Sanger and Dorjee produced strong neuropsychological evidence for the positive effects of mindfulness practice in adolescence. This could reduce the risk of relapse in SUD patients. This opens opportunities for modifying reactions instead of following established stimulus–response behaviors, which may involve modifying unpleasant sensations or emotions with substance use. Mindfulness practice can help people to become aware of craving and substance use habits. Mindfulness brings attention to highly automated and minimally controlled habits, which are often involved in craving and substance use relapse. Initial neuroimaging and clinical studies provide evidence that mindfulness skills can help SUD patients.
Mindfulness skills are associated with cognitive and affective stability and flexibility, adaptive coping, and reduced cue-reactivity towards stress-induced cravings.
#MTASA CENTERED WINDOW FULL#
Mindfulness is defined as bringing full awareness to present-moment experiences in an accepting, non-judgmental, and open-minded way.
Preliminary evidence from research-informed treatments links self-regulatory models of SUD to mindfulness-based approaches, because mindfulness targets several aspects of self-regulation. However, the findings on SUD mechanisms have barely been translated into treatment programs, which may be a reason for the limited success of SUD treatment in minors. The research into mechanisms focuses on self-regulatory processes, specifically, motivational aspects such as reward responsiveness, delay discounting, and impulsivity. In recent years, there has been significant research on (neuro-)biological mechanisms for the development of substance use in minors. Specific research on SUD patients who are minors is scarce, but would be greatly desirable. Relapse rates range between 50% and 81% across various delivery modes, such as highly structured outpatient settings, inpatient settings, and combined psychotherapeutic and pharmacological treatments. In essence, SUDs in children and adolescents are an enormous public health burden.Īlthough progress has been made for both access to and availability of pharmacological and psychotherapeutic SUD treatments, current research on the effects of treatment in SUD patients for various age groups shows disappointing results. National health report data show that 34% of patients with substance dependence are younger than 25 years and about 35,000 patients under 20 years receive costly inpatient treatment due to diagnoses relating to “mental or behavioral disorders due to psychoactive substance use” (ICD-10, chapter F10-F19). Cannabis abuse was reported by 5.5% and cannabis dependence by 2.2% in the same sample. Prevalence rates of SUDs in children and adolescents from population-based samples have not yet been measured in Germany, but some previous research allows for estimates: 10 to 15% of German males aged 14–24 were found to have alcohol dependence or misuse according to DSM-IV criteria. Specifically, when individual substance use patterns exacerbate, the risks for negative health and psychosocial outcomes increase. Adolescence is a vulnerable period for the development of substance use disorders (SUDs). The use of alcohol and illegal drugs and their associated detrimental health outcomes amount to 19.737 disability adjusted life years (DALYs) in Europe. Mindfulness, impulsivity, and emotion regulation will be analyzed as possible mediators of treatment effects.
Secondary outcomes include craving, severity of dependence, and abstinence motivation. The primary outcome is substance use in the past 30 days at follow-up based on the Timeline Followback self-report. Participants in the intervention group will receive mindfulness-based group psychotherapy in addition to their existing treatment regime.
#MTASA CENTERED WINDOW TRIAL#
The study is a prospective randomized controlled multi-center trial in which patients are assessed: (1) after completing a prior detoxification phase ( t 0), (2) at 4 weeks ( t 1), (3) at 8 weeks ( t 2), and (4) at 6 months after t 2 ( t 3). There will be N = 340 participants aged between 13 and 19 years who are receiving child or adolescent psychiatric or psychotherapeutic inpatient or day treatment targeting their SUD and who have reported substance use 30 days before detoxification and do not show acute psychotic or suicidal symptoms at baseline.
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