Changing Impulsivity With Mindful Breathing Therapy to Reduce Problem Drinking (BBMT)
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|ClinicalTrials.gov Identifier: NCT02527720|
Recruitment Status : Completed
First Posted : August 19, 2015
Last Update Posted : September 13, 2019
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:
- 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;
- to investigate the feasibility and preliminary efficacy of applying BBMT for reducing problem drinking with a pilot randomized controlled trial (RCT);
- 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.
|Condition or disease||Intervention/treatment||Phase|
|Problem Drinking||Behavioral: Mindfulness Therapy||Not Applicable|
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||10 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||Changing Impulsivity With Mindful Breathing Therapy to Reduce Problem Drinking|
|Actual Study Start Date :||June 1, 2015|
|Actual Primary Completion Date :||August 1, 2016|
|Actual Study Completion Date :||December 1, 2016|
Experimental: Mindfulness Therapy
For the current study the investigators have developed a breathing-based, adapted for feasible application among SUD populations, and easy to carry out in clinical or non-clinical settings referred to as breathing-based mindfulness training (BBMT). BBMT is a simplified form of MM. Its core components are near resonance-frequency breathing (RFB), mindfulness training, positivity and inward attention (more details below).
Behavioral: Mindfulness Therapy
BBMT is a simplified form of MM. Its core components are near resonance-frequency breathing (RFB), mindfulness training, positivity and inward attention. A key component in BBMT is to be mindful of breathing whenever possible, and breathe at near resonance frequency (RF), known as heart rate variability biofeedback. The human cardiovascular system is known to have resonance characteristics, with the first RF at ~0.1 Hz. RF varies between 4.5 and 7 cycles per minute. Breathing at RF stimulates the cardiovascular system to oscillate at that frequency at a very high amplitude and greatly stimulates the baroreflex system. RFB is known to reduce depression and stress symptoms as well as various diseases related to malfunction of the autonomic nervous system, such as asthma and hypertension.
- Changes in substance use utilizing the Timeline Follow Back from the baseline to 3 months [ Time Frame: Weeks 1-8 and 3 month follow up ]Timeline Follow-back (TLFB) (C. Sobell & B. Sobell, 1992) will be used to record and track participants' recent (past 30 days and 7 days) alcohol-use as well as other drug use frequency. Alcohol-use and other drug use quantity will be recorded for each day on which use was reported. The TLFB method has been shown to have good reliability and validity in college students (Sobell et al., 1989)
- Audit [ Time Frame: Baseline ]Alcohol Use Diagnostic Identification Test (AUDIT) (Babor et al., 2004), has 10 items which assess frequency of drinking, typical quantity, frequency of heavy drinking, impaired control over drinking, increased salience of drinking, morning drinking, blackouts, and alcohol-related injuries within the past year. A total score of 8 or more has been found to indicate a strong likelihood of hazardous or harmful alcohol consumption
- Readiness to Change [ Time Frame: Baseline , Week 4 , Week 8, and 3 month Follow Up ]Readiness to Change: Drug and Alcohol version of SOCRATES (Miller & Tonigan, 1996) will be used to evaluate motivation for change
- Customary Drinking and Drug Use Record [ Time Frame: Baseline , Week 4 , Week 8, and 3 month Follow Up ]Customary Drinking and Drug Use Record (CDDR; Brown et al., 1998) measures lifetime alcohol use and problems to provide a baseline and examine the impact of treatment. The CDDR records age at first use and makes separate lifetime frequency use estimations for beer, wine, and distilled spirits. The CDDR has good reliability for assessing substance use behaviors among adolescents and young adults (Brown et al., 1998) and has been used specifically in college-student samples Doran et al., 2007)
- Barratt Impulsiveness Scale [ Time Frame: Baseline , Week 4 , Week 8, and 3 month Follow Up ]Barratt Impulsiveness Scale (BIS-11) , includes questions focusing on motor impulsivity (acting without thinking), cognitive impulsivity (making quick cognitive decisions), and future-planning impulsivity (lack of concern about the future), with good internal consistency (alpha = 0.89 to 0.92) and test-retest reliability (0.80). Mean plus one SD in total BIS score from UM study (M = 64; SD = 17) will be used to screen and select those with high impulsivity to be included in this study to assess possible change over time.
- UPPS Impulsive Behavioral Scale [ Time Frame: Baseline , Week 4 , Week 8, and 3 month Follow Up ]UPPS Impulsive Behavior scale (Whiteside & Lynam, 2001) assesses five personality pathways to impulsive behavior: negative urgency, positive urgency, (lack of) premeditation, (lack of) perseverance, and sensation seeking
- Delay Discounting of Hypothetical Money Gains [ Time Frame: Baseline , Week 4 , Week 8, and 3 month Follow Up ]Delay Discounting of Hypothetical Money Gains, is a computerized binary-choice procedure. On each trial, two outcomes will be presented on the screen: one is an amount of money available immediately; the other is a larger amount of money ($50, $1,000) available after some delay (1 week, 1 year, etc.). The computerized algorithm (Holt et al., 2003) will adjust the immediate outcome for each amount/delay pairing over 6 trials to determine an indifference point, resulting in 6 indifference points (corresponding to the 6 delays) for each of 2 amounts ($50, $1,000).
- Stop-Signal Task (SST) [ Time Frame: Baseline , Week 4 , Week 8, and 3 month Follow Up ]A personal computer will be used to conduct the SST, which presents two types of trials: GO and STOP. In GO trials, participants will respond with a keystroke as quickly as possible following the presentation of a visual go stimulus. In STOP trials (25% of all trials), an auditory stop signal will follow the presentation of the visual go signal. Subjects will be instructed to inhibit the go response on hearing the stop signal. The latency between onset of the go and stop signals will be titrated in the following manner: failure on a STOP trial will result in a 50ms increase in this latency, and success will result in a 50ms decrease. This method will converge on a latency, the stop signal delay (SSD) at which a participant succeeds on half of all STOP trials. After 16 GO practice trials, participants will complete five blocks of 64 trials.
- Spielberger State-Trait Anxiety Inventory (STAI): [ Time Frame: Baseline , Week 4 , Week 8, and 3 month Follow Up ]both trait and state anxiety will be measured monthly to monitor changes over time
- The Center for Epidemiological Studies Depression Scale (CES-D) [ Time Frame: Baseline , Week 4 , Week 8, and 3 month Follow Up ]The Center for Epidemiological Studies Depression Scale (CES-D) (Radloff, 1977) is a 20-item self-report inventory measuring mood and symptoms of depression.
- Perceived Stress Scale [ Time Frame: Baseline , Week 4 , Week 8, and 3 month Follow Up ]Perceived Stress Scale is a global measure of perceived stress in daily life (Chiang et al., 2005) designed to gauge the degree to which common situations are appraised as stressful
- Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004) [ Time Frame: Baseline , Week 4 , Week 8, and 3 month Follow Up ]Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004) is a well-validated 36-item, self-report questionnaire that assesses multiple aspects of emotion dysregulation. The DERS yields a total score that is comprised of scores on six subscales: nonacceptance of emotional responses, lack of emotional awareness, impulse control difficulties, difficulties engaging in goal directed behavior, lack of emotional clarity, and limited access to emotion regulation strategies.
- Five-Facet Mindfulness Questionnaire [ Time Frame: Baseline , Week 4 , Week 8, and 3 month Follow Up ]Five-Facet Mindfulness Questionnaire (FFMQ; Baer et al., 2006) is an instrument based on factor analysis of five independently developed mindfulness scales. The five factors appear to represent elements of mindfulness as it is currently conceptualized. The five facets are observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience. The FFMQ is one of the most popular scales used in study of mindfulness.
- Perceived Quality of Life Measure [ Time Frame: Baseline , Week 4 , Week 8, and 3 month Follow Up ]Perceived Quality of Life Measure (Burckhardt & Anderson, 2003) will be employed to assess general well-being. These measures will be given at baseline and every 4 weeks during treatment.
- Therapist adherence and competence [ Time Frame: Week 4, Week 8, and 3 month Follow Up ]Therapist adherence and competence. During the open trial all treatment sessions will be audio taped and rated by independent raters (e.g., not associated with treatment delivery) so as to assess therapist adherence to the treatment protocol. Specific therapist behaviors will be considered "prescribed" and "proscribed" (Waltz et al., 1993) in order to assure that BBMT and SC + PMR treatment are distinct. Drs. Chen and Lejuez will review 20% of the audiotapes to maintain reliability. If therapist drift from the protocol is detected, the problem will be discussed in staff meetings and corrected through supervision.
- The Program Evaluation Form [ Time Frame: Week 4, Week 8, and 3 month Follow Up ]he Program Evaluation Form is an 8-item self-report measure assessing participants' perceptions of and satisfaction with the treatment services.
- Working Alliance Inventory (WAI) [ Time Frame: Week 4, Week 8 ]he Working Alliance Inventory (WAI) (Horvath & Greenberg, 1989) will be used to assess therapeutic alliance. The WAI is a 36-item measure composed of items reflecting desirable aspects of the therapeutic relationship. Each item is assessed on a 7-point Likert scale ranging from 1 (never) to 7 (always), with higher scores indicating more positive therapeutic alliance.
- RFB or MM Feedback and Quality Assessment [ Time Frame: Weeks 1-8 and 3 month follow up ]RFB or MM Feedback and Quality Assessment: BBMT participants will report daily quantity and quality of RFB or MM practice
- Treatment Progress/Completion [ Time Frame: Week 8 ]Treatment Progress/Completion: A checklist for the therapist to document the proportion of training components being delivered and practiced by the end of week 8 facilitation.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02527720
|United States, Maryland|
|2103 Cole Field House|
|College Park, Maryland, United States, 20742|
|Principal Investigator:||Carl Lejuez, PhD||University of Maryland, College Park|