A Pilot Study of Group Mindfulness-Based Cognitive Therapy (Mbct) for Combat Veterans With Posttraumatic Stress Disorder (Ptsd)

Abstract

Background “Mindfulness-based” interventions show promise for stress-reduction in general medical conditions, and initial evidence suggests that they are well accepted in trauma-exposed individuals. Mindfulness-based Cognitive Therapy (MBCT) shows substantial efficacy for prevention of depression relapse, but it has been less studied in anxiety disorders. This study investigated the feasibility, acceptability, and clinical outcomes of an MBCT group intervention adapted for combat PTSD. Methods Consecutive patients seeking treatment for chronic PTSD (veterans of Vietnam, Korea, WWII, Desert Storm) at a VA outpatient clinic were enrolled in eight week MBCT groups, modified for PTSD (four groups, n=20) or brief treatment-as-usual (TAU) comparison group interventions (three groups, n=16). MBCT consisted of PTSD psychoeducation, mindfulness of body, breath, and emotions, mindful movement, exercises for managing intrusive thoughts and feelings, and daily home practice though audio recording. Pre- and post-therapy psychological assessments with clinician administered PTSD scale (CAPS) were performed with all patients, and self-report measures (PTSD diagnostic scale, PDS, and Posttraumatic cognitions inventory, PTCI) were administered in the MBCT group. Results Pre- to post-treatment effects analysis demonstrated significant improvement in PTSD symptoms. Intent to treat analyses showed significant improvement in CAPS (t(19)=4.8, p<.001) in the MBCT condition but not the TAU conditions, and a significant Condition*Time interaction (F[1,26]=16.4, p<.005). MBCT completers analysis (n =15, 75%) also showed good compliance with assigned homework exercises, and significant and clinically meaningful improvement in PTSD symptom severity on post-treatment assessment in CAPS and PDS (particularly in avoidance/numbing symptoms), and reduced PTSD-relevant cognitions in PTCI (in particular, self-blame). Conclusions These data suggest group mindfulness-based cognitive therapy as an acceptable brief intervention / adjunct therapy for combat PTSD, with potential for reducing avoidance symptom cluster and PTSD cognitions. Further studies are needed to examine efficacy in a randomized controlled design and to identify factors influencing acceptability and effectiveness.

Mindfulness as Mediator and Moderator of Post-traumatic Symptomatology in Adolescence Following Childhood Sexual Abuse or Assault

“…Although unexpected, results of the current study are not exceptional. Other studies have found that higher levels of acceptance vis-à-vis one's thoughts and emotions were associated with higher levels of physical partner violence perpetration (Godbout et al, 2016), that under certain conditions, higher levels of self-kindness were associated with increases in anxiety (Valdez and Lilly 2015) and that mindfulness exercises focused on bodily sensations may increase anxiety and treatment dropout, especially for those with a history of sexual abuse (King et al 2013). With regards to our study results, it may be that initially, being more aware in a context of sexual abuse is associated with experiencing more anxiety and anger.…”

“…Effectiveness studies need to be conducted over increased periods of time because improving youth's ability to be mindfully aware of their thoughts and emotions may initially be associated with increases in anxiety and anger in sexually abused youth and has entailed increases in anxiety or aggressive behaviours in other populations (Godbout et al 2016;King et al 2013;Valdez and Lilly 2015). In this regard, mindfulness-based interventions initially teaching stress reduction/emotional regulation strategies may be most appropriate to mitigate potentially distressing effects for sexually abused youth (Briere and Scott 2015;Daigneault et al 2004;Lebowitz et al 1993).…”

Mindfulness-Based Cognitive Therapy: Theoretical Background and Use

“…Metoda sprawdza się w ograniczaniu agresji u adolescentów [27]. Przeprowadzono również obiecujące badania pilotażowe u weteranów armii amerykańskiej chorujących na PTSD [28]. Wstępne jakościowe badania pokazują też potencjał metody u pacjentów cierpiących na chorobę Parkinsona [29].…”

Feasibility, Acceptability, and Clinical Trends of a Mindfulness-Informed Child Welfare Intervention: Implications for Trauma-Focused Practice

“…Mindfulness has been used with a variety of groups with high levels of trauma, including child abuse survivors (Kimbrough, Magyari, Langenberg, Chesney, & Berman, 2010) and combat veterans (King et al, 2013).…”

“…In addition, because experiencing adversity may result in avoidant-related behaviors subsequently impacting parent participation in treatment (Littell, Alexander, & Reynolds, 2001;Littell & Tajima, 2000), promoting acceptance and awareness through mindfulness may also positively affect parents' engagement in child welfare services more broadly. Prior research demonstrates that mindfulness-based interventions are effective in reducing stress (Carlson, Speca, Patel, & Goodey, 2004;Williams, Kolar, Reger, & Pearson, 2001), trauma symptoms (Kimbrough et al, 2010;King et al, 2013), and substance misuse (Bowen et al, 2009), as well as improving parent-child interactions (Duncan, Coatsworth, & Greenberg, 2009a).…”