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2019 HSR&D/QUERI National Conference Abstract

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1135 — Trauma-Sensitive Yoga v. Cognitive Processing Therapy for Women Veterans with PTSD and Co-Morbid Depression who Experienced Military Sexual Trauma

Lead/Presenter: Ursula Kelly,  Atlanta VAHCS
All Authors: Kelly UA (Atlanta VAHCS and Emory University Nell Hodgson Woodruff School of Nursing), Higgins, M (Emory University Nell Hodgson Woodruff School of Nursing),

Objectives:
To evaluate the effectiveness of trauma-sensitive yoga (TSY) to treat PTSD and co-morbid depression symptoms in women Veterans with PTSD who experienced military sexual trauma (MST).

Methods:
In this RCT, women Veterans (n = 80) were recruited in a VAHCS from PTSD, mental health, and other out-patient clinics. Participants were randomized to TSY or cognitive processing therapy (CPT). The protocol-driven interventions were provided in 60-75 minute group sessions, for 10 (TSY) and 12 (CPT) weekly sessions. Data were collected at baseline, mid-intervention, 2-weeks post-intervention and 3-months post-intervention. Measures include the PTSD Symptom Checklist (PCL-5), the Clinician Administered PTSD Scale (CAPS-5), and the Beck Depression Inventory (BDI). Data analyses included group comparisons at baseline (t-tests, Mann Whitney non-parametric tests, and chi-square tests). Multilevel mixed models were used to analyze the differences between the groups over time on outcome variables.

Results:
PTSD symptom severity decreased significantly (p < .001) in both groups, with progressively lower scores at each time point for both self-reported (PCL-5) and clinician assessed (CAPS-5) PTSD symptoms. Mean total PCL scores decreased from 51.44 to 36.88 (TSY) and from 51.87 to 30.67 (CPT), baseline and 3-months post-intervention respectively. Mean total CAPS severity decreased from 34.29 to 19.40 (TSY) and 33.53 to 14.36 (CPT), from baseline to 3-months post-intervention. Depression symptom severity (BDI) also decreased significantly (p < .001) in both groups, with progressively lower scores at each time point. Mean total BDI scores were 28.45 and 18.29 (TSY) and 30.84 and 16.14 (CPT), at baseline and 3-months post-intervention, respectively. There were no significant differences between TSY and CPT groups in changes in PTSD and depression symptoms over time.

Implications:
The study results support the use of TSY for the treatment of PTSD and co-morbid depression in women Veterans with sexual trauma. Additional research is needed to evaluate the differential benefits of TSY as an alternative, precursor, or adjunctive treatment to psychotherapy for PTSD.

Impacts:
These early study findings support TSY as a cost-effective scalable PTSD intervention that could be implemented in VA Health Care Systems nationwide, expanding treatment options beyond current evidence-based PTSD psychotherapy, which is not universally acceptable or effective.