Mindfulness intervention helps veterans with PTSD

Military personnel are at particularly high risk of PTSD because deployments to combat zones increase the risk of exposure to trauma. The effects of PTSD on military and civilian patients, their families, and society in general can be profound. Posttraumatic stress disorder is associated with increased risks of suicide, depression, substance use disorders, intimate partner violence, unemployment, and persistently low quality of life. 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. There are also spiritual and moral dimensions to experiencing or committing acts of trauma, which can endure across the life span.

Although the results reported by Dr. Polusny and her associates are promising, the short duration of follow-up calls into question whether the effects of MBSR persist over time; thus, additional studies of MBSR and other mindfulness-based interventions for PTSD are warranted.

Group interventions such as PCT and MBSR could expand the availability of therapies for PTSD. Given the large number of individuals with PTSD, not all of whom will opt for or benefit sufficiently from existing approaches, additional treatments suitable for broad implementation are needed. If additional studies confirm that MBSR is efficacious for PTSD, it may represent a cost-effective approach to care. Mindfulness-based stress reduction can be led by facilitators who are not psychotherapists, which could expand the availability of PTSD practitioners and services. Other non–trauma focused approaches to PTSD include forms of meditation for which there is initial support among military personnel.

Another potential approach for improving patient outcomes is to involve family members in treatment, as recommended in a recent report of PTSD therapy by the Institute of Medicine (“Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment,” Washington: The National Academies Press, 2014). For mindfulness-based and other skills-based approaches, inclusion of family members in groups or homework practices might help support the patients consistently practice the new skills in their everyday lives through encouragement and reminders that are available more frequently and organically than would be the case through weekly sessions with the instructor. Additionally, if family members are also learning more effective ways of coping with stress and the family is working together to support the patient, these efforts might lead to additional gains over time or shifts in family relational dynamics in support of a more robust recovery.

Dr. David J. Kearney and Tracy L. Simpson, Ph.D., are with the VA Puget Sound Health Care System, Seattle. Neither author reported having financial conflicts. Their remarks were condensed from an accompanying editorial (JAMA. 2015 Aug 4;314(5):453-5.).