Mindfulness for Alcohol Abusing Offenders

The pernicious link between substance abuse and criminal behavior imposes major costs to
society, totaling billions of dollars in the U.S. annually. There is a critical need for more
effective interventions to counteract the high rates of relapse and recidivism in alcohol and
substance abusing criminal offenders. Periods of offender incarceration provide a unique
opportunity to develop and deploy such interventions. Progress in intervention development
could be achieved by targeting specific cognitive and affective vulnerabilities that are
common among substance abusing criminal offenders. Preliminary studies suggest that
meditative or mindfulness interventions may confer significant psychological and behavioral
benefits to inmates. However, the mechanisms and extent of intervention efficacy are unclear,
as these previous studies have been beset by a number of methodological limitations.
Moreover, to date no study has examined the neurobiological mechanisms that relate to
treatment success in this population. NIAAA has recently made a program call to address these
issues (PA-15-299). Here we answer this program call and propose to undertake a rigorous and
comprehensive longitudinal study of mindfulness treatment of alcohol and substance use
disorders among female inmates. This project will randomly assign over 400 female inmates to
a mindfulness or relapse prevention training course, and both will be compared against a no
treatment control. The mindfulness intervention will be tailored to address two key
neuropsychological deficits in alcohol abusing criminal offenders: impulsivity and craving.
We will test hypotheses about the neural changes over time with treatment to elucidate
mechanisms of change. We will obtain estimates of "real-world" efficacy of the intervention
by collecting outcome measures in prison (conduct reports) and following release (alcohol use
relapse and antisocial behavior). This project takes advantage of a unique, longstanding
partnership between the research team and the states of New Mexico and Wisconsin Correction
Departments that allows collection of comprehensive assessment data from inmates during
incarceration, including brain imaging data with a mobile MRI scanner, as well as access to
post-release outcomes and relapse data. Completion of these aims is a critical step for
implementing and evaluating a promising mindfulness intervention for this high-risk
population. The proposed research will also begin to elucidate the psychological and
neurobiological mechanisms of the treatment. These results will thus significantly advance a
program of research seeking to translate the growing knowledge of neuropsychological deficits
into more targeted and effective treatments for alcohol and substance abuse problems in
criminal offenders.

Inclusion Criteria:

- 18-65 years of age

- Alcohol Use Disorder

- Female (biological sex at birth)

- Time to release from incarceration > 3 months < 24 months

- 5th grade or higher reading level

- Able to speak and understand English

Exclusion Criteria:

- Uncorrectable auditory or visual deficits

- Intelligence Quotient score below 70

- History of serious head injury with loss of consciousness and ongoing soft signs, or
positive radiology MRI read for significant brain damage

- History of dementia or other cognitive disability

- Current psychotic disorder

- Currently taking antipsychotic medication

- Major medical illness or Central Nervous System disease

- MRI incompatibility (e.g., metal in body)