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Part 2. Marcus, Deidra Carroll, L. Kian Granmayeh, Stanley G. Decrease in problems and psychiatric symptoms with alcohol as well as increase in positive psychosocial outcomes were also found . Paulus et al. Self-efficacy was also found to have improved [49 , 80]. Participants of MBIs were also found to spend more time at home  thus leading to lower alcohol abuse.
Better and healthier choices and more freedom with regards to choosing alternatives when facing interpersonal threats and disappointments were also recorded . MBIs were also found to weaken the automatic neural processes that were related to alcohol use . The awareness component of mindfulness negatively related to alcohol use but positively related to alcohol related consequences .
The acceptance component was negatively related to alcohol related consequences . Individuals with higher levels of trait mindfulness were found to use less alcohol, and reported less stress and craving, and the ability to resist the urge in high risk situations . MBIs were found to have a significant impact on individuals with gambling addiction . They were found to be useful in avoidance, disassociation, impulse attenuation, induced positive thinking, reduced conflict; and reduced relapse .
Better clinical outcomes  and temper withdrawal symptoms  were also found. Gratitude and hope were found to be negatively related to gambling, gambling related thinking and urges . MBIs were found to have a better effect on smoking cessation than current treatments [36 , 57] and Cognitive Behavioural Therapy  in preventing relapses. MBIs reduced craving [7 , 88] and increased rates of post-treatment abstinence [51 , 88 , 36 , 89]. Individuals were found to have reduced negative affect, reduced depressive symptoms, and reduction in nicotine dependence .
MBIs also resulted in reduced use [88 , 36] and coping strategies for triggers . More activity in the neural networks associated with self-control were found with individuals . Generally, MBIs were found to be superior to treatment as usual [51 , 57]. There has been significantly less research on workaholism and MBIs. Limited literature found that MBIs broadened perspectives, induced re-evaluation of life priorities, balanced the level of organisational identification, enhanced work engagement, reduced work duration and reduced psychological distress .
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It was found that individuals reduced working hours without impacting job performance and had better job satisfaction . Limited studies have been done with individuals with sex addiction and disorders. Disassociation to experiences [93 , 94] and reduced problematic sexual fantasies, urges, anxiety, depression, impulsivity, stress  were also found with MBIs.
From the various descriptions and definitions of mindfulness practices, three primary components appear to be significant, which were attention [1 , 2 , 4 , 5 , 7 , 9] , acceptance [3 , 7 , 11 , 49 , 54 , 82] and awareness [2 , 8 , 11 , 28 , 49 , 54 , 82].
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Therefore, mindfulness is the disposition and practice of awareness, attention and acceptance. More focus and study could be given to these components thus allowing a more focused and targeted design of MBIs to achieve positive outcomes. MBIs significantly impacted the neural networks related to addictive disorders to achieve treatment outcomes.
These appear to be the primary impact of all MBIs where neurological networks related to craving, reactivity and compulsive use are weakened, thereby strengthening response, awareness and acceptance.
Individuals with co-morbid mood, anxiety disorders and depression were also known to benefit from MBIs. The positive effects of MBIs are consistent across the types of addictive disorders studied. It included stress reduction, reduced urges and craving, and reduced impact of negative affect. MBIs were also known to impact secondary outcomes in the areas of social outcomes, mental health, and dealing with pain amongst others. Trait or dispositional mindfulness has been found to be the objective of all MBIs. Trait mindfulness were found to be associated with reduced use, reduced stress, craving and resist urges.
More studies are needed in the area of measuring trait mindfulness so that more progress could be made in rehabilitation of addictive disorders. Contrary to the views of Shonin and Van Gordon  , the type of MBI employed did not appear to be as important as all of them consistently had positive outcomes. But exception has to be made to mindfulness related programmes which had created psychotic episodes. Regardless of the diverse nature and design of the MBIs, the same or similar mindfulness practices were involved.
Some of the MBIs varied from one another by the additional components fused into it. Components such as cognitive behavioural therapy CBT , positive psychology, traditional relapse prevention strategies and buddhistic ontological investigations were coupled with mindfulness practices.
However, at this point it can be speculated that the cause of structural brain changes were primarily the mindfulness practices rather than the additional components. More studies are required to delineate the impact areas of mindfulness practices and the additional components built into MBIs. The integrity of MBIs largely depended on the targeted disorder, history of the participant, competence and embodiment of the teacher, the emphasis laid on meditation by the participants and therapeutic alliance. Adverse effects were largely unknown with MBIs, except with individuals with a history of mental illness or due to loosely designed programmes incorporating mindfulness.
MBIs were also known to cause an addiction to mindfulness itself.
Most of the studies on the effectiveness of MBIs have been on substance misuse and alcoholism. More studies are needed on workaholism and sex addiction. More qualitative and longitudinal studies are recommended to better understand the long term impact of mindfulness on relapse prevention. The author declare that there is no competing interests regarding the publication of this article.