Improve Posttraumatic Stress Disorder (PTSD) with Mindfulness
Improve Posttraumatic Stress Disorder (PTSD) with Mindfulness
By John M. de Castro, Ph.D.
“Mind-body exercise offers a low-cost approach that could be used as a complement to traditional psychotherapy or drug treatments. These self-directed practices give PTSD patients control over their own treatment and have few side effects.” – Sang Kim
Experiencing trauma is quite common. It has been estimated that 60% of men and 50% of women will experience a significant traumatic event during their lifetime. But, only a fraction will develop Post-Traumatic Stress Disorder (PTSD). But this still results in a frightening number of people with 7%-8% of the population developing PTSD at some point in their life. For military personnel, it’s much more likely for PTSD to develop with about 11%-20% of those who have served in a war zone developing PTSD.
PTSD involves a number of troubling symptoms including reliving the event with the same fear and horror in nightmares or with a flashback. PTSD sufferers avoid situations that remind them of the event this may include crowds, driving, movies, etc. and may avoid seeking help because it keeps them from having to think or talk about the event. They often experience negative changes in beliefs and feelings including difficulty experiencing positive or loving feelings toward other people, avoiding relationships, memory difficulties, or see the world as dangerous and no one can be trusted. Sufferers may feel hyperarousal, feeling keyed up and jittery, or always alert and on the lookout for danger. They may experience sudden anger or irritability, may have a hard time sleeping or concentrating, may be startled by a loud noise or surprise.
Obviously, these are troubling symptoms that need to be addressed. There are a number of therapies that have been developed to treat PTSD including, Mindfulness Based Stress Reduction (MBSR). It includes body scan, meditation, and yoga practices. Although MBSR has been used successfully to treat PTSD, it has always been implemented in addition to other treatments and has never been examined as a stand-alone treatment. In today’s Research News article “Mindfulness-Based Stress Reduction (MBSR) as a Standalone Intervention for Posttraumatic Stress Disorder after Mixed Traumatic Events: A Mixed-Methods Feasibility Study.” See summary below or view the full text of the study at: http://journal.frontiersin.org/article/10.3389/fpsyg.2017.01407/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_388380_69_Psycho_20170912_arts_A, Müller-Engelmann and colleagues examine the efficacy of MBSR as a stand-alone treatment for PTSD.
They recruited adult male and female patients who were diagnosed with PTSD as the result of experiencing interpersonal violence. Mindfulness Based Stress Reduction (MBSR) was administered in 8 weekly-2 ½ hour sessions in combination with required practice at home. The patients were measured before and after treatment for mindfulness, depression, PTSD symptoms, trauma symptoms, and experience with the program. They were also interviewed after the program regarding their experience with and feelings about the program.
They found that following treatment there were significant reductions in PTSD symptoms and in depression. Also, they found that the greater the increase in mindfulness the greater the decrease in PTSD symptoms. During post-treatment interviews the patients reported an overall increase in their sense of well-being. No adverse reactions were observed. Hence, MBSR treatment appeared to be an acceptable, safe, and effective stand-alone treatment for PTSD.
It should be noted that there was not a control or comparison condition. This markedly limits the ability to conclude that MBSR was responsible for the improvements. There is a need to perform a randomized controlled clinical trial with an active control condition. In addition, over a third of the patients who started the program dropped out. The drop-outs had significantly greater PTSD symptoms than the completers. This suggests that modifications of the program must be undertaken to keep the most severely affected patients in the program. Nevertheless, the findings are encouraging and justify further research.
So, improve posttraumatic stress disorder (PTSD) with mindfulness.
“People who practiced mindfulness meditation about half an hour a day for 8 weeks saw a change in several brain structures related to learning, memory, emotion, and the fear response. These are all things that play a role in post-traumatic stress responses.” – Sara Staggs
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Müller-Engelmann M, Wünsch S, Volk M and Steil R (2017) Mindfulness-Based Stress Reduction (MBSR) as a Standalone Intervention for Posttraumatic Stress Disorder after Mixed Traumatic Events: A Mixed-Methods Feasibility Study. Front. Psychol. 8:1407. doi: 10.3389/fpsyg.2017.01407
Abstract
Objectives: There is promising evidence that mindfulness-based interventions are effective in reducing the symptoms of posttraumatic stress disorder (PTSD). However, until now, studies have often lacked a full clinical PTSD assessment, and interventions are often administered in addition to other interventions. This study examined the feasibility of mindfulness-based stress reduction (MBSR) as a standalone intervention in patients with PTSD who have experienced mixed traumatic events.
Method: Fourteen patients participated in 8 weeks of MBSR. The patients were assessed prior to treatment, post-treatment and at a 1-month follow-up through self-ratings (e.g., the Davidson Trauma Scale) and the Clinician-Administered PTSD Scale to determine the effects of the intervention. Furthermore, after the intervention, the patients participated in qualitative interviews regarding their experiences with MBSR and their ideas for future improvements.
Results: Nine patients finished the program, and these patients considered the exercises to be applicable and helpful. In the Clinician-Administered PTSD Scale, we found large effects regarding the reduction of PTSD symptoms among completers (Cohen’s d = 1.2). In the Davidson Trauma Scale, the effect sizes were somewhat lower (Cohen’s d = 0.6) but nevertheless confirmed the efficacy of MBSR in reducing PTSD symptoms. In the qualitative interviews, the patients reported an augmentation of wellbeing and improvement regarding the handling of difficult situations and more distance from the traumatic event.
Conclusion: Despite the large effects, the high dropout rates and the results of the post-treatment interviews suggest that the intervention should be better adapted to the needs of PTSD patients, e.g., by giving more information regarding the exercises and by including shorter exercises to manage acute distress.