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瑜伽方案对改善退伍军人和民众创伤后应激障碍症状的作用机制。

Mediators of improved PTSD symptoms in veterans and civilians following a yoga program.

机构信息

Research Department, Roudebush VA Medical Center, Indianapolis, Indiana, USA.

Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.

出版信息

Acta Neuropsychiatr. 2023 Aug;35(4):232-240. doi: 10.1017/neu.2023.5. Epub 2023 Jan 30.

Abstract

OBJECTIVE

Although yoga shows some promise as an intervention for post-traumatic stress disorder (PTSD), little is known about how yoga reduces PTSD symptoms. The current study hypothesised that aspects of interoceptive awareness would mediate the effect of a yoga intervention on PTSD symptoms.

METHODS

We used data from our recently completed randomised controlled trial of a 16-week holistic yoga programme for veterans and civilians diagnosed with PTSD ( = 141) that offered weekly 90-minute sessions. We conducted a mediation analysis using interoceptive awareness and other variables that were associated with PTSD symptom reduction at mid-treatment and treatment end.

RESULTS

Although measures of anxiety, interoceptive awareness, and spirituality were identified in individual mediator models, they were no longer found to be significant mediators when examined jointly in multiple mediator models. When examining the multiple mediator models, the strongest mediator of the yoga intervention on PTSD symptoms was mental well-being at mid-treatment and stigma at the treatment end. The total effect of yoga on CAPS and PCL at the treatment end mediated by stigma was 37.1% (-1.81/-4.88) and 33.6% (-1.91/-5.68), respectively.

CONCLUSION

Investigation of mental well-being and mental illness stigma as potential mediators is warranted in future studies of yoga as a treatment for PTSD as they may prove to be important foci for yoga interventions.

摘要

目的

尽管瑜伽在治疗创伤后应激障碍(PTSD)方面显示出一定的潜力,但对于瑜伽如何减轻 PTSD 症状知之甚少。本研究假设,内感受意识的各个方面将介导瑜伽干预对 PTSD 症状的影响。

方法

我们使用了最近完成的针对 PTSD 退伍军人和平民的 16 周整体瑜伽计划的随机对照试验的数据(n=141),该计划提供每周 90 分钟的课程。我们进行了中介分析,使用了与治疗中期和治疗结束时 PTSD 症状减轻相关的内感受意识和其他变量。

结果

尽管焦虑、内感受意识和灵性的测量值在个别中介模型中得到了识别,但当在多个中介模型中共同检查时,它们不再被认为是显著的中介。在检查多个中介模型时,瑜伽干预对 PTSD 症状的最强中介是治疗中期的心理健康和治疗结束时的耻辱感。治疗结束时,瑜伽对 CAPS 和 PCL 的总效应通过耻辱感介导,分别为 37.1%(-1.81/-4.88)和 33.6%(-1.91/-5.68)。

结论

在未来研究瑜伽作为 PTSD 治疗方法时,有必要进一步调查心理健康和精神疾病耻辱感作为潜在的中介因素,因为它们可能是瑜伽干预的重要焦点。

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