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Cited by 315Posttraumatic Stress Disorder ResearchMindfulness and Compassion InterventionsPsychotherapy Techniques and Applications

Mindfulness-Based Stress Reduction for Posttraumatic Stress Disorder Among Veterans: A Randomized Clinical Trial

Open access
Polusny, Melissa A., Erbes, Christopher R., Thuras, Paul, Moran, Amy, Lamberty, Greg J., Collins, Rose C., Rodman, John L., Lim, Kelvin O.·2015·JAMA
DOI 10.1001/jama.2015.8361
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Abstract

IMPORTANCE: Mindfulness-based interventions may be acceptable to veterans who have poor adherence to existing evidence-based treatments for posttraumatic stress disorder (PTSD). OBJECTIVE: To compare mindfulness-based stress reduction with present-centered group therapy for treatment of PTSD. DESIGN, SETTING, AND PARTICIPANTS: Randomized clinical trial of 116 veterans with PTSD recruited at the Minneapolis Veterans Affairs Medical Center from March 2012 to December 2013. Outcomes were assessed before, during, and after treatment and at 2-month follow-up. Data collection was completed on April 22, 2014. INTERVENTIONS: Participants were randomly assigned to receive mindfulness-based stress reduction therapy (n = 58), consisting of 9 sessions (8 weekly 2.5-hour group sessions and a daylong retreat) focused on teaching patients to attend to the present moment in a nonjudgmental, accepting manner; or present-centered group therapy (n = 58), an active-control condition consisting of 9 weekly 1.5-hour group sessions focused on current life problems. MAIN OUTCOMES AND MEASURES: The primary outcome, change in PTSD symptom severity over time, was assessed using the PTSD Checklist (range, 17-85; higher scores indicate greater severity; reduction of 10 or more considered a minimal clinically important difference) at baseline and weeks 3, 6, 9, and 17. Secondary outcomes included PTSD diagnosis and symptom severity assessed by independent evaluators using the Clinician-Administered PTSD Scale along with improvements in depressive symptoms, quality of life, and mindfulness. RESULTS: Participants in the mindfulness-based stress reduction group demonstrated greater improvement in self-reported PTSD symptom severity during treatment (change in mean PTSD Checklist scores from 63.6 to 55.7 vs 58.8 to 55.8 with present-centered group therapy; between-group difference, 4.95; 95% CI, 1.92-7.99; P=.002) and at 2-month follow-up (change in mean scores from 63.6 to 54.4 vs 58.8 to 56.0, respectively; difference, 6.44; 95% CI, 3.34-9.53, P < .001). Although participants in the mindfulness-based stress reduction group were more likely to show clinically significant improvement in self-reported PTSD symptom severity (48.9% vs 28.1% with present-centered group therapy; difference, 20.9%; 95% CI, 2.2%-39.5%; P = .03) at 2-month follow-up, they were no more likely to have loss of PTSD diagnosis (53.3% vs 47.3%, respectively; difference, 6.0%; 95% CI, -14.1% to 26.2%; P = .55). CONCLUSIONS AND RELEVANCE: Among veterans with PTSD, mindfulness-based stress reduction therapy, compared with present-centered group therapy, resulted in a greater decrease in PTSD symptom severity. However, the magnitude of the average improvement suggests a modest effect. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01548742.

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Crossref · 10.1001/jama.2015.8361

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  • A previous study on USA veterans with PTSD determined a between-group effect size of 0.59 comparing mindfulness-based intervention and present-centred therapy.

    “A previous study conducted on USA veterans with PTSD determined a between-group effect size of 0.59, comparing mindfulness-based intervention and present-centred therapy [48].”

    From Effects of mindfulness-based cognitive therapy for Chinese adults with PTSD symptoms: protocol for a randomised controlled trial (2024) · cites this paper as [48]

    The Abstract describes a trial of US veterans with PTSD comparing mindfulness-based stress reduction with present-centered group therapy. The Data Analysis section says between-group effect sizes were computed as Cohen’s d, but the passages found do not report an effect size of 0.59; the reported effect size of 0.52 is a power-analysis target, not a study result. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Mindfulness and acceptance-based approaches have shown promise as alternative interventions to trauma-focused therapies for PTSD.

    “Mindfulness and acceptance-based approaches have shown promise as alternative interventions to trauma-focused therapies for PTSD.”

    From Group-Based Acceptance and Commitment Therapy for PTSD in a HMO Psychiatry Clinic: An Open Trial (2024) · cites this paper as Polusny et al., 2015

  • A randomised control trial among veterans with a larger sample size (n = 116) found that MBSR could significantly improve PTSD symptoms compared to present-centered focused therapy.

    “A randomised control trial among veterans with a larger sample size (n = 116) found that MBSR could significantly improve PTSD symptoms, compared to a group of present-centered focused therapy [48].”

    From Effects of mindfulness-based cognitive therapy for Chinese adults with PTSD symptoms: protocol for a randomised controlled trial (2024) · cites this paper as [48]

  • Mindfulness training has a specific effect on a broad range of affective and physical health outcomes, as indicated by studies that controlled for nonspecific factors or lacked group support.

    “Still, there is evidence that mindfulness training studies that either control for these factors or lack these intervention elements (e.g., group support) have been linked with affective and physical health outcomes (e.g., Kabat-Zinn et al., 1998; Polusny et al., 2015; Rosenkranz et al., 2013; Taren et al., 2015), suggesting a mindfulness-specific impact on a broad array of outcomes.”

    From Mechanisms of mindfulness training: Monitor and Acceptance Theory (MAT (2017) · cites this paper as Polusny et al., 2015

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Research works printed but not linked: 3

  1. Institute of Medicine. Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence. Washington, DC: National Academies Press; 2007.
  2. First MB, Spitzer RL, Gibbon M, Williams JBW. Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition (SCID-I/NP). New York: Biometrics Research, New York State Psychiatric Institute; 2002.
  3. Foy DW, Unger WS, Wattenberg MS. Module 4: an overview of evidence-based group approaches to trauma with adults. In: Group Interventions for Treatment of Psychological Trauma. New York, NY: American Group Psychotherapy Association; 2004:116-166.

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Authors
Polusny, M. A., Erbes, C. R., Thuras, P., Moran, A., Lamberty, G. J., Collins, R. C., Rodman, J. L., & Lim, K. O.
Affiliations
  • University of Minnesota (US)
  • Minneapolis VA Health Care System (US)
Corresponding author
Polusny, Melissa A.
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2015-08-04
Volume
314
Issue
5
Pages
456
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2015.8361
OpenAlex
W2105141573
Cited by
315
References
39
Citations by year
2026: 20 · 2025: 22 · 2024: 31 · 2023: 14 · 2022: 26 · 2021: 27 · 2020: 34 · 2019: 31 · 2018: 36 · 2017: 38 · 2016: 33 · 2015: 3
FWCI
45.48
Type
journal article
Language
en
Open access
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
post-traumatic stress disorder, veterans, mindfulness-based stress reduction, PTSD symptom severity, medication adherence, depressive symptoms, quality of life, mindfulness, active control, group therapy, PTSD diagnosis, treatment acceptability, treatment discontinuation
MeSH terms
Aged, Depression, Female, Humans, Male, Middle Aged, Psychotherapy, Group, Quality of Life, Severity of Illness Index, Stress Disorders, Post-Traumatic, Stress, Psychological, Veterans, Treatment Outcome, Mindfulness

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