Discussion
SUDs, impulsivity, impulsive behavior
The literature on impulsivity has already pointed out the challenge of measuring and understanding this construct, which leads to difficulty in intervening on it. With the benefit of investigating different dimensions of impulsivity through multiple measures, this study found the effects of the MBRP group overtime on the total score of the IGT, even though it has not found any improvement in other impulsivity aspects evaluated. Therefore, the hypothesis previously made was partially corroborated and needed to be taken with caution.The IGT is an instrument for investigating decision options in ambiguous outcomes [According to the Somatic Marker Hypothesis, people with SUDs have an impaired reasoning and decision-making that contributes to failure in learning with ambiguous or negative consequences of their behavior focusing on immediate reward. Particularly, there is an imbalance between impulsive and reflective systems due to biased interoceptive signals systems promoted and maintained by continuous substance use. Considering this, the treatments for SUDs have been focused on improving the reasoning and decision-making by evaluating and avoiding the activation of those triggers that led to relapse to override the impulsive behavior. However, the relapse rates are still high with these treatment strategies [In our study, we hypothesized that mindfulness training would increase self-awareness and reduce the impulsivity via meditation practices and attitudes taught during the MBRP protocol (e.g., non-judgment, patience, acceptance, letting go, trust, non-striving and beginner’s mind) [It was hypothesized that the MBRP+TAU group would have lower rates of impulsivity on specific dimensions over time based on previous literature that observed it in RCTs with patients with SUDs in treatment [First, the compared studies have essential experimental design differences. For example, a study applied a twice-a-week rolling MBRP protocol with daily supervised thirty minutes practice and compared it to the usual treatment [Finally, it is important to consider that there are other main differences in the sample of previous studies, such as age average. Previous RCTs evaluated MBRP in younger patients when compared to our sample [It is worth observing that middle-aged people could have more severe substance use, neuroplasticity may be more compromised, and they may present more related problems as a consequence of drug use than younger people. Therefore, it seems challenging to understand what the actual cause of the observed impulsivity is, given that it could be a personality trait prior to substance use, or a consequence of it, if the use of the substance specifically contributed to accelerating the expected cognitive decline of aging and, consequently, intervene in those deficits [