The Effectiveness of Mindfulness-Based Relapse Prevention in Improving Cognitive Flexibility and Decision Making for Methamphetamine Addicts: A Pilot Study

Hui-Ping Chan, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
Hsueh Chen Lu, Kaiser Permanente Santa Clara Medical Center, Sunnyvale, United States
Chun-Hung Chan, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan


Mindfulness-based Relapse Prevention (MBRP) is increasingly used in the treatment of substance use disorders (SUDs) and has been shown to be effective in reducing cravings and emotional responses in people with methamphetamine use disorders. Studies have also shown that mindfulness-based interventions are positively associated with cognitive flexibility. However, no study has examined the effectiveness of MBRP on cognitive flexibility and decision-making in methamphetamine addiction individuals. The purpose of this study was to examine the efficacy of MBRP on cognitive flexibility, decision-making, and depression in individuals with methamphetamine use disorders.

Participants and Methods:

Twenty-three participants were recruited from the addiction psychiatry unit of the psychiatric center with a methamphetamine use disorder without intellectual disability and without comorbid medical diseases, mental disorders, and a history of brain injury for an 8-week MBRP group intervention. MBRP was administered by two licensed clinical psychologists. Pre- and post-test measures included a 128-card version of the Wisconsin Card Sorting Test (WCST), the Iowa Gambling Task (IGT), and the Beck Depression Inventory–II (BDI-II).


One-Way Repeated Measures ANOVA showed significantly less perseverative error (F = 5.25, p < .05), fewer perseverative responses (F = 5.45, p < .05 ), and lower overall error (F = 6.28, p < .05) on the posttest than on the pretest on WCST. On the IGT, participants chose more advantageous decks than disadvantageous decks post-test. There was also a significant decrease in depression at post-test on BDI-II (F = 7.62, p < .05). At baseline, depression measures were significantly inversely correlated with block net scores (first block: r = -.54, p < .001).


This study highlights mindfulness principles for relapse prevention to help patients with methamphetamine dependence improve cognitive flexibility, value-based decision-making, and depression. In addition, this study is consistent with previous studies indicating that depression is associated with maladaptive decision-making. The future study will recruit more participants and investigate the effectiveness of MBRP in treating different types of substance use disorders.


Category: Addiction/Dependence

Keyword 1: methamphetamine
Keyword 2: cognitive functioning
Keyword 3: substance abuse treatments