Mindfulness program proves a secret weapon against post-traumatic stress

For a diagnosis of ‘full’ post-traumatic stress disorder (PTSD), the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) – psychiatry’s ‘bible’ – requires a person to have had symptoms for at least one month. However, many don’t meet the diagnostic criteria for full PTSD but experience post-traumatic stress symptoms (PTSS), exhibiting clinically meaningful levels of functional difficulty and leaving them vulnerable to the development of future PTSD or other psychiatric diagnoses. Oftentimes, because they lack a PTSD diagnosis, those with PTSS can be denied access to treatment.

A new study by researchers at Murdoch University in Perth, Australia, has assessed whether an eight-week program centered around compassion and mindfulness is an effective way of treating people with PTSS.

“Although post-traumatic stress symptoms can be debilitating, many people don’t seek treatment unless they experience a full post-traumatic stress disorder,” said Auretta Kummar, lead and corresponding author of the study.

Kummar and Murdoch University Adjunct Professor Helen Correia, another of the study’s authors, developed the eight-week Compassion-oriented and Mindfulness-based Exposure Therapy (CoMET) program. Exposure therapy involves exposing a person to their source of anxiety or its context without the intention of causing any danger to help them overcome their distress. Recent studies have suggested that mindfulness supports emotion regulation – the ability to exert control over one’s own emotional state – during standard exposure treatments. And evidence has emerged that self-compassion is a protective mechanism against PTSS.

Mindfulness-Based Exposure Therapy (MBET) is a 16-week non-trauma-focused intervention developed for combat-related PTSD. Integrating mindfulness strategies with exposure, the therapy was found to reduce symptom severity amongst veterans with clinical levels of PTSD. Using MBET as the basis, the researchers developed the CoMET program for civilians. Like MBET, CoMET included graded exposure conducted with avoided but objectively safe situations or activities, with no imaginal exposure or processing of traumatic memories. However, CoMET more strongly emphasized compassion-oriented practices, hence the name change.

The researchers recruited 28 people aged 18 to 39 for their study. Participants were eligible if they had witnessed a traumatic event listed in the DSM-5 criteria for PTSD (Criterion A) and exhibited at least one symptom from each PTSD symptom cluster (Criteria B-D) but had not been diagnosed with the condition. The PCL-5, a 20-item self-report PTSD checklist for the DSM-5, was used to measure the presence and severity of symptoms, as well as assessments that measured emotion regulation, mindfulness, and self-compassion. EEGs were taken to analyze brain connectivity.

Following the eight-week CoMET program, participants reported significant decreases in PTSS severity from clinical to non-clinical levels, emotional dysregulation and experiential avoidance, as well as significant increases in mindfulness, self-compassion and quality of life. The researchers also noted that after CoMET, there was improved functional connectivity in areas of the brain that play a crucial role in emotion regulation.

“Mindfulness and compassion are helpful emotion regulatory strategies, and this innovative use of the same principles has been shown to improve quality of life for participants,” said Hakuei Fujiyama, a co-author of the study.

The study’s findings demonstrate that the CoMET program has potential as an intervention to alleviate PTSS by enhancing emotion regulation. Kummar plans to put the new technique into practice with her clients.

“In line with my research, my expertise lies in the areas of anxiety and trauma, so the majority of my clients present with these issues,” Kummar said. “I already use elements of the intervention with my individual clients, but with the publication of this research, I hope to start group programs at my practice.”

The study was published in the journal Clinical Psychology & Psychotherapy.

Source: Murdoch University via Scimex

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