Abstract
Objectives: There is promising evidence that mindfulness-based interventions are effective in reducing the symptoms of posttraumatic stress disorder (PTSD). However, until now, studies have often lacked a full clinical PTSD assessment, and interventions are often administered in addition to other interventions. This study examined the feasibility of mindfulness-based stress reduction (MBSR) as a standalone intervention in patients with PTSD who have experienced mixed traumatic events.Method: Fourteen patients participated in 8 weeks of MBSR. The patients were assessed prior to treatment, post-treatment and at a 1-month follow-up through self-ratings (e.g., the Davidson Trauma Scale) and the Clinician-Administered PTSD Scale to determine the effects of the intervention. Furthermore, after the intervention, the patients participated in qualitative interviews regarding their experiences with MBSR and their ideas for future improvements.Results: Nine patients finished the program, and these patients considered the exercises to be applicable and helpful. In the Clinician-Administered PTSD Scale, we found large effects regarding the reduction of PTSD symptoms among completers (Cohen's d = 1.2). In the Davidson Trauma Scale, the effect sizes were somewhat lower (Cohen's d = 0.6) but nevertheless confirmed the efficacy of MBSR in reducing PTSD symptoms. In the qualitative interviews, the patients reported an augmentation of wellbeing and improvement regarding the handling of difficult situations and more distance from the traumatic event.Conclusion: Despite the large effects, the high dropout rates and the results of the post-treatment interviews suggest that the intervention should be better adapted to the needs of PTSD patients, e.g., by giving more information regarding the exercises and by including shorter exercises to manage acute distress.
Highlights
A traumatic event is defined as exposure to actual or threatened death, serious injury or sexual violence (American Psychiatric Association., 2013)
The inclusion criteria were a DSM-IV (American Psychiatric Association, 1994) diagnosis of posttraumatic stress disorder (PTSD), as determined by the Clinician-Administered PTSD Scale
Stronger involvement on the part of the trauma therapist was suggested (Patient 7). In this pre-post study, we tested the feasibility of an 8-week mindfulness-based stress reduction (MBSR) as a standalone group intervention for patients with PTSD who have experienced different types of traumatic events
Summary
A traumatic event is defined as exposure to actual or threatened death, serious injury or sexual violence (American Psychiatric Association., 2013). PTSD comprises symptoms of intrusion, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity (American Psychiatric Association., 2013). Clinical experience indicates that many severely affected patients are unwilling to directly address the traumatic event; compliance with trauma-focused treatment is often low (Scott and Stradling, 1997), non-response rates are high (Schottenbauer et al, 2008), and a substantial number of patients still have residual symptoms after treatment (Bradley et al, 2005). An additional difficulty is that exposure-based techniques are underutilized in clinical practice and lack acceptance because of therapists’ concerns regarding problematic behaviors, such as suicide attempts or substance abuse (Becker et al, 2004)
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