Improve PTSD Symptoms Related to Childhood Sexual Abuse with Mindfulness

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

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.