Journal of Traumatic Stress
January 1, 1998
J. Douglas Bremner, John H. Krystal, Frank W. Putnam et al.
826 citations
A new instrument, the Clinician Administered Dissociative States Scale (CADSS), was developed to measure present-state dissociative symptoms. Initial analyses showed good interrater reliability and construct validity. CADSS scores successfully discriminated patients with dissociative disorders from patients with other psychiatric disorders and from healthy subjects.
Journal of Traumatic Stress
July 25, 2013
David J. Kearney, Carol A. Malte, Carolyn Mcmanus et al.
232 citations
An open pilot trial of loving-kindness meditation for veterans with PTSD found that the practice was safe, acceptable, and associated with reduced symptoms. After a 12-week course, self-compassion increased with large effect sizes, and mindfulness increased with medium to large effect sizes. At 3-month follow-up, PTSD symptoms showed a large reduction (d = -0.89) and depression a medium reduction (d = -0.49). Enhanced self-compassion appeared to mediate these symptom reductions. Attendance was high, with 74% attending 9-12 classes. Further controlled study is needed to confirm whether the changes are due to the meditation itself rather than other influences.
Journal of Traumatic Stress
August 1, 2014
Emma M Seppala, Jack B. Nitschke, Dana Tudorascu et al.
180 citations
A breathing-based meditation called Sudarshan Kriya yoga reduced posttraumatic stress disorder (PTSD) symptoms, anxiety, and respiration rate in male U.S. veterans of the Iraq or Afghanistan wars. Twenty-one veterans were randomly assigned to either the active meditation group or a waitlist control group. The active group showed large reductions in PTSD scores and anxiety symptoms, while the control group did not. Reductions in startle response correlated with reduced hyperarousal symptoms immediately after the intervention and at one-year follow-up. The findings suggest Sudarshan Kriya yoga may be a useful alternative treatment for PTSD.
Journal of Traumatic Stress
March 31, 2019
Ariel J Lang, Anne Malaktaris, Pollyanna Casmar et al.
50 citations
A pilot randomized controlled trial compared compassion meditation (CM) to a relaxation-based program (Veteran.calm) for veterans with PTSD. Both interventions involved ten weekly 90-minute group sessions. Twenty-eight veterans who attended at least one session completed pre- and posttreatment measures. PTSD symptoms reduced more substantially in the CM group than in the comparison group, with a between-group effect size of -0.85. Credibility, attendance, and satisfaction were similar across conditions, demonstrating the feasibility of CM and the appropriateness of the comparison condition. These initial findings support further research on CM for veterans with PTSD.
Journal of Traumatic Stress
February 19, 2020
Ingmar Gorman, Alexander Belser, Lisa Jerome et al.
43 citations
MDMA-assisted psychotherapy for posttraumatic stress disorder (PTSD) not only reduces symptoms but also promotes posttraumatic growth (PTG)—positive changes in self-perception, relationships, and life philosophy. Pooled data from three phase 2 clinical trials with 60 participants showed that those receiving active MDMA (75–125 mg) had significantly more PTG and larger reductions in PTSD symptom severity at the primary endpoint compared to the control group (0–40 mg MDMA). At 12-month follow-up, PTG remained higher, symptom severity lower, and two-thirds of participants no longer met PTSD criteria. These large-magnitude effects suggest PTG may be a new mechanism of action for this treatment.
Journal of Traumatic Stress
August 1, 2021
Linnae Ponté, Lisa Jerome, Scott Hamilton et al.
42 citations
Sleep disturbances are common and hard to treat in PTSD. In four randomized controlled double-blind studies, 63 participants received either active MDMA (75-125 mg) or placebo/control MDMA (0-40 mg) during psychotherapy sessions. At the primary endpoint 1-2 months after sessions, PTSD symptoms dropped more with active MDMA than placebo (CAPS-IV score change -34.0 vs. -12.4). Sleep quality also improved more with active MDMA (PSQI score change -3.5 vs. +0.6). Sleep quality continued to improve from treatment exit to 12-month follow-up. These data provide evidence that MDMA-assisted psychotherapy benefits sleep disturbances in PTSD.
Journal of Traumatic Stress
March 12, 2026
Leslie A. Morland, B O Rothbaum, Lauren M. Sippel et al.
2 citations
MDMA-assisted psychotherapy for PTSD shows promising results in recent randomized controlled trials, with high response and remission rates, but the FDA declined to approve it in August 2024 due to insufficient evidence. This review examines the current scientific literature on MDMA-AT, covering proposed mechanisms, methodological strengths and limitations, evidence gaps, and clinical, ethical, and regulatory issues. Key limitations include challenges with blinding, lack of active comparator conditions, no head-to-head comparisons of different therapy models, inadequate safety monitoring, and limited sample generalizability. Emerging research integrates MDMA with established trauma-focused therapies like prolonged exposure and cognitive processing therapy to leverage MDMA's effects on cognitive behavioral mechanisms.
Journal of Traumatic Stress
May 7, 2025
Mark Creamer, Richard Bryant, Amy Lehrner et al.
1 citation
A panel of clinicians and researchers at the 2024 ISTSS annual meeting discussed psychedelic-assisted psychotherapy for PTSD. Despite diverse views, they largely agreed the approach is an exciting possibility for patients who have not responded to existing evidence-based treatments. However, they also agreed that considerably more rigorous research is needed before definitive conclusions about its components and efficacy can be drawn. Ethical concerns, especially regarding accessibility, will pose a significant challenge for provider organizations.
Journal of Traumatic Stress
June 1, 2026
Kadek Suhardita, Veno Dwi Krisnanda, Rikas Saputra et al.
MDMA-assisted psychotherapy shows promise for treating PTSD, but the evidence base has major limitations: difficulties in blinding, expectancy effects, lack of active comparators, unclear mechanisms, and safety concerns. The commentary argues these issues are central to interpreting the therapy's effects and future translation. It calls for moving beyond symptom reduction to broader recovery indicators like functioning, quality of life, relational restoration, and long-term durability. Stronger attention to equity, scalability, therapist training, and ethical safeguards is needed, especially for global mental health frameworks. The discussion aims to stimulate deeper debate on evaluating innovation in trauma treatment before widespread clinical adoption.
Journal of Traumatic Stress
February 1, 2022
Mayer Bellehsen, Valentina Stoycheva, Barry H. Cohen et al.
Transcendental Meditation (TM) reduces PTSD symptoms more than treatment-as-usual in veterans. In a randomized controlled trial, 40 veterans with PTSD were assigned to either 16 TM sessions over 12 weeks or usual care. After three months, the TM group showed a significantly larger average decrease in clinician-rated PTSD symptoms (11.28 points) compared to the control group (1.62 points). Half of the TM group no longer met PTSD diagnostic criteria, versus 10% in the control group. Self-reported PTSD, depression, anxiety, and sleep difficulties also improved more with TM. No significant differences were found for anger or quality of life. The findings suggest TM is an effective, non-trauma-focused treatment for PTSD.
Journal of Traumatic Stress
August 1, 2018
Geneviève Belleville, Mylène Dubé-Frenette, Andréanne Rousseau
Adding nightmare therapy (imagery rehearsal therapy) to cognitive behavioral therapy for PTSD may improve nighttime symptoms more quickly than CBT alone. In a randomized trial with 42 adult sexual assault victims with PTSD, both groups showed significant reductions in PTSD symptoms and improvements in functioning after CBT. However, the group that received nightmare therapy before CBT showed medium to large additional improvements in nighttime symptoms compared to a waiting period. The combined treatment was not clearly superior to CBT alone overall, but targeting nightmares early may benefit patients with limited time or those whose primary complaint is nightmares.
Journal of Traumatic Stress
February 1, 2014
Brian Rees, Fred Travis, David Shapiro et al.
Among Congolese refugees with posttraumatic stress, learning Transcendental Meditation was followed by large reductions in PTSD symptoms within 10 days. Average scores on a standard PTSD checklist fell from 77.9 to 48.0 in 10 days, then further to 35.3 at 30 days. The effect size at 10 days was very large (d = 4.05). No adverse events occurred, and all 11 participants completed the study.
Journal of Traumatic Stress
April 1, 2013
Brian Rees, Fred Travis, David Shapiro et al.
In a matched single-blind pilot study, Congolese refugees in Kampala, Uganda who learned Transcendental Meditation (TM) showed substantial reductions in posttraumatic stress symptoms. The TM group's average PCL-C score dropped from 65 (severe symptoms) at baseline to below 30 after 30 days of practice, remaining low at 135 days. The control group's scores trended upward. Effect size was large (d > 1.0). Compliance was good, with no adverse events. The results suggest TM may be an effective, safe intervention for reducing PTS symptoms in this population.
Journal of Traumatic Stress
October 1, 2012
Gerlinde C. Harb, Richard Thompson, Richard J Ross et al.
The nightmares of 48 male U.S. Vietnam war veterans with combat-related PTSD were predominantly replays of actual combat events involving death, violence, and fear for one's life. In Imagery Rehearsal therapy, rescripted dreams that addressed or resolved the nightmare theme were linked to reduced sleep disturbance, but including violent details in the rescripted dream predicted poorer treatment outcome in nightmare frequency (B = 5.69, SE = 1.14). Experiencing olfactory sensations in nightmares, a possible marker of nightmare intensity, also predicted poorer treatment response (B = 2.95, SE = 1.06). The therapy may be most effective when rescripted dreams resolve the nightmare theme and exclude violent content.
Journal of Traumatic Stress
June 1, 2012
S. Perona-Garcelán, Francisco Carrascoso-López, J. García-Montes et al.
Among 71 patients with psychosis, childhood trauma was linked to higher dissociation, hallucinations, and delusions. Dissociative experiences, particularly depersonalization, mediated the relationship between childhood trauma and hallucinations but not between childhood trauma and delusions. This suggests the impact of childhood trauma on hallucinations may operate partly through dissociation rather than being entirely direct.
Journal of Traumatic Stress
February 1, 2011
Nirit Soffer-Dudek, Reut Wertheim, Golan Shahar
Among 79 Israeli young adults, having lucid dreams—being aware of dreaming—appeared to buffer the psychological impact of terrorism exposure. For those with few lucid dreams, indirect exposure via media and perceived stress predicted increased distress over three years. This protective effect was not seen in frequent lucid dreamers. The findings suggest that lucid dreaming may help regulate emotional responses to trauma.
Journal of Traumatic Stress
June 1, 2009
Mary Lu, Amy Wagner, Lynn Van Male et al.
Imagery rehearsal therapy (IRT) may help reduce residual nightmares and PTSD symptoms in male U.S. veterans who had not previously completed trauma-focused PTSD treatment. Fifteen veterans attended 6 IRT group sessions. No benefits were seen immediately after treatment, but at 3- and 6-month follow-up, trauma-related nightmare frequency decreased from baseline. At 3 months, the number of trauma-related nightmares per week, total nightmares per week, and PTSD symptoms also decreased. Nightmare severity and fear of sleep improved over time. No effects were found on the impact of nightmares, sleep quality, or depression.
Journal of Traumatic Stress
June 1, 2007
T L Simpson, D Kaysen, S Bowen et al.
In an incarcerated sample, PTSD symptom severity did not predict who chose to take a Vipassana meditation course, and the course led to significantly greater reductions in substance use than treatment as usual, regardless of PTSD severity. The findings suggest Vipassana meditation merits further investigation for people with both PTSD and substance use problems.
Journal of Traumatic Stress
October 1, 2003
David Forbes, Andrea J Phelps, Anthony F McHugh et al.
Australian Vietnam veterans with chronic combat-related PTSD who received six weekly sessions of Imagery Rehearsal Therapy showed significant reductions in nightmare frequency and intensity that were maintained 12 months after treatment. Improvements in overall PTSD, depression, anxiety, and broader symptoms also persisted to the 12-month follow-up. The findings provide preliminary evidence that the positive effects of IRT on posttraumatic nightmares and related symptoms are durable over the longer term.
Journal of Traumatic Stress
April 1, 2001
David Forbes, Andrea J Phelps, Tony McHugh
Imagery rehearsal therapy significantly reduced combat-related nightmares and improved PTSD and related symptoms in 12 Vietnam veterans with PTSD. Three groups of four veterans each completed six standardized treatment sessions. Nightmare diaries and established instruments (IES-R, BDI, BAI, SCL-90-R) showed significant reductions in targeted nightmares and improvements in PTSD and comorbid symptoms. The authors recommend a randomized controlled trial based on these promising preliminary data.
Journal of Traumatic Stress
October 1, 2000
B Krakow, M Hollifield, R Schrader et al.
Imagery-rehearsal therapy reduced nightmare frequency and PTSD severity and improved sleep quality in sexual assault survivors with PTSD. In a randomized controlled trial, 169 women were assigned to either a treatment group receiving three therapy sessions over 5 weeks or a wait-list control. At a 3-month follow-up of 91 women, the treatment group showed moderate to large improvements compared to small changes in the control group, with effect sizes ranging from 0.57 to 1.26. Despite a large dropout rate, the therapy is effective for chronic nightmares in this population.
Journal of Traumatic Stress
October 1, 1999
K Esposito, A Benitez, L Barza et al.
Among Vietnam combat veterans diagnosed with PTSD, target dreams vary in how closely they replicate traumatic events and incorporate typical dream elements, but they are almost always threatening. A new PTSD dream rating instrument was developed to systematically assess dream content, incorporating dimensions from dream content analysis literature. In 18 veterans, about half of the target dreams contained features characteristic of combat, all but 17% were moderately to highly threatening, 53% were set at least partially in the present, and 79% contained distorted elements. The findings indicate that PTSD-related dreams are not uniformly replicative of trauma but consistently threatening.