Changing Impulsivity With Mindful Breathing Therapy to Reduce Problem Drinking
| Status: | Recruiting |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 30 |
| Updated: | 4/21/2016 |
| Start Date: | June 2015 |
| End Date: | August 2016 |
| Contact: | Carl Lejuez, PhD |
| Email: | clejuez@umd.edu |
| Phone: | 2405350467 |
The investigators plan to establish the efficacy of a novel breathing-based mindfulness
training (BBMT, a much simplified, easy-to-use version of standard MM) for problem drinking,
and test whether impulsivity mediates this effect among a sample of student problem drinkers
(i.e., > 8 on AUDIT, the problem drinking Screening Test). The specific aims of this pilot
study are as follows:
1. to modify and further develop the easy-to-use BBMT program for directly targeting
impulsivity to produce an indirect reduction in problem drinking among college
students;
2. to investigate the feasibility and preliminary efficacy of applying BBMT for reducing
problem drinking with a pilot randomized controlled trial (RCT);
3. to examine changes in impulsivity, as measured by both behavioral and self-report
assessments, as one of the possible mediators in the effect of BBMT on problem
drinking, with control for changes in perceived stress and anxiety.
training (BBMT, a much simplified, easy-to-use version of standard MM) for problem drinking,
and test whether impulsivity mediates this effect among a sample of student problem drinkers
(i.e., > 8 on AUDIT, the problem drinking Screening Test). The specific aims of this pilot
study are as follows:
1. to modify and further develop the easy-to-use BBMT program for directly targeting
impulsivity to produce an indirect reduction in problem drinking among college
students;
2. to investigate the feasibility and preliminary efficacy of applying BBMT for reducing
problem drinking with a pilot randomized controlled trial (RCT);
3. to examine changes in impulsivity, as measured by both behavioral and self-report
assessments, as one of the possible mediators in the effect of BBMT on problem
drinking, with control for changes in perceived stress and anxiety.
An efficacious strategy for addressing problem substance use among college student drinkers
is to target core risk factors. Arguably one of the most clearly documented risk factors for
problem drinking among college students is impulsivity, with the relationship holding across
various dimensions of impulsivity. Available evidence supports the importance of intervening
with impulsivity to limit problem drinking among college students, but there are few proven
treatments for any dimension of impulsivity. This notable lack may be due to the traditional
view of impulsivity as an unchangeable personality trait. However, recent research suggests
personality can change and is sensitive to behavior manipulation. As a result there is clear
need for novel approaches targeted at core changes in the individual and their behavior
patterns. Mindfulness meditation (MM) is a unique option in this direction as MM is
especially useful in reducing impulsive behaviors including problem drinking, but its exact
role in affecting different dimensions of impulsivity and in effecting change in problem
drinking has yet to be explored. Based on evidence from recent studies, as well as our own
pilot work, the investigators hypothesize that one of the mechanisms by which MM reduces
problem drinking among college students is by lessening impulsivity - moreover, the focus on
changing college student problem drinking is done without any explicit focus on drinking
behavior itself. The specific aims of this Stage 1 therapy development study are to: 1)
modify and further develop a breathing-based mindfulness therapy (BBMT) for reducing
impulsivity and problem drinking among college youth; 2) investigate the feasibility and
preliminary efficacy of applying BBMT for reducing problem drinking with a pilot randomized
controlled trial (RCT); 3) examine changes in impulsivity, as measured by both behavioral
and self-report assessments, as one of possible mediators in the observed effect of BBMT on
problem drinking. These aims will be achieved in two phases. In Phase 1 the investigators
will expand and fully develop the existing BBMT program with manuals to determine the
effective treatment dosage for both problem drinking and impulsivity in an open label trial
(n = 10). Using the modified treatment materials from Phase 1, in Phase 2 the investigators
will conduct a RCT comparing the effects of modified BBMT to a Supportive Counseling +
Progressive Muscle Relaxation (SC + PMR) control condition (n = 36 each) on problem
drinking, assessed at baseline, weeks 4 and 8, and a 3-month follow-up. Other potential
mediators such as perceived stress and anxiety also will be examined in the final model.
This study has great potential implications for reaching college students drinkers less
willing to acknowledge their drinking problems as it addresses a core vulnerability
(impulsivity) among at-risk students in a manner that limits stigma and may reduce
resistance to change. A diverse team experienced in mindfulness, impulsivity and behavior
therapy development has been assembled to conduct the proposed R34 project and prepare for a
full therapy development study in the future.
is to target core risk factors. Arguably one of the most clearly documented risk factors for
problem drinking among college students is impulsivity, with the relationship holding across
various dimensions of impulsivity. Available evidence supports the importance of intervening
with impulsivity to limit problem drinking among college students, but there are few proven
treatments for any dimension of impulsivity. This notable lack may be due to the traditional
view of impulsivity as an unchangeable personality trait. However, recent research suggests
personality can change and is sensitive to behavior manipulation. As a result there is clear
need for novel approaches targeted at core changes in the individual and their behavior
patterns. Mindfulness meditation (MM) is a unique option in this direction as MM is
especially useful in reducing impulsive behaviors including problem drinking, but its exact
role in affecting different dimensions of impulsivity and in effecting change in problem
drinking has yet to be explored. Based on evidence from recent studies, as well as our own
pilot work, the investigators hypothesize that one of the mechanisms by which MM reduces
problem drinking among college students is by lessening impulsivity - moreover, the focus on
changing college student problem drinking is done without any explicit focus on drinking
behavior itself. The specific aims of this Stage 1 therapy development study are to: 1)
modify and further develop a breathing-based mindfulness therapy (BBMT) for reducing
impulsivity and problem drinking among college youth; 2) investigate the feasibility and
preliminary efficacy of applying BBMT for reducing problem drinking with a pilot randomized
controlled trial (RCT); 3) examine changes in impulsivity, as measured by both behavioral
and self-report assessments, as one of possible mediators in the observed effect of BBMT on
problem drinking. These aims will be achieved in two phases. In Phase 1 the investigators
will expand and fully develop the existing BBMT program with manuals to determine the
effective treatment dosage for both problem drinking and impulsivity in an open label trial
(n = 10). Using the modified treatment materials from Phase 1, in Phase 2 the investigators
will conduct a RCT comparing the effects of modified BBMT to a Supportive Counseling +
Progressive Muscle Relaxation (SC + PMR) control condition (n = 36 each) on problem
drinking, assessed at baseline, weeks 4 and 8, and a 3-month follow-up. Other potential
mediators such as perceived stress and anxiety also will be examined in the final model.
This study has great potential implications for reaching college students drinkers less
willing to acknowledge their drinking problems as it addresses a core vulnerability
(impulsivity) among at-risk students in a manner that limits stigma and may reduce
resistance to change. A diverse team experienced in mindfulness, impulsivity and behavior
therapy development has been assembled to conduct the proposed R34 project and prepare for a
full therapy development study in the future.
Inclusion Criteria:
1. UM College Park students aged 18-30
2. AUDIT score of 8 or higher (Babor et al., 2004)
3. A total score on the Barratt Impulsiveness Scale of 73 or higher, which is the mean
plus half (1/2) standard deviation, (M=64; SD=17) (Patton et al., 1995)
4. A commitment to adhere to the study protocol with a weekly therapy meeting (about 40
minutes each), and an extra 1.5 to 2 hours for study data collection at week 4 and
week 8
5. No plan to move away from the UM campus area for next 2 months
Exclusion Criteria:
1. At current risk of suicide, including suicidal behavior or attempts in the past 30
days
2. A history of schizophrenia or other psychotic disorders
3. Current participation in other clinical studies of addiction or impulsive behavior
4. Severe physical and mental health problems
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