An Overview of the Research on Mindfulness-Based Interventions for Treating Symptoms of Posttraumatic Stress Disorder: A Systematic Review

Abstract

Objective: This systematic review aimed to collate and evaluate the existing research for the use of mindfulness based approaches to treat post-traumatic stress disorder. Primary objectives were to explore the effects of mindfulness based approaches on post-traumatic stress symptoms and associated psychological distress; with secondary objectives to explore the attrition rate, adverse effects, resource implications and long term effects of such interventions.Method: Research databases, EMBASE, OVID MedLine, Psycinfo, CINAHL and PILOTS were systematically searched, relevant authors in the field were contacted and a hand search of relevant papers was conducted.Results: The search resulted in 12 studies that met eligibility criteria. Many of these studies lacked methodological rigour. The majority of studies indicated positive outcomes with improvements in post-traumatic stress symptoms, particularly in reducing avoidance. Post-traumatic stress disorder (PTSD) is defined as a presentation of characteristic symptoms following direct exposure, witnessing or learning of an event that involves actual or threatened death or serious injury or harm to self or others (American Psychiatric Association, 2013). PTSD is characterised by four clusters of symptoms which can be summarised as-re-experiencing traumatic events which may occur through flashbacks or nightmares, negative cognitions and mood, avoidance of trauma related cognitions and triggers which may present as dissociation or emotional numbing; and hyper arousal such as, hyper-vigilance to threat, irritability and sleep problems (APA, 2013). PTSD symptoms can be variable in terms of impact, severity, and duration; many researchers have suggested that a chronic form of complex PTSD may occur following prolonged or repeated traumatic events (Cloitre et al., 2009). PTSD is a significant health issue: it has been estimated that 25-30% of people who experience a traumatic life event go on to develop PTSD (National Institute Clinical Excellence, 2005). A recent study highlighted the high prevalence rate of trauma symptoms amongst mental health service users: 89% of a representative sample of individuals referred to primary care psychology reported exposure to traumatic life events and 51% met the screening criteria for PTSD despite trauma not always being the primary reason for referral (Noel, Gillanders & Power, 2012). PTSD InterventionsThe cognitive model of PTSD largely dominates the literature and is one of the most pervasive models for conceptualizing the development and maintenance of this disorder (Ehlers & Clark, 2000). The model proposes two main perpetuating factors which lead to a perceived sense of current threat: negative appraisals of the traumatic events and disrupted processing of trauma There is a significant evidence base for these approaches and the effectiveness of these interventions has been well documented (Powers, Halpern, Ferenschak, Gillihan & Foa, 2010;Mendes, Mello, Venture, Passarela & Mari, 2008;Seidler & Wagner, 2006). However attrit...

Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence

“…[26][27][28]37,38 Lang and colleagues 27 discuss 3 components of mindfulness that may promote recovery from PTSD, including attention, a mindful cognitive style, and nonjudgment. Specifically, the authors explain how mindful, intentional shifting of attention to the present moment fosters a capacity for attentional control and may lead to reductions in attentional bias to traumarelated stimuli (see Fig.…”

“…24 Mindfulness, defined as "the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment by moment," 25 has emerged over the past decade as an alternative technique for targeting symptoms of avoidance and negative cognitions, including self-blame, shame and guilt among individuals with PTSD. [26][27][28] With its roots in ancient Eastern traditions, the use of mindfulnessbased treatments in psychiatric populations has grown exponentially following its introduction to Western psychology in the 1980s and 1990s. 29 Mindfulness-based stress reduction (MBSR) is among the most commonly cited mindfulness-based treatment approaches.…”

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

“…Being able to pay attention to novelty and to the context of a current situation (Langer et al 1978) or in a purposeful manner, in the present moment, and non-judgmentally (Kabat-Zinn et al 1985), is thought to help reduce Running head: SEXUAL ABUSE OR ASSAULT AND MINDFULNESS 6 psychopathology in general and post-traumatic symptoms, in particular (Banks et al 2015;Follette et al 2006). In this regard, mindfulness can also be conceptualized as at least partly countering experiential avoidance (Thompson and Waltz 2010).…”

The effect of mindfulness training on rumination and intrusions after analogue trauma

“…Overall, mindfulness or certain components of mindfulness appear to be negatively related to PTSD symptoms. However the utility of mindfulness‐based therapies for PTSD is understudied and there is not yet particularly rigorous empirical support for its use with PTSD (see Banks, Newman, & Saleem, ; Hopwood & Schutte, , for review).…”