Category: Addictive Behaviors
Compulsive sexual behaviors (CSB; i.e., excessive or compulsive sexual desire, drive, and activity; Kafka, 2010), are overrepresented among men with substance use disorders (SUD; Deneke et al., 2015). Untreated CSB may facilitate relapse for men in substance use treatment (Schneider & Irons, 2001), suggesting a need to better examine factors related to CSB in this population. Dispositional mindfulness (i.e., being attentive/aware of present-moment experiences) gained increased attention as a protective factor for men with CSB and SUD (Shorey et al., 2016). However, less is known about the processes underlying this relationship. Mindfulness theory posits that increased mindfulness facilitates decreases in experiential avoidance (EA; Baer, 2003), a mechanism that elicits CSB (Carnes, 2001). Further, EA mediates the impact of mindfulness-based treatments on psychological health, including substance use (Flaxman & Bond, 2010; Gifford et al., 2004). It follows that dispositional mindfulness may negatively relate to CSB through decreased EA. However, no studies examined this hypothesis among men with SUD. The present study tested a model by which EA mediated the association between dispositional mindfulness and CSB among men in residential treatment for SUD.
We reviewed medical records of 969 men in residential treatment for SUD, which included self-report measures of EA (i.e., Acceptance and Action Questionnaire-II; Bond et al., 2011), dispositional mindfulness (i.e., Mindful Attention Awareness Scale; Brown & Ryan, 2003), CSB (i.e., Sexual Addiction Screening Test-Revised; Carnes et al., 2010), alcohol use and problems (i.e., Alcohol Use Disorders Identification Test; Saunders et al., 1993), and drug use and problems (i.e., Drug Use Disorders Identification Test; Stuart et al., 2003).
We conducted a mediation analysis using 5,000 bootstrapped samples and bias-corrected 95% confidence intervals (CIs) to test for significance of the indirect effect (i.e., that EA would mediate the relation between dispositional mindfulness and CSB, controlling for the influence of drug/alcohol use and problems; Preacher & Hayes, 2004; 2008). Dispositional mindfulness had a significant total effect in predicting CSB, β = -.25, p < .001. With EA included in the model, the effect of dispositional mindfulness was reduced, β = -.16, p < .001. There was a significant indirect effect of EA (β = -.21, SE = .08; 95% CI: [-.45, -.14]), supporting a model by which EA partially mediated the relation between dispositional mindfulness and CSB among men in residential treatment for SUD.
Meagan Brem– Graduate Research Assistant, University of Tennessee, Knoxville, Tennessee
Ryan Shorey– Assistant Professor, Ohio University, Athens, Ohio
Scott Anderson– Clinical Director, Cornerstone of Recovery
Gregory Stuart– Professor, University of Tennessee