Rhodes Alison, Spinazzola Joseph, van der Kolk Bessel
1 The Trauma Center at Justice Resource Institute , Brookline, MA.
2 Tufts University Counseling and Mental Health Services , Medford, MA.
J Altern Complement Med. 2016 Mar;22(3):189-96. doi: 10.1089/acm.2014.0407. Epub 2016 Feb 10.
Yoga-the integrative practice of physical postures and movement, breath exercises, and mindfulness-may serve as a useful adjunctive component of trauma-focused treatment to build skills in tolerating and modulating physiologic and affective states that have become dysregulated by trauma exposure. A previous randomized controlled study was carried out among 60 women with chronic, treatment-resistant post-traumatic stress disorder (PTSD) and associated mental health problems stemming from prolonged or multiple trauma exposures. After 10 sessions of yoga, participants exhibited statistically significant decreases in PTSD symptom severity and greater likelihood of loss of PTSD diagnosis, significant decreases in engagement in negative tension reduction activities (e.g., self-injury), and greater reductions in dissociative and depressive symptoms when compared with the control (a seminar in women's health). The current study is a long-term follow-up assessment of participants who completed this randomized controlled trial.
Participants from the randomized controlled trial were invited to participate in long-term follow-up assessments approximately 1.5 years after study completion to assess whether the initial intervention and/or yoga practice after treatment was associated with additional changes. Forty-nine women completed the long-term follow-up interviews. Hierarchical regression analysis was used to examine whether treatment group status in the original study and frequency of yoga practice after the study predicted greater changes in symptoms and PTSD diagnosis.
Group assignment in the original randomized study was not a significant predictor of longer-term outcomes. However, frequency of continuing yoga practice significantly predicted greater decreases in PTSD symptom severity and depression symptom severity, as well as a greater likelihood of a loss of PTSD diagnosis.
Yoga appears to be a useful treatment modality; the greatest long-term benefits are derived from more frequent yoga practice.
瑜伽——一种将身体姿势与动作、呼吸练习和正念相结合的练习方式——可能作为以创伤为重点的治疗的有益辅助组成部分,以培养耐受和调节因创伤暴露而失调的生理和情感状态的技能。之前一项随机对照研究对60名患有慢性、难治性创伤后应激障碍(PTSD)以及因长期或多次创伤暴露导致的相关心理健康问题的女性进行。在进行10节瑜伽课程后,与对照组(女性健康研讨会)相比,参与者的PTSD症状严重程度在统计学上显著降低,PTSD诊断消失的可能性更大,参与消极减压活动(如自我伤害)的情况显著减少,解离和抑郁症状的减轻幅度更大。本研究是对完成这项随机对照试验的参与者的长期随访评估。
随机对照试验的参与者在研究完成约1.5年后被邀请参加长期随访评估,以评估初始干预和/或治疗后的瑜伽练习是否与额外的变化相关。49名女性完成了长期随访访谈。采用分层回归分析来检验原始研究中的治疗组状态以及研究后瑜伽练习的频率是否能预测症状和PTSD诊断的更大变化。
原始随机研究中的分组并非长期结果的显著预测因素。然而,持续进行瑜伽练习的频率显著预测了PTSD症状严重程度和抑郁症状严重程度的更大降低,以及PTSD诊断消失的更大可能性。
瑜伽似乎是一种有用的治疗方式;最大的长期益处来自更频繁的瑜伽练习。