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2015 HSR&D/QUERI National Conference Abstract

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1089 — Trauma-Sensitive Yoga for Women Veterans with PTSD who Experienced Military Sexual Trauma: A Feasibility Study

Kelly UA, Atlanta VAMC; Emory University; Patel MN, Atlanta VAMC; Bradley B, Atlanta VAMC; Corwin EJ, Emory University; Norrholm SD, Atlanta VAMC; McCullough SA, Atlanta VAMC; Forbus LA, Atlanta VAMC;

Objectives:
The purpose of this pilot study was to establish the feasibility of conducting a study of a trauma-sensitive yoga intervention in women Veterans with posttraumatic stress disorder (PTSD) who experienced military sexual trauma (MST). Specifically, we sought to assess the feasibility of recruitment, retention, and intervention implementation and determine the feasibility of obtaining biological and psycho-physiological data as outcomes for yoga and PTSD research in this population.

Methods:
Mixed-methods were used to develop and evaluate the implementation of the yoga intervention. Data collection included focus groups, individual qualitative interviews, self-report measures, clinical interviews, cytokines, sleep actigraphy and dark-enhanced startle response. Two cohorts of women Veterans (N = 42) seeking MST-related PTSD treatment in a VA Medical Center were randomized to a 10-week trauma-sensitive yoga intervention (n = 17) or a 12-week Cognitive-Processing Therapy-Cognitive (CPT-C) intervention (n = 25). Data were collected at baseline, mid-intervention, 2-weeks post-intervention and 3-months post-intervention.

Results:
Recruitment challenges included unwillingness to be randomized to psychotherapy versus yoga and implementation of open-access scheduling in the recruitment site, which greatly reduced the sample pool. Study retention, defined as completing final data collection, was 58% for yoga and 32% for CPT-C. Cytokine and startle response data collection were feasible, while 24-hour sleep actigraphy was not. Intervention completion, defined as 7/10 yoga sessions and 10/12 CPT-C, was 58% for yoga and 36% for CPT-C. Participants in the yoga group experienced improvements in PTSD severity (PCL decrease 25% versus 8% decrease in the CPT-C group), depression (45% decrease in BDI-II versus 17% increase in the CPT-C group), and chronic pain levels (Pain Outcomes Questionnaire decrease of 36% versus 16.2% increase in the CPT-C group).

Implications:
These findings support the design of a larger study to evaluate the effectiveness of trauma-sensitive yoga in reducing PTSD and depression symptoms, chronic pain and biological and physiological stress in women Veterans who experienced MST, potentially providing evidence for trauma-sensitive yoga as an effective PTSD treatment for women Veterans with MST.

Impacts:
Trauma-sensitive yoga may be an effective alternative or adjunct to current first line PTSD treatment (i.e. CPT) that could be implemented in the VA nationally.