Mindfulness-based stress reduction therapy teaches people to pay attention to the present moment in an accepting way. Past studies have shown it can reduce symptoms of depression and anxiety, but could it also provide relief for those who suffer from posttraumatic stress disorder (PTSD)? A new study finds veterans with PTSD who received mindfulness-based therapy reported greater improvement in symptom severity than veterans in group therapy sessions focused on current problems. Their overall improvement, though, was modest.

PTSD affects nearly a quarter — 23 percent — of all veterans who have returned from deployments in Afghanistan and Iraq. Left untreated, this condition poses unique dangers to veterans and their families.

PTSD “is associated with increased risks of suicide, depression, substance use disorders, intimate partner violence, unemployment, and persistently low quality of life,” wrote Dr. David J. Kearney and Dr. Tracy L. Simpson of the VA Puget Sound Health Care System in an editorial accompanying the new study. “In addition, trauma and PTSD are associated with a higher risk of other health problems, including coronary artery disease, arthritis, asthma, gastrointestinal symptoms, and all-cause mortality.”

While the Department of Veterans Affairs (VA) offers exposure therapy and cognitive processing therapy to service members suffering from PTSD, 60 percent of eligible veterans either failed to begin or dropped out of such treatment programs, noted the authors of the current study. Sadly, up to half of those who did participate in these VA programs failed to show significant improvements. What else can be done for suffering veterans then?

Mindfulness-Based Stress Reduction

The current study compared mindfulness-based stress reduction with present-centered group therapy to assess its overall value and potential for widespread use. Because it encourages acceptance, Dr. Melissa A. Polusny of the Minneapolis Veterans Affairs Health Care System, and her colleagues theorized mindfulness-based therapy might effectively target avoidance, a key factor in the maintenance of PTSD.

To begin their study, the researchers randomly assigned 116 veterans with PTSD to either nine sessions of mindfulness-based stress reduction therapy or nine sessions of present-centered therapy, which focuses on current life problems. Participants in the two randomly selected groups were similar in terms of combat exposure, number of traumatic events, medication use, and mental health history. However, more of the participants in the mindfulness-based therapy group reported a history of sexual trauma and had greater PTSD severity at the beginning of the study. (In fact, more women happened to be randomly selected for the mindfulness group.)

Therapists delivered treatment in group sessions for both sets of participants. The two-and-a-half hour mindfulness sessions involved training and formal practice in three types of meditation techniques: body scan, sitting meditation, and mindful yoga. By comparison, the one-and-a-half hour present-centered therapy sessions mainly consisted of a group discussion of current life problems as manifestations of PTSD. Of the total participants in both groups, 99 completed treatment (participated in at least seven of the nine treatment sessions). What did the researchers observe?

Participants in the mindfulness-based stress reduction group showed greater improvement in self-reported symptom severity during treatment and at two-month follow-up (49 percent versus 28 percent). However, improvements based on interview-rated symptoms were considered insignificant: at posttreatment, 42 percent for the mindfulness group versus 44 percent; and at the two-month follow-up, 53 percent for the mindfulness group versus 47 percent.

Though their findings support the effectiveness of mindfulness-based stress reduction therapy as a treatment of PTSD for veterans, “the magnitude of the average improvement suggests a modest effect,” wrote the authors of the study. Importantly, a key limitation of the study is that most of the participants were veterans who had served during the Vietnam era, suggesting these “results may not generalize to nonveterans or veterans from other eras....”

Source: Polusny MA, Erbes CR, Thuras P, et al.  Mindfulness-Based Stress Reduction for Posttraumatic Stress Disorder Among Veterans: A Randomized Clinical Trial. JAMA. 2015.