Lang Ariel J, Malaktaris Anne, Maluf Katrina S, Kangas Julie, Sindel Selin, Herbert Matthew, Bomyea Jessica, Simmons Alan N, Weaver Judy, Velez Deborah, Liu Lin
VA San Diego Center of Excellence for Stress and Mental Health, UCSD Departments of Psychiatry and Family Medicine and Public Health, 3350 La Jolla Village Dr. (MC 111N1), San Diego, CA, 92161, USA.
VA San Diego Healthcare System/Center of Excellence for Stress and Mental Health, UCSD Department of Psychiatry, 3350 La Jolla Village Dr., San Diego, CA, 92161, USA.
Contemp Clin Trials Commun. 2021 Jan 28;21:100719. doi: 10.1016/j.conctc.2021.100719. eCollection 2021 Mar.
Posttraumatic stress disorder (PTSD) is a chronic, disabling, and prevalent mental health disorder among Veterans. Despite the availability of empirically supported psychotherapies, many Veterans remain symptomatic after treatment and/or prefer to seek complementary and integrative health approaches, including yoga, to manage PTSD. The randomized controlled trial (RCT) described herein will evaluate the efficacy of a manualized yoga program as compared to nonaerobic exercise in reducing PTSD severity among Veterans. A secondary aim of this study is to better understand the mechanisms of change.
Veterans ( = 192) with PTSD will be randomized to hatha yoga or nonaerobic physical activity control; both groups consist of 12 weekly, 60-min group or online training sessions with 15-20 min of daily at-home practice. Outcome measures will be administered at baseline, mid-treatment, posttreatment, and 12-week follow-up.
This study will evaluate changes in PTSD severity (primary outcome) as well as depression, anxiety, anger, sleep problems, and psychosocial disability (secondary outcomes). We will also use multiple mediation to examine two potential models of the mechanisms of clinical effect: the Attention Model (i.e., yoga increases attentional control, which reduces PTSD symptoms), the Coping Model (i.e., yoga increases distress tolerance, which improves coping, which reduces PTSD symptoms), and the combination of these models. This aspect of the study is innovative and important given the absence of an existing, comprehensive model for understanding yoga's impact on PTSD. Ultimately, we hope to develop guidelines for application of yoga to PTSD recovery.
创伤后应激障碍（PTSD）是退伍军人中一种慢性、致残且普遍存在的心理健康障碍。尽管有经验证支持的心理治疗方法，但许多退伍军人在治疗后仍有症状，并且/或者更倾向于寻求包括瑜伽在内的补充和综合健康方法来管理创伤后应激障碍。本文所述的随机对照试验（RCT）将评估与非有氧运动相比，一种标准化瑜伽课程在降低退伍军人创伤后应激障碍严重程度方面的疗效。本研究的第二个目的是更好地理解其改变机制。
192名患有创伤后应激障碍的退伍军人将被随机分配到哈他瑜伽组或非有氧运动对照组；两组均包括每周12次、每次60分钟的小组或在线培训课程，以及每天15 - 20分钟的家庭练习。结果测量将在基线、治疗中期、治疗后和12周随访时进行。
本研究将评估创伤后应激障碍严重程度（主要结果）以及抑郁、焦虑、愤怒、睡眠问题和心理社会功能障碍（次要结果）的变化。我们还将使用多重中介来检验临床效果机制的两种潜在模型：注意力模型（即瑜伽增强注意力控制，从而减轻创伤后应激障碍症状）、应对模型（即瑜伽提高痛苦耐受性，从而改善应对能力，进而减轻创伤后应激障碍症状），以及这些模型的组合。鉴于目前尚无全面的模型来理解瑜伽对创伤后应激障碍的影响，本研究的这一方面具有创新性和重要性。最终，我们希望制定出将瑜伽应用于创伤后应激障碍康复的指南。
