Abstract
The therapeutic effect of mindfulness interventions on problematic drinking is thought to be driven by increased resilience to the impact of stress on negative mood and alcohol-seeking behaviour, but this claim needs empirical support. To address this hypothesis, the current study tested whether brief training of one component of mindfulness – breath counting – would reduce drinkers’ sensitivity to the effect of noise stress on subjective mood and alcohol-seeking behaviour. Baseline alcohol-seeking was measured by choice to view alcohol versus food thumbnail pictures in 192 student drinkers. Participants then received a 6-minute audio file which either trained breath counting or recited a popular science extract, in separate groups. All participants were then stressed by a loud industrial noise and alcohol-seeking was measured again simultaneously to quantify the change from baseline. Subjective mood was measured after all three stages (baseline, post intervention, post stress test). The breath counting group were instructed to deploy this technique during the stress test. Results showed that the breath counting versus control intervention improved subjective mood relative to baseline, attenuated the worsening of subjective mood produced by stress induction, and accelerated recovery from a stress induced increase in alcohol-seeking behaviour. Exploratory moderation analysis showed that this accelerated recovery from stress induced alcohol-seeking by breath counting was weaker in more alcohol dependent participants. Mindfulness therapies may improve problematic drinking by increasing resilience to stress induced negative mood and alcohol-seeking, as observed in this study. The weaker therapeutic effect of breath counting in more dependent drinkers may reveal limitations to this intervention strategy.
Highlights
Negative affective states play a major role in triggering problematic drinking and relapse (Baker, Piper, McCarthy, Majeskie, & Fiore, 2004)
Results showed that the breath counting versus control intervention improved subjective mood relative to baseline, attenuated the worsening of subjective mood produced by stress induction, and accelerated recovery from a stress induced increase in alcohol-seeking behaviour
Contrasts of baseline versus post intervention timepoints indicated that breath counting significantly increased happiness, F(1,92) = 13.76, p < .001, ηp2 = 0.130, whereas the control intervention decreased happiness, F(1,94) = 20.73, p < .001, ηp2 = 0.181. These analyses suggest that breath counting compared to the control intervention increased happiness after the intervention, and protected from a stress induced decrease in happiness in the stress test
Summary
Negative affective states play a major role in triggering problematic drinking and relapse (Baker, Piper, McCarthy, Majeskie, & Fiore, 2004). Available studies are equivocal as to whether mindfulness training attenuates craving responses to negative triggers, and there is no obvious methodological parameter that distinguishes the positive from the negative findings To address these uncertainties, the current study tested whether one specific element of mindfulness therapy – breath counting (attention directed to breathing) – would attenuate stress-induced increases in alcohol-seeking behaviour, and subjective negative affect, measured in the lab. It was predicted that in the control group stress induction would increase alcohol choice and annoyance and decrease happiness, and that these induction effects would be attenuated in the breath counting group These data would support the hypothesis that mindfulness interventions achieve therapeutic impact on substance use outcomes by building resilience to acute stress triggers, and that brief breath counting training may have therapeutic potential in its own right
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