Relationships Among PTSD, Trait Mindfulness, and Factors of SUD in Veterans Enrolled in Specialty SUD Treatment.

Summary

Mindfulness facets relate to substance use disorder factors in veterans, but not always in expected ways. Among 159 veterans in a VA SUD treatment program, after accounting for PTSD, depression, and craving, the mindfulness facet 'observe' was linked to more frequent alcohol use, 'non-judging' to more hazardous alcohol use, and 'non-reactivity' to fewer consequences from substance use. Non-reactivity also appeared to mediate the connection between PTSD and consequences. The positive associations of observe and non-judging with worse outcomes were contrary to hypotheses, suggesting that mindfulness-based interventions for veterans with co-occurring PTSD and SUD may require careful tailoring.

Study at a glance

Abstract

A growing body of evidence points to a role for mindfulness in the development or maintenance of co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD). However, the mechanisms of this relationship remain unclear in the veteran population. This study seeks to understand how PTSD and facets of mindfulness are associated with factors of SUD in veterans enrolled in a VA specialty SUD treatment program. Veterans enrolled in the SUD treatment program were recruited from group classes and waiting rooms, and completed measures assessing SUD-related factors of frequency of alcohol use, hazardous alcohol use, consequences from substance use, and craving, as well as PTSD symptoms, mindfulness facets, and depressive symptoms. Three hierarchical multiple regressions assessed the extent to which significant relationships between mindfulness and SUD-related factors exist beyond associations commonly found with PTSD, depression, and craving. Participants (n = 159) were predominately male (91.2%) and White (86.2%) (age: Mean = 57.3; SD = 12.9). After controlling for demographic factors, PTSD, and clinical variables, mindfulness facets were associated with SUD-related factors; observe was positively related to frequency of alcohol use, non-judging was positively related to hazardous alcohol use, and non-reactivity was negatively associated with consequences from use. Exploratory analyses suggested that non-reactivity mediated the relationship between PTSD and consequences from use. Facets of observe, non-judging, and non-reactivity may help explain relationships between PTSD and SUD-related factors. However, associations with non-judging and observe were in the opposite direction hypothesized. More research is needed to understand positive associations between mindfulness and factors of SUD in veteran samples.