Brief mindfulness program for veterans with PTSD

Bergen-Cico, D., Possemato, K., & Pigeon, W. (2014). Reductions in Cortisol Associated With Primary Care Brief Mindfulness Program for Veterans With PTSD. Medical care, 52, S25-S31. For the full text, go to Abstract and click on “View as pdf.” 

From the Abstract. Patients with posttraumatic stress disorder (PTSD) have significant medical morbidity, which may be mediated by hypothalamic pituitary axis (HPA) dysfunction and reflected in cortisol output. Many veterans with PTSD are hesitant to engage in trauma-focused exposure treatments; therefore briefer, non–exposure-based treatments are needed; one such promising approach is an abbreviated Primary Care brief Mindfulness Program (PCbMP).

Objective: This study investigated the relationship between dose-response to participation in a veterans PCbMP program and diurnal cortisol. Cortisol reflects HPA function and PTSD is associated with HPA dysregulation.

Design: Forty veterans (90% men) with PTSD were identified in primary care and randomly assigned to treatment as usual, or participation in brief 4-week Mindfulness Based Stress Reduction program.

Results: Analyses revealed that significant changes in cortisol were associated with PCbMP treatment engagement and dosing (number of mindfulness program sessions completed). Veterans completing 4 mindfulness-based meditation sessions significantly reduced their cortisol awakening response; and had significant changes in cortisol area under the curve increase compared with TAU participants.

Loving-kindness meditation for veterans with PTSD

Kearney, D. J., McManus, C., Malte, C. A., Martinez, M. E., Felleman, B., & Simpson, T. L. (2014). Loving-Kindness Meditation and the Broaden-and-Build Theory of Positive Emotions Among Veterans With Posttraumatic Stress Disorder. Medical care, 52, S32-S38.

From the Abstract. Loving-kindness meditation (LKM) is a practice intended to enhance feelings of kindness and compassion for self and others.

Objectives: To assess whether participation in a 12-week course of LKM for veterans with posttraumatic stress disorder (PTSD) is associated with improved positive emotions, decentering, and personal resources.

Design: In an open-pilot trial, 42 veterans with active PTSD (40% female ) were assessed at baseline, after the course, and 3 months later. Emotions, decentering, psychological wellbeing including autonomy, environmental mastery, personal growth, positive relations, purpose in life, self-acceptance, and sense of social support were measured at each time point.

Conclusions: Overall, positive emotions increased, and enhancement of personal resources occurred over time. Further investigation of LKM for PTSD is warranted.

Self-compassion as intervention for trauma exposure

Seligowski, A. V., Miron, L. R., & Orcutt, H. K. (2014). Relations Among Self-Compassion, PTSD Symptoms, and Psychological Health in a Trauma-Exposed Sample. Mindfulness, 1-9.

From the Abstract. Emerging literature on self-compassion suggests that establishing and maintaining a compassionate perspective toward oneself and one’s experiences may help buffer against the negative effects of trauma exposure, such as psychopathology and reduced quality of life.

The goal of the current study was to examine relations among self-compassion, posttraumatic stress disorder (PTSD) symptom severity, and overall psychological health in a sample of trauma-exposed university students. Further, the current study explored these associations while controlling for a theoretically related construct, psychological inflexibility. Participants were 453 undergraduate students enrolled in an introductory psychology course at a large Midwestern University (M age = 19.75).

Results demonstrate that increasing levels of self-compassion may represent an important area of intervention for trauma-exposed individuals.

For mothers with childbirth-related trauma

Kendall-Tackett, K. (2014). Intervention for Mothers Who Have Experienced Childbirth-Related Trauma and Posttraumatic Stress Disorder. Clinical Lactation, 5(2), 56-61.Full text via Open Access.

The author advocates mindfulness meditation as one of several complementary healing modalities suitable for relief from posttraumatic stress.

Abstract: Lactation consultants may be one of the first healthcare providers who see mothers following a difficult birth. As such, they can be key sources of support and information for mothers at this critical time. Several aspects of the International Board Certified Lactation Consultant’s (IBCLC) scope of practice can fit within trauma-informed care, including helping mothers identify possible trauma symptoms and posttraumatic stress disorder (PTSD), and addressing breastfeeding issues that may be sequelae of a traumatic birth. IBCLCs can inform mothers about their treatment options and refer them to additional sources of support.

This article describes breastfeeding issues that might arise in the wake of a traumatic birth and summarizes evidence-based treatment options for PTSD so that IBCLCs can share this information with mothers.

Post-traumatic stress symptoms

Goldsmith, R. E., et al. (2014). Mindfulness-Based Stress Reduction for Posttraumatic Stress Symptoms: Building Acceptance and Decreasing Shame. Journal of Evidence-Based Complementary & Alternative Medicine, 2156587214533703. Abstract

Mindfulness-based psychotherapies are associated with reductions in depression and anxiety. However, few studies address whether mindfulness-based approaches may benefit individuals with posttraumatic stress symptoms. The current pilot study explored whether group mindfulness-based stress reduction therapy reduced posttraumatic stress symptoms, depression, and negative trauma-related appraisals in 9 adult participants who reported trauma exposure and posttraumatic stress or depression.

Participants completed 8 sessions of mindfulness-based stress reduction treatment, as well as pretreatment, midtreatment, and posttreatment assessments of psychological symptoms, acceptance of emotional experiences, and trauma appraisals. Posttraumatic stress symptoms, depression, and shame-based trauma appraisals were reduced over the 8-week period, whereas acceptance of emotional experiences increased. Participants’ self-reported amount of weekly mindfulness practice was related to increased acceptance of emotional experiences from pretreatment to posttreatment.

Results support the utility of mindfulness-based therapies for posttraumatic stress symptoms and reinforce studies that highlight reducing shame and increasing acceptance as important elements of recovery from trauma.

Associated with reduced PTSD symptoms and depression

Kearney, D. J., Malte, C. A., McManus, C., Martinez, M. E., Felleman, B., & Simpson, T. L. (2013). Loving‐Kindness Meditation for Posttraumatic Stress Disorder: A Pilot Study. Journal of Traumatic Stress. Epub prior to publication. Abstract.

Excerpts: Loving-kindness meditation is a practice designed to enhance feelings of kindness and compassion for self and others. Loving-kindness meditation involves repetition of phrases of positive intention for self and others.

We undertook an open pilot trial of loving-kindness meditation for veterans with posttraumatic stress disorder (PTSD). Measures of PTSD, depression, self-compassion, and mindfulness were obtained at baseline, after a 12-week loving-kindness meditation course, and 3 months later. Effect sizes were calculated from baseline to each follow-up point, and self-compassion was assessed as a mediator.

A large effect size was found for PTSD symptoms at 3-month follow-up, and a medium effect size was found for depression at 3-month follow-up. There was evidence of mediation of reductions in PTSD symptoms and depression by enhanced self-compassion.

Overall, loving-kindness meditation appeared safe and acceptable and was associated with reduced symptoms of PTSD and depression. Additional study of loving-kindness meditation for PTSD is warranted to determine whether the changes seen are due to the loving-kindness meditation intervention versus other influences, including concurrent receipt of other treatments.