Combat veterans with post-traumatic stress disorder (PTSD) who completed an eight-session mindfulness-based stress reduction (MBSR) program showed lasting improvement in PTSD symptoms for six months after treatment, along with increased mindfulness. Brain imaging revealed that MBSR increased activity in the anterior cingulate and inferior parietal lobule while decreasing activity in the insula and precuneus when veterans were exposed to traumatic reminders, compared to those who received present-centered group therapy. These brain changes are linked to fear extinction and stress regulation. MBSR appears to be a safe and effective non-pharmacologic treatment for PTSD.
Dissociative symptoms can arise from psychological trauma or as a side effect of certain medications, making accurate assessment important. The 23-item Clinician Administered Dissociative States Scale (CADSS) was evaluated in 276 participants: 148 with trauma history and PTSD, 100 with trauma history but no PTSD, and 28 healthy controls without trauma or psychiatric disorder. The scale showed high internal consistency (Cronbach's alpha 0.91) and a single-factor structure. Trauma-exposed participants with PTSD had higher CADSS scores than those without PTSD or without trauma. Veterans with combat-related PTSD showed increased scores after exposure to combat-related stimuli. The CADSS performs reliably for assessing dissociation in psychologically traumatized individuals.
Dissociative symptoms are common in many patients with PTSD and also appear during the first esketamine treatment for treatment-resistant depression. Comparing 134 PTSD patients and 759 TRD patients receiving their first esketamine dose, dissociative symptoms were more prevalent overall in the esketamine group. However, the pattern differed: PTSD patients more often reported dissociative amnesia and identity fragmentation, while esketamine patients most frequently experienced depersonalization and derealization. This distinct pattern suggests that the underlying causes of dissociative symptoms may differ between these conditions.