Differences in Trait Mindfulness Across Mental Health Symptoms Among Adults in Substance Use Treatment

Abstract

Mindfulness is a growing area of investigation among individuals manifesting substance use disorders, as mindfulness meditation may help to prevent relapse to substance use. The current study examined levels of trait mindfulness in substance users seeking treatment from May 2012 to August 2012 in a Tennessee residential center and whether patients with probable (i.e., diagnoses based on a self-report screening instrument) comorbid depression or PTSD reported lower mindfulness than patients without a probable comorbid diagnosis. Data were collected from a convenience sample of archival patient records (N = 125) and four instruments. The majority of patients were male (n = 84) and non-Hispanic Caucasian (92%); the mean age of the sample was 37.36 (SD = 12.47). Results showed that lower trait mindfulness was associated with increased levels of substance use, depression, and PTSD. Patients with a probable depression or PTSD diagnosis reported lower mindfulness than patients without these disorders. Patients with probable comorbid depression and PTSD reported the lowest levels of mindfulness. These findings suggest that altering levels of mindfulness may be important for individuals manifesting dual-diagnoses in substance user treatment. The study's limitations are noted.

Keywords :

• mindfulness
• substance use
• depression
• posttraumatic stress disorder
• treatment
• relapse

THE AUTHORS

Ryan C. Shorey, M.A., is a doctoral student in Clinical Psychology at the University of Tennessee-Knoxville. His research focuses primarily on intimate partner violence (IPV), particularly among dating couples, as well as the influence of substance use on IPV perpetration. He is also interested in the role of mindfulness-based interventions in improving substance use and IPV treatment outcomes.

Hope Brasfield, M.S., received her master's degree from the University of South Alabama and is currently a graduate student in Clinical Psychology at the University of Tennessee-Knoxville. Her research interests include interpersonal aggression, partner abuse, and the role of substance use in violence perpetration and victimization.

Scott E. Anderson, Ph.D., is Clinical Director at Cornerstone of Recovery in Louisville, Tennessee. He has worked as a Clinician and/or Consultant in a variety of settings during his career, including university counseling centers, chemical dependency treatment centers, private practice, and other agencies. He has over 25 years experience working in the field of addictions. He is particularly interested in merging research and clinical practice.

Gregory L. Stuart, Ph.D., is a Professor of Psychology at the University of Tennessee-Knoxville. He is an adjunct Professor of Psychiatry and Human Behavior at the Warren Alpert Medical School of Brown University and Director of Family Violence Research at Butler Hospital. His research has focused on the comorbidity of intimate partner violence and substance abuse. He is particularly interested in interventions that address both substance use and relationship aggression.

Notes

2 The reader is reminded that psychiatric diagnoses are the outcome of a checklisted consensual perception and judgment and are not empirically informed. A diagnostic process, in simplistic terms, permits the collection of necessary and relevant data/information in order to facilitate decision making. From a medical-treatment perspective, an useful diagnosis “offers,” minimally, three critical, necessary types of information: etiology, process, and prognosis…which are not always known. The relatively recent substance-use-disorder-related nosology, which relates as well to “dual diagnosis,” is inadvertently misleading in that any substance use and user, of whatever type(s) can be “tagged”/diagnosed in each area of his/her life: medically, psychiatrically, socially, gender identification, educationally, spiritually, morally, IQ, SES, ethnically, racially, legal-status, etc., depending upon the criteria used (whatever their underpinnings and validity) and the needs of the categorizers. Neither “substance use disorder” (in its variations) nor dual diagnosis, also in its variations offer, in a predictable sense, etiological, process, and prognostic information which can be or which are used for effective treatment planning, implementation, and evaluation of the range of heterogeneous drug users. Editor's note.

3 The reader is reminded that the concepts of “risk” or “vulnerability” factors,” as well as “protective factors,” are often noted in the literature, without adequately noting their dimensions (linear, nonlinear; rates of development; anchoring or integration, cessation, etc.), their “demands,” the critical necessary conditions (endogenously as well as exogenously; from a micro to a meso to a macro level) which are necessary for either of them to operate (begin, continue, become anchored, and integrate, change as de facto realities change, cease, etc.) or not to and whether their underpinnings are theory-driven, empirically based, individual, and/or systemic stake holder-bound, based upon “principles of faith,” doctrinaire positions, “personal truths,” historical observation, precedents and traditions that accumulate over time, conventional wisdom, perceptual and judgmental constraints, “transient public opinion,” or what. This is necessary to consider and to clarify if these terms are not to remain as yet additional shibboleth in a field of many stereotypes, tradition-driven activities, “principles of faith,” and stakeholder objectives. Editor's note.

4 A more generic unresolved issue relates to viable, measurable criteria for assessing when treatment, however delineated, is indicated, contraindicated, irrelevant, or even potentially harmful (iatrogenic-related harm) for a specific person or at a particular time or stage/level of adaptation and functioning in that person's life given his or her resources as well as limitations, life space, contexts, and situations. Editor's note.