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06-02-2020 | ORIGINAL PAPER

Increasing Mindfulness Skills of Veterans With PTSD Through Daily Mindfulness Training Incorporated Into an Intensive Treatment Program

Auteurs: Michelle L. Miller, Jenna M. Bagley, Patricia Normand, Michael B. Brennan, Rebecca Van Horn, Mark H. Pollack, Philip Held

Gepubliceerd in: Mindfulness | Uitgave 4/2020

Abstract

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 pre- to 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.

vorige artikel Applying Generalizability Theory to Differentiate Between Trait and State in the Five Facet Mindfulness Questionnaire (FFMQ)

volgende artikel Nonattachment Predicts Empathy, Rejection Sensitivity, and Symptom Reduction After a Mindfulness-Based Intervention Among Young Adults with a History of Childhood Maltreatment

Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45. https://doi.org/10.1177/1073191105283504.CrossRefPubMed

Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., et al. (2008). Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment, 15(3), 329–342. https://doi.org/10.1177/1073191107313003.CrossRefPubMed

Beidel, D. C., Frueh, B. C., Neer, S. M., & Lejuez, C. W. (2017). The efficacy of trauma management therapy: A controlled pilot investigation of a three-week intensive outpatient program for combat-related PTSD. Journal of Anxiety Disorders, 50, 23–32. https://doi.org/10.1016/j.janxdis.2017.05.001.CrossRefPubMed

Bergomi, C., Tschacher, W., & Kupper, Z. (2013). The assessment of mindfulness with self-report measures: Existing scales and open issues. Mindfulness, 4(3), 191–202. https://doi.org/10.1007/s12671-012-0110-9.CrossRef

Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., Segal, Z. V., Abbey, S., Speca, M., Velting, D., & Devins, G. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11, 230–241. https://doi.org/10.1093/clipsy.bph077.CrossRef

Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The posttraumatic stress disorder checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28(6), 489–498. https://doi.org/10.1002/jts.22059.CrossRefPubMed

Boyd, J. E., Lanius, R. A., & McKinnon, M. C. (2018). Mindfulness-based treatments for posttraumatic stress disorder: A review of the treatment literature and neurobiological evidence. Journal of Psychiatry & Neuroscience, 43(1), 7–25. https://doi.org/10.1503/jpn.170021.CrossRef

Bremner, J. D., Mishra, S., Campanella, C., Shah, M., Kasher, N., Evans, S., et al. (2017). A pilot study of the effects of mindfulness-based stress reduction on post-traumatic stress disorder symptoms and brain response to traumatic reminders of combat in operation enduring freedom/operation Iraqi freedom combat veterans with post-traumatic stress disorder. Frontiers in Psychiatry, 8, article ID 157. https://doi.org/10.3389/fpsyt.2017.00157.

Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role inpsychological well-being. Journal of Personality and Social Psychology, 84(4), 822. https://doi.org/10.1037/0022-3514.84.4.822.CrossRefPubMed

Calm.com, Inc. (2019). Mindfulness coach. [Mobile application software].

Carmody, J., & Baer, R. A. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. Journal of Behavioral Medicine, 31(1), 23–33.CrossRefPubMed

Carmody, J., & Baer, R. A. (2009). How long does a mindfulness‐based stress reduction program need to be? A review of class contact hours and effect sizes for psychological distress. Journal of Clinical Psychology, 65(6), 627–638.

Carroll, K. K., Lofgreen, A. M., Weaver, D. C., Held, P., Klassen, B. J., Smith, D. L., et al. (2018). Negative posttraumatic cognitions among military sexual trauma survivors. Journal of Affective Disorders, 238, 88–93. https://doi.org/10.1016/j.jad.2018.05.024.CrossRefPubMedPubMedCentral

Chard, K. M., Schumm, J. A., Owens, G. P., & Cottingham, S. M. (2010). A comparison of OEF and OIF veterans and Vietnam veterans receiving cognitive processing therapy. Journal of Traumatic Stress, 23(1), 25–32. https://doi.org/10.1002/jts.20500.CrossRefPubMed

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Earlbaum Associates.

Creswell, J. D. (2017). Mindfulness interventions. Annual Review of Psychology, 68, 491–516. https://doi.org/10.1146/annurev-psych-042716-051139.CrossRefPubMed

Davis, L. L., Whetsell, C., Hamner, M. B., Carmody, J., Rothbaum, B. O., Allen, R. S., et al. (2019). A multisite randomized controlled trial of mindfulness-based stress reduction in the treatment of posttraumatic stress disorder. Psychiatric Research and Clinical Practice, 1, 39–48.CrossRefPubMed

Delizonna, L. L., Williams, R. P., & Langer, E. J. (2009). The effect of mindfulness on heart ratecontrol. Journal of Adult Development, 16(2), 61–65. https://doi.org/10.1007/s10804-009-9050-6.CrossRef

Ehlers, A., Hackmann, A., Grey, N., Wild, J., Liness, S., Albert, I., et al. (2014). A randomized controlled trial of 7-day intensive and standard weekly cognitive therapy forPTSD and emotion-focused supportive therapy. American Journal of Psychiatry, 171(3), 294–304. https://doi.org/10.1176/appi.ajp.2013.13040552.CrossRefPubMed

Fulton, J. J., Calhoun, P. S., Wagner, H. R., Schry, A. R., Hair, L. P., Feeling, N., et al. (2015). The prevalence of posttraumatic stress disorder in operation enduring freedom/operation Iraqi freedom (OEF/OIF) veterans: A meta-analysis. Journal of Anxiety Disorders, 31, 98–107. https://doi.org/10.1016/j.janxdis.2015.02.003.CrossRefPubMed

Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: A meta-analysis. Journal of Psychosomatic Research, 57(1), 35–43. https://doi.org/10.1016/S0022-3999(03)00573-7.CrossRefPubMed

Gu, J., Strauss, C., Crane, C., Barnhofer, T., Karl, A., Cavanagh, K., & Kuyken, W. (2016). Examining the factor structure of the 39-item and 15-item versions of the five facet mindfulness questionnaire before and after mindfulness-based cognitive therapy for people with recurrent depression. Psychological Assessment, 28(7), 791. https://doi.org/10.1037/pas0000263.CrossRefPubMedPubMedCentral

Harvey, M. M., Rauch, S. A. M., Zalta, A. K., Sornborger, J., Pollack, M. H., Rothbaum, B. O., et al. (2017). Intensive treatment models to address posttraumatic stress among post-9/11 warriors: The warrior care network. FOCUS, 15(4), 378–383. https://doi.org/10.1176/appi.focus.20170022.CrossRefPubMedPubMedCentral

Hayes, S. C., & Smith, S. (2005). Get out of your mind and into your life: The new acceptance and commitment therapy. Oakland: New Harbinger Publications.

Held, P., Bagley, J. M., Klassen, B. J., & Pollack, M. H. (2019). Intensively delivered cognitive-behavioral therapies: An overview of a promising treatment delivery format for PTSD and other mental health disorders. Psychiatric Annals, 49(8), 339–342. https://doi.org/10.3928/00485713-20190711-01.CrossRef

Held, P., Owens, G. P., Monroe, J. R., & Chard, K. M. (2017). Increased mindfulness skills as predictors of reduced trauma-related guilt in treatment-seeking veterans. Journal of Traumatic Stress, 30(4), 425–431. https://doi.org/10.1002/jts.22209.CrossRefPubMed

IBM Corp. Released. (2012). IBM SPSS statistics for windows, version 21.0. Armonk, NY: IBM Corp.

Jasbi, M., Sadeghi Bahmani, D., Karami, G., Omidbeygi, M., Peyravi, M., Panahi, A., et al. (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/10.1080/16506073.2018.1445773.CrossRefPubMed

Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Dell.

Kessler, R. C., Chiu, W., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62(6), 617–627. https://doi.org/10.1001/archpsyc.62.6.617.CrossRefPubMedPubMedCentral

Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P., Bouchard, V., et al. (2013). Mindfulness-based therapy: A comprehensive meta-analysis. Clinical Psychology Review, 33(6), 763–771. https://doi.org/10.1016/j.cpr.2013.05.005.CrossRefPubMed

Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x.CrossRefPubMedPubMedCentral

Lande, R. G., Banks Williams, L., Francis, J. L., Gragnani, C., & Morin, M. L. (2011). Characteristics and effectiveness of an intensive military outpatient treatment program for PTSD. Journal of Aggression, Maltreatment & Trauma, 20(5), 530–538. https://doi.org/10.1080/10926771.2011.588149.CrossRef

Niles, B. L., Vujanovic, A. A., Silberbogen, A. K., Seligowski, A. V., & Potter, C. M. (2013). Changes in mindfulness following a mindfulness telehealth intervention. Mindfulness, 4(4), 301–310. https://doi.org/10.1007/s12671-012-0130-5.CrossRef

Omidi, A., Mohammadi, A., Zargar, F., & Akbari, H. (2013). Efficacy of mindfulness-based stress reduction on mood states of veterans with post-traumatic stress disorder. Archives of Trauma Research, 1(4), 151. https://doi.org/10.5812/atr.8226.CrossRefPubMedPubMedCentral

Owens, G. P., Walter, K. H., Chard, K. M., & Davis, P. A. (2012). Changes in mindfulness skills and treatment response among veterans in residential PTSD treatment. Psychological Trauma Theory Research Practice and Policy, 4(2), 221. https://doi.org/10.1037/a0024251.CrossRef

Pagotto, L. F., Mendlowicz, M. V., Coutinho, E. S. F., Figueira, I., Luz, M. P., Araujo, A. X., & Berger, W. (2015). The impact of posttraumatic symptoms and comorbid mental disorders on the health-related quality of life in treatment-seeking PTSD patients. Comprehensive Psychiatry, 58, 68–73. https://doi.org/10.1016/j.comppsych.2015.01.002.CrossRefPubMed

Polusny, M. A., Erbes, C. R., Thuras, P., Moran, A., Lamberty, G. J., Collins, R. C., et al. (2015). Mindfulness-based stress reduction for posttraumatic stress disorder among veterans: A randomized clinical trial. JAMA, 314(5), 456–465. https://doi.org/10.1001/jama.2015.8361.CrossRefPubMed

Resick, P. A., Monson, C. M., & Chard, K. M. (2016). Cognitive processing therapy for PTSD: A comprehensive manual. Guilford Publications.

Riiskjær, E., Ammentorp, J., & Kofoed, P.-E. (2012). The value of open-ended questions in surveys on patient experience: Number of comments and perceived usefulness from a hospital perspective. International Journal for Quality in Health Care, 24(5), 509–516. https://doi.org/10.1093/intqhc/mzs039.CrossRefPubMed

Rudkin, E., Medvedev, O. N., & Siegert, R. J. (2018). The five-facet mindfulness questionnaire: Why the observing subscale does not predict psychological symptoms. Mindfulness, 9(1), 230–242. https://doi.org/10.1007/s12671-017-0766-2.CrossRef

Saunders, J. B., Aasland, O. G., Babor, T. F., De la Fuente, J. R., & Grant, M. (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction, 88(6), 791–804.CrossRefPubMed

Schnurr, P. P., Lunney, C. A., Bovin, M. J., & Marx, B. P. (2009). Posttraumatic stress disorder and quality of life: Extension of findings to veterans of the wars in Iraq and Afghanistan. Clinical Psychology Review, 29(8), 727–735. https://doi.org/10.1016/j.cpr.2009.08.006.CrossRefPubMed

Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford.

Stephenson, K. R., Simpson, T. L., Martinez, M. E., & Kearney, D. J. (2017). Changes in mindfulness and posttraumatic stress disorder symptoms among veterans enrolled in mindfulness-based stress reduction. Journal of Clinical Psychology, 73(3), 201–217. https://doi.org/10.1002/jclp.22323.CrossRefPubMed

US Department of Veterans Affairs (2019). Mindfulness coach. [Mobile application software]. Retrieved from http://itunes.apple.com.

Valdez, C. E., & Lilly, M. M. (2017). Posttraumatic rumination: Content, correlates, and processes. Journal of Clinical Psychology, 73(6), 707–721. https://doi.org/10.1002/jclp.22371.CrossRefPubMed

Voelkel, E., Pukay-Martin, N. D., Walter, K. H., & Chard, K. M. (2015). Effectiveness of cognitive processing therapy for male and female US veterans with and without military sexual trauma. Journal of Traumatic Stress, 28(3), 174–182. https://doi.org/10.1002/jts.22006.CrossRefPubMed

Vujanovic, A., Niles, B., Pietrefesa, A., Schmertz, S., & Potter, C. (2011). Mindfulness in the treatment of posttraumatic stress disorder among military veterans. Professional Psychology: Research and Practice, 42(1), 24–31. https://doi.org/10.1037/a0022272.CrossRef

Weathers, F. W., Blake, D.D., Schnurr, P.P., Kaloupek, D.G., Marx, B.P., & Keane, T.M. (2013). The clinician-administered PTSD scale for DSM-5 (CAPS-5). Interview available from The National Center for PTSD at https://www.ptsd.va.gov/.

Zalta, A. K., Held, P., Smith, D. L., Klassen, B. J., Lofgreen, A. M., Normand, P. S., et al. (2018). Evaluating patterns and predictors of symptom change during a three-week intensive outpatient treatment for veterans with PTSD. BMC Psychiatry, 18(1), 242 1–15.CrossRefPubMedPubMedCentral

Titel: Increasing Mindfulness Skills of Veterans With PTSD Through Daily Mindfulness Training Incorporated Into an Intensive Treatment Program
Auteurs: Michelle L. Miller
Jenna M. Bagley
Patricia Normand
Michael B. Brennan
Rebecca Van Horn
Mark H. Pollack
Philip Held
Publicatiedatum: 06-02-2020
Uitgeverij: Springer US
Gepubliceerd in: Mindfulness / Uitgave 4/2020
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI: https://doi.org/10.1007/s12671-020-01326-5

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Abstract

Objectives

Methods

Results

Conclusions

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