Effectiveness of combined therapy of the matrix model and mindfulness-based stress reduction" on rumination, emotional regulation, and reducing relapse in drug addicts"

Dissertation for M.A

Field: Psychology, Major: Clinical

Abstract

A common problem in substance abuse disorders is the relapse of drug use even among treated people, which is more applicable to the drug glass. On the other hand, mindfulness is a cognitive structure that can be monitored and intervened in psychology. The main goal of this research was to evaluate the effectiveness of the combined treatment of the common matrix model and "mindfulness-based stress reduction" (MBSR) on rumination, emotional regulation, mindfulness, and the rate of drug relapse. With the purposeful sampling method and after group matching, 54 subjects were randomly selected and randomly placed in three equal groups of integration, mindfulness, and matrix (control). Three questionnaires were completed by all three groups before and after completing the 8-week MBSR training program. Rumination was measured with the rumination questionnaire, emotional regulation with the emotional regulation difficulty scale, mindfulness with the mindfulness scale, and relapse rate with the methamphetamine diagnostic test. Univariate analysis of covariance and Wilcoxon tests were used to analyze the data. The results showed a significant decrease in rumination (p < 0.01), emotional regulation difficulties (p < 0.001), relapse rate (p < 0.04), and a significant increase in mindfulness (p < 0.035) in the integrated group compared to the control group, while in the mindfulness only group, the decrease in relapse was not significant compared to the control group (p < 0.6), which means that hypothesis 7 was rejected, although other The variables had similar changes. Despite the rejection of the mentioned hypothesis, an alternative model was proposed, which means that a new mechanism resulting from the combination of the matrix model and MBSR treatment leads to a greater reduction in relapse in the combined group compared to the control group. This finding indicates that MBSR treatment is a useful factor but not a sufficient factor to target drug relapse. In other words, the present study provides evidence of the value of integrating MBSR therapy in drug abuse treatments, that is, it reveals a potential mechanism of change through integrative therapy.

Key words: integration, mindfulness, matrix model, rumination, emotion regulation

Introduction

Dependence disorder or substance abuse, which has become a social harm in recent years, is a chronic and recurrent disorder. which has heavy costs for the individual, family and society. With the increasing use of all kinds of drugs, there is an urgent need for more research in the field of preventing drug use or relapse. The United Nations Drug Control and Crime Prevention Organization recently reported that more than two hundred million people around the world are currently using drugs, and the organization states that the global drug-related problem continues as most countries report an increase in drug use rather than a decrease (Appel and Kim-Appel, 2009; Zagirska et al., 2009).  

"Methamphetamine[4], also known as "Meth"[5], "Crystal"[6], or "Speed"[7], is a nervous system stimulant and a derivative of amphetamine[8] that was widely prescribed in the 1950s and 1960s as a medication for depression and obesity" (Angelina[9] et al., 2000, p. 1). Current statistics have estimated the increasing increase in the abuse of methamphetamine more than other substances, for example, statistics show that there are more than 42 million chronic users of methamphetamine worldwide, while there are about 15 million and 10 million chronic users of heroin [10] and cocaine [11], respectively (Saldanao Barker [12], 2004). In Iran, in recent years, the pattern of drug consumption has changed to a great extent, and drug abusers try new drugs such as methamphetamine, crack, etc. are In Iran, the crystallized form of methamphetamine (ice), known as "glass", is one of the substances that has been heavily abused recently. According to Naranjeha [13] et al. (2005), the frequency of "glass" consumption in Iran is 2.5% of all users.

Although some initial treatments for drug addiction have been effective in the short term, they have shown a high rate of relapse after treatment. Therefore, "substance abuse disorders" [14] have been described as "disorders with chronic relapse" [15] with a relapse rate of more than 60% (Miller [16] et al., 2001).On the other hand, according to Rosen[17] et al., (2006), a review of past studies shows that the effectiveness of drug maintenance treatments without psycho-social interventions is weak due to low drug compliance[18] and a high dropout rate[19], and 20 to 90% of addicts who are treated relapse. The term "disorders with chronic relapse" applies to drugs such as methamphetamine more than other substances, one of the reasons is that for the treatment of addiction to amphetamines, including methamphetamine, which is a subgroup of these compounds, there is no specific drug treatment such as methadone [20] or buprenorphine [21] (in opioids).

In response to the high rate of drug relapse, including methamphetamine, other new treatments have been invented The introduction of mindfulness-based treatments into the world of therapy has prepared the ground for this treatment to enter the field of drug abuse. In the third wave of psychotherapies [22], which are known as postmodern psychotherapies, they combine traditional cognitive-behavioral techniques with mindfulness (Hayes [23] et al., 2006). Today, third wave psychotherapy treatments emphasize people's awareness and acceptance of feelings, emotions, cognitions, and behaviors (basic elements in mindfulness) instead of challenging cognitions.

Mindfulness has been noticed in the West since the 1970s, since then more than 240 programs based on mindfulness have been conducted in North America and Europe (Kayon [24], 2011). The most common method of teaching mindfulness is "stress reduction based on mindfulness" [25], which is known as a stress reduction program and a relaxation training program (Kabat-Zinn [26], 1990) and is used in this research.

Rumination (a variable in the research) is a general term and refers to thoughts that are repetitive, revolving, self-centered and depressing, so that they do not play a major role in depression. (Ray Perry [27], 1997, quoted by Azargon et al., 2018). Also, the results of a research conducted on a sample of young males proved the effect of rumination as a predictor of the onset of substance abuse disorders and the severity of the symptoms of this disorder in the next 4 years (Nalan Hoeksma[28] et al., 2007). In mindfulness therapy, patients are trained to stop the cycle of rumination and distance themselves from their negative thoughts. In fact, attention flexibility, mental enrichment, stopping rumination, correcting false positive and negative beliefs, as well as challenging negative beliefs related to emotions, reduce depression and rumination (Tisdale [29] et al., 2000).

On the other hand, emotion regulation (another variable in the research) includes all Conscious and non-conscious strategies are used to increase, maintain, and reduce the emotional, behavioral, and cognitive components of an emotional response (Garnefsky [30] et al., 2001). Greenberg and Pieve [31] (1997, cited in Breslin [32] et al., 2002), express emotional dysregulation as the underlying pathological cause of substance abuse and mental illness. Hayes and Feldman [33] (2004) state that mindfulness training is an expanding clinical intervention to strengthen emotional regulation. Today, researchers have realized the role of rumination and emotional regulation in creating and maintaining different types of mental disorders. Targeting vulnerabilities such as rumination and emotional regulation that facilitate turning to drugs and relapse should be the treatment priority of new treatment approaches in this group of patients.

1-2 statement of the problem

Substance abuse disorders are one of the most common psychiatric problems that result from the interaction of genetic and environmental factors such as developmental abnormalities and adverse psychosocial status. These disorders can be caused by the use of alcohol, opioids, hashish, methamphetamine, cocaine, etc. and show themselves in the form of dependence and abuse. The use of narcotic drugs and psychotropic substances, as a serious problem, threatens all human societies today. The adverse and destructive effects of drug use and addiction on the human body and soul have increased this concern and caused an increase in family and social insecurity.