Alcoholism, including R21AA024926 (PI: Witkiewitz), T32AA018108 (PI: Witkiewitz), R01AA022328-06 (PI: Witkiewitz), F31AA028971 (PI: Stein), and F31AA029266 (PI: Votaw).
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BG assisted with the analysis, conceptualization, and data analyses and wrote the first draft of the manuscript. VV assisted with data analyses, writing of the manuscript, and data collection. ES assisted with writing and data collection. VP and EC collaborated with the design of the original study and editing of the manuscript. KW helped to conceptualize the present analysis, conducted data analyses, supervised the project, designed the original study, and edited the manuscript.
Note: Craving scores are from the Penn Alcohol Craving Scale and mindfulness scores are from the Toronto Mindfulness Scale. DPDD, drinks per drinking day. Post-treatment sample sizes for craving and mindfulness scores were 32 in the active tDCS group and 18 in the sham tDCS group.
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All procedures performed in the study were approved by the institutional review board at the University of New Mexico.
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Informed consent was obtained from all participants in the present study.
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VC is a Scientific Consultant for NeuroGeneces, Inc. The authors declare that they have no other conflicts of interest.
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Gibson, B.C., Votaw, V.R., Stein, E.R. et al. Transcranial Direct Current Stimulation Provides No Additional Benefit to Improvements in Self-Reported Craving Following Mindfulness-Based Relapse Prevention. Mindfulness 13, 92–103 (2022). https://doi.org/10.1007/s12671-021-01768-5
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DOI: https://doi.org/10.1007/s12671-021-01768-5