Baseline patterns of substance use disorder severity and depression and anxiety symptoms moderate the efficacy of mindfulness-based relapse prevention.

Roos, Corey R.; Bowen, Sarah; Witkiewitz, Katie

doi:10.1037/ccp0000249

Cited by 94Substance Abuse Treatment and OutcomesMindfulness and Compassion InterventionsOpioid Use Disorder Treatment

Baseline patterns of substance use disorder severity and depression and anxiety symptoms moderate the efficacy of mindfulness-based relapse prevention.

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Roos, Corey R., Bowen, Sarah, Witkiewitz, Katie·2017·Journal of Consulting and Clinical Psychology

DOI 10.1037/ccp0000249PMC PMC5679292

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Abstract

OBJECTIVE: Few studies have evaluated moderators of mindfulness-based relapse prevention (MBRP) for substance use disorders (SUDs). We tested whether baseline patterns of scores for SUD symptom severity and depression and anxiety symptoms moderated the efficacy of MBRP. METHOD: We used a latent class moderation approach with data from a randomized trial of MBRP compared to cognitive-behavioral relapse prevention and treatment as usual (TAU; Bowen et al., 2014; N = 286, 71.8% male, 48.4% non-White, mean age = 38.44 years, SD = 10.92) and a randomized trial comparing MBRP to TAU (Bowen et al., 2009; N = 168, 63.7% male, 44.6% non-White, mean age = 40.45, SD = .28). Indicators for the latent class models were measures of SUD severity (Severity of Dependence Scale and Short Inventory of Problems), depression symptoms (Beck Depression Inventory), and anxiety symptoms (Beck Anxiety Inventory). RESULTS: In both trials, 3 latent classes provided the best fit: a high-high class characterized by high SUD severity and depression and anxiety symptoms, a high-low class characterized by high SUD severity and low depression and anxiety symptoms, and a low-low class characterized by low SUD severity and depression and anxiety symptoms. In both trials, we found significant latent Class × Treatment interaction effects: There were significant and large effects of MBRP on substance use outcomes in the high-high and high-low classes, but no MBRP effect in the low-low class. CONCLUSION: MBRP may be an optimal treatment for preventing relapse among clients with severe levels of SUD symptoms and depression and anxiety symptoms, as well as clients with only severe SUD symptoms. (PsycINFO Database Record

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The findings are consistent with several studies showing superior effects of mindfulness-based interventions for individuals with greater baseline symptom severity, more complex presentations, and/or greater baseline vulnerability.
“Although these sub-analyses involved small sample sizes, the findings are consistent with several studies showing the superior effects of mindfulness-based interventions for individuals with greater baseline symptom severity (Arch & Ayers, 2013; Roos et al., 2017) more complex presentations (e.g., Wolitzky-Taylor et al., 2012) and/or greater baseline 'vulnerability' (e.g., greater childhood trauma”
From A randomised trial comparing a brief online delivery of mindfulness-plus-values versus values only for symptoms of depression: Does baseline severity matter? (2020) · cites this paper as Roos et al., 2017
The only study of MBI moderators for addiction outcomes is a secondary analysis of data from two RCTs of MBRP, which found that patients with greater substance use disorder severity and more affective symptoms received significantly greater benefit from mindfulness training than patients with low levels of substance use and affective symptoms.
“The only study of MBI moderators for addiction outcomes is a secondary analysis of data from two RCTs of MBRP, which found that patients with greater substance use disorder severity and more affective symptoms received significantly greater benefit from mindfulness training than patients with low levels of substance use and affective symptoms [72].”
From Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research (2018) · cites this paper as [72]

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Authors: Roos, C. R., Bowen, S., & Witkiewitz, K.
Affiliations: University of New Mexico (US)
Pacific University (US)
ORCID: Roos, Corey R.
Bowen, Sarah
Witkiewitz, Katie
Venue: Journal of Consulting and Clinical Psychology
Publisher: American Psychological Association (APA)
Published: 2017-11
Volume: 85
Issue: 11
Pages: 1041-1051
ISSN: 0022-006X (ISSN-L)
1939-2117
DOI: 10.1037/ccp0000249
PMC: PMC5679292
OpenAlex: W2765330385
Cited by: 92
References: 40
Citations by year: 2026: 8 · 2025: 8 · 2024: 8 · 2023: 9 · 2022: 8 · 2021: 16 · 2020: 18 · 2019: 11 · 2018: 5 · 2017: 1
FWCI: 7.50
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: other-oa
www.apa.org/pubs/journals/resources/open-access.aspx (am, 363 d)
Locations: Journal of Consulting and Clinical Psychology (publishedVersion, other-oa)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (1T32 AA0018108-01A1)
National Institute on Alcohol Abuse and Alcoholism (T32-AA018108)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords: mindfulness-based relapse prevention, substance use disorders, relapse prevention, depressive symptoms, anxiety symptoms, treatment moderators, latent class analysis, usual care, treatment effect heterogeneity
MeSH terms: Adult, Anxiety, Depression, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Severity of Illness Index, Cognitive Behavioral Therapy, Treatment Outcome, Substance-Related Disorders, Secondary Prevention, Mindfulness

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Baseline patterns of substance use disorder severity and depression and anxiety symptoms moderate the efficacy of mindfulness-based relapse prevention.

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