Interoception Underlies Therapeutic Effects of Mindfulness Meditation for Posttraumatic Stress Disorder: A Randomized Clinical Trial.
Seung Suk Kang, Scott R Sponheim, Kelvin O Lim
Biological Psychiatry: Cognitive Neuroscience and Neuroimaging August 1, 2022 DOI: 10.1016/j.bpsc.2021.10.005 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 98 |
| Population | Veterans with PTSD |
| Interventions | Mindfulness-based stress reduction (MBSR) Present-centered group therapy |
| Duration | 8-week intervention |
| Topics | Meditation PTSD |
| Keywords | EEG Interoception Neurobiological mechanism Posttraumatic stress disorder |
| Key findings | Changes in frontal theta heartbeat-evoked brain responses mediated the MBSR treatment effect on PTSD symptoms. |
Abstract
Mindfulness-based interventions have proven efficacy in treating posttraumatic stress disorder (PTSD), but the neurobiological mechanism underlying the therapeutic effects is unknown. As mindfulness meditation cultivates attention to the present moment and bodily sensations, neural functions related to interoception (i.e., central processes of bodily signals) might be such a mechanism. We conducted a clinical trial in which veterans with PTSD were randomly assigned to receive an 8-week mindfulness-based stress reduction (MBSR) intervention (n = 47) or an active control intervention (present-centered group therapy; n = 51). We assessed pre- and postintervention PTSD symptoms and electroencephalography measures of neural outcomes, including spontaneous brain activity, cognitive task-related brain responses, and interoceptive brain responses (heartbeat-evoked brain responses). We conducted statistical causal mediation analyses using treatment type as a predictor, pre- and postintervention measures of symptom severity as treatment response, and the neural outcomes as mediators. Compared with the control group, the MBSR group had greater improvements in PTSD symptoms and increases in spontaneous alpha power (8-13 Hz), task-related frontal theta power (4-7 Hz in 140-220 ms after stimulus), and frontal theta heartbeat-evoked brain responses (3-5 Hz and 265-336 ms after R peak). The mediation analysis using latent difference score modeling revealed that only changes in frontal theta heartbeat-evoked brain responses mediated the MBSR treatment effect. Mindfulness meditation improves brain functions of attentional control and resting brain states reflective of internally oriented relaxation. However, interoceptive neural functions enhanced by MBSR seem to be a primary cerebral mechanism that improves symptoms of PTSD.
Comparable studies
Other randomized controlled trials on PTSD, most cited first.
Citations in the library
Cited by 7
- Neurophysiological changes associated with vibroacoustically-augmented breath-focused mindfulness for dissociation: targeting interoception and attention Psychological Medicine May 5, 2023
- Eight-month intensive meditation-based intervention improves refractory hallucinations and delusions and quality of life in male inpatients with schizophrenia: a randomized controlled trial. Psychiatry and Clinical Neurosciences April 1, 2024
- Towards therapeutic paths with mindfulness meditation–based and psychedelics assisted psychotherapies in PTSD: Randomized controlled trials systematic review and meta-analysis Cortica December 15, 2025
- Predicting and exploring ayahuasca effects: Perception, mind-wandering, and EEG oscillations Journal of Psychopharmacology December 4, 2025
- A Meta-Analysis of the Impact of Mindfulness-Based Stress Reduction Therapy Intervention on Post-traumatic Stress Disorder. Cureus October 1, 2025
and 2 more in the library
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