A Web-Based Cognitive Behavioral Therapy, Mindfulness Meditation, and Yoga Intervention for Posttraumatic Stress Disorder: Single-Arm Experimental Clinical Trial.
Megan A Kirk, Bilal Taha, Kevin Dang, Hugh McCague, Dimitrios Hatzinakos, Joel Katz, Paul Ritvo
JMIR Mental Health February 28, 2022 DOI: 10.2196/26479 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Single-arm experimental clinical trial Randomized Cross-sectional Peer reviewed |
|---|---|
| Sample size | 22 |
| Population | Adults aged 18-35 years reporting PTSD symptoms |
| Interventions | Web-based cognitive behavioral therapy mindfulness and yoga (CBT-MY) web-based counseling |
| Duration | 8-week intervention |
| Measures | Peak pupil dilation (PPD), heart rate variability (HRV) |
| Topics | Meditation PTSD |
| Keywords | Cognitive behavioral therapy Cognitive therapy Internet delivery Intervention Posttraumatic stress disorder Psychophysiology Pupillometry |
| Registration | NCT03684473 |
| Key findings | Web-based CBT-MY was associated with large pre-post reductions in PTSD severity (d=1.60), depression (d=0.83), anxiety (d=0.99), and mindfulness (d=0.88), and a significant reduction in peak pupil dilation (d=0.90) but no significant change in heart rate variability. The authors suggest these gains indicate clinically significant symptom improvement and healthier autonomic functioning, while noting that randomized controlled trials are needed. |
Abstract
Posttraumatic stress disorder (PTSD) is a debilitating, undertreated condition. The web-based delivery of cognitive behavioral therapy supplemented with mindfulness meditation and yoga is a viable treatment that emphasizes self-directed daily practice. This study aims to examine the effectiveness of a web-based cognitive behavioral therapy, mindfulness, and yoga (CBT-MY) program designed for daily use. We conducted an 8-week, single-arm, experimental, registered clinical trial on adults reporting PTSD symptoms (n=22; aged 18-35 years). Each participant received web-based CBT-MY content and an hour of web-based counseling each week. Pre-post outcomes included self-reported PTSD symptom severity, depression, anxiety, chronic pain, and mindfulness. Pre-post psychophysiological outcomes included peak pupil dilation (PPD) and heart rate variability (HRV). HRV and PPD were also compared with cross-sectional data from a non-PTSD comparison group without a history of clinical mental health diagnoses and CBT-MY exposure (n=46). Pre-post intention-to-treat analyses revealed substantial improvements in PTSD severity (d=1.60), depression (d=0.83), anxiety (d=0.99), and mindfulness (d=0.88). Linear multilevel mixed models demonstrated a significant pre-post reduction in PPD (B=-0.06; SE=0.01; P<.001; d=0.90) but no significant pre-post change in HRV (P=.87). Overall, participants spent an average of 11.53 (SD 22.76) min/day on self-directed mindfulness practice. Web-based CBT-MY was associated with clinically significant symptom reductions and significant PPD changes, suggesting healthier autonomic functioning. Future randomized controlled trials are needed to further examine the gains apparent in this single-arm study. ClinicalTrials.gov NCT03684473; https://clinicaltrials.gov/ct2/show/NCT03684473.
Comparable studies
Other non-randomized and open-label trials on PTSD, most cited first.
Citations in the library
Cited by 5
- The association of mindfulness and psychological well-being among individuals who have recovered from COVID-19 in Jianghan District, Wuhan, China: A cross-sectional study Journal of Affective Disorders September 23, 2022
- Impact of Meditation–Based Lifestyle Modification on HRV in Outpatients With Mild to Moderate Depression: An Exploratory Study Frontiers in Psychiatry June 9, 2022
- Effectiveness of Meditation Techniques in Treating Post-Traumatic Stress Disorder: A Systematic Review and Meta-Analysis. Medicina (Kaunas, Lithuania) December 12, 2024
- The Cumulative Effect of a 12-Week Online Mindfulness-Based Meditation Intervention Programme on Autonomic Nerve Functions by Pupillary Light Reflex: A Pilot Randomised Controlled Trial. Stress and Health August 1, 2025
- Backdraft in Self-Compassion: An Overlooked Yet Vital Research Focus Mindfulness March 1, 2024
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