Vol. 7, Issue 2, Part A (2025)

Craving is a major predictor of relapse among individuals recovering from substance use disorders (SUDs), and emerging evidence suggests that deficits in emotion regulation, particularly impulsivity under emotional distress, play a central role in driving these cravings. This study aimed to identify emotional, environmental, and cognitive triggers contributing to craving episodes; examine the relationship between emotion regulation abilities and craving intensity; and evaluate the impact of a Mindfulness-Based Relapse Prevention (MBRP) intervention on these factors. Sixty recovering individuals who had maintained abstinence for at least one month were recruited from rehabilitation centers. At baseline, participants completed the Difficulties in Emotion Regulation Scale (DERS) and substance-specific craving scales. A 30-day ecological momentary assessment (EMA) phase was used to capture real-time emotional states, environmental exposures, and craving episodes. Following EMA monitoring, participants attended an eight-week MBRP program consisting of weekly two-hour sessions. Post-intervention assessments revealed that the most common real-world triggers included stress, negative mood states, presence of peers using substances, and euphoric recall. Higher DERS scores, particularly in impulse control difficulties, were strongly correlated with greater craving intensity at baseline (r ≈ .45). The MBRP intervention resulted in significant reductions in both emotion dysregulation and craving scores (p<0.001, Cohen’s d ≈ 0.7). Mediation analysis indicated that improvements in emotion regulation skills accounted for approximately 40% of the reduction in craving intensity, with bootstrap confidence intervals confirming statistical significance. These findings underscore the importance of targeting emotion regulation deficits in relapse prevention and highlight the potential of integrating mindfulness-based approaches with personalized, real-time monitoring to support long-term recovery.