A Pilot Study of Mindfulness-Based Exposure Therapy in OEF/OIF Combat Veterans with PTSD: Altered Medial Frontal Cortex and Amygdala Responses in Social–Emotional Processing
Open accessAbstract
Combat-related PTSD is common among returning veterans, and is a serious and debilitating disorder. While highly effective treatments involving trauma exposure exist, difficulties with engagement and early drop may lead to sub-optimal outcomes. Mindfulness training may provide a method for increasing emotional regulation skills that may improve engagement in trauma-focused therapy. Here we examine potential neural correlates of mindfulness training and in vivo exposure (non-trauma focused) using a novel group therapy (Mindfulness-based Exposure Therapy) in Afghanistan (OEF) or Iraq (OIF) combat veterans with PTSD. OEF/OIF combat veterans with PTSD (N=23) were treated with MBET (N = 14) or a comparison group therapy (Present-centered group therapy [PCGT], N = 9). PTSD symptoms were assessed at pre- and post-therapy with Clinician Administered PTSD scale (CAPS). Functional neuroimaging (3 Tesla fMRI) before and after therapy examined responses to emotional faces (angry, fearful, and neutral faces). Patients treated with MBET had reduced PTSD symptoms (effect size d = .92) but effect was not significantly different from PCGT (d = .43). Improvement in PTSD symptoms from Pre- to Post treatment in both treatment groups was correlated with increased activity in rostral ACC, dorsal medial PFC, and left amygdala. The MBET group showed greater increases in amygdala and fusiform gyrus responses to Angry faces, as well as increased response in left medial PFC to Fearful faces. These preliminary findings provide intriguing evidence that MBET group therapy for PTSD may lead to changes in neural processing of social-emotional threat related to symptom reduction.
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A study among veterans revealed increased activity in the medial prefrontal cortex to fearful cues after receiving a mindfulness-based exposure therapy, which might enhance top-down regulation of the limbic system and improve hyperarousal and intrusion symptoms.
“A study conducted among veterans revealed increased activity in the medial prefrontal cortex to fearful cues after receiving a mindfulness-based exposure therapy, which might enhance top-down regulation of the limbic system and improve hyperarousal and intrusion symptoms [52].”
From Effects of mindfulness-based cognitive therapy for Chinese adults with PTSD symptoms: protocol for a randomised controlled trial (2024) · cites this paper as [52]
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Mindfulness Meditation and Psychopathology
Wielgosz, J., Goldberg, S. B., Kral, T. R. A., Dunne, J. D., & Davidson, R. J. (2019) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-021815-093423 · Cited by 435 · see citing works
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Present-centered therapy (PCT) for post-traumatic stress disorder (PTSD) in adults
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Scoping Review of Mindfulness Research: a Topic Modelling Approach
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Santarnecchi, E., Bossini, L., Vatti, G., Fagiolini, A. M., Porta, P. L., Lorenzo, G. D., Siracusano, A., Rossi, S., & Rossi, A. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00129 · Cited by 60 · see citing works
Examining connection to nature and mindfulness at promoting psychological well-being
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Behavioral and neural correlates of disrupted orienting attention in posttraumatic stress disorder
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Self-citationThe Impact of Psychological Interventions on Posttraumatic Stress Disorder and Pain Symptoms
Goldstein, E., McDonnell, C., Atchley, R., Dorado, K., Bedford, C. E., Brown, R., & Zgierska, A. E. (2019) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000730 · Cited by 46 · see citing works
Melton, H., Meader, N., Dale, H. E., Wright, K. E., Jones-Diette, J. S., Temple, M., Shah, I., Lovell, K., McMillan, D., Churchill, R. C., et al. (2020) · Health Technology Assessment · doi:10.3310/hta24430 · Cited by 44 · see citing works
Sheynin, J., Duval, E. R., King, A. P. J., Angstadt, M., Phan, K. L., Simon, N. M., Rauch, S. A. M., & Liberzon, I. (2020) · Depression and Anxiety · doi:10.1002/da.23075 · Cited by 41 · see citing works
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Zhou, Y., Shang, Z., Zhang, F., Wu, L., Sun, L., Jia, Y., Yu, H., & Liu, W. (2021) · Chinese Journal of Traumatology · doi:10.1016/j.cjtee.2021.04.011 · Cited by 41 · see citing works
Rauch, S. A. M., Simon, N. M., Kim, H. M., Acierno, R. E., King, A. P. J., Norman, S. B., Venners, M. R., Porter, K. E., Phan, K. L., Tuerk, P. W., et al. (2017) · Contemporary Clinical Trials · doi:10.1016/j.cct.2017.10.013 · Cited by 30 · see citing works
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Marchand, W. R., Sandoval, K., Lackner, R. J., Parker, S. C., Herrmann, T. S., Yabko, B. A., Velasquez, T., Lewis, L., & Butler, J. M. (2020) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2020.101274 · Cited by 27 · see citing works
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Woodward, S. H., Jamison, A. L., Gala, S., & Holmes, T. H. (2017) · PLoS ONE · doi:10.1371/journal.pone.0179912 · Cited by 21 · see citing works
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“Medical diagnoses Any medical diagnosis 89 (91) Chronic pain 50 (51) Diabetes 13 (13) Obesity 43 (44) Sleep disorder 34 (35) History of traumatic brain injury 5 (5) Cardiac disease 15 (15) Vitamin D deficiency 7 (7) Hypertension 38 (39) Hyperlipidemia 32 (33) 904 MARCHAND ET AL.”
BackgroundParedes, D., Knippenberg, A. R., Bulin, S. E., Keppler, L. J., & Morilak, D. A. (2022) · Neurobiology of Stress · doi:10.1016/j.ynstr.2022.100468 · Cited by 16 · see citing works
Angry and Fearful Face Conflict Effects in Post-traumatic Stress Disorder
Ashley, V., & Diane Swick, A. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00136 · Cited by 17 · see citing works
Moore, B. A., Pujol, L. A. M., Waltman, S. H., & Shearer, D. S. (2021) · Current Psychiatry Reports · doi:10.1007/s11920-020-01220-w · Cited by 17 · see citing works
A Mindful Approach to Diabetes Self-Management Education and Support for Veterans
DiNardo, M. M., Saba, S. K., Greco, C. M., Broyles, L. M., Terhorst, L. A., Chasens, E. R., Bair, B., Charron-Prochownik, D., & Cohen, S. M. (2017) · The Science of Diabetes Self-Management and Care · doi:10.1177/0145721717738019 · Cited by 16 · see citing works
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Neural Mechanisms of Spatial Attention Deficits in Trauma
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Self-citationBabiy, Z., Frey, B. N., Bieling, P., McCabe, R. E., & Green, S. M. (2025) · Mindfulness · doi:10.1007/s12671-025-02549-0 · Cited by 14 · see citing works
Sornborger, J., Fann, A. V., Serpa, J. G., Ventrelle, J., n, M. S.-R., Foynes, M. M., Carleton, M. E., Sherrill, A. M., Kao, L., Jakubovic, R. J., et al. (2017) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20170026 · Cited by 14 · see citing works
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Functional neuro-anatomy of social cognition in posttraumatic stress disorder: A systematic review
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Gender differences in PTSD severity and pain outcomes: Baseline results from the LAMP trial
Friedman, J. K., Taylor, B. C., Campbell, E. H., Allen, K. D., Bangerter, A. K., Branson, M., Brønfort, G., Calvert, C., Cross, L. J. S., Driscoll, M., et al. (2024) · PLoS ONE · doi:10.1371/journal.pone.0293437 · Cited by 8 · see citing works
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Predictors of PTSD Treatment Retention and Response: A Systematic Review
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“A study conducted among veterans revealed increased activity in the medial prefrontal cortex to fearful cues after receiving a mind-fulness-based exposure therapy, which might enhance top-down regulation of the limbic system and improve hyperarousal and intrusion symptoms [52].”
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Psychosocial Implications of Yoga for Healthcare Workers During Covid-19
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- Authors
- King, A. P., Block, S. R., Sripada, R. K., Rauch, S. A. M., Porter, K. E., Favorite, T. K., Giardino, N., & Liberzon, I.
- Affiliations
- University of Michigan (US)
- Emory University (US)
- VA Ann Arbor Healthcare System (US)
- Corresponding author
- King, Anthony P.
- ORCID
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2016-09-20
- Volume
- 7
- Pages
- 154-154
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC5028840
- OpenAlex
- W2526135733
- Cited by
- 64
- References
- 82
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 7 · 2023: 5 · 2022: 6 · 2021: 4 · 2020: 6 · 2019: 16 · 2018: 4 · 2017: 8 · 2016: 1
- FWCI
- 12.94
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- U.S. Department of Defense (W81XWH-08-2-0208)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- combat veterans, post-traumatic stress disorder, OEF/OIF veterans, amygdala, medial prefrontal cortex, anterior cingulate cortex, fusiform gyrus, emotional face processing, group therapy, treatment engagement
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