05 Aug Mindfulness-Based Stress Therapy May Reduce PTSD Symptoms in Veterans
MedicalResearch.com Interview with:
Melissa A. Polusny, PhD, LP
Staff Psychologist/Clinician Investigator
Core Investigator, Center for Chronic Disease Outcomes Research
Associate Professor, University of Minnesota Medical School
Minneapolis VA Health Care System
One Veterans Drive Minneapolis, MN 5541
Medical Research: What is the background for this study? What are the main findings?
Dr. Polusny: VA has invested heavily in the dissemination of prolonged exposure therapy and cognitive processing therapy as first-line treatments for PTSD; however, 30% to 50% of Veterans do not show clinically significant improvements and dropout rates are high. Evidence suggests that mindfulness-based stress reduction – an intervention that teaches individuals to attend to the present moment in a non-judgmental, accepting manner – can reduce symptoms of anxiety and depression. This randomized clinical trial compared mindfulness-based stress reduction with present-centered group therapy – sessions focused on current life problems. We randomly assigned 116 Veterans with PTSD to receive nine sessions of mindfulness-based stress reduction therapy (n=58) or nine sessions of present-centered group therapy (n=58). Outcomes were assessed before, during and after treatment, and at two-month follow-up. Exclusion criteria included: substance dependence (except nicotine), psychotic disorder, suicidal or homicidal ideation, and/or cognitive impairment or medical illness that could interfere with treatment. The primary outcome was a change in self-reported PTSD symptom severity over time. Secondary outcomes included interview-rated PTSD severity scores, self-reported depression symptoms, quality of life, and mindfulness skills.
Mindfulness-based stress reduction therapy – compared with present-centered group therapy – resulted in a greater decrease in self-reported PTSD symptom severity. Veterans in the mindfulness-based stress reduction group were more likely to show clinically significant improvement in self-reported PTSD symptom severity (49% vs. 28%) at two-month follow-up, but they were no more likely to have loss of PTSD diagnosis (53% vs. 47%). Veterans participating in mindfulness-based stress reduction therapy reported greater improvement in quality of life and depressive symptoms than those in present-centered group therapy; however improvement in depressive symptoms scores did not reach the level of significance. Improvements in quality of life made during treatment were maintained at 2-month follow-up for Veterans in the mindfulness-based stress reduction group, but reports of quality of life returned to baseline levels for those in present-centered group therapy. The dropout rate observed for mindfulness-based stress reduction therapy (22%) in this study was lower than dropout rates reported in previous studies for PE (28.1% to 44%) and CPT (26.8% to 35%).
Medical Research: What should clinicians and patients take away from your report?
Dr. Polusny: Several effective treatments for PTSD are available, and veterans and others with PTSD should be encouraged to seek help for their problems with PTSD. Mindfulness-based stress reduction therapy – an intervention that teaches individuals to attend to the present moment (immediate emotional and physical states, including discomfort) in a non-judgmental, accepting manner – shows promise as a treatment for PTSD. While clinicians should continue to encourage Veterans to engage in existing evidence-based treatments for PTSD, mindfulness-based stress reduction therapy may be acceptable to veterans who have poor adherence to existing evidence-based treatments for PTSD.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Polusny: While mindfulness-based stress reduction therapy shows promise as a treatment for PTSD among Veterans, replication of findings from this study with more diverse samples and additional centers is needed.
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Melissa A. Polusny, PhD, LP (2015). Mindfulness-Based Stress Therapy May Reduce PTSD Symptoms in Veterans MedicalResearch.com