Mindfulness-Based Stress Reduction Effective for Veterans With PTSD

Military veterans experienced improvements in symptoms of posttraumatic stress disorder (PTSD) following mindfulness-based stress reduction (MBSR) treatment, according to study data published in Psychiatric Research and Clinical Practice.

Military veterans diagnosed with PTSD were randomly assigned to receive 8 weeks of either MBSR or present-centered group therapy (PCGT) as control treatment. Therapies were administered at 3 Veterans Affairs Medical Centers across the southeastern United States. MBSR training comprised weekly 90-minute sessions focusing on body scan meditation, sitting meditation, and mindful stretching. MBSR participants were also given guided meditation CDs to practice while at home. The PCGT treatment group also met for weekly 90-minute psychoeducational sessions. The Clinician-Administered PTSD Scale for DSM-IV was used to assess symptom improvements at baseline and at 3, 6, and 9 weeks of follow-up. An additional assessment was repeated at 16 weeks posttreatment.

No significant between-group demographic or clinical differences were observed at baseline. The study cohort was 32% white and 68% black or another racial/ethnic minority. The average age was 51 years, and 48% of participants reported combat-related trauma. The majority (84%) of patients were men. In the MBSR group, 71 completed treatment but just 65 (68%) attended the week 9 assessment. In the PCGT arm, 81 remained in the study for 8 weeks and 77 (81%) were present for the week 9 assessment. Loss to follow-up was the primary reason for absence at the 9-week end point. An additional 36% of MBSR and 27% of PCGT participants did not attend the 16-week posttreatment assessment. Both treatment modes were associated with substantial reduction in PTSD symptoms. PTSD Checklist-Self Report scores were lower among MBSR participants compared with the PCGT group (P =.04). However, for all other measures of PTSD symptoms, no significant between-group differences were observed. Additionally, a statistically significant correlation was observed between reduction in PTSD symptoms and improvement in Five Facet Mindfulness Questionnaire scores for both groups (P =.023).

These data support the use of MBSR as a treatment method for veterans with PTSD. Subsequent analyses identified a strong relationship between self-reported mindfulness and improvement in PTSD symptoms, supporting the effectiveness of mindfulness-based treatments for individuals with PTSD.

“The overall small effect sizes of mindfulness-based meditation should be viewed with caution in the context of larger effect sizes of trauma-focused behavioral psychotherapies,” the researchers concluded. “As with all complementary and integrative health approaches, mindfulness-based meditation should be a supplement to, not a replacement for, trauma focused behavioral psychotherapies.”

Reference

Davis LL, Whetsell C, Hamner MB, et al. A multisite randomized controlled trial of mindfulness-based stress reduction in the treatment of posttraumatic stress disorder [published online September 13, 2018]. Psychiatric Res Clin Pract. doi:10.1176/appi.prcp.20180002