Retraining the addicted brain: a review of hypothesized neurobiological mechanisms of mindfulness-based relapse prevention.
Katie Witkiewitz, M Kathleen B Lustyk, Sarah Bowen
Psychology of Addictive Behaviors July 9, 2012 DOI: 10.1037/a0029258 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Randomized Peer reviewed |
|---|---|
| Intervention | Mindfulness-based relapse prevention (MBRP) |
| Topics | Meditation |
| Keywords | Brain Humans Substance-related disorders Chronic disease Treatment outcome Adaptation, psychological Behavior, addictive Awareness Neurobiology Secondary prevention |
| Key findings | The authors propose that MBRP, which integrates cognitive-behavioral relapse prevention with mindfulness meditation, may reduce relapse risk by altering neural responses to craving and negative affect. They cite a prior efficacy trial in which MBRP participants showed significantly lower substance use and greater craving decreases than controls, and no increase in craving or use after negative affect, and hypothesize that MBRP may reverse, repair, or compensate for addiction-related neuroadaptive changes. |
Abstract
Addiction has generally been characterized as a chronic relapsing condition (Leshner, 1999). Several laboratory, preclinical, and clinical studies have provided evidence that craving and negative affect are strong predictors of the relapse process. These states, as well as the desire to avoid them, have been described as primary motives for substance use. A recently developed behavioral treatment, mindfulness-based relapse prevention (MBRP), was designed to target experiences of craving and negative affect and their roles in the relapse process. MBRP offers skills in cognitive-behavioral relapse prevention integrated with mindfulness meditation. The mindfulness practices in MBRP are intended to increase discriminative awareness, with a specific focus on acceptance of uncomfortable states or challenging situations without reacting "automatically." A recent efficacy trial found that those randomized to MBRP, as compared with those in a control group, demonstrated significantly lower rates of substance use and greater decreases in craving following treatment. Furthermore, individuals in MBRP did not report increased craving or substance use in response to negative affect. It is important to note, areas of the brain that have been associated with craving, negative affect, and relapse have also been shown to be affected by mindfulness training. Drawing from the neuroimaging literature, we review several plausible mechanisms by which MBRP might be changing neural responses to the experiences of craving and negative affect, which subsequently may reduce risk for relapse. We hypothesize that MBRP may affect numerous brain systems and may reverse, repair, or compensate for the neuroadaptive changes associated with addiction and addictive-behavior relapse.
Comparable studies
Other narrative reviews on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical populations | 2003 | Review | |
| Mindfulness: Theoretical Foundations and Evidence for its Salutary Effects | 2007 | Review | |
| Mindfulness Interventions | 2016 | Review | |
| Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation | 2017 | Review | |
| Mindfulness and acceptance: expanding the cognitive-behavioral tradition | 2005 | Review |
Citations in the library
Cited by 28
- A narrative review of yoga and mindfulness as complementary therapies for addiction. Complementary Therapies in Medicine June 1, 2013
- Ultra-Brief Mindfulness Training Reduces Alcohol Consumption in At-Risk Drinkers: A Randomized Double-Blind Active-Controlled Experiment The International Journal of Neuropsychopharmacology July 28, 2017
- Mindfulness-based interventions for addictive behaviors: Implementation issues on the road ahead. Psychology of Addictive Behaviors October 26, 2017
- Immediate Effects of Mindful Awareness in Body-Oriented Therapy as an Adjunct to Medication for Opioid Use Disorder. Mindfulness November 1, 2024
- Efficacy of Mindfulness Meditation as a Therapeutic Tool in Problematic Pornography Consumption Sexual Health & Compulsivity October 2, 2023
and 23 more in the library
Cites 50
- Using Self-Report Assessment Methods to Explore Facets of Mindfulness Assessment January 27, 2006
- How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective Perspectives on Psychological Science October 14, 2011
- Meditation experience is associated with increased cortical thickness Neuroreport November 7, 2005
- Short-term meditation training improves attention and self-regulation Proceedings of the National Academy of Sciences October 11, 2007
- Meditation experience is associated with differences in default mode network activity and connectivity Proceedings of the National Academy of Sciences November 23, 2011
and 45 more in the library