The role of mindfulness as approach-based coping in the PTSD-substance abuse cycle

Addiction Science & Clinical Practice

Background Women with co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) experience systemic barriers that place them in danger of poorer treatment outcomes. Some mindfulness-based interventions (MBIs) have demonstrated efficacy in reducing PTSD and SUD symptoms. Mindfulness practice is a core component of MBIs, thought to elicit and maintain positive behavioral change; however, no research to our knowledge has assessed the role of mindfulness practice on sustained treatment gains among women with co-occurring PTSD-SUD. Such research is necessary to better inform MBIs for dually diagnosed women. Methods This secondary analysis assessed whether post-intervention formal and informal mindfulness practice predicted reductions in PTSD symptoms and substance craving 6 months following an 8-session mindfulness-based relapse prevention intervention for women diagnosed with co-occurring PTSD-SUD (N = 23). Data were derived from a pilot randomized controlled tr...

Background. Previous reviews have concluded that whilst mindfulness-based interventions reduce PTSD symptoms through fear extinction and cognitive restructuring, further research is needed. Objective. The aim of this report is to systematically review existing literature about the association between standardized mindfulness-based interventions and PTSD with the aim of identifying implications for practice and recommendations for future research. Method. The CINAHL Complete, PsycINFO, Medline, and PsycArticles databases were searched, looking for full-text articles from 2018 up to march 2022. Results. There was a significant improvement in PTSD symptoms in MBCT participants, even if some experienced a high increase at baseline. MBSR participants with moderate to severe trauma symptoms showed a greater reduction in symptoms whereas mild trauma symptoms at baseline showed slightly higher symptomatology at the end of treatment. Discussion and conclusion. From the results, MBCT, MBSR, and their variations seem to tackle different domains of the diagnosis. Whilst MBSR is associated with improvements in terms of attentional difficulties, MBCT facilitates the connection between dysfunctional cognitive concepts and avoidant behaviours that maintain the symptomatology. Nevertheless, the active components of MBCT or MBSR that have an impact on symptom reduction are undetermined. Future studies will be enhanced by monitoring the change in underlying mechanisms attached to the practice of mindfulness through outcome measurements, among other considerations. (English)

Your article is protected by copyright and all rights are held exclusively by Springer Science+Business Media New York (outside the USA). This e-offprint is for personal use only and shall not be self-archived in electronic repositories. If you wish to self-archive your article, please use the accepted manuscript version for posting on your own website. You may further deposit the accepted manuscript version in any repository, provided it is only made publicly available 12 months after official publication or later and provided acknowledgement is given to the original source of publication and a link is inserted to the published article on Springer's website. The link must be accompanied by the following text: "The final publication is available at link.springer.com". Abstract Mindfulness-based stress reduction programs have improved psychological health for clinical populations including veterans with posttraumatic stress disorder (PTSD).

A Fresh Look at Anxiety Disorders, 2015

Combining mindfulness to strengthen emotion regulation with existing empirically supported post-traumatic stress disorder (PTSD) treatments may improve outcomes through increasing (a) engagement, (b) compliance, and (c) decreasing the level of ruminations in PTSD. Several psychotherapeutic interventions incorporating training in mindfulness are clinically relevant to traumatic stress. In order to see how far PTSD treatment could benefit from including mindfulness into the therapeutic process, we analyzed researches regarding: (a) the neuroscience of mindfulness, (b) assessment instruments for mindfulness, (c) mechanism of mindfulness, respective, and (d) the relation between mindfulness and other techniques. Based on this analysis, we can conclude that mindfulness may improve the therapeutic results and the outcome of PTSD patients. Mindfulness can be used in two ways: (a) as an emotion regulation support technique for existing empirically supported PTSD treatments and (b) as a standalone treatment-mindfulness-based cognitive behavior psychotherapies.

Professional Psychology: Research and Practice, 2011

How might a practice that has its roots in contemplative traditions, seeking heightened awareness through meditation, apply to trauma-related mental health struggles among military veterans? In recent years, clinicians and researchers have observed the increasing presence of mindfulness in Western mental health treatment programs. Mindfulness is about bringing an attitude of curiosity and compassion to present experience. This review addresses the above question in a detailed manner with an emphasis on the treatment of military veterans suffering from posttraumatic stress disorder (PTSD) and related psychopathology. In addition, the integration of mindfulness with current empirically supported treatments for PTSD is discussed with specific attention to directions for future research in this area.

Mindfulness, 2020

Objectives-Mindfulness training is frequently included as part of an integrative care approach to treating PTSD in veterans. However, the utility and acceptability of daily group mindfulness training in an intensive treatment program (ITP) for PTSD have not been explored. The study objectives were to determine: (a) whether mindfulness skills significantly increased from pre-to post-treatment and (b) if daily group mindfulness training was acceptable to veterans. Methods-Veterans (N = 170 outpatients, age M = 40.7 (SD 9.3), 67.6% male) in this prospective study were consecutively enrolled in a 3-week ITP that included daily mindfulness group sessions. Mindfulness skills were assessed using the Five Facet of Mindfulness Questionnaire (FFMQ) at intake and post-treatment. Acceptability was assessed using an anonymous post-treatment program satisfaction survey. Results-Paired t tests demonstrated significant increases in overall mindfulness skills from preto post-treatment (t(169) = − 6.33, p < 0.001, d = 0.49). Small to medium effect sizes were observed across subscales: describing, (t(169) = − 5.91, p < 0.001, d = 0.38); acting with awareness, (t(169) = − 3.70, p < 0.001, d = 0.29); nonjudging, (t(169) = − 7.54, p < 0.001, d = 0.58); and nonreactivity, (t(169) = − 4.84, p < 0.001, d = 0.41). Most veterans (n = 125, 74.4%) found daily mindfulness training moderately to very helpful. Conclusions-Veterans' mindfulness skills significantly increased over the course of a 3-week ITP, and mindfulness training was found acceptable. Mindfulness training can be delivered daily as part of an ITP for veterans with PTSD, and mindfulness skills can meaningfully increase over the course of 3 weeks. A significant limitation is the lack of control condition.

Mindfulness, 2019

Objectives Combat experiences predict PTSD and depression in U.S. military veterans. However, few studies have investigated associations between mindfulness and these constructs. We examined main, direct, and indirect effects for mindfulness and combat experiences on veterans' PTSD and depressive symptoms and investigated the explanatory value of mindfulness on outcome variance in these models. Methods A total of 485 post-9/11 era military veterans with previous combat deployments residing in four major US cities completed online surveys asking about their combat experiences, mindfulness, and mental health. Two multivariable ordinary least squares regression models were specified to investigate main effects of mindfulness and combat experiences on veterans' PTSD and depressive symptoms. Path models examined direct and indirect effects of combat experiences and mindfulness on these outcomes. Results There were significant associations for mindfulness (β = − 0.68, p < 0.001), (β = − 0.67, p < 0.001) and combat experiences (β = 0.12, p < 0.001), (β = 0.09, p < 0.001) with PTSD and depression respectively. In both models, the addition of the mindfulness parameter significantly increased model R 2. Path analysis demonstrated significant direct effects for mindfulness and combat experiences and indirect effects for combat experiences on PTSD and depressive symptoms through the mindfulness pathway. Conclusions The associations of mindfulness with PTSD and depressive symptoms were greater in magnitude than the associations for combat experiences, and mindfulness explained a large and significant proportion of the variance in outcomes. Additional longitudinal research investigating how mindfulness skills and strategies may buffer against risk for PTSD and depression posed by combat experience is warranted in this high risk population.

Mindfulness, 2014

Your article is protected by copyright and all rights are held exclusively by Springer Science+Business Media New York (outside the USA). This e-offprint is for personal use only and shall not be self-archived in electronic repositories. If you wish to self-archive your article, please use the accepted manuscript version for posting on your own website. You may further deposit the accepted manuscript version in any repository, provided it is only made publicly available 12 months after official publication or later and provided acknowledgement is given to the original source of publication and a link is inserted to the published article on Springer's website. The link must be accompanied by the following text: "The final publication is available at link.springer.com". Abstract Mindfulness-based stress reduction programs have improved psychological health for clinical populations including veterans with posttraumatic stress disorder (PTSD).

(2017). "Trauma Sensitive Yoga as a complementary treatment for posttraumatic stress disorder: A Qualitative Descriptive analysis." Int J Stress Manag 24(2): 173-195. Research on Posttraumatic Stress Disorder and chronic childhood abuse has revealed that traditional trauma treatments often fail to fully address the complicated symptom presentation, including the somatic complaints, loss of awareness of one's emotional and physical being in the present moment, and overall lack of integration between the self and the body. The mindfulness-based intervention of hatha yoga shows promise as a complementary treatment, and focuses on personal growth in addition to symptom reduction. This qualitative study explored the experiences of thirty-one adult women with PTSD related to chronic childhood trauma who participated in a 10-week Trauma Sensitive Yoga class, specifically examining perceived changes in symptoms and personal growth. Five themes were identified that reflect participants' feelings of Gratitude and compassion, Relatedness, Acceptance, Centeredness, and Empowerment. Results and implications for research and clinical work are presented. (2017). "Changes in Mindfulness and Posttraumatic Stress Disorder Symptoms Among Veterans Enrolled in Mindfulness-Based Stress Reduction." J Clin Psychol 73(3): 201-217. OBJECTIVES: The current study assessed associations between changes in 5 facets of mindfulness (Acting With Awareness, Observing, Describing, Non-Reactivity, and Nonjudgment) and changes in 4 posttraumatic stress disorder (PTSD) symptom clusters (Re-Experiencing, Avoidance, Emotional Numbing, and Hyperarousal symptoms) among veterans participating in mindfulness-based stress reduction (MBSR). METHOD: Secondary analyses were performed with a combined data set consisting of 2 published and 2 unpublished trials of MBSR conducted at a large Veterans Affairs hospital. The combined sample included 113 veterans enrolled in MBSR who screened positive for PTSD and completed measures of mindfulness and PTSD symptoms before and after the 8-week intervention. RESULTS: Increases in mindfulness were significantly associated with reduced PTSD symptoms. Increases in Acting With Awareness and Non-Reactivity were the facets of mindfulness most strongly and consistently associated with reduced PTSD symptoms. Increases in mindfulness were most strongly related to decreases in Hyperarousal and Emotional Numbing. CONCLUSIONS: These results extend previous research, provide preliminary support for changes in mindfulness as a viable mechanism of treatment, and have a number of potential practical and theoretical implications. Shipherd, J. C. and K. Salters-Pedneault (2017). "Do Acceptance and Mindfulness Moderate the Relationship Between Maladaptive Beliefs and Posttraumatic Distress?" Psychol Trauma. OBJECTIVE: Maladaptive pre-and posttraumatic beliefs are reliable predictors of distress in the wake of trauma. Acceptance and mindfulness skills may be associated with less distress in the presence of these beliefs, but few studies have explored these relationships. This study examined whether individual differences in acceptance and mindfulness moderate the relationship between maladaptive thoughts and distress in postdeployment soldiers. METHOD: We explored the relationships between posttraumatic maladaptive beliefs, acceptance, mindfulness, and posttraumatic distress (posttraumatic stress disorder [PTSD] and general psychological symptoms) in a sample of recently postdeployed active duty U.S. Army Soldiers (N = 1,524). RESULTS: Maladaptive thoughts, acceptance, and mindfulness predicted posttraumatic distress, adjusted for combat exposure. In addition, mindfulness partially moderated the relationship between maladaptive thoughts and PTSD symptoms, and acceptance partially moderated the relationship between maladaptive thoughts and general psychological symptoms. Moderation effects were small. CONCLUSIONS: These findings suggest that individual differences in acceptance and mindfulness may weakly mitigate the relationship between maladaptive thinking and posttraumatic distress, but additional skills may be necessary to fully address maladaptive beliefs in Soldier postdeployment. (PsycINFO Database Record

Journal of alternative and complementary medicine (New York, N.Y.), 2018

U.S. veterans are at increased risk of developing post-traumatic stress disorder (PTSD). Prior studies suggest a benefit of mindfulness-based stress reduction (MBSR) for PTSD, but the mechanisms through which MBSR reduces PTSD symptoms and improves functional status have received limited empirical inquiry. This study used a qualitative approach to better understand how training in mindfulness affects veterans with PTSD. Qualitative study using semistructured in-depth interviews following participation in an MBSR intervention. Outpatient. Eight-week MBSR program. Participants&#39; narratives of their experiences from participation in the program. Interviews were completed with 15 veterans. Analyses identified six core aspects of participants&#39; MBSR experience related to PTSD: dealing with the past, staying in the present, acceptance of adversity, breathing through stress, relaxation, and openness to self and others. Participants described specific aspects of a holistic mindfulness...