Abuse

Improve Well-Being in Adults who Experienced Childhood Maltreatment with Mindfulness

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Improve Well-Being in Adults who Experienced Childhood Maltreatment with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness-based interventions can be beneficial for childhood maltreatment survivors to alleviate psychological symptoms including stress, anxiety, recurrent depression, substance use, and post-traumatic stress.” – Diane Joss

 

Childhood trauma can leave in its wake symptoms which can haunt the victims for the rest of their lives. These include persistent recurrent re-experiencing of the traumatic event, including flashbacks and nightmares, loss of interest in life, detachment from other people, increased depression, anxiety and emotional arousal, including outbursts of anger, difficulty concentration, and jumpiness, startling easily. Unfortunately, childhood maltreatment can continue to affect mental and physical health throughout the individual’s life. How individuals cope with childhood maltreatment helps determine the effects of the maltreatment on their mental health.

 

It has been found that experiencing the feelings and thoughts produced by trauma completely, allows for better coping. This can be provided by mindfulness. Indeed, mindfulness has been found to be effective for relieving trauma symptoms. But it is not known how mindfulness works to impact the psychological well-being of adults who experienced childhood maltreatment.

 

In today’s Research News article “Nonattachment Predicts Empathy, Rejection Sensitivity, and Symptom Reduction After a Mindfulness-Based Intervention Among Young Adults with a History of Childhood Maltreatment.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205188/ ) Joss and colleagues recruited patience with a history of childhood maltreatment including physical and emotional abuse or neglect, and sexual abuse, verbal abuse, witnessing violence between parents or physical abuse of siblings.

 

They were assigned to either a wait-list control condition or to receive mindfulness training. The training was modelled after the Mindfulness-Based Stress Reduction (MBSR) program and met once a week for eight weeks along with daily home practice and contained “breath awareness meditation, body scan meditation, mindful yoga, open awareness meditation, loving-kindness meditation, walking meditation, mountain meditation, mindful eating as well as noticing mindful moments in daily lives”. They were measured before and after training for mindfulness, childhood trauma, adverse childhood experiences, anxiety sensitivity, PTSD symptoms, rejection sensitivity, nonattachment, and interpersonal reactivity.

 

They found that in comparison to baseline and the wait-list control group, the group that received mindfulness training had significantly higher levels of mindfulness and nonattachment and significantly lower levels of PTSD symptoms, rejection sensitivity, and interpersonal reactivity. In addition, the greater the attendance at the mindfulness training sessions the greater the increases in mindfulness and nonattachment and decreases in personal distress and anxiety sensitivity. Further they found that mindfulness was associated with reduced rejection sensitivity indirectly by being associated with higher levels of nonattachment and empathy which were in turn associated with lower levels of rejection sensitivity.

 

The results suggest that mindfulness training improves the psychological well-being of young adults who had experienced childhood maltreatment in a dose dependent way. Nonattachment is a “flexible way of relating to one’s experiences without clinging to or suppressing them” and is increased by mindfulness training. In addition, empathy is “the capacity to understand others’ perspectives and to feel and share others’ feelings” and is increased by mindfulness training. These factors in turn appear to be important for the improvement in psychological well-being. In other words, mindfulness increases the ability to let go of experiences and not ruminate or worry about them and improves empathy and these factors improve the well-being of young adults who had experienced childhood maltreatment. All this suggests that mindfulness training should be recommended for people who experienced childhood maltreatment to reduce the impact of the trauma and improve psychological well-being.

 

So, improve well-being in adults who experienced childhood maltreatment with mindfulness.

 

“Mindfulness skills tend to be lower among adolescents and adults exposed to various forms of childhood maltreatment.” – Alan R. King

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available on Twitter @MindfulResearch

 

Study Summary

 

Joss, D., Lazar, S. W., & Teicher, M. H. (2020). Nonattachment Predicts Empathy, Rejection Sensitivity, and Symptom Reduction After a Mindfulness-Based Intervention Among Young Adults with a History of Childhood Maltreatment. Mindfulness, 11(4), 975–990. https://doi.org/10.1007/s12671-020-01322-9

 

Abstract

Objectives:

Individuals with a childhood maltreatment history tend to have various psychological symptoms and impaired social functioning. This study aimed to investigate the related therapeutic effects of a mindfulness-based intervention in this population.

Methods:

We analyzed self-report questionnaire scores of the Mindful Attention Awareness Scale (MAAS), Non-Attachment Scale (NAS), Adult Rejection Sensitivity Questionnaire (A-RSQ), Interpersonal Reactivity Index (IRI), PTSD CheckList (PCL), and Anxiety Sensitivity Index (ASI), from 16 (3 males) young adults (age range 22–29) with mild to moderate childhood maltreatment, compared to 18 matched participants (6 males) on a waiting list, during both pre- and post-intervention/waiting periods. Analyses were conducted with linear mixed effects models, partial correlation analyses and t-tests.

Results:

There were group by time interaction effects with the scores of MAAS, NAS, PCL, IRI-Fantasy, and A-RSQ (p < .05). The mindfulness group had significant increase in MAAS (17.325%) and NAS (8.957%) scores, as well as reduction in PCL (15.599%) and A-RSQ (23.189%) scores (p < .05). Changes in non-attachment, but not mindfulness, had significant contributions to the score changes of PCL (16.375%), ASI (36.244%), IRI-Personal Distress (24.141%), IRI-Empathic Concern (16.830%), and A-RSQ (10.826%) (p < .05). The number of intervention sessions attended was correlated with score changes of NAS (r = .955, p < .001), and ASI (r = −.887, p < .001), suggesting a dose-dependent effect.

Conclusions:

Findings from this pilot study suggest that the mindfulness-based intervention improved mindfulness, non-attachment and empathy, which contributed to reduced interpersonal distress, rejection sensitivity and other psychological symptoms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7205188/

 

Reduce the Depressive Effects of Adverse Childhood Experiences with Mindfulness

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Reduce the Depressive Effects of Adverse Childhood Experiences with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness instruction may mitigate the negative effects of stress and trauma related to adverse childhood exposures, improving short- and long-term outcomes, and potentially reducing poor health outcomes in adulthood.” – Robin Ortiz

 

Childhood trauma can leave in its wake symptoms which can haunt the victims for the rest of their lives. These include persistent recurrent re-experiencing of the traumatic event, including flashbacks and nightmares, loss of interest in life, detachment from other people, increased depression, anxiety and emotional arousal, including outbursts of anger, difficulty concentration, and jumpiness, startling easily. Unfortunately, childhood maltreatment can continue to affect mental and physical health throughout the individual’s life. How individuals cope with childhood maltreatment helps determine the effects of the maltreatment on their mental health.

 

It has been found that experiencing the feelings and thoughts produced by trauma completely, allows for better coping. This can be provided by mindfulness. Indeed, mindfulness has been found to be effective for relieving trauma symptoms. But it is not known how mindfulness interacts with adverse childhood experiences to impact psychological well-being later on.

 

In today’s Research News article “Mindfulness as a mediator and moderator in the relationship between adverse childhood experiences and depression.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215089/ ) McKeen and colleagues recruited college students and had them complete measures of mindfulness, adverse childhood experiences, and depression. Adverse childhood experiences included instances of physical or emotional abuse and family dysfunction. Of the students 71% reported some form of adverse childhood experiences.

 

They found that the greater the adverse childhood experiences the higher the levels of depression and the lower the levels of mindfulness, especially the describing, acting with awareness, and non-judging facets. They also found that the higher the levels of mindfulness the lower the levels of depression. Further they found that mindfulness moderated the relationship of adverse childhood experiences with depression such that the greater the level of adverse childhood experiences the lower the levels of mindfulness and in turn the lower the levels of depression.

 

The results of the present study are correlational and so no conclusions can be reached regarding causation. Previous research by others, however, has demonstrated a causal connection between mindfulness and lower depression. So, the observed relationship here is likely due to mindfulness causing a reduction in depression.

 

It has also been previously observed that adverse childhood experiences are associated with lower mindfulness and well-being.  What is new here is the demonstration that adverse childhood experiences are linked to depression by reduced mindfulness. This suggests that mindfulness training may be a means to reduce depression caused by adverse childhood experiences.

 

So, reduce the depressive effects of adverse childhood experiences with mindfulness.

 

“Numerous studies support the use of mindfulness as an effective intervention for youth exposed to trauma.” – Jennifer Peterson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available on Twitter @MindfulResearch

 

Study Summary

 

McKeen, H., Hook, M., Podduturi, P., Beitzell, E., Jones, A., & Liss, M. (2021). Mindfulness as a mediator and moderator in the relationship between adverse childhood experiences and depression. Current psychology (New Brunswick, N.J.), 1–11. Advance online publication. https://doi.org/10.1007/s12144-021-02003-z

 

Abstract

Adverse childhood experiences (ACEs) have been associated with a variety of negative physical and psychological health outcomes. The mechanisms by which this occurs and potential protective factors present in this relationship are understudied. Mindfulness is a cognitive resource that may protect individuals against symptoms of psychological distress. It has five core facets and encourages a nonjudgmental acceptance of the present moment. The purpose of this study was to explore the role of mindfulness in the relationship between ACEs and depression, both as a mediator and as a moderator, or protective factor. We hypothesized that the aware, describe, and non-judgement facets of mindfulness would be key factors in both sets of analyses. Participants at a university (N = 279) were given the Five Factor Mindfulness Questionnaire (FFMQ), the Adverse Childhood Experiences Scale (ACES), and the Patient Health Questionnaire (PHQ-8) to measure depression. Results indicated that the describe CI [.02, .11], aware CI [.05, .17], and non-judgement CI [.06, .18] facets of mindfulness significantly mediated the relationship between ACEs and depression. Additionally, the aware facet of mindfulness was also a significant moderator in this relationship, [t (interaction) = −3.22, p < 0.01], such that individuals with a high level of awareness had no increase in depression even as the number of ACEs increased. Negative cognitions associated with ACEs may harm one’s ability to effectively describe their feelings and to be fully aware of the present moment, which may contribute to symptoms of depression. Implications for mindfulness-based interventions (MBIs) are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8215089/

 

Spirituality is Associated with Fewer Suicide Attempts

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Spirituality is Associated with Fewer Suicide Attempts

 

By John M. de Castro, Ph.D.

 

“spirituality can engender the perspective that things happen for some reason and serve a greater purpose. This, in turn, deploys our attention toward the potential for a brighter future, which can create a sense of optimism even when one’s situation seems dire.” – David Rosmarin

 

Around 43,000 people take their own lives each year in the US. Someone dies from suicide every 12.3 minutes. Worldwide over 800,000 people die by suicide every year. The problem is far worse than these statistics suggest as it has been estimated that for every completed suicide there were 12 unsuccessful attempts. In other words, about a half a million people in the U.S. attempt suicide each year. Yet compared with other life-threatening conditions there has been scant research on how to identify potential suicide attempters, intervene, and reduce suicidality.

 

Depression and other mood disorders are the number-one risk factor for suicide. More than 90% of people who kill themselves have a mental disorder, whether depression, bipolar disorder or some other diagnosis. So, the best way to prevent suicide may be to treat the underlying cause. For many this means treating depression. Spirituality may help to provide meaning and prevent suicide. But there is scant research on the relationship of spirituality and religiosity and suicide.

 

In today’s Research News article “Factors Related to Suicide Attempts: The Roles of Childhood Abuse and Spirituality.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044867/ ) Tae and Chae recruited patients with anxiety or depressive disorders and had them complete measures of suicide attempts, anxiety, depression, childhood trauma, spiritual well-being, and social support. 25% of the participants indicated that they had attempted suicide.

 

They found that in comparison to non-suicide attempters, the participants who had attempted suicide had significantly higher levels of anxiety, depression, emotional, physical, and sexual abuse, and emotional and physical neglect and significantly lower levels of spirituality and social support. A hierarchal regression revealed that a high level of emotional abuse and a high level of sexual abuse as well as low spirituality predicted suicide attempts. A mediation analysis revealed that childhood emotional, sexual abuse, and low spirituality were all significant direct predictors of suicide attempts and also significant indirect predictors such that abuse and low spirituality were associated with higher levels of depression which, in turn was associated with suicide attempts.

 

These results are correlational. So, no conclusions concerning causation can be reached. But the associations are clear. Depression, childhood emotional and sexual abuse, and low spirituality are all associated with suicide attempts. It is also clear that in addition to being directly associated with suicide attempts, childhood emotional and sexual abuse, and low spirituality also are associated with higher levels of depression which, in turn, is associated with suicide attempts.

 

Childhood emotional and sexual abuse are clearly risk factors for suicide and should be viewed as red flags in evaluating a patient. But these abuses occurred in the past and cannot be changed. Spirituality on the other hand can change. There are many religious and contemplative practices that can improve spirituality. The present results suggest that this may be helpful and lowering depression and preventing suicide. Future research is needed to investigate this idea, that increasing spirituality can decrease suicide risk.

 

So, spirituality is associated with fewer suicide attempts.

 

“I personally think spirituality is a part of each of our beings. It has been the difference in my life and has walked me back from the place where I thought suicide was my only option.” – Kelli Evans

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Tae, H., & Chae, J. H. (2021). Factors Related to Suicide Attempts: The Roles of Childhood Abuse and Spirituality. Frontiers in psychiatry, 12, 565358. https://doi.org/10.3389/fpsyt.2021.565358

 

Abstract

Objectives: The purpose of this article was to identify independent factors associated with suicide attempts in patients with depression and/or anxiety.

Background and Aims: This study was conducted in order to examine whether risk and protective psychological factors influence the risk of suicide attempts among outpatients with anxiety and/or depressive disorders. In this regard, explanatory models have been reported to detect high-risk groups for suicide attempt. We also examined whether identified factors serve as mediators on suicide attempts.

Materials and Methods: Patients from 18 to 65 years old from an outpatient clinic at Seoul St. Mary’s Hospital were invited to join clinical studies. From September 2010 to November 2017, a total of 737 participants were included in the final sample. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Childhood Trauma Questionnaire (CTQ), Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp-12), and Functional Social Support Questionnaire (FSSQ) were used to assess psychiatric symptoms. An independent samples t-test, a chi-square test, hierarchical multiple regression analyses, and the Baron and Kenny’s procedures were performed in order to analyze data.

Results: Young age, childhood history of emotional and sexual abuse, depression, and a low level of spirituality were significant independent factors for increased suicide attempts. Depression was reported to mediate the relationship between childhood emotional and sexual abuse, spirituality, and suicide attempts.

Conclusions: Identifying the factors that significantly affect suicidality may be important for establishing effective plans of suicide prevention. Strategic assessments and interventions aimed at decreasing depression and supporting spirituality may be valuable for suicide prevention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044867/

 

Spirituality is associated with Childhood Trauma

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Spirituality is associated with Childhood Trauma

 

By John M. de Castro, Ph.D.

 

“traumatic childhood experiences must be solved by making new good experiences with relationships, with closeness.” – Gopal Klein

 

“Child maltreatment is the abuse and neglect that occurs to children under 18 years of age. It includes all types of physical and/or emotional ill-treatment, sexual abuse, neglect, negligence and commercial or other exploitation, which results in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power. Exposure to intimate partner violence is also sometimes included as a form of child maltreatment” (World Health Organization, 2016)

 

This maltreatment is traumatic and can leave in its wake symptoms which can haunt the victims for the rest of their lives. These include persistent recurrent re-experiencing of the traumatic event, including flashbacks and nightmares, loss of interest in life, detachment from other people, increased anxiety and emotional arousal, including outbursts of anger, difficulty concentration, and jumpiness, startling easily. Unfortunately, childhood maltreatment can continue to affect mental and physical health throughout the individual’s life. How individuals cope with childhood maltreatment helps determine the effects of the maltreatment on their mental health. It has been found that experiencing the feelings and thoughts completely allows for better coping. This can be provided by mindfulness. Indeed, mindfulness has been found to be effective for relieving trauma symptoms.

 

Spirituality is defined as “one’s personal affirmation of and relationship to a higher power or to the sacred. There have been a number of studies of the influence of spirituality on the physical and psychological well-being of practitioners mostly showing positive benefits, with spirituality encouraging personal growth and mental health. So, it would make sense to investigate the relationship of spirituality to childhood trauma.

 

In today’s Research News article “Childhood Trauma Is Associated with the Spirituality of Non-Religious Respondents.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068247/), Kosarkova and colleagues sampled the Czech population over 15 years of age and had them complete measures of childhood trauma, including emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect subscales, religiosity, spirituality, and religious conversion experiences.

 

They found that the higher the levels of spirituality in the non-religious but not the religious participants in the sample the greater the amounts of childhood trauma including emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect. Hence, for the non-religious people childhood trauma of all varieties are associated with spirituality.

 

The present results are correlational and as such causation cannot be determined. It is equally likely that childhood trauma increases spirituality, spirituality increases childhood trauma, or some third factor was responsible for both. It can be speculated, though, that the individual experiencing trauma looks for a means to explain the reason for the trauma. Individuals who are religious may interpret it in a religious context and conclude that god has abandoned them and so become even less spiritual. On the other hand, non-religious individuals would not fault god for the trauma and thus could take refuge in spirituality as a coping mechanism. It remains for future research to investigate these possibilities.

 

“childhood violence survivors often mention the importance of spirituality in their survival and recovery as being a resource for healing, meaning making, and truth.” -Thelma Bryant-Davis

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Kosarkova, A., Malinakova, K., Koncalova, Z., Tavel, P., & van Dijk, J. P. (2020). Childhood Trauma Is Associated with the Spirituality of Non-Religious Respondents. International journal of environmental research and public health, 17(4), 1268. https://doi.org/10.3390/ijerph17041268

 

Abstract

Childhood trauma experience (CT) is negatively associated with many aspects of adult life. Religiosity/spirituality (R/S) are often studied as positive coping strategies and could help in the therapeutic process. Evidence on this is lacking for a non-religious environment. The aim of this study was to assess the associations of different types of CT with R/S in the secular conditions of the Czech Republic. A nationally representative sample (n = 1800, mean age = 46.4, SD = 17.4; 48.7% male) of adults participated in the survey. We measured childhood trauma, spirituality, religiosity and conversion experience. We found that four kinds of CT were associated with increased levels of spirituality, with odds ratios (OR) ranging from 1.17 (95% confidence interval 1.03–1.34) to 1.31 (1.18–1.46). Non-religious respondents were more likely to report associations of CT with spirituality. After measuring for different combinations of R/S, each CT was associated with increased chances of being “spiritual but non-religious”, with OR from 1.55 (1.17–2.06) to 2.10 (1.63–2.70). Moreover, converts were more likely to report emotional abuse OR = 1.46 (1.17–1.82) or emotional neglect with OR = 1.42 (1.11–1.82). Our findings show CT is associated with higher levels of spirituality in non-religious respondents. Addressing spiritual needs may contribute to the effectiveness of psychotherapeutic treatment of the victims.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068247/

 

Improve PTSD Symptoms Related to Childhood Sexual Abuse with Mindfulness

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Improve PTSD Symptoms Related to Childhood Sexual Abuse with Mindfulness

 

By John M. de Castro, Ph.D.

 

“DBT-PTSD significantly reduced the women’s PTSD symptoms, including depression and anxiety. In addition, the women’s PTSD symptoms were still improving six weeks after they completed the treatment, suggesting that they may have learned skills during the study that helped them continue to recover from PTSD after the treatment ended.” – Matthew Tull

 

Childhood sexual abuse is a horrific crime. The trauma created in the victim changes them forever. It changes the trusting innocence of childhood to a confused, guilt ridden, frightening, and traumatized existence. It not only produces short-term trauma which includes both psychological and physical injury, it has long-term consequences. It damages the victim’s self-esteem and creates difficulties entering into intimate relationship in adulthood. It can create post-traumatic stress disorder (PTSD) complete with painful flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event. Victims often experience depression and sometimes become suicidal. It is a heinous crime that haunts the victims for the rest of their lives.

 

Unfortunately, childhood sexual abuse is shockingly common. It is estimated that 20% of girls and 10% of boys have experienced childhood sexual abuse and half of these were forcefully assaulted. Children between the ages of 7 and 13 are the most vulnerable but abuse is also prevalent in adolescence with 16% of children between 14 to 17 having been sexually victimized. Compounding the problem disclosure of sexual abuse is often delayed; children often avoid telling because they are either afraid of a negative reaction from their parents or of being harmed by the abuser. As such, they often delay disclosure until adulthood. This makes it unlikely that they’ll seek help and instead suffer in silence.

 

Mindfulness training has been shown to be effective in treating victims of trauma and PTSD.

Dialectical Behavior Therapy (DBT) focuses on changing the thoughts and emotions that precede problem behaviors, as well as by solving the problems faced by individuals that contribute to problematic thoughts, feelings and behaviors. In DBT five core skills are practiced; mindfulness, distress tolerance, emotion regulation, the middle path, and interpersonal effectiveness. So, it would make sense to explore the effectiveness of DBT for the treatment of adult survivors of childhood sexual abuse.

 

In today’s Research News article “Dialectical behaviour therapy for posttraumatic stress disorder related to childhood sexual abuse: a pilot study in an outpatient treatment setting.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774406/ ), Steil and colleagues recruited adult healthy women who had experienced childhood sexual abuse and were diagnosed with post-traumatic stress disorder (PTSD). They treated them with Dialectical Behavior Therapy (DBT) in a group for 90 minutes, once a week for 24 weeks. They were measured before and after treatment and 6 weeks later for frequency and intensity of PTSD symptoms, personality disorders, borderline symptoms, depression, and dissociative symptoms.

 

They found that the average duration of the PTSD symptoms prior to treatment was 14.5 years. 81% of the patients completed treatment. Following treatment, the women had significant reductions in PTSD symptoms including fewer intrusions, less avoidances, and hyperarousal episodes with large effect sizes. Treatment also produced large significant reductions in borderline symptoms, depression, and dissociative symptoms. These effects were still present and significant at the 6-week follow-up measurement.

 

The results suggest that Dialectical Behavior Therapy (DBT) is a safe, lasting, and effective treatment for PTSD symptoms resulting from childhood sexual abuse. But this was a pilot study without a control group. It relied upon before and after treatment comparisons. As such, there are many potential confounding factors. But the results are so positive and beneficial that a large randomized controlled clinical trial is warranted.

 

So, improve PTSD symptoms related to childhood sexual abuse with mindfulness.

 

“Mindfulness has been shown to be an effective stress reduction practices in general, but there may be other ways it works for people with PTSD as well. Recent research suggests that mindfulness may help to mitigate the relationship between maladaptive thinking and posttraumatic distress.” – Matthew Tull

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Regina Steil, Clara Dittmann, Meike Müller-Engelmann, Anne Dyer, Anne-Marie Maasch, Kathlen Priebe. Dialectical behaviour therapy for posttraumatic stress disorder related to childhood sexual abuse: a pilot study in an outpatient treatment setting. Eur J Psychotraumatol. 2018; 9(1): 1423832. Published online 2018 Jan 19. doi: 10.1080/20008198.2018.1423832

 

ABSTRACT

Background: Dialectical behaviour therapy for posttraumatic stress disorder (DBT-PTSD), which is tailored to treat adults with PTSD and co-occurring emotion regulation difficulties, has already demonstrated its efficacy, acceptance and safety in an inpatient treatment setting. It combines elements of DBT with trauma-focused cognitive behavioural interventions.

Objective: To investigate the feasibility, acceptance and safety of DBT-PTSD in an outpatient treatment setting by therapists who were novice to the treatment, we treated 21 female patients suffering from PTSD following childhood sexual abuse (CSA) plus difficulties in emotion regulation in an uncontrolled clinical trial.

Method: The Clinician Administered PTSD Symptom Scale (CAPS), the Davidson Trauma Scale (DTS), the Borderline Section of the International Personality Disorder Examination (IPDE) and the Borderline Symptom List (BSL-23) were used as primary outcomes. For secondary outcomes, depression and dissociation were assessed. Assessments were administered at pretreatment, post-treatment and six-week follow-up.

Results: Improvement was significant for PTSD as well as for borderline personality symptomatology, with large pretreatment to follow-up effect sizes for completers based on the CAPS (Cohens d = 1.30), DTS (d = 1.50), IPDE (d = 1.60) and BSL-23 (d = 1.20).

Conclusion: The outcome suggests that outpatient DBT-PTSD can safely be used to reduce PTSD symptoms and comorbid psychopathology in adults who have experienced CSA.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774406/

 

Recover from Sexual Abuse with Mindfulness

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By John M. de Castro, Ph.D.

 

“Our unwanted and self-destructive habits often were formed as children to help us survive. Childhood abuse, whether physical, emotional, verbal, sexual, or the covert traumas of neglect, oppression, and isolation, demands that if the child is to survive, she must create coping skills to deal with the abuse and the inherent messages about who she is. Mindfulness offers the possibility of relating differently to what’s already here by understanding that there’s nothing to get rid of and everything to accept.” – Char Wilkins

 

Childhood sexual abuse (CSA) is a horrific crime. The trauma created in the victim changes them forever. It changes the trusting innocence of childhood to a confused, guilt ridden, frightening, and traumatized existence. It not only produces short-term trauma which includes both psychological and physical injury, it has long-term consequences. It damages the victim’s self-esteem and creates difficulties entering into intimate relationship in adulthood. It can create post-traumatic stress disorder (PTSD) complete with painful flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event. Victims often experience depression and sometimes become suicidal. It is a heinous crime that haunts the victims for the rest of their lives.

 

Unfortunately, childhood sexual abuse (CSA) is shockingly common. It is estimated that 20% of girls and 10% of boys have experienced childhood sexual abuse and half of these were forcefully assaulted. Children between the ages of 7 and 13 are the most vulnerable but abuse is also prevalent in adolescence with 16% of children between 14 to 17 having been sexually victimized. Compounding the problem disclosure of sexual abuse is often delayed; children often avoid telling because they are either afraid of a negative reaction from their parents or of being harmed by the abuser. As such, they often delay disclosure until adulthood. This makes it unlikely that they’ll seek help and instead suffer in silence.

 

Mindfulness training has been shown to be effective in treating victims of trauma and PTSD. So, it would make sense that mindfulness training may be helpful for the treatment of adult CSA survivors. In today’s Research News article “Mindfulness Intervention for Child Abuse Survivors: A 2.5-Year Follow-Up.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1271288269561763/?type=3&theater

or below, Earley and colleagues performed a long-term (2.5 year) follow-up of adult survivors of CSA who had received treatment with an 8-week Mindfulness Based Stress Reduction (MBSR) program. MBSR involves meditation, body scan, and yoga practices. In the original study participants reported significant decreases in levels of depression, PTSD symptoms, and anxiety at treatment’s end (8 weeks), and at follow-up (24 weeks). In the present study, the participants from this original study were invited back and re-measured two and a half years after the completion of the original study.

 

Earley and colleagues found that the decreases in depression, anxiety, and PTSD symptoms and the increases in mindfulness were sustained. Improvements in PTSD symptoms of re-experiencing, avoidance/numbing/, and hyperarousal were all sustained. Hence, MBSR treatment produced significant improvements in the psychological health of the CSA survivors and these benefits were still present 2.5 years later. It is very unusual for a research study to be followed up this long after completion. But, it is very important. It demonstrates that treatment effects are are not fleeting. These results conclusively demonstrate that the benefits of MBSR treatment for CSA survivors are very long lasting.

 

Mindfulness training is known to improve all of the key symptoms of childhood sexual abuse (CSA) including depression, anxiety, self-esteem, and PTSD symptoms. It may do so by improving emotion regulation allowing the survivors to honestly feel their emotions but respond to them in an adaptive way. It may also do so by focusing the individual on the present moment and thereby reducing the rumination about the past that is so characteristic of CSA survivors. Regardless of the mechanism, the fact that the symptom relief is so long lasting supports use of MBSR training to treat adult survivors of childhood sexual abuse.

 

So, get over sexual abuse with mindfulness.

 

“Each person’s healing journey, while it will partake of some common elements, will be unique. For professionals, it’s important not to force survivors into a practice that might not work for them. For survivors, it’s important to not get discouraged if we don’t find the right practice at first. There are endless ways to practice being mindful and, sooner or later, something will resonate.” – Christopher Anderson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts

 

Study Summary

Earley, M. D., Chesney, M. A., Frye, J., Greene, P. A., Berman, B., & Kimbrough, E. (2014). Mindfulness Intervention for Child Abuse Survivors: A 2.5-Year Follow-Up. Journal of Clinical Psychology, 70(10), 933-941. doi:10.1002/jclp.22102.

 

Abstract

OBJECTIVE: The present study reports on the long-term effects of a mindfulness-based stress reduction (MBSR) program for adult survivors of childhood sexual abuse.

METHOD: Of the study participants, 73% returned to the clinic for a single-session follow-up assessment of depression, posttraumatic stress disorder (PTSD), anxiety, and mindfulness at 2.5 years.

RESULTS: Repeated measures mixed regression analyses revealed significant long-term improvements in depression, PTSD, anxiety symptoms, and mindfulness scores. The magnitude of intervention effects at 128 weeks ranged from d = .5 to d = 1.1.

CONCLUSION: MBSR may be an effective long-term treatment for adults who have experienced childhood sexual abuse. Further investigation of MBSR with this population is warranted given the durability of treatment effects described here.