Mediating Effects of Thought Suppression in the Relationship Between Mindfulness and Substance Use Craving

Abstract Background: Substance use disorder (SUD) is a significant issue in the United States, characterized by chronic relapse following periods of abstinence. One of the primary precursors to relapse is craving. Findings from several studies have shown a negative association between trait mindfulness and craving in clinical samples; however, further research is needed to understand mechanisms underlying this relationship. Purpose/Objectives: The current study assessed thought suppression as a partial mediator of the relationship between trait mindfulness and craving. Methods: The current study used data from a previous randomized controlled trial of adults (N = 244) enrolled in community-based treatment for substance use disorder (SUD). Results: Analyses showed a significant moderate positive association between thought suppression and craving, a significant moderate negative association between thought suppression and trait mindfulness, and a significant moderate negative association between trait mindfulness and craving. Subsequent analyses confirmed a partial mediating role of thought suppression in the relationship between trait mindfulness and craving, indicating the inverse relationship between trait mindfulness and craving was partially explained by thought suppression. Conclusions/importance: These findings may inform treatment for SUD. Specifically, targeting thought suppression through mindfulness-based treatment approaches may be a mechanism through which craving can be reduced.

[1]  P. Fitzgerald,et al.  Mindfulness Meditators Show Enhanced Accuracy and Different Neural Activity During Working Memory , 2020 .

[2]  M. Greene,et al.  How Many Recovery Attempts Does it Take to Successfully Resolve an Alcohol or Drug Problem? Estimates and Correlates From a National Study of Recovering U.S. Adults , 2019, Alcoholism, clinical and experimental research.

[3]  E. Garland,et al.  Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research , 2018, Addiction Science & Clinical Practice.

[4]  Meagan J. Brem,et al.  Experiential avoidance, distress tolerance, and substance use cravings among adults in residential treatment for substance use disorders , 2017, Journal of addictive diseases.

[5]  E. Garland,et al.  Thought suppression as a mediator of the association between depressed mood and prescription opioid craving among chronic pain patients , 2016, Journal of Behavioral Medicine.

[6]  James Allen,et al.  To suppress, or not to suppress? That is repression: controlling intrusive thoughts in addictive behaviour. , 2015, Addictive behaviors.

[7]  Fuschia Serre,et al.  Ecological momentary assessment in the investigation of craving and substance use in daily life: a systematic review. , 2015, Drug and alcohol dependence.

[8]  Sarah Bowen,et al.  Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders: a randomized clinical trial. , 2014, JAMA psychiatry.

[9]  Adam W. Hanley,et al.  Cognitive and Affective Mechanisms Linking Trait Mindfulness to Craving Among Individuals in Addiction Recovery , 2014, Substance use & misuse.

[10]  G. Stuart,et al.  Differences in Trait Mindfulness Across Mental Health Symptoms Among Adults in Substance Use Treatment , 2014, Substance use & misuse.

[11]  D. Strong,et al.  Craving predicts opioid use in opioid-dependent patients initiating buprenorphine treatment: A longitudinal study , 2014, The American journal of drug and alcohol abuse.

[12]  S. Bowen,et al.  Relationship between dispositional mindfulness and substance use: findings from a clinical sample. , 2014, Addictive behaviors.

[13]  A. Hayes.  Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach , 2013 .

[14]  L. Lander,et al.  The Impact of Substance Use Disorders on Families and Children: From Theory to Practice , 2013, Social work in public health.

[15]  A. R. Lang,et al.  Affect and craving: positive and negative affect are differentially associated with approach and avoidance inclinations. , 2013, Addictive behaviors.

[16]  James R McKay,et al.  Development and initial evaluation of the Brief Addiction Monitor (BAM). , 2013, Journal of substance abuse treatment.

[17]  K. Witkiewitz,et al.  Mindfulness-based relapse prevention for substance craving. , 2013, Addictive behaviors.

[18]  E. Garland,et al.  Differential roles of thought suppression and dispositional mindfulness in posttraumatic stress symptoms and craving. , 2013, Addictive behaviors.

[19]  Joshua C. Magee,et al.  Psychopathology and thought suppression: a quantitative review. , 2012, Clinical psychology review.

[20]  S. Tiffany,et al.  The clinical significance of drug craving , 2012, Annals of the New York Academy of Sciences.

[21]  E. Garland,et al.  Thought suppression, impaired regulation of urges, and Addiction-Stroop predict affect-modulated cue-reactivity among alcohol dependent adults , 2012, Biological Psychology.

[22]  E. Garland,et al.  Trait Mindfulness Predicts Attentional and Autonomic Regulation of Alcohol Cue-Reactivity. , 2011, Journal of psychophysiology.

[23]  C. Boettiger,et al.  Targeting cognitive-affective risk mechanisms in stress-precipitated alcohol dependence: an integrated, biopsychosocial model of automaticity, allostasis, and addiction. , 2011, Medical hypotheses.

[24]  M. Antony,et al.  Coping with Cigarette Cravings: Comparison of Suppression Versus Mindfulness-Based Strategies , 2011 .

[25]  E. Bohlmeijer,et al.  Does Experiential Avoidance Mediate the Effects of Maladaptive Coping Styles on Psychopathology and Mental Health? , 2010, Behavior modification.

[26]  K. Witkiewitz,et al.  Depression, craving, and substance use following a randomized trial of mindfulness-based relapse prevention. , 2010, Journal of consulting and clinical psychology.

[27]  S. Tiffany,et al.  The continuing conundrum of craving. , 2009, Addiction.

[28]  D. Wegner,et al.  Hidden Complications of Thought Suppression , 2009 .

[29]  M. Paulus.  Neural basis of reward and craving - a homeostatic point of view , 2007, Dialogues in clinical neuroscience.

[30]  K. Witkiewitz,et al.  The role of thought suppression in the relationship between mindfulness meditation and alcohol use. , 2007, Addictive behaviors.

[31]  E. Garland.  The Meaning of Mindfulness: A Second-Order Cybernetics of Stress, Metacognition, and Coping , 2007 .

[32]  S. McMain,et al.  An Information-Processing Analysis of Mindfulness: Implications for Relapse Prevention in the Treatment of Substance Abuse , 2006 .

[33]  Gregory T. Smith,et al.  Using Self-Report Assessment Methods to Explore Facets of Mindfulness , 2006, Assessment.

[34]  J. Kabat-Zinn,et al.  Mindfulness-Based Interventions in Context: Past, Present, and Future , 2003 .

[35]  J. Marsden,et al.  Factors associated with abstinence, lapse or relapse to heroin use after residential treatment: protective effect of coping responses. , 2002, Addiction.

[36]  S. Shiffman,et al.  The measurement of drug craving. , 2000, Addiction.

[37]  J. Volpicelli,et al.  Psychometric properties of the Penn Alcohol Craving Scale. , 1999, Alcoholism, clinical and experimental research.

[38]  R. Horselenberg,et al.  Individual differences in thought suppression. The White Bear Suppression Inventory: factor structure, reliability, validity and correlates. , 1996, Behaviour research and therapy.

[39]  B Powis,et al.  The Severity of Dependence Scale (SDS): psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users. , 1995, Addiction.

[40]  D. Wegner,et al.  Chronic thought suppression. , 1994, Journal of personality.

[41]  K. Berridge,et al.  The neural basis of drug craving: An incentive-sensitization theory of addiction , 1993, Brain Research Reviews.

[42]  C. Johanson,et al.  Craving: consensus of status and agenda for future research. , 1992, Drug and alcohol dependence.

[43]  A Thomas McLellan,et al.  Substance Misuse and Substance use Disorders: Why do they Matter in Healthcare? , 2017, Transactions of the American Clinical and Climatological Association.

[44]  Amanda J Quisenberry,et al.  Computerized Working-Memory Training as a Candidate Adjunctive Treatment for Addiction , 2014, Alcohol research : current reviews.

[45]  W. Martin,et al.  Thought Suppression and Mindfulness : A Randomized Controlled Study , 2013 .

[46]  H. Merckelbach,et al.  Suppression of intrusive thoughts and working memory capacity in repressive coping. , 2007, The American journal of psychology.

[47]  S. Hayes,et al.  Experimental avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. , 1996, Journal of consulting and clinical psychology.

[48]  D M Wegner,et al.  Paradoxical effects of thought suppression. , 1987, Journal of personality and social psychology.