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The Application of Mindfulness-Based Cognitive Interventions in the Treatment of Co-occurring Addictive and Mood Disorders

Published online by Cambridge University Press:  07 November 2014

Kimberly Hoppes
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Abstract

This article reviews the theory, clinical application, and empirical findings on mindfulness–based cognitive therapy (MBCT) for mental health and addictive disorders. Expanding upon the research demonstrating the efficacy of cognitive-behavioral therapy (CBT) for addiction, this article develops and explores the rationale for combining mindfulness-based interventions with evidence-based CBTs in treating addictive disorders, with an emphasis on substance use disorders with co-occurring mood disorders.This article proposes that deficits in affect regulation — related to the behavioral and emotional effects of neurobiological changes that occur with longterm substance abuse — pose a unique set of challenges in early recovery. Prolonged use of addictive substances impairs the brain pathways to detach or maintain perspective in response to strong emotional states. In treating this affective dysregulation, which can contribute to the vulnerability to relapse in the early stages of recovery, the affect–regulation-specific focus of MBCT adds a valuable element to augment CBT for addiction. Summarizing magnetic resonance imaging and positron emission tomography findings on the effects of MBCT and the neurobiology of drug addiction, this article out-lines directions for further research on potential benefits of MBCT for the recovering individual. Finally, this article describes a structured protocol, developed at the Mount Sinai School of Medicine in New York City, which combines CBT with mindfulness-based intervention, for the treatment of affect-regulation issues specific to co-occurring addictive and mood disorders.

Type
Review Article
Information
CNS Spectrums , Volume 11 , Issue 11 , November 2006 , pp. 829 - 851
Copyright
Copyright © Cambridge University Press 2006

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References

REFERENCES

1. Rotgers, F, Morgenstern, J, Walters, ST, eds. Treating Substance Abuse: Theory and Technique. New York, NY: Guilford Press; 2003.Google Scholar
2. Carroll, KM, Connors, GJ, Cooney, NL, et al. Internal validity of project MATCH treatments discriminability and integrity. J Consult Clin Psychol. 1998;66:290–303.Google Scholar
3. Project MATCH Matching alcohol treatments to client heterogeneity. Post treatment drinking outcomes. J Stud Alcohol. 1997;58:7–29.Google Scholar
4. Brownell, KD, Marlatt, GA, Lichtenstein, E, Wilson, GT. Understanding and preventing relapse. Am Psychol. 1986;41:765–782.Google Scholar
5. Stratyner, HB. Carefrontation: utilizing engagement and motivation in the treatment of dually diagnosed individuals. Mental Health News. Winter, vol 2. no 1: 2000:24.Google Scholar
6. Morgenstern, J, Longabaugh, R. Cognitive-behavioral treatment for alcohol dependence: a review of evidence for its hypothesized mechanisms of action. Addiction. 2000;95:1475–1490.Google Scholar
7. McKay, M, Davis, M, Fanning, P. Taking Control of Your Moods and Your Life: A Thoughts and Feelings Workbook. New York, NY: MJF Books; 1997.Google Scholar
8. Beck, AT, Rush, AJ, Shaw, BF, Emery, G. Cognitive Therapy of Depression. New York, NY: Guilford Press; 1979.Google Scholar
9. Greenberger, D, Padesky, C. Mind over Mood: Change How You Feel by Changing the Way You Think. New York, NY: Guilford Press; 1995.Google Scholar
10. Segal, Z, Williams, J, Teasdale, J. Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York, NY: Guilford Press; 2002.Google Scholar
11. Kadden, R, Carroll, KM, Donovan, D, et al. Cognitive-Behavioral Coping Skills Therapy Manual: A Clinical Research Guide for Therapists Treating Individuals With Alcohol Abuse and Dependence. Rockville, Md: National Institute on Alcohol Abuse and Alcoholism; 1992.Google Scholar
12. Neuroscience of Psychoactive Substance Use and Dependence. World Health Organization: Geneva, Switzerland; 2004.Google Scholar
13. Raimo, EB, Schuckit, MA. Alcohol dependence and mood disorders. Addict Behav. 1998;23:933–946.Google Scholar
14. Kessler, RC, McGonagle, KA, Zhao, S, et. al. Lifetime and 12-month prevalence of DSM-IIIR psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51:8–19.Google Scholar
15. Volkow, N, Li, T. Drug addiction: the neurobiology of behavior gone awry. Neuroscience. 2004;5:963–969.Google Scholar
16. Wise, R. Neurobiology of addiction. Neurobiology. 1996;6:243–251.Google Scholar
17. Miller, WR, Rollnick, S. Motivational Interviewing—Preparing People to Change Addictive Behavior. New York, NY: Guilford Press; 1991.Google Scholar
18. Volkow, ND, Fowler, JS, Wang, GJ, Swanson, JM. Dopamine in drug abuse and addiction: results from imaging studies and treatment implication. Mol Psychiatry. 2004;9:557–569.Google Scholar
19. Volkow, ND, Fowler, JS, Wang, GJ. Role of dopamine in drug reinforcement and addiction in humans: results from imaging studies. Behav Pharmacol. 2002;13:355–366.Google Scholar
20. Volkow, ND, Fowler, JS, Wang, GJ. The addicted human brain: insights from imaging studies. J Clin Invest. 2003;111:1444–1451.Google Scholar
21. Lubman, DI, Yucel, M, Pantelis, C. Addiction: a condition of compulsive behavior? Neuroimaging and neuropsychological evidence of inhibitory dysregulation. Addiction. 2004;99:1491–1502.Google Scholar
22. Goldstein, RZ, Volkow, ND. Drug addiction and its underlying neurobiological basis: neuroimaging evidence for the involvement of the frontal cortex. Am J Psychiatry. 2002;159:1642–1652.Google Scholar
23. Spanagel, R, Heilig, M. Addiction and its science: addiction and its brain science. Addiction. 2005;100:1813.Google Scholar
24. Spanagel, R, Weiss, F. The dopamine hypothesis of reward: past and current status. Trends Neurosci. 1999;22:521–527.Google Scholar
25. Christie, C. The Addicted Brain. Jacksonville, FI: Professional Development Resources, Inc; 2000.Google Scholar
26. Bien, T, Bien, B. Mindful Recovery: A Spiritual Path to Healing From Addiction. New York, NY: John Wiley; 2002.Google Scholar
27. Witkiewitz, K, Marlatt, GA. Relapse prevention for alcohol and drug problems: that was Zen, this is Tao. Am Psychol. 2004;59:224–235.Google Scholar
28. Linehan, MM. Cognitive-Behavioral Treatment of Personality Disorder. New York, NY: Guilford Press; 1993.Google Scholar
29. Kabat-Zinn, J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness. New York, NY: Delacorte; 1990.Google Scholar
30. Kabat-Zinn, J, Massion, MD, Kristeller, J, et al. Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry. 1992;149:936–943.Google Scholar
31. Kabat-Zinn, J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. Gen Hosp Psychiatry. 1982;4:33–47.Google Scholar
32. Ma, SH, Teasdale, JD. Mindfulness-based cognitive therapy for depression replication and exploration of differential relapse prevention effects. Consult Clin Psychol. 2004;72:31–40.Google Scholar
33. Teasdale, J, Segal, Z, Williams, J, Ridgeway, V, Soulsby, J, Lau, MA. Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. J Consult Clin Psychol. 2000;68:615–623.Google Scholar
34. Hayes, S. Acceptance, mindfulness and science. Clin Psychol Sci Prac. 2002;9:101–106.Google Scholar
35. Hayes, S, Follette, V, Linehan, M. Mindfulness and Acceptance: Expanding the Cognitive-Behavioral Tradition. New York, NY: Guilford Press; 2004.Google Scholar
36. Kabat-Zinn, J, Wheeler, E, Light, T, et al. Influence of mindfulness meditation based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA). Psychosom Med. 1998;60:625–632.Google Scholar
37. Miller, JJ, Fletcher, K, Kabat-Zinn, J. Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. Gen Hosp Psychiatry. 1995;17:192–200.Google Scholar
38. Speca, M, Carlson, L, Goodey, E, Angen, M. A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosom Med. 2000;62:613–622.Google Scholar
39. Davidson, R, Kabat-Zinn, J, Schmacher, J, et al. Alterations in brain and immune function produced by mindfulness meditation. Psychosom Med. 2003;65:564–570.Google Scholar
40. Linehan, M, Dimenoff, L, Reynolds, S, et al. Dialetical behavioral therapy versus comprehensive validation therapy plus 12-step for the treatment of opoid dependent women meeting criteria for borderline personality disorder. Drug Alcohol Depend. 2002;67:13–26.Google Scholar
41. Linehan, MM, Armstrong, HE, Suarez, A, Allmon, D, Heard, HL. Cognitive-behavioral treatment of chronically suicidal borderline patients. Arch Gen Psychiatry. 1991;48:1060–1064.Google Scholar
42. Marlatt, GA. Buddhist philosophy and the treatment of addictive behavior. Cogn Behav Pract. 2002;9:44–49.Google Scholar
43. Bauer, RA. Mindfulness training as a clinical intervention: a conceptual and empirical review. Clin Psychol Sci Prac. 2003;10:125–143.Google Scholar
44. Kabat-Zinn, J. Mindfulness-based interventions in context: past, present, and future. Clin Psychol Sci Prac. 2003;10:144–156.Google Scholar
45. Kiecolt-Glaser, JK, Glaser, R, Graverstein, S, Marlarkey, WB, Sheridan, J. Chronic stress alters the immune response to influenza virus vaccine in older adults. Proc Natl Acad Sci U S A. 1996;93:3043–3047.Google Scholar
46. Kabat-Zinn, J, Lipworth, L, Burnery, R. The clinical use of mindfulness for the self-regulation of chronic pain. J Behav Med. 1985;8:163–190.Google Scholar
47. Kristeller, J, Hallet, C. An exploratory study of meditation-based intervention for binge eating disorder. J Health Psychol. 1999;4:357–363.Google Scholar
48. Lazar, S, Kerr, C, Wasserman, R, et al. Meditation experience is associated with increased cortical thickness. Neuroreport. 2005;16:1893–1897.Google Scholar
49. Lazar, SW, Bush, G, Gollub, RL, Fricchione, GL, Khalsa, G, Benson, H. Functional brain mapping of the relaxation response and meditation. Neuroreport. 2000;11:1581–1585.Google Scholar
50. Borkovec, TD, Costello, E. Efficacy of applied relaxation and cognitive-behavioral therapy in the treatment of generalized anxiety disorder. J Consult Clin Psychol. 1993;61:611–619.Google Scholar
51. Borkovec, T, Matthews, AM. Treatment of nonphobic anxiety disorders: a comparison of nondirective, cognitive, and coping desensitization therapy. J Consult Clin Psychol. 1988;56:877–884.Google Scholar
52. Barlow, DH. Long-term outcome to patients with panic disorder treated with cognitive-behavioral therapy. J Clin Psychiatry. 1990;51(suppl A):17–23.Google Scholar
53. Davidson RJ, . Emotion and affective style: hemispheric substrates. Psychol Sci. 1992;3:39–43.Google Scholar
54. Davidson, RJ, Ekman, P, Saron, CD, Senulis, JA, Friesen, WV. Approach/withdrawal and cerebral asymmetry: emotional expression and brain physiology. J Pers Soc Psychol. 1990;58:330–341.Google Scholar
55. Linehan, M, Schmidt, H, Dimeff, L, Craft, C, Kanter, S, Comois, K. Dialetical behavior therapy for patients with borderline personality disorder and drug-dependence. Am J Addict. 2002;8:279–292.Google Scholar
56. Bishop, SR, Lau, M, Shapiro, SL, Carlson, L, Anderson, ND. Mindfulness: a proposed operational definition. Clin Psychol Sci Prac. 2004;11:230–241.Google Scholar
57. Ingram, RE, Hollon, SD. Cognitive therapy for depression from an information processing perspective. In: Ingram, RE, ed. Information Processing Approached to Clinical Psychology. Orlando, FL: Academic Press; 1986:261–284.Google Scholar
58. Kabat-Zinn, J. Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. New York, NY: Hyperion; 1994.Google Scholar
59. Hayes, S, Feldman, G. Clarifying the construct of mindfulness in the context of emotion regulation and the process of change in therapy. Clin Psychol Sci Prac. 2004;11:255–262.Google Scholar
60. Walach, H, Buchheld, N, Buttenmüller, V, Kleinknecht, N, Schmidt, S. Measuring mindfulness—the Freiburg Mindfulness Inventory (FMI). Pers Individ Dif. 2006;40:1543–1555.Google Scholar
61. Watson, D, Clark, LA, Tellegen, A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988;54:1063–1070.Google Scholar