Publication year
2016
Citation Title
Predictors of depression and PTSD treatment response among veterans participating in mindfulness-based stress reduction.
Journal Name
Mindfulness
Journal Volume
7
Issue Number
4
Page Numbers
886-895
DOI
10.1007/s12671-016-0527-7
Summary
There is growing interest regarding the effectiveness of mindfulness-based interventions among Veterans who experience depression and posttraumatic stress disorder (PTSD). This study used a sample of Veterans who participated in mindfulness-based stress reduction (MBSR) to examine PTSD and depression outcomes and baseline predictors of response before and after treatment. Results suggested clinically significant reductions in both PTSD and depression symptoms posttreatment and at four months follow-up.
Key Findings
Significant reductions in PTSD and depression occurred after participation in MBSR.
Veterans with higher levels of PTSD and depression before treatment experienced the greatest reduction in symptoms after MBSR treatment.
Women experienced a more rapid decline in PTSD and depressive symptoms compared to men, however these differences were not maintained at follow-up.
Implications for Program Leaders
Disseminate information to military families regarding the mitigating effects of MBSR treatments on PTSD and depression
Continue to provide support groups for Service members that experience PTSD and depression
Offer support groups for the spouses and children of Service members who experiences PTSD and depression
Implications for Policy Makers
Continue to support research that examines the effectiveness of MBSR treatments on the reduction of depression and PTSD in military families
Support programs that offer MBSR treatments options for Service members who experience PTSD and depression
Encourage collaboration among DoD and community-based programs that provide services for military families coping with PTSD and depression to provide MBSR treatment options
Methods
Veterans participated in eight, two-and-a-half hour weekly MBSR groups. They also participated in a seven hour silent retreat that occurred on a weekend between the sixth and seventh group.
All groups were led by MBSR instructors who had completed foundational trainings at the University of Massachuesetts, Worcester, Center for Mindfulness.
Participants completed the PTSD Checklist Civilian Version, the NIH-sponsored Patient Reported Outcomes Measurement Information System, and the Patient Health Questionnaire-9.
Researchers examined differences in PTSD and depressive symptoms before and after MBSR treatment.
Participants
Participants were 117 Veterans collected from data gathered from the retrospective analysis of three MBSR clinical trials conducted at the VA Puget Sound Health Care System.
The racial and ethnic breakdown of the sample was 78.4% White, 6% Black, 4.3% Latino, and the remainder of the sample was categorized as Other or Unknown.
Approximately three-fourths of the sample was male (75.9%) and no data was provided regarding which branches of the military the Veterans served.
Limitations
The current study used a non-randomized treatment design, and although conclusions can be made regarding the efficacy of MBSR on PTSD or depression, a randomized treatment design may produce more confidence in the findings.
The majority of the sample was older White men and limits the generalizability of the findings to other populations.
All data gathered on PTSD and depression were self-report, thus increasing the chances of self-report bias.
Avenues for Future Research
Use a randomized treatment design to better understand the effectiveness of MBSR treatment on PTSD and depression among Veterans
Recruit a more racially and ethnically diverse sample to increase generalizability among Veterans
Consider using clinical reports or the reports of others (e.g., signifiant others) in obtaining data regarding PTSD and depressive symptoms
Focus
Multiple Branches
Target Population
Population Focus
Abstract
Posttraumatic stress disorder (PTSD) and depression are prevalent and often co-occur among veterans. There is growing interest in the effects of mindfulness-based interventions among veterans. This study examined PTSD and depression outcomes, and baseline predictors of response, among veterans who participated in mindfulness-based stress reduction (MBSR). Participants included 116 veterans with PTSD before and after MBSR. Multilevel modeling assessed baseline predictors of change in PTSD and depressive symptoms. There were clinically significant reductions in PTSD and depression symptoms posttreatment and at 4 months follow-up. For PTSD, effect sizes were in the medium range posttreatment (d = −.63) and at follow-up (d = −.69), and for depression posttreatment (d = −.58) and at follow-up (d = −.70). Baseline PTSD was a significant predictor of slope (β = .03, p = .04) on PTSD outcomes; higher baseline PTSD predicted greater rate of reduction in symptoms. For depression (β = .04, p < .01,), those with severe or moderately severe depression exhibited the greatest rate of improvement. However, veterans with high symptom severity did remain symptomatic post-MBSR. These findings show preliminary support for MBSR in facilitating symptom reduction for veterans with severe PTSD and co-occurring depression.
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