Portable Mantram Meditation for Veterans with Military Related PTSD

为患有军事相关创伤后应激障碍 (PTSD) 的退伍军人提供便携式咒语冥想

• 批准号: 8413424
• 负责人: JILL E. BORMANN
• 金额: --
• 依托单位: VA SAN DIEGO HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-01-01 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8413424
• 关键词: Address; Afghanistan; Aftercare; Anger; Anxiety; Anxiety Disorders; Appointment; Attention; Attitude; Awareness; Behavioral; Case Management; Chronic; Clinic; Clinical Trials; Clinical Trials Design; Cognitive Therapy; Complementary therapies; Control Groups; Diagnosis; Diagnostic; Distress; Dropout; Educational process of instructing; Emotional; Enrollment; Event; Evidence based treatment; Eye Movements; Funding; Geographic Locations; Goals; Group Meetings; Group Therapy; Health; Healthcare; Intervention; Interview; Iraq; Language; Measures; Medication Management; Meditation; Mental Depression; Mental Health; Mental disorders; Methods; Military Personnel; Mission; Modality; Monitor; Outpatients; Panic; Patient Self-Report; Patient-Centered Care; Personal Satisfaction; Pharmaceutical Preparations; Pilot Projects; Post-Traumatic Stress Disorders; Posttraumatic growth; Primary Health Care; Process; Psychotherapy; Quality of life; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Recruitment Activity; Relaxation Therapy; Research; Research Methodology; Sampling; Severities; Site; Sleeplessness; Surveys; Symptoms; Testing; Therapeutic; Thinking; Time; Trauma; Treatment Efficacy; Veterans; War; Woman; Women' s Health; base; clinically significant; coping; desensitization; disorder control; follow-up; group support; improved; interest; medical specialties; meetings; men; mindfulness; novel strategies; phrases; post intervention; programs; prospective; psychological distress; response; secondary outcome; social stigma; standard care; symptom management; tool; treatment as usual

DESCRIPTION (provided by applicant): Anticipated Impacts on Veteran's Healthcare: With wars in Iraq and Afghanistan, there is a growing number of Veterans with posttraumatic stress disorder (PTSD). Traditional PTSD treatments are not beneficial to all Veterans, thus creating a need for new approaches. Currently, there are few complementary therapies that have been studied as first-line treatments for PTSD. We have developed and tested a method of portable, concentrative meditation called the Mantram Repetition Program (MRP) in Veterans with PTSD and found it effective for symptom management when offered as an adjunct to usual care (i.e., medication and case management). If this meditation-based program is found effective as a first-line treatment for PTSD, it could fill a gap for those Veterans for whom traditional treatments fail. Project Background: We have conducted several pilot studies including a randomized controlled trial on the feasibility and acceptability of a 6-week (90 minutes per week) MRP in 146 Veterans with chronic PTSD from military-related trauma. Those assigned to usual care plus the MRP demonstrated significant decreases in self- reported PTSD compared to usual care controls. At post-intervention, 30% of those in the MRP compared to 14% of those in the usual care condition, no longer met diagnostic criteria of PTSD. Qualitative interviews at 3- months post-treatment revealed that MRP was used most frequently to regulate disruptive emotional and behavioral responses (e.g., manage irritable, angry outbursts), tolerate distress (e.g., calm down, relax, reduce anxiety/panic), and interrupt obsessive thoughts about negative events. These findings suggest that the MRP has promise as a stand-alone treatment to help Veterans manage their symptoms of PTSD, but this research is needed to control for the effects of group support. Project Objectives: The goal of this study is to evaluate the treatment efficacy of the MRP as a first-line, stand-alone treatment for PTSD compared to an attention control consisting of Present Centered Group Therapy (PCGT) in a representative sample of Veterans with PTSD. Project Methods: This study will use a prospective, two-site, randomized clinical trial design comparing two groups (MRP and PCGT) at three time points (pre-intervention, post-intervention and 16-week follow-up). Outpatient Veterans (N=324) diagnosed with PTSD will be recruited and randomly assigned to either an 8- week MRP (n=162) or 8-week PCGT control (n=162). PTSD will be measured using Clinician Administered PTSD Scale (CAPS) and PTSD checklist-military (PCL-M). Secondary outcomes will include measures of psychological distress (depression, insomnia, anger) and quality of life and spiritual wellbeing.

描述（由申请人提供）： 对退伍军人的医疗保健的预期影响：随着伊拉克和阿富汗的战争，创伤后应激障碍（PTSD）的退伍军人越来越多。传统的PTSD治疗对所有退伍军人都不是有益的，因此需要新方法。当前，很少有补充疗法被研究为PTSD的一线治疗方法。我们已经开发并测试了一种在具有PTSD的退伍军人中的便携式，浓缩冥想方法，称为Mantram重复计划（MRP），并在作为常规护理的辅助手术（即药物和病例管理）提供时发现对症状管理有效。如果发现该基于冥想的计划是有效的PTSD一线治疗方法，则可以填补那些传统治疗失败的退伍军人的空白。项目背景：我们进行了几项试点研究，包括一项关于146名退伍军人的6周（每周90分钟）MRP的可行性和可接受性的随机对照试验，患有与军事相关创伤的慢性PTSD。与常规护理对照相比，分配给常规护理的人士，自我报告的PTSD的降低显着下降。干预后，MRP中有30％的人在通常的护理状况中，其中14％不再符合PTSD的诊断标准。治疗后3个月进行的定性访谈表明，MRP最常用于调节破坏性的情绪和行为反应（例如，管理易怒，愤怒的爆发），容忍痛苦（例如，平静下来，放松，放松，减轻焦虑/恐慌），以及对负面事件的中断痴迷思想。这些发现表明，MRP有望成为一种独立的治疗方法，可以帮助退伍军人管理PTSD的症状，但是需要这项研究来控制小组支持的影响。项目目标：本研究的目的是评估MRP作为PTSD的一线，独立治疗的治疗效果，与由PTSD的代表性退伍军人样本组成的注意力控制相比。项目方法：本研究将使用前瞻性的，两次的随机临床试验设计，比较三个时间点（干预前，干预后和16周的随访）的两组（MRP和PCGT）。诊断为PTSD的门诊退伍军人（n = 324）将被招募并随机分配给8周MRP（n = 162）或8周PCGT对照（n = 162）。 PTSD将使用临床医生管理PTSD量表（CAPS）和PTSD清单 - 军事（PCL-M）测量。次要结果将包括心理困扰（抑郁，失眠，愤怒）和生活质量和精神健康的度量。