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Cited by 389Posttraumatic Stress Disorder ResearchMindfulness and Compassion InterventionsPsychotherapy Techniques and Applications

Yoga as an Adjunctive Treatment for Posttraumatic Stress Disorder: A Randomized Controlled Trial

van der Kolk, Bessel A., Stone, Laura, West, Jennifer, Rhodes, Alison, Emerson, David, Suvak, Michael, Spinazzola, Joseph·2014·The Journal of Clinical Psychiatry
DOI 10.4088/jcp.13m08561
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Abstract

BACKGROUND: More than a third of the approximately 10 million women with histories of interpersonal violence in the United States develop posttraumatic stress disorder (PTSD). Currently available treatments for this population have a high rate of incomplete response, in part because problems in affect and impulse regulation are major obstacles to resolving PTSD. This study explored the efficacy of yoga to increase affect tolerance and to decrease PTSD symptomatology. METHOD: Sixty-four women with chronic, treatment-resistant PTSD were randomly assigned to either trauma-informed yoga or supportive women's health education, each as a weekly 1-hour class for 10 weeks. Assessments were conducted at pretreatment, midtreatment, and posttreatment and included measures of DSM-IV PTSD, affect regulation, and depression. The study ran from 2008 through 2011. RESULTS: The primary outcome measure was the Clinician-Administered PTSD Scale (CAPS). At the end of the study, 16 of 31 participants (52%) in the yoga group no longer met criteria for PTSD compared to 6 of 29 (21%) in the control group (n = 60, χ²₁ = 6.17, P = .013). Both groups exhibited significant decreases on the CAPS, with the decrease falling in the large effect size range for the yoga group (d = 1.07) and the medium to large effect size decrease for the control group (d = 0.66). Both the yoga (b = -9.21, t = -2.34, P = .02, d = -0.37) and control (b = -22.12, t = -3.39, P = .001, d = -0.54) groups exhibited significant decreases from pretreatment to the midtreatment assessment. However, a significant group × quadratic trend interaction (d = -0.34) showed that the pattern of change in Davidson Trauma Scale significantly differed across groups. The yoga group exhibited a significant medium effect size linear (d = -0.52) trend. In contrast, the control group exhibited only a significant medium effect size quadratic trend (d = 0.46) but did not exhibit a significant linear trend (d = -0.29). Thus, both groups exhibited significant decreases in PTSD symptoms during the first half of treatment, but these improvements were maintained in the yoga group, while the control group relapsed after its initial improvement. DISCUSSION: Yoga significantly reduced PTSD symptomatology, with effect sizes comparable to well-researched psychotherapeutic and psychopharmacologic approaches. Yoga may improve the functioning of traumatized individuals by helping them to tolerate physical and sensory experiences associated with fear and helplessness and to increase emotional awareness and affect tolerance. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00839813.

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  • In one randomized controlled trial, women with chronic, treatment-resistant post-traumatic stress problems who completed a 10 week trauma-sensitive yoga program experienced a significant reduction in post-traumatic stress symptoms that were sustained for a greater length of time compared to women who received only conventional talk therapy.

    “In one RCT, women with chronic, treatment-resistant PTS problems who completed a 10 week TSY program experienced a significant reduction in PTS symptoms that were sustained for a greater length of time compared to women who received only conventional talk therapy [60].”

    From Psychological Interventions for Survivors of Intimate Partner Violence in Humanitarian Settings: An Overview of the Evidence and Implementation Considerations (2022) · cites this paper as [60]

  • Two randomized controlled trials of women with treatment-resistant PTSD showed reductions in symptoms and dissociation; the shorter-duration study (10-weeks) resulted in symptom decreases comparable to psychopharmaceutical and psychotherapeutic interventions while extended yoga practice (20-weeks) drove even greater improvements.

    “Two randomized controlled trials of women with treatment-resistant PTSD showed reductions in symptoms and dissociation; the shorter-duration study (10-weeks) resulted in symptom decreases comparable to psychopharmaceutical and psychotherapeutic interventions ( van der Kolk et al., 2014 ) while extended yoga practice (20-weeks) drove even greater improvements ( Price et al., 2017 ).”

    From The brain-body disconnect: A somatic sensory basis for trauma-related disorders (2022) · cites this paper as van der Kolk et al., 2014

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Authors
van der Kolk, B. A., Stone, L., West, J., Rhodes, A., Emerson, D., Suvak, M., & Spinazzola, J.
Affiliations
Suffolk University (US)
ORCID
Venue
The Journal of Clinical Psychiatry
Publisher
Physicians Postgraduate Press, Inc
Published
2014-06-15
Volume
75
Issue
06
Pages
e559-e565
ISSN
0160-6689 (ISSN-L)
DOI
10.4088/jcp.13m08561
OpenAlex
W2163976266
Cited by
389
References
57
Citations by year
2026: 27 · 2025: 47 · 2024: 36 · 2023: 27 · 2022: 26 · 2021: 39 · 2020: 37 · 2019: 27 · 2018: 40 · 2017: 33 · 2016: 19 · 2015: 24 · 2014: 6
FWCI
32.25
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (1r21at003905-01a2)
  • National Center for Complementary and Integrative Health (1R21AT003905)
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, trauma-informed yoga, interpersonal violence, women, emotion regulation, affect tolerance, depression, treatment-resistant PTSD, adjunctive therapy, relapse, women's health education, medication adherence
MeSH terms
Adult, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Middle Aged, Personality Inventory, Psychometrics, Psychotherapy, Group, Stress Disorders, Post-Traumatic, Yoga

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