Top

Mindfulness

Gepubliceerd in:

11-09-2021 | ORIGINAL PAPER

Effects of Mindfulness-Based Internet Intervention on ICD-11 Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder Symptoms: a Pilot Randomized Controlled Trial

Auteurs: Austeja Dumarkaite, Inga Truskauskaite-Kuneviciene, Gerhard Andersson, Julija Mingaudaite, Evaldas Kazlauskas

Gepubliceerd in: Mindfulness | Uitgave 11/2021

Abstract

Objectives

A substantial proportion of trauma survivors with posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) continue to experience symptoms even after trauma-focused therapies. Internet-based interventions could facilitate access to treatment for PTSD and CPTSD. The current pilot study aimed to investigate the effects of mindfulness-based internet intervention on PTSD and CPTSD symptoms.

Methods

A randomized controlled trial (RCT) design with two measurement points (pre-test and post-test) was used to investigate the effects of a structured mindfulness-based internet intervention on PTSD and CPTSD symptoms as well as anxiety, depression, and positive mental health. In total, 70 university students with high levels of PTSD and CPTSD symptoms based on ICD-11 criteria participated in the study: 31 in the intervention group and 39 in the waiting list control group.

Results

We found that the mindfulness-based internet intervention reduced CPTSD disturbances in self-organization (DSO) symptoms (ES = − 0.48 [− 0.96; 0.00]), particularly negative self-concept (ES = − 0.72 [− 1.21; − 0.24]) and disturbances in relationships (ES = − 0.55 [− 1.03; − 0.07]). Moreover, the intervention reduced the symptoms of PTSD sense of threat (ES = − 0.48 [− 0.96; − 0.01]) and promoted positive mental health (ES = 0.51 [0.03; 0.99]). High user satisfaction and good usability of the intervention were reported.

Conclusions

Promising treatment effects were found, indicating that mindfulness-based internet intervention can reduce CPTSD symptoms and have a positive effect on mental health among youth in general. The findings of the current study contribute to the further development of trauma care using internet-delivered interventions.

Trial registration: ClinicalTrials.gov NTC04333667 (3 April 2020)

vorige artikel Mindful Versus Diaphragmatic Breathing: Spirituality Moderates the Impact on Heart Rate Variability

volgende artikel Effectiveness of a Blended Internet-Based Mindfulness Intervention in Inflammatory Bowel Disease Patients: a Mixed-Methods Non-randomized Controlled Trial

American Psychological Association. (2017). Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. https://doi.org/10.1162/jocn

Andersson, G., Carlbring, P., Titov, N., & Lindefors, N. (2019). Internet interventions for adults with anxiety and mood disorders: A narrative umbrella review of recent meta-analyses. Canadian Journal of Psychiatry, 64(7), 465–470. https://doi.org/10.1177/0706743719839381CrossRefPubMedPubMedCentral

Bisson, J. I., & Olff, M. (2021). Prevention and treatment of PTSD: The current evidence base. European Journal of Psychotraumatology, 12(1). https://doi.org/10.1080/20008198.2020.1824381

Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A multidimensional meta-analysis of psychotherapy for PTSD. American Journal of Psychiatry, 162(2), 214–227. https://doi.org/10.1177/153476560501100304CrossRefPubMed

Brewin, C. R. (2020). Complex post-traumatic stress disorder: A new diagnosis in ICD-11. Bjpsych Advances, 26(3), 145–152. https://doi.org/10.1192/bja.2019.48CrossRef

Butkutė-Šliuožienė, K. (2019). Generalizuoto nerimo sutrikimo skalė-7. Biological Psychiatry and Psychopharmacology, 21(1), 21–22. http://biological-psychiatry.eu/wp-content/uploads/2019/07/BPP_2019_21to22.pdf

Cloitre, M., Shevlin, M., Brewin, C. R., Bisson, J. I., Roberts, N. P., Maercker, A., Karatzias, T., & Hyland, P. (2018). The International Trauma Questionnaire: Development of a self-report measure of ICD-11 PTSD and complex PTSD. Acta Psychiatrica Scandinavica, 138(6), 536–546. https://doi.org/10.1111/acps.12956CrossRefPubMed

Cohen, J. (1988). Statistical power analysis for the behavoral sciences (2nd ed.). Lawrence Erlbaum Accociates.

Colgan, D. D., Christopher, M., Michael, P., & Wahbeh, H. (2016). The body scan and mindful breathing among veterans with PTSD: Type of intervention moderates the relationship between changes in mindfulness and post-treatment depression. Mindfulness, 7(2), 372–383. https://doi.org/10.1007/s12671-015-0453-0CrossRefPubMed

Crescentini, C., & Capurso, V. (2015). Mindfulness meditation and explicit and implicit indicators of personality and self-concept changes. Frontiers in Psychology, 6, 1–6. https://doi.org/10.3389/fpsyg.2015.00044CrossRef

Fairburn, C. G., & Patel, V. (2017). The impact of digital technology on psychological treatments and their dissemination. Behaviour Research and Therapy, 88, 19–25. https://doi.org/10.1016/j.brat.2016.08.012CrossRefPubMedPubMedCentral

Fritz, C. O., Morris, P. E., & Richler, J. J. (2012). Effect size estimates: Current use, calculations, and interpretation. Journal of Experimental Psychology: General, 141(1), 2–18. https://doi.org/10.1037/a0024338CrossRef

Guendelman, S., Medeiros, S., & Rampes, H. (2017). Mindfulness and emotion regulation: Insights from neurobiological, psychological, and clinical studies. Frontiers in Psychology, 8, 1–23. https://doi.org/10.3389/fpsyg.2017.00220CrossRef

ISTSS. (2018). Posttraumatic stress disorder prevention and treatment guidelines. Methodology and recommendations. http://www.istss.org/getattachment/Treating-Trauma/New-ISTSS-Prevention-and-Treatment-Guidelines/ISTSS_PreventionTreatmentGuidelines_FNL.pdf.aspx

Iverson, G. L. (2019). Reliable Change Index. In J. Kreutzer, J. DeLuca, & B. Caplan (Eds.), Encyclopedia of Clinical Neuropsychology. Springer, Cham. https://doi.org/10.1007/978-3-319-56782-2_1242-3

Jasbi, M., Sadeghi Bahmani, D., Karami, G., Omidbeygi, M., Peyravi, M., Panahi, A., Mirzaee, J., Holsboer-Trachsler, E., & Brand, S. (2018). Influence of adjuvant mindfulness-based cognitive therapy (MBCT) on symptoms of post-traumatic stress disorder (PTSD) in veterans–results from a randomized control study. Cognitive Behaviour Therapy, 47(5), 431–446. https://doi.org/10.1080/16506073.2018.1445773CrossRefPubMed

Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156. https://doi.org/10.1093/clipsy/bpg016CrossRef

Karatzias, T., & Cloitre, M. (2019). Treating adults with complex posttraumatic stress disorder using a modular approach to treatment: Rationale, evidence, and directions for future research. Journal of Traumatic Stress, 32(6), 870–876. https://doi.org/10.1002/jts.22457CrossRefPubMed

Karremans, J. C., Schellekens, M. P. J., & Kappen, G. (2017). Bridging the sciences of mindfulness and romantic relationships: A theoretical model and research agenda. Personality and Social Psychology Review, 21(1), 29–49. https://doi.org/10.1177/1088868315615450CrossRefPubMed

Kazlauskas, E. (2017). Challenges for providing health care in traumatized populations: Barriers for PTSD treatments and the need for new developments. Global Health Action, 10(1). https://doi.org/10.1080/16549716.2017.1322399

Kazlauskas, E., Gegieckaite, G., Hyland, P., Zelviene, P., & Cloitre, M. (2018). The structure of ICD-11 PTSD and complex PTSD in Lithuanian mental health services. European Journal of Psychotraumatology, 9(1). https://doi.org/10.1080/20008198.2017.1414559

Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.xCrossRefPubMedPubMedCentral

Lang, A. J., Strauss, J. L., Bomyea, J., Bormann, J. E., Hickman, S. D., Good, R. C., & Essex, M. (2012). The theoretical and empirical basis for meditation as an intervention for PTSD. Behavior Modification, 36(6), 759–786. https://doi.org/10.1177/0145445512441200CrossRefPubMed

Lewis, C., Roberts, N. P., Andrew, M., Starling, E., & Bisson, J. I. (2020a). Psychological therapies for post-traumatic stress disorder in adults: Systematic review and meta-analysis. European Journal of Psychotraumatology, 11(1). https://doi.org/10.1080/20008198.2020.1729633

Lewis, C., Roberts, N. P., Bethell, A., Robertson, L., & Bisson, J. I. (2018). Internet-based cognitive and behavioural therapies for posttraumatic stress disorder (PTSD) in adults. Cochrane Database of Systematic Reviews, 2018(12). https://doi.org/10.1002/14651858.CD011710.pub2

Lewis, C., Roberts, N. P., Gibson, S., & Bisson, J. I. (2020b). Dropout from psychological therapies for post-traumatic stress disorder (PTSD) in adults: Systematic review and meta-analysis. European Journal of Psychotraumatology, 11(1). https://doi.org/10.1080/20008198.2019.1709709

Liu, C. H., Zhang, E., Wong, G. T. F., Hyun, S., & Hahm, H. C. (2020). Factors associated with depression, anxiety, and PTSD symptomatology during the COVID-19 pandemic: Clinical implications for U.S. young adult mental health. Psychiatry Research, 290. https://doi.org/10.1016/j.psychres.2020.113172

Lukat, J., Margraf, J., Lutz, R., Der Veld, W. M., & Becker, E. S. (2016). Psychometric properties of the positive mental health scale (PMH-scale). BMC Psychology, 4(1), 1–14. https://doi.org/10.1186/s40359-016-0111-xCrossRef

Maercker, A., Brewin, C. R., Bryant, R. A., Cloitre, M., Van Ommeren, M., Jones, L. M., Humayan, A., Kagee, A., Llosa, A. E., Rousseau, C., Somasundaram, D. J., Souza, R., Suzuki, Y., Weissbecker, I., Wessely, S. C., First, M. B., & Reed, G. M. (2013). Diagnosis and classification of disorders specifically associated with stress: Proposals for ICD-11. World Psychiatry, 12(3), 198–206. https://doi.org/10.1002/wps.20057CrossRefPubMedPubMedCentral

Montvidas, J. (2018). Paciento sveikatos klausimynas-9. Biological Psychiatry and Psychopharmacology, 20(2), 57–59. http://biological-psychiatry.eu/wp-content/uploads/2019/01/JBPP_2018_v20_No2_57-59.pdf.

Morris, S. B. (2008). Estimating effect sizes from pretest-posttest-control group designs. Organizational Research Methods, 11(2), 364–386. https://doi.org/10.1177/1094428106291059CrossRef

Murphy, D., Shevlin, M., Pearson, E., Greenberg, N., Wessely, S., Busuttil, W., & Karatzias, T. (2020). A validation study of the International Trauma Questionnaire to assess post-traumatic stress disorder in treatment-seeking veterans. British Journal of Psychiatry, 216(3), 132–137. https://doi.org/10.1192/bjp.2020.9CrossRef

Reyes, A. T., Bhatta, T. R., Muthukumar, V., & Gangozo, W. J. (2020). Testing the acceptability and initial efficacy of a smartphone-app mindfulness intervention for college student veterans with PTSD. Archives of Psychiatric Nursing, 34(2), 58–66. https://doi.org/10.1016/j.apnu.2020.02.004CrossRefPubMed

Schulz, K. F., Altman, D. G., & Moher, D. (2011). CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. International Journal of Surgery, 9(8), 672–677. https://doi.org/10.1016/j.ijsu.2011.09.004CrossRefPubMed

Spitzer, R. L., Kroenke, K., Williams, J. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092CrossRefPubMed

Truskauskaite-Kuneviciene, I., Kazlauskas, E., Ostreikaite-Jurevice, R., Brailovskaia, J., & Margraf, J. (2020). Positive mental health and adjustment following life-stressors among young adults. Current Psychology. https://doi.org/10.1007/s12144-020-00714-3

Valenstein-Mah, H., Simpson, T. L., Bowen, S., Enkema, M. C., Bird, E. R., In Cho, H., & Larimer, M. E. (2019). Feasibility pilot of a brief mindfulness intervention for college students with posttraumatic stress symptoms and problem drinking. Mindfulness, 10(7), 1255–1268. https://doi.org/10.1007/s12671-018-1077-yCrossRefPubMedPubMedCentral

Vlaescu, G., Alasjö, A., Miloff, A., Carlbring, P., & Andersson, G. (2016). Features and functionality of the Iterapi platform for internet-based psychological treatment. Internet Interventions, 6, 107–114. https://doi.org/10.1016/j.invent.2016.09.006CrossRefPubMedPubMedCentral

Weathers, F. W., Blake, D. D., Schnurr, P. P., Kaloupek, D. G., Marx, B. P., & Keane, T. M. (2013). The Life Events Checklist for DSM-5 (LEC-5). www.ptsd.va.gov

Wind, T. R., Rijkeboer, M., Andersson, G., & Riper, H. (2020). The COVID-19 pandemic: The ‘black swan’ for mental health care and a turning point for e-health. Internet Interventions, 20. https://doi.org/10.1016/j.invent.2020.100317

World Health Organization. (2018). International classification of diseases for mortality and morbidity statistics (11th Revision). https://icd.who.int/browse11/l-m/en

Titel: Effects of Mindfulness-Based Internet Intervention on ICD-11 Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder Symptoms: a Pilot Randomized Controlled Trial
Auteurs: Austeja Dumarkaite
Inga Truskauskaite-Kuneviciene
Gerhard Andersson
Julija Mingaudaite
Evaldas Kazlauskas
Publicatiedatum: 11-09-2021
Uitgeverij: Springer US
Gepubliceerd in: Mindfulness / Uitgave 11/2021
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI: https://doi.org/10.1007/s12671-021-01739-w

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Objectives

Methods

Results

Conclusions

Log in om toegang te krijgen

Andere artikelen Uitgave 11/2021

Parents’ Depressive Symptoms and Child Adjustment: the Mediating Role of Mindful Parenting and Children’s Self-Regulation

Effectiveness and Mechanisms of Mindfulness Training for School Teachers in Difficult Times: A Randomized Controlled Trial

Emotional Intelligence Mediates the Connection Between Mindfulness and Gratitude: a Meta-Analytic Structural Equation Modeling Study

Mindful Versus Diaphragmatic Breathing: Spirituality Moderates the Impact on Heart Rate Variability

The Role of Mindfulness and Life Satisfaction in Psychological Distress During the COVID-19 Lockdown in New Zealand: a Quasi-experimental Study

Mindfulness and Parenting: A Meta-analysis and an Exploratory Meta-mediation