Non-trauma-focused meditation versus exposure therapy in veterans with post-traumatic stress disorder: a randomised controlled trial.
Sanford Nidich, Paul J Mills, Maxwell Rainforth, Pia Heppner, Robert H Schneider, Norman Rosenthal, John Salerno, Carolyn Gaylord-King, Thomas Rutledge
The Lancet Psychiatry December 1, 2018 DOI: 10.1016/s2215-0366(18)30384-5 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 203 |
| Population | Military veterans with a current diagnosis of PTSD resulting from active military service |
| Interventions | Transcendental Meditation Prolonged exposure therapy PTSD health education |
| Duration | 12-week intervention with daily home practice; 3-month post-test assessment |
| Topics | Meditation PTSD |
| Registration | NCT01865123 |
| Key findings | Transcendental Meditation was non-inferior to prolonged exposure therapy in reducing PTSD symptom severity, and both were superior to PTSD health education. |
Abstract
Post-traumatic stress disorder (PTSD) is a complex and difficult-to-treat disorder, affecting 10-20% of military veterans. Previous research has raised the question of whether a non-trauma-focused treatment can be as effective as trauma exposure therapy in reducing PTSD symptoms. This study aimed to compare the non-trauma-focused practice of Transcendental Meditation (TM) with prolonged exposure therapy (PE) in a non-inferiority clinical trial, and to compare both therapies with a control of PTSD health education (HE). We did a randomised controlled trial at the Department of Veterans Affairs San Diego Healthcare System in CA, USA. We included 203 veterans with a current diagnosis of PTSD resulting from active military service randomly assigned to a TM or PE group, or an active control group of HE, using stratified block randomisation. Each treatment provided 12 sessions over 12 weeks, with daily home practice. TM and HE were mainly given in a group setting and PE was given individually. The primary outcome was change in PTSD symptom severity over 3 months, assessed by the Clinician-Administered PTSD Scale (CAPS). Analysis was by intention to treat. We hypothesised that TM would show non-inferiority to PE in improvement of CAPS score (Δ=10), with TM and PE superior to PTSD HE. This study is registered with ClinicalTrials.gov, number NCT01865123. Between June 10, 2013, and Oct 7, 2016, 203 veterans were randomly assigned to an intervention group (68 to the TM group, 68 to the PE group, and 67 to the PTSD HE group). TM was significantly non-inferior to PE on change in CAPS score from baseline to 3-month post-test (difference between groups in mean change -5·9, 95% CI -14·3 to 2·4, p=0·0002). In standard superiority comparisons, significant reductions in CAPS scores were found for TM versus PTSD HE (-14·6 95% CI, -23·3 to -5·9, p=0·0009), and PE versus PTSD HE (-8·7 95% CI, -17·0 to -0·32, p=0·041). 61% of those receiving TM, 42% of those receiving PE, and 32% of those receiving HE showed clinically significant improvements on the CAPS score. A non-trauma-focused-therapy, TM, might be a viable option for decreasing the severity of PTSD symptoms in veterans and represents an efficacious alternative for veterans who prefer not to receive or who do not respond to traditional exposure-based treatments of PTSD. Department of Defense, US Army Medical Research.
Comparable studies
Other randomized controlled trials on PTSD, most cited first.
Citations in the library
Cited by 39
- Biological mechanism study of meditation and its application in mental disorders General Psychiatry July 13, 2020
- Meditation, mindfulness, and acceptance methods in psychotherapy: A systematic review Psychotherapy Research May 8, 2023
- The effectiveness of mindfulness-based stress reduction (MBSR) on depression, PTSD, and mindfulness among military veterans: A systematic review and meta-analysis. Health Psychology Open 2024
- Randomized controlled trials of mind-body interventions for posttraumatic stress disorder: a systematic review. Frontiers in Psychology 2023
- The Role of Mindfulness and Embodiment in Group-Based Trauma Treatment Psychotherapy and Counselling Journal of Australia March 27, 2024
and 34 more in the library
Cites 18
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- Effect of Transcendental Meditation on Employee Stress, Depression, and Burnout: A Randomized Controlled Study The Permanente Journal January 30, 2014
- Effectiveness of transcendental meditation on functional capacity and quality of life of African Americans with congestive heart failure: a randomized control study. 2007
and 13 more in the library