Orme-Johnson David W, Barnes Vernon A, Rees Brian, Tobin Jean, Walton Kenneth G
Department of Psychology, Maharishi International University, Fairfield, IA 52557, USA.
Georgia Prevention Institute, Augusta University, Augusta, GA 30912, USA.
Medicina (Kaunas). 2024 Dec 12;60(12):2050. doi: 10.3390/medicina60122050.
: Post-traumatic stress disorder (PTSD) is a debilitating condition worldwide. The limited effectiveness of current psychological and pharmacological treatments has motivated studies on meditation techniques. This study is a comprehensive, multiple-treatments meta-analysis comparing the effectiveness of different categories of meditation in treating PTSD. : We followed Prisma guidelines in our published protocol to search major databases and to conduct a meta-analysis of the studies. : We located 61 studies with 3440 subjects and divided them logically into four treatment groups: Mindfulness-Based Stress Reduction (MBSR, 13 studies); Mindfulness-Based Other techniques (MBO, 16 studies), Transcendental Meditation (TM, 18 studies), and Other Meditations that were neither mindfulness nor TM (OM, 14 studies). Trauma populations included war veterans, war refugees, earthquake and tsunami victims, female survivors of interpersonal violence, clinical nurses, male and female prison inmates, and traumatized students. Of those offered, 86% were willing to try meditation. The baseline characteristics of subjects were similar across meditation categories: mean age = 52.2 years, range 29-75; sample size = 55.4, range 5-249; % males = 65.1%, range 0-100; and maximum study duration = 13.2 weeks, range 1-48. There were no significant differences between treatment categories on strength of research design nor evidence of publication bias. The pooled mean effect sizes in Hedges's g for the four categories were MBSR = -0.52, MBO = -0.66, OM = -0.63, and TM = -1.13. There were no appreciable differences in the study characteristics of research conducted on different meditations in terms of the types of study populations included, outcome measures, control conditions, gender, or length of time between the intervention and assessment of PTSD. TM's effect was significantly larger than for each of the other categories, which did not differ from each other. No study reported serious side effects. : All categories of meditation studied were helpful in mitigating symptoms of PTSD. TM produced clinically significant reductions in PTSD in all trauma groups. We recommend a multisite Phase 3 clinical trial to test TM's efficacy compared with standard treatment.
创伤后应激障碍(PTSD)在全球范围内都是一种使人衰弱的病症。当前心理和药物治疗效果有限,这促使人们对冥想技巧展开研究。本研究是一项全面的多治疗方法荟萃分析,比较了不同类别的冥想在治疗PTSD方面的效果。
我们按照已发表方案中的PRISMA指南,检索了主要数据库并对各项研究进行荟萃分析。
我们找到了61项研究,涉及3440名受试者,并将其合理地分为四个治疗组:基于正念的减压疗法(MBSR,13项研究);基于正念的其他技巧(MBO,16项研究),超觉静坐法(TM,18项研究),以及既非正念也非TM的其他冥想(OM,14项研究)。创伤人群包括退伍军人、战争难民、地震和海啸受害者、人际暴力的女性幸存者、临床护士、男性和女性囚犯以及受创伤的学生。在提供冥想的人群中,86%愿意尝试冥想。各冥想类别的受试者基线特征相似:平均年龄 = 52.2岁,范围29 - 75岁;样本量 = 55.4,范围5 - 249;男性比例 = 65.1%,范围0 - 100%;最长研究持续时间 = 13.2周,范围1 - 48周。在研究设计的强度或发表偏倚证据方面,各治疗类别之间没有显著差异。四类的合并平均效应量(以Hedges's g表示)为:MBSR = -0.52,MBO = -0.66,OM = -0.63,TM = -1.13。就纳入的研究人群类型、结局指标、对照条件、性别或干预与PTSD评估之间的时间长度而言,不同冥想研究的研究特征没有明显差异。TM的效果显著大于其他各类,而其他各类之间没有差异。没有研究报告严重的副作用。
所研究的所有冥想类别都有助于减轻PTSD症状。TM在所有创伤组中都使PTSD产生了临床上显著的减轻。我们建议开展一项多中心3期临床试验,以测试TM与标准治疗相比的疗效。