OBJECTIVE This study compared two mechanisms by which mindfulness may reduce hazardous drinking: effortful control and craving, "top-down" and "bottom-up" processes, respectively. These relationships were compared in a secondary analysis of a randomized controlled trial of mindfulness-based relapse prevention (MBRP) versus relapse prevention (RP) treatments to explore if they differed based on more explicit versus subtle mindfulness training. METHOD A total of 182 individuals (48.4% female; 21-60 years old) who reported drinking > 14/21 drinks/week (for females/males, respectively) in the past 3 months but who wished to quit/reduce their drinking were recruited from Denver and Boulder, CO, United States. Participants were randomly assigned to either 8 weeks of MBRP or RP treatment and completed assessments at baseline, halfway through treatment, and at the end of treatment. The Five-Factor Mindfulness Questionnaire-Short Form, Alcohol Urge Questionnaire, and Effortful Control Scale completed halfway through treatment assessed the predictor, dispositional mindfulness, and mediators, craving and effortful control, respectively. The Alcohol Use Disorder Identification Task was completed after treatment and measured hazardous drinking. Cross-group path analyses were conducted including both mediators/treatments in the same model. RESULTS Comparing models with and without equality constraints across treatments, no paths significantly differed based on a chi-square test of difference, χ²(5) = 5.11, p = .40, and only the indirect effect of craving was significant (B = -1.01, p = .01). CONCLUSIONS Findings suggest mindfulness may be associated with hazardous drinking reductions through craving but not effortful control and this indirect relationship works similarly across treatments engendering mindfulness explicitly and implicitly. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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饮酒中的正念机制：比较自上而下和自下而上的过程。

目的 这项研究比较了正念可以减少危险饮酒的两种机制：努力控制和渴望，分别是“自上而下”和“自下而上”的过程。在基于正念的复发预防（MBRP）与复发预防（RP）治疗的随机对照试验的二次分析中对这些关系进行了比较，以探讨它们是否基于更明确的正念训练和微妙的正念训练而存在差异。方法 共有 182 名个体（48.4% 女性；21-60 岁）报告过去 3 个月每周饮酒量 > 14/21 杯（分别针对女性/男性），但希望戒烟/减少饮酒量从美国科罗拉多州丹佛和博尔德招募。参与者被随机分配接受为期 8 周的 MBRP 或 RP 治疗，并在基线、治疗中途和治疗结束时完成评估。在治疗中途完成的五因素正念问卷、酒精冲动问卷和努力控制量表分别评估了预测因素、倾向性正念以及中介因素、渴望和努力控制。治疗后完成酒精使用障碍识别任务并测量危险饮酒。进行跨组路径分析，包括同一模型中的两种中介/治疗。结果比较不同治疗中具有和不具有平等约束的模型，根据卡方差异检验，没有路径存在显着差异，χ2(5) = 5.11，p = .40，并且只有渴望的间接影响是显着的（B = - 1.01，p = .01）。结论 研究结果表明，正念可能通过渴望而不是努力控制与危险饮酒的减少相关，并且这种间接关系在显式和隐式产生正念的治疗中的作用类似。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。