Effects of a brief mindfulness intervention on negative affect and urge to drink among college student drinkers.

Several theories have proposed that negative affect (NA) plays a large role in the maintenance of substance use behaviors - a phenomenon supported in laboratory-based and clinical studies. It has been demonstrated that mindfulness meditation can improve the regulation of NA, suggesting that mindfulness may be very beneficial in treating problematic substance use behavior. The current study tested whether a brief mindfulness meditation would lower levels of NA, increase willingness to experience NA, lower urges to drink, and increase time to next alcoholic drink in a sample of at-risk college student drinkers (N = 207). Participants were randomized to one of three brief interventions (mindfulness, relaxation, or control) followed by an affect manipulation (negative or neutral stimuli). Affect and urge were measured prior to intervention (Time 1 [T1]), after intervention but prior to affect manipulation (Time 2 [T2]), and immediately after the affect manipulation (Time 3 [T3]). Levels of mindfulness and relaxation were assessed from T1-T3. The additional measures of willingness to continue watching NA images and time to next alcoholic drink were examined at T3. Results indicated that the mindfulness intervention increased state mindfulness and relaxation, and decreased NA immediately following the mindfulness intervention. However, the mindfulness intervention did not influence responses to NA induction on any of the outcome variables at T3. One potential explanation is that the mindfulness intervention was not robust enough to maintain the initial gains made immediately following the intervention.

Differences between methamphetamine users and cocaine users in treatment.

To better understand the distinguishing characteristics of methamphetamine users versus cocaine users, we conducted a retrospective chart review of the 345 patients admitted to an outpatient stimulant treatment program during 1995--1997. Analyses revealed an increase in methamphetamine patients over the 3-year period, and that these patients were more likely than cocaine patients to be male, Caucasian, and gay or bisexual. Methamphetamine patients were also more likely to be HIV-positive, engage in behaviors such as using and sharing needles that place them at high risk for HIV transmission, have a psychiatric diagnosis, and be on psychiatric medications. The two populations did not differ in treatment adherence, as measured by clinic attendance, drug-free urines, and successful completion of treatment. These findings suggest that highly specialized substance abuse treatments for methamphetamine patients may not be needed. Resources may be directed toward addressing their medical and psychiatric diagnostic issues by providing ancillary services to stimulant treatment programs.

Testing the causal role of expectancies in smoking motivation and behavior.

The causal role of outcome expectancies in smoking motivation and behavior was tested in a laboratory experiment. Two expectancy manipulations-Health Consequences Expectancy Increase (HC) and Mood Management Expectancy Challenge (MM)-were crossed in a 2 x 2 factorial design. One hundred twenty-three heavy smokers were randomly assigned to the conditions and shown videotaped interviews of smokers and exsmokers followed by an interview that personalized the information. Both manipulations produced changes in targeted expectancies on at least one of two expectancy instruments. As predicted, only the HC manipulation produced increases in motivation to quit smoking and a reduction in smoking 3 months later. This study provides initial evidence that smoking expectancies play a causal role in smoking motivation, consistent with previous research with alcohol.

Drug abuse treatment as an HIV prevention strategy: a review.

We review drug abuse treatment as a means of preventing infection with HIV. Thirty-three studies, with an aggregate of over seventeen thousand subjects, were published in peer-reviewed journals from 1988-1998. Research on the utility of drug abuse treatment as an HIV prevention strategy has focused primarily on methadone maintenance treatment (MMT) rather than other modalities such as residential or outpatient drug-free treatment. Recent research provides clear evidence that MMT reduces HIV risk behaviors, particularly needle-use, and strong evidence that MMT prevents HIV infection. There is less definitive evidence that MMT reduces needle-sharing and unsafe sexual behavior, or that other treatment modalities prevent HIV infection. Future research should take into account patient self-selection processes and investigate other treatment modalities for heroin and stimulant abuse to determine their effects on HIV risk behaviors and HIV infection.

Programmed therapeutic messages as a smoking treatment adjunct: reducing the impact of negative affect.

Maintaining treatment gains remains a challenge to smoking cessation programs. Smokers prone to negative affect are most likely to relapse. In an effort to improve maintenance, a standard cognitive-behavioral treatment was supplemented with the provision of computer-controlled audiotape players containing personalized therapeutic messages. Either the standard treatment alone, or the standard treatment plus 2 months use of the tape player were provided to 41 smokers. No outcome difference was found between the 2 conditions during the 1-year follow-up. (The combined 1-year abstinence rate was 61%, with 34% continuously abstinent.) The frequency with which participants used the device predicted both posttreatment coping skill use and smoking rate. Most notable was an interaction between treatment condition and negative affect. Provision of the devices negated or reversed the usual association between negative affect and poorer outcome.