Mindfulness-based interventions for women victims of interpersonal violence: A systematic review

Abstract

•Reduction of post-traumatic stress symptoms was associated with Mindfulness-based interventions.•Mindfulness-based interventions were effective in reducing symptoms of depression in women victims of violence.•Anxiety symptoms also showed a decrease after Mindfulness-based interventions in studies with women victims of violence. Violence is considered as “the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation” (World Health Organization, 2002World Health Organization World report on violence and health. World Health Organization, Genebra2002Google Scholar). Three subtypes of classification are described: self-directed violence (self-inflicted), collective violence (inflicted by larger groups like militias or terrorist organizations) and interpersonal violence. Interpersonal violence, which is the focus of this study, encompasses the type of aggression that involves individuals of the same family, intimate partners, friends, acquaintances and strangers, child maltreatment and violence against women (World Health Organization, 2002World Health Organization World report on violence and health. World Health Organization, Genebra2002Google Scholar). Interpersonal violence against women is responsible for a number of serious consequences for the victim, which can be socially damaging and may generate harm to physical and mental health (Black, 2011Black M.C. Intimate partner violence and adverse health consequences: Implications for clinicians.American Journal of Lifestyle Medicine. 2011; 5: 428-439https://doi.org/10.1177/1559827611410265Crossref Scopus (290) Google Scholar). Mental damage includes increased psychiatric morbidity and a prolonged response to stress, which may result in chronic health problems (Grippo and Johnson, 2010Grippo A.J. Johnson A.K. NIH public access.Physiology. 2010; 12: 1-21https://doi.org/10.1080/10253890802046281.StressCrossref Google Scholar). Therefore, the negative influence of violence on the victim occurs not only during the traumatic experience but may also persist after the event, becoming a serious health problem, which highlights the eminent necessity for effective interventions for this population. The negative outcomes for the mental health of women exposed to violence include suicide ideation, alcohol and drug abuse, Common Mental Disorders (CMD), depression, anxiety disorders and Post-Traumatic Stress Disorder (PTSD) (Follette et al., 2004Follette V.M. Palm K.M. Rasmussen H.M.L. Acceptance, mindfulness, and trauma.in: Hayes S.C. Follette V.M. Linehan M. Mindfulness and acceptance. Expanding the cognitive behavioral tradition. Guilford Press, New York2004Google Scholar). Therefore, interpersonal violence is an important public health issue and the services that assist this population need to be able to offer adequate clinical care and include the demands of scientific method in their practice, with the aim of applying effective interventions and establishing adequate care (World Health Organization, 2002World Health Organization World report on violence and health. World Health Organization, Genebra2002Google Scholar). In the context of promising interventions, non-pharmacological practices aimed at the treatment of individuals exposed to interpersonal violence has gained the attention of researchers in recent decades. Among such practices, Mindfulness-based interventions present growing, albeit incipient research initiatives demonstrating benefits (Fjorback et al., 2011Fjorback L.O. Arendt M. Ornbol E. Fink P. Walach H. Mindfulness- based stress reduction and mindfulness-based cognitive therapy: A systematic review of randomized controlled trials.Acta Psychiatrica Scandinavica. 2011; 124: 102-119https://doi.org/10.1111/j.1600-0447.2011.01704Crossref PubMed Scopus (0) Google Scholar; Williams et al., 2015Williams H. Simmons L.A. Tanabe P. Mindfulness-Based Stress Reduction in Advanced Nursing Practice.Journal of Holistic Nursing American Holistic Nurses Association. 2015; 33: 247-259https://doi.org/10.1177/0898010115569349Crossref PubMed Scopus (24) Google Scholar). Mindfulness is recognized for developing a mental state characterized by the intentional regulation of attention to what is happening at a given moment (Kabat-Zinn, 2003Kabat-Zinn J. Mindfulness-based stress reduction (MBSR).Constructivism in the Human Sciences. 2003; 8: 73-107Google Scholar). Although the concept of Mindfulness has its origins in many contemplative and philosophical traditions such as Hinduism and Buddhism, its practice does not necessarily imply following a specific philosophy or religion. From a clinical perspective, the original concept of Mindfulness has been used through standardized interventions with the intention of obtaining improvement in determined outcomes for physical and mental health (Kabat-Zinn, 1990Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Delta, New York, NY1990Google Scholar; Ludwig and Kabat-Zinn, 2008Ludwig D.S. Kabat-Zinn J. Mindfulness in medicine.Journal of the American Medical Association. 2008; 300: 1350-1352Crossref PubMed Scopus (524) Google Scholar). According to John Kabat-Zinn, founder of the program known as Mindfulness Based Stress Reduction (MBSR), Mindfulness is considered to be consciousness developed from intentional attention, in the present moment, with the absence of judgment a compassion (Kabat-Zinn, 1990Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Delta, New York, NY1990Google Scholar; Kabat-Zinn, 2003Kabat-Zinn J. Mindfulness-based stress reduction (MBSR).Constructivism in the Human Sciences. 2003; 8: 73-107Google Scholar). Mindfulness-based interventions can be delivered in an organized program which is composed by several mindfulness based practices. The first organized and investigated program was the MBSR (Kabat-Zinn, 2003Kabat-Zinn J. Mindfulness-based stress reduction (MBSR).Constructivism in the Human Sciences. 2003; 8: 73-107Google Scholar; Salmon et al., 2004Salmon P. Sephton S. Weissbecker I. Hoover K. Ulmer C. Studts J.L. Mindfulness meditation in clinical practice.Cognitive and Behavioral Practice. 2004; 11: 434-446https://doi.org/10.1016/S1077-7229(04)80060-9Crossref Scopus (77) Google Scholar). After others were developed based on MBSR components, such as the Mindfulness-based Cognitive Therapy – MBCT and Mindfulness-based Relapse Prevention – MBRP (Segal et al., 2002Segal Z.V. Williams J.M.G. Teasdale J.D. Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. Guilford Press, New York2002Google Scholar; Sipe and Eisendrath, 2012Sipe W.E. Eisendrath S.J. Mindfulness-based cognitive therapy: Theory and practice.The Canadian Journal of Psychiatry. 2012; 57: 63-69https://doi.org/10.1177/070674371205700202Crossref PubMed Scopus (69) Google Scholar). MBSR is a non-pharmacological clinical tool performed through a structured protocol. This is an intensive program composed by 8 meetings, once a week, as well as an all-day retreat. The program is based on face-to-face instructor-led activities and daily practice at home (Kabat-Zinn, 2003Kabat-Zinn J. Mindfulness-based stress reduction (MBSR).Constructivism in the Human Sciences. 2003; 8: 73-107Google Scholar; Salmon et al., 2004Salmon P. Sephton S. Weissbecker I. Hoover K. Ulmer C. Studts J.L. Mindfulness meditation in clinical practice.Cognitive and Behavioral Practice. 2004; 11: 434-446https://doi.org/10.1016/S1077-7229(04)80060-9Crossref Scopus (77) Google Scholar). Participants perform several exercises that include concentration on breathing, meditation, yoga exercises, body movements, cognitive techniques, and biofeedback. These techniques primarily focus on physical, emotional, and cognitive sensations, and involve gradually over during the whole program (Kabat-Zinn, 2003Kabat-Zinn J. Mindfulness-based stress reduction (MBSR).Constructivism in the Human Sciences. 2003; 8: 73-107Google Scholar; Salmon et al., 2004Salmon P. Sephton S. Weissbecker I. Hoover K. Ulmer C. Studts J.L. Mindfulness meditation in clinical practice.Cognitive and Behavioral Practice. 2004; 11: 434-446https://doi.org/10.1016/S1077-7229(04)80060-9Crossref Scopus (77) Google Scholar). Scientific evidence suggests that the use of these strategies induces an improvement in chronic diseases, including depression (Segal et al., 2002Segal Z.V. Williams J.M.G. Teasdale J.D. Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. Guilford Press, New York2002Google Scholar), anxiety (Hofmann et al., 2010Hofmann S.G. Sawyer A.T. Witt A.A. Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review.Journal of Consulting and Clinical Psychology. 2010; 78: 169-183https://doi.org/10.1037/a0018555Crossref PubMed Scopus (2156) Google Scholar), stress (Kabat-Zinn, 1990Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Delta, New York, NY1990Google Scholar; Kabat-Zinn, 2003Kabat-Zinn J. Mindfulness-based stress reduction (MBSR).Constructivism in the Human Sciences. 2003; 8: 73-107Google Scholar), drug dependency (Fjorback et al., 2011Fjorback L.O. Arendt M. Ornbol E. Fink P. Walach H. Mindfulness- based stress reduction and mindfulness-based cognitive therapy: A systematic review of randomized controlled trials.Acta Psychiatrica Scandinavica. 2011; 124: 102-119https://doi.org/10.1111/j.1600-0447.2011.01704Crossref PubMed Scopus (0) Google Scholar), heart disease (Gotink et al., 2017Gotink R.A. et al.Online mindfulness as a promising method to improve exercise capacity in heart disease: 12-month follow-up of a randomized controlled trial.PLoS One. 2017; 12: 9https://doi.org/10.1371/journal.pone.0175923Crossref Scopus (19) Google Scholar), and diabetes (Merkes, 2010Merkes M. Mindfulness-based stress reduction for people with chronic diseases.Australian Journal of Primary Health. 2010; 16: 200-210https://doi.org/10.1071/py09063Crossref PubMed Scopus (0) Google Scholar). Furthermore, such interventions are possible low-cost treatment options, when compared to conventional treatment (Herman et al., 2017Herman P.M. Anderson M.L. Sherman K.J. Balderson B.H. Turner J.A. Cherkin D.C. Cost-effectiveness of mindfulness-based stress reduction versus cognitive behavioral therapy or usual care among adults with chronic low Back pain.Spine. 2017; 42: 1511-1520https://doi.org/10.1097/brs.0000000000002344Crossref PubMed Scopus (0) Google Scholar). Specifically in relation to victims of violence, studies indicate that therapeutic interventions based on Mindfulness may lead to a general reduction of symptoms and promote positive changes in behavior (Thompson et al., 2011Thompson R.W. Arnkoff D.B. Glass C.R. Conceptualizing mindfulness and acceptance as components of psychological resilience to trauma.Trauma Violence Abuse. 2011; 12: 220-235https://doi.org/10.1177/1524838011416375Crossref PubMed Scopus (223) Google Scholar; Dutton et al., 2013Dutton M.A. Bermudez D. Matás A. Majid H. Myers N.L. Mindfulness-based stress reduction for low-income, predominantly African American women with PTSD and a history of intimate partner violence.Cognitive and Behavioral Practice. 2013; https://doi.org/10.1016/j.cbpra.2011.08.003Crossref PubMed Scopus (113) Google Scholar). The hypothesis suggested is that the practice of Mindfulness may increase consciousness of sensorial, cognitive and affective responses of an individual (Thompson et al., 2011Thompson R.W. Arnkoff D.B. Glass C.R. Conceptualizing mindfulness and acceptance as components of psychological resilience to trauma.Trauma Violence Abuse. 2011; 12: 220-235https://doi.org/10.1177/1524838011416375Crossref PubMed Scopus (223) Google Scholar). However, this recognition occurs from a non-judgmental perspective, with self-compassion and appreciation of the efforts to control the internal experience (Kabat-Zinn, 1990Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Delta, New York, NY1990Google Scholar). Unlike most traditional therapy for traumatic experiences, Mindfulness does not require intentional or explicit exposure to the content or details of the victim's history of violence, instead, this strategy concentrates on moment to moment experiences (Dutton et al., 2013Dutton M.A. Bermudez D. Matás A. Majid H. Myers N.L. Mindfulness-based stress reduction for low-income, predominantly African American women with PTSD and a history of intimate partner violence.Cognitive and Behavioral Practice. 2013; https://doi.org/10.1016/j.cbpra.2011.08.003Crossref PubMed Scopus (113) Google Scholar). Unconscious behavior and the avoidance of traumatic experiences seem to result in greater vulnerability to the principal symptoms of PTSD (Thompson et al., 2011Thompson R.W. Arnkoff D.B. Glass C.R. Conceptualizing mindfulness and acceptance as components of psychological resilience to trauma.Trauma Violence Abuse. 2011; 12: 220-235https://doi.org/10.1177/1524838011416375Crossref PubMed Scopus (223) Google Scholar). From our clinical experience, rumination on traumatic events maintains negative emotions related to mood. As such, the development of abilities of full attention, and especially of acceptance, may assist in emotional regulation of the individual. The conscious mental state in the moment, with the absence of judgment before the traumatic experience, reduces symptoms of post-traumatic stress disorder, besides depression and anxiety symptoms (Follette et al., 2004Follette V.M. Palm K.M. Rasmussen H.M.L. Acceptance, mindfulness, and trauma.in: Hayes S.C. Follette V.M. Linehan M. Mindfulness and acceptance. Expanding the cognitive behavioral tradition. Guilford Press, New York2004Google Scholar). Although the research indicates promising results for the use of Mindfulness interventions in various contexts and countries since its development, recent studies have raised questions on such scientific evidence. Researchers indicate the possibility of methodological limitations, especially in studies with randomized clinical trial experimental designs, using control groups in inactive conditions. They also criticize the lack of specificity in relation to the results presented on intervention outcomes and suggest that individual personality characteristics may have interfered in the results, for example, individuals with a profile “open to new experiences” may benefit more from Mindfulness interventions (Farias et al., 2016Farias M. Wikholm C. Delmonte R. What is mindfulness-based therapy good for?.Lancet Psychiatry. 2016; 3: 1012-1013https://doi.org/10.1016/S2215-0366(16)30211-5Abstract Full Text Full Text PDF PubMed Scopus (22) Google Scholar). In considering Mindfulness interventions as a recent theme for investigation and the existence of criticism on their effectiveness, this systematic review aims to identify empirical evidence on the benefits of Mindfulness interventions for the treatment of women affected by violence, specifically victims of interpersonal violence. Moreover, as secondary objectives, the present study intends to assess the principal Mindfulness interventions investigated, evaluating methodological quality of the selected studies and confirming the principal outcomes used in the selected articles. The research question was constructed according to the PICO strategy, of Patient, Intervention, Comparison and Outcomes. Therefore, this study seeks to answer the following question: What benefits (O) do Mindfulness-based interventions offer (I) in comparison to other interventions (C) aimed at the treatment of female victims of interpersonal violence (P)? To guarantee rigorous methodological quality and scientific relevance, this systematic review was developed following recommendations of Preferred Reporting Items for Systematic Review and Meta-Analysis- PRISMA (Liberati et al., 2009Liberati A. Altman D.G. Tetzlaff J. Mulrow C. Gøtzsche P.C. Ioannidis J.P.A. Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration.BMJ (Clinical Research Ed.). 2009; https://doi.org/10.1136/bmj.b2700Crossref Scopus (10111) Google Scholar). Mindfulness is considered a wide-ranging term and may indicate different meanings, including, principally, individual trait Mindfulness related to characteristics of personality, Mindfulness based practices, and state of Mindfulness, the latter being composed of different aspects. As such, the authors chose to include studies evaluating outcomes of the use of structured protocols of Mindfulness Practices or Interventions for the treatment of female victims of interpersonal violence. Also included were studies that selected the specific aspects of Mindfulness approach, such as, “non-judgment” and “contact with the present moment”, and which evaluated the outcome of these components after interventions aimed at the same population. With the aim of fulfilling the purpose of this review, the authors excluded studies testing other approaches that did not evaluate Mindfulness-based interventions, as well as studies whose authors did not describe the intervention as Mindfulness, such as exclusive activities of Yoga, transcendental or Tibetan meditation, Cognitive Therapy or dialectic behavioral therapy. Also excluded were studies with samples of individuals with PTSD without specifying exposure to interpersonal violence, studies evaluating the application of Mindfulness aimed at the aggressor, or with samples that did not include female victims of violence, studies evaluating the application of this strategy with outcomes of reduced aggressiveness and violence, theses, dissertations, reviews and studies with qualitative methodology. The articles were identified through searches on Pubmed, Web of Science, Embase and Scopus electronic databases. The research was conducted during the period from January to February 2018. The selected articles were those with samples exclusively or primarily composed of women, published in English, Spanish or Portuguese and without time limitations regarding year of publication. The search strategy included the terms “Mindfulness”, “MBCT” or “MBSR” in combination with the terms “Violence”, “Physical abuse”, “Intimate partner violence” or “Trauma”. The articles were initially identified through a search on PubMed (http://www.pubmed.gov) using the following combination of words: “Mindfulness*” OR “MBCT” OR “MBSR” in combination with the terms “Violence” OR “Physical abuse” OR “Intimate partner violence” OR “Trauma”, which identified a total of 338 studies. Subsequently, bibliographic searches were carried out on the Embase database, identifying 382 articles, on Web of Science, finding 94 studies and on the Scopus database with 101 articles. As such, a total of 915 studies were identified for critical analysis. The selection process for the articles in this systematic review identified that the studies applied different research methodologies. Two review authors independently assessed the risk of bias in included studies. Therefore, the authors opted to evaluate the quality of the studies and risk of bias based on methodological design. Thus, the Cochrane risk of bias tool was used to assess the quality of the studies with a random clinical trial design (Table 1). This instrument makes a judgment through six principal domains: Random sequence generation, Allocation concealment, Blinding of participants and personnel, Blinding of outcome assessment, Incomplete outcome data, Selective reporting and others (Higgins and Altman, 2008Higgins, J. P., & Altman, D. G. (2008). Assessing risk of bias in included studies Edited by Julian PT Higgins and Douglas G Altman on behalf of the Cochrane Statistical Methods Group and the Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series.Google Scholar)Table 1Risk of bias assessment of the included studies using the Cochrane risk of bias tool for randomized controlled trials.StudyRisk of biasRandom sequence generation (“Selection”)Allocation concealment (“Selection”)Blinding of participants and personnel (“Performance”)Blinding of outcome assessment (“Detection”)Incomplete outcome data (“Attrition”)Selective reporting (“Reporting”)OtherBrotto et al., 2012Brotto L.A. Seal B.N. Rellini A. Pilot study of a brief cognitive behavioral versus mindfulness-based intervention for women with sexual distress and a history of childhood sexual abuse.Journal of Sex & Marital Therapy. 2012; 38: 1-27https://doi.org/10.1080/0092623X.2011.569636Crossref PubMed Scopus (110) Google ScholarLow riskUnclearUnclearUnclearLow riskLow riskUnclearKelly and Garland, 2016Kelly A. Garland E.L. Trauma-informed mindfulness-based stress reduction for female survivors of interpersonal violence: Results from a stage I RCT.Journal of Clinical Psychology. 2016; https://doi.org/10.1002/jclp.22273Crossref PubMed Scopus (61) Google ScholarLow riskUnclearLow riskLow riskLow riskLow riskLow riskGhahari et al., 2017Ghahari S. Khademolreza N. Poya F.S. Ghasemnejad S. Gheitarani B. Pirmoradi M.R. Effectiveness of mindfulness techniques in decreasing anxiety and depression in women victims of spouse abuse.Asian Journal of Pharmaceutical Research and Health Care. 2017; 9: 28-33https://doi.org/10.18311/ajprhc/2017/7644Crossref Google ScholarLow riskUnclearUnclearUnclearUnclearHigh riskHigh riskValdez and Lilly, 2016Valdez C.E. Lilly M.M. Self-compassion and trauma processing outcomes among victims of violence.Mindfulness. 2016; https://doi.org/10.1007/s12671-015-0442-3Crossref Scopus (9) Google ScholarLow riskUnclearLow riskHigh riskLow riskLow riskLow riskValdez et al., 2016Valdez C.E. Sherrill A.M. Lilly M. Present moment contact and nonjudgment: Pilot data on dismantling mindful awareness in trauma-related symptomatology.Journal of Psychopathology and Behavioral Assessment. 2016; https://doi.org/10.1007/s10862-016-9548-8Crossref Scopus (4) Google ScholarLow riskUnclearLow riskHigh riskLow riskLow riskLow risk Open table in a new tab The studies with non-randomized quasi-experimental designs that used pre-test and post-test strategies, were analyzed based on the criteria established by the Risk of Bias Assessment Tool for Non-randomized Studies - RoBANS (Table 2), which analyzes the following domains: selection of participants, confounding variables, measurement of intervention (exposure), blinding of outcome assessment, incomplete outcome data and selective outcome reporting (Kim et al., 2013Kim S.Y. Park J.E. Lee Y.J. Seo H.J. Sheen S.S. Hahn S. Testing a tool for assessing the risk of bias for nonrandomized studies showed moderate reliability and promising validity.Journal of Clinical Epidemiology. 2013; 66: 408-414https://doi.org/10.1016/j.jclinepi.2012.09.016Abstract Full Text Full Text PDF PubMed Scopus (561) Google Scholar).Table 2Risk of bias assessment of the included studies using the Risk of Bias Assessment Tool for Non-Randomized Studies - RoBANS.StudyRisk of biasSelection of participantsConfoundin g variablesMeasurement of intervention (exposure)Blinding of outcome assessmentIncomplete outcome dataSelective outcome reportingKimbrough et al., 2010Kimbrough E. Magyari T. Langenberg P. Chesney M. Berman B. Mindfulness intervention for child abuse survivors.Journal of Clinical Psychology. 2010; https://doi.org/10.1002/jclp.20624Crossref PubMed Scopus (168) Google Scholar.High riskLow riskLow riskUnclearLow riskLow riskGallegos et al., 2015Gallegos A.M. Lytle M.C. Moynihan J.A. Talbot N.L. Mindfulness-based stress reduction to enhance psychological functioning and improve inflammatory biomarkers in trauma-exposed women: A pilot study.Psychological Trauma Theory Research Practice and Policy. 2015; https://doi.org/10.1037/tra0000053Crossref PubMed Scopus (42) Google Scholar.High riskLow riskLow riskUnclearLow riskLow riskHill et al., 2011Hill J.M. Vernig P.M. Lee J.K. Brown C. Orsillo S.M. The development of a brief acceptance and mindfulness-based program aimed at reducing sexual revictimization among college women with a history of childhood sexual abuse.Journal of Clinical Psychology. 2011; https://doi.org/10.1002/jclp.20813Crossref PubMed Scopus (21) Google ScholarHigh riskHigh riskHigh riskUnclearLow riskLow riskGoldsmith et al., 2014Goldsmith R.E. Gerhart J.I. Chesney S.A. Burns J.W. Kleinman B. Hood M.M. Mindfulness-based stress reduction for posttraumatic stress symptoms: Building acceptance and decreasing shame.Journal of Evidence-Based Complementary and Alternative Medicine. 2014; https://doi.org/10.1177/2156587214533703Crossref PubMed Scopus (44) Google ScholarHigh riskHigh riskLow riskUnclearLow riskLow risk Open table in a new tab The search on the databases resulted in a total of 915 articles, whereby 36 studies were duplicated leaving 879 for analysis. After detailed evaluation of the titles and abstracts and application of the eligibility criteria, a total of 15 studies were selected for a thorough review of the text. A further five articles were excluded in this stage due to the following factors: qualitative methodological design (Dutton et al., 2013Dutton M.A. Bermudez D. Matás A. Majid H. Myers N.L. Mindfulness-based stress reduction for low-income, predominantly African American women with PTSD and a history of intimate partner violence.Cognitive and Behavioral Practice. 2013; https://doi.org/10.1016/j.cbpra.2011.08.003Crossref PubMed Scopus (113) Google Scholar, Ferszt et al., 2015Ferszt G.G. Miller R.J. Hickey J.E. Maull F. Crisp K. The impact of a mindfulness-based program on perceived stress, anxiety, depression and sleep of incarcerated women.International Journal of Environmental Research and Public Health. 2015; 12: 11594-11607https://doi.org/10.3390/ijerph120911594Crossref PubMed Scopus (28) Google Scholar), critical review of the literature (Tesh et al., 2015Tesh M. Learman J. Pulliam R.M. Mindful self-compassion strategies for survivors of intimate partner abuse.Mindfulness. 2015; 6: 192-201https://doi.org/10.1007/s12671-013-0244-4Crossref Scopus (13) Google Scholar), evaluation of Post- Traumatic Stress Disorder not being related exclusively to trauma resulting from interpersonal violence and qualitative evaluation (Muller-Engelmann et al., 2017Muller-Engelmann M. Wünsch S. Volk M. Steilet S. Mindfulness-based stress reduction (MBSR) as a standalone intervention for posttraumatic stress disorder after mixed traumatic events: a mixed-methods feasibility study.Frontiers in Psychology. 2017; 8: 1407https://doi.org/10.3389/fpsyg.2017.01407Crossref PubMed Scopus (15) Google Scholar) and absence of the complete text (Dempsey et al., 2014Dempsey C. Chesney M. Lao L. Vegella P. Magyari T. Robertson M.B. Kimbrough E. Acupuncture and mindfulness-based stress reduction among female child abuse survivors: A randomized waitlist-controlled pilot study.Journal of Alternative and Complementary Medicine. 2014; 20Crossref Google Scholar). An additional study was identified that fulfilled the inclusion criteria but only its abstract, submitted for presentation at a conference, could be found. The researchers responsible for said study were contacted; however, they informed that the complete article had not yet been published, so it was excluded (Dempsey et al., 2014Dempsey C. Chesney M. Lao L. Vegella P. Magyari T. Robertson M.B. Kimbrough E. Acupuncture and mindfulness-based stress reduction among female child abuse survivors: A randomized waitlist-controlled pilot study.Journal of Alternative and Complementary Medicine. 2014; 20Crossref Google Scholar). Therefore, in the end, this systematic review was composed of 10 articles. The following figure identifies the strategies during article selection and describes the exclusion factors used in each stage (Fig. 1). A total of 10 studies were included in this review, of which five were randomized clinical trials, four were non-randomized clinical trials, and one was a retrospective cohort study. All the studies were published in English, during the last 10 years (between 2010 and 2017). In relation to sample composition, all the studies assessed adult individuals exposed to different types of interpersonal violence (history of physical abuse as a child and in adulthood, domestic violence or interpersonal trauma). Exclusive participation of women occurred in seven studies and, in the other three studies, the participants were mixed, albeit with women composing at least 80% of the sample (Earley et al., 2014Earley M.D. Chesney M.A. Frye J. Greene P.A. Berman B. Kimbrough E. Mindfulness intervention for child abuse survivors: A 2.5-year follow-up.Journal of Clinical Psychology. 2014; https://doi.org/10.1002/jclp.22102Crossref PubMed Scopus (53) Google Scholar; Goldsmith et al., 2014Goldsmith R.E. Gerhart J.I. Chesney S.A. Burns J.W. Kleinman B. Hood M.M. Mindfulness-based stress reduction for posttraumatic stress symptoms: Building acceptance and decreasing shame.Journal of Evidence-Based Complementary and Alternative Medicine. 2014; https://doi.org/10.1177/2156587214533703Crossref PubMed Scopus (44) Google Scholar; Kimbrough et al., 2010Kimbrough E. Magyari T. Langenberg P. Chesney M. Berman B. Mindfulness intervention for child abuse survivors.Journal of Clinical Psychology. 2010; https://doi.org/10.1002/jclp.20624Crossref PubMed Scopus (168) Google Sc