VA San Diego Center of Excellence for Stress and Mental Health, San Diego, California, USA.
Department of Psychiatry, University of California, San Diego, California, USA.
J Integr Complement Med. 2024 Oct;30(10):1002-1007. doi: 10.1089/jicm.2024.0181. Epub 2024 Jul 31.
This secondary analysis examined five facets of mindful awareness as potential moderators of clinical outcomes using data from a randomized controlled trial (RCT) that compared Mantram Repetition Program (MRP) with present-centered therapy (PCT) in veterans with post-traumatic stress disorder (PTSD). Data were examined from 173 veterans with military-related PTSD randomly assigned to receive eight sessions of MRP ( = 89) or PCT ( = 84). Clinician-administered and self-report measures of mindfulness (Five Facet Mindfulness Questionnaire [FFMQ]), PTSD severity, insomnia symptoms, and depression symptoms, and were obtained pre- and post-intervention. Hierarchical regressions were used to test for FFMQ moderation on clinical outcomes within the two treatment groups. For those with greater ability to "describe their internal experience" (+1 standard deviation [SD]), MRP was associated with lower PTSD hyperarousal symptoms post-intervention than PCT ( < 0.001). For those with lower "nonreactivity to internal stimuli" (-1 SD), MRP was associated with greater reductions in PTSD avoidance and numbing symptoms and insomnia compared with PCT (all s < 0.002). Pre-intervention mindfulness domains of "describe" and "nonreactivity to inner experience" differentially predicted improvements in PTSD and insomnia symptoms for MRP as compared with PCT subjects. The FFMQ may be an important tool for predicting patient preparedness for mindfulness-based interventions, such as MRP.
本二次分析使用来自一项随机对照试验(RCT)的数据,检验了正念觉察的五个方面作为潜在的调节因素,该 RCT 比较了曼特拉重复方案(MRP)与以当下为中心的疗法(PCT)在患有创伤后应激障碍(PTSD)的退伍军人中的临床疗效。 从 173 名患有与军事相关 PTSD 的退伍军人中,对随机分配接受 8 次 MRP(n=89)或 PCT(n=84)的退伍军人的数据进行了检查。 在干预前后,通过临床医生管理的和自我报告的正念测量(五因素正念问卷[FFMQ])、PTSD 严重程度、失眠症状和抑郁症状来评估数据。 使用分层回归检验了 FFMQ 在两种治疗组中的临床疗效的调节作用。 对于那些具有更高的“描述内部体验的能力”(+1 个标准差[SD])的人,MRP 与 PCT 相比,干预后 PTSD 过度警觉症状较低(<0.001)。 对于那些“对内部刺激不反应”(-1 SD)的人,与 PCT 相比,MRP 与 PTSD 回避和麻木症状以及失眠的更大改善相关(所有 s<0.002)。 在干预前,“描述”和“对内部体验不反应”的正念领域分别预测了 MRP 与 PCT 受试者相比,PTSD 和失眠症状的改善。 FFMQ 可能是预测患者对基于正念的干预(如 MRP)准备程度的重要工具。