Mindfulness-Based Stress Reduction in Veterans With PTSD

In modern society, post-traumatic stress disorder (PTSD) is surprisingly prevalent, with the National Institute of Mental Health estimating that 6.8% of Americans will experience PTSD during their lifetime (NIMH, 2018). War veterans are at an even higher risk of suffering from PTSD than the general population (Norris, 2013) and also face more barriers to treatment (Tanielian, 2008). Past studies have demonstrated a wide range of adverse mental and physical health outcomes from PTSD (Spitzer, 2009) and high rates of suicide among veterans with PTSD are well documented (U.S. Department of Veterans Affairs). In addition to individual burden, relationship distress is a likely outcome of PTSD in couples (Campbell & Renshaw, 2018) along with a loss of family functioning (Evans, 2003) and national economic hardship (Congressional Budget Office). Exploring effective treatment options for PTSD encompasses the practical and ethical obligation of health care providers. Pharmacological interventions such as antipsychotics, antiadrenergic drugs, and anxiolytics have shown efficacy in treating PTSD symptoms (Alderman, 2009; Ravindran, 2009) while benzodiazepines are falling out of favor given their non-effectiveness and potential for addiction and harmful side effects (VA/DoD Clinical Practice Guideline for PTSD). The use of psychological interventions, however, has been argued to benefit patients, both alone and in combination with medication (Ursano, 2004; Forbes, 2007).

Due to the high rates of dropout and high self-reported residual PTSD symptoms with trauma-focused interventions, which includes prolonged exposure, cognitive processing therapy, and eye movement desensitization therapy, and non-trauma focused interventions, made up of cognitive behavioral therapy (Bradley, 2005), a different approach is warranted and requested from both the patient and provider end (Bomyea, 2012).Mindfulness-based techniques has been shown to reduce symptoms of depression and psychological stress while increasing the quality of life of patients from different cultural backgrounds (Vujanovic, 2009). Mindfulness is the act of experiencing the present moment non-judgmentally and openly, which may reduce PTSD symptoms of intrusion, cognitive avoidance, negative alterations in cognitions and mood, and alterations in arousal by allowing health care practitioners to approach rather than avoid upsetting thoughts and feelings (Gallegos, 2015).

A review of the current literature through CINAHL, Cochrane Reviews, and PubMed found that mindfulness-based stress reduction (MBSR) as a therapy option for veterans with PTSD is a new and emerging field, despite MBSR’s proven benefit for the general public. After an assessment, review process, and understanding of the current research, there is sufficient evidence to suggest that different forms of MBSR,including mantram repetition practice, yoga, mindfulness-based cognitive therapy, breathing exercises, sitting meditation, breathing meditation, and body awareness training is effective in improving quality of life outcomes for veterans with PTSD, without the high dropout rates nor residual PTSD symptoms found in other interventional therapies.Given that MBSR interventions are low cost, cost effective, minimally time intensive, and easily implemented in a practice setting, MBSR may be a viable adjunctive therapy for veterans who may not feel supported in coming forward with their disorder as well as for veterans who want another approach in treating their PTSD.