Mindfulness-Based Intervention Improves Depression, Anxiety, and Quality of Life in Unstably-Housed Women with PTSD and Substance Use Disorder

Abstract Objective This study sought to evaluate the efficacy of Mindfulness-based Stress Reduction (MBSR) on symptoms of posttraumatic stress, depression, anxiety, and perceived stress and quality of life in unstably-housed women undergoing substance use disorder (SUD) treatment. Despite the potential for MBSR to be a helpful adjunct to ongoing care, prior research on the benefit of MBSR in this population is limited.

Method: Participants were 156 unstably-housed women residing in a state-funded residential SUD treatment program. Using a community-engaged approach, we conducted an open-label, cluster-based clinical trial. Clusters of participants were assigned to 8-week, 9-session MBSR or Health Promotion Attention Control (HP Control) interventions. Participants were evaluated at Time 1 (T1, baseline), Time 2 (T2, immediately post-intervention), and Time 3 (T3, 6-months post-baseline). Mixed-effects modeling examined group-by-time effects on primary (posttraumatic stress) and secondary (depression, anxiety, quality of life, perceived stress) outcomes. The trial was registered on ClincialTrials.gov.

Results: Posttraumatic stress symptoms improved from T1 to T2 and T3 ( p -values < 0.001); however, MBSR and HP groups did not differ significantly ( p -values > 0.05). Depression also improved over time, with significant between-group differences. Participants reported lower depression at T2 and T3 ( p -values < 0.05); MBSR participants reported significantly greater improvements at T2 ( contrast = -3.57, p = 0.008, 95% CI, -6.23, -0.91) and T3 ( contrast = -5.65, p < 0.001, 95% CI, -8.68, -2.63) compared to HP participants. Anxiety similarly improved over time: MBSR compared to HP participants reported lower anxiety at T3 ( contrast = -3.74, p = 0.007, 95% CI, -6.44, -1.04). Quality of life and perceived stress improved from T1 to T2 and T3; between-group differences were significant ( p -values < 0.05). Small to medium effect sizes were consistently indicated.

Conclusions: MBSR-based interventions may help ameliorate comorbidities and improve quality of life in unstably-housed women recovering from trauma and SUD. Preregistration Study design and proposed analyses were preregistered on ClinicalTrials.gov (NCT04605198).