Mantram repetition for Veterans with PTSD: Two randomized clinical trials

Elwy AR, Beck D, Plumb D, Bormann JE, Osei-Bonsu PE, Johnston J, Mohr E, Thorp S. Mantram repetition for Veterans with PTSD: Two randomized clinical trials. Presented at: International Conference on Violence, Abuse, and Trauma; 2014 Sep 8; San Diego, CA.

Abstract: A non-pharmacological, complementary intervention known as the Mantram Repetition Program (MRP) was provided to Veterans with posttraumatic stress disorder (PTSD) for effects on symptom management. Findings from two randomized controlled trials will be presented and comparisons of group versus individual delivery of the intervention will be highlighted. Objectives: 1. Participants will identify the components of the Mantram Repetition Program (MRP). 2. Participants will outline the differences between MRP intervention and study control conditions when delivered individually versus in groups. 3. Participants will describe health-related outcomes in symptom severity from two randomized controlled trials. Summary: Main Points: There are few non-pharmacological, complementary therapies that have been tested empirically using rigorous study designs to determine effects on symptom management in Veterans diagnosed with posttraumatic stress disorder (PTSD). Unlike meditative practices that require a specific amount of time, a quiet environment, or particular posture, mantram repetition is portable, practical, invisible, and immediately available anytime or place. When practiced consistently during non-stressful moments, such as before falling asleep or while waiting in lines, the mantram becomes paired with a physiological state of relaxation. As such, it can become a "portable stress reducer" when PTSD symptoms are triggered. The MRP has been studied using both group and individual delivery formats. There are advantages and disadvantages of these formats depending on the nature of the trauma and demographic characteristics of the population. It is suggested that Veterans who have suffered military sexual trauma are more likely to prefer individual treatment for reasons of privacy. Older Veterans of the Vietnam and Korean era have demonstrated acceptance of group interventions. Younger Veterans returning from Iraq and Afghanistan prefer individual sessions rather than groups, but the effectiveness of program delivery type has not been compared. Two randomized clinical trials (N = 146 and N = 189, respectively) will be presented showing results between the group delivered versus individually delivered Mantram Programs and control conditions (Case Management/Usual Care or Present Centered Therapy). One study includes two sites (San Diego, CA, and Bedford, MA) for greater generalizability of findings. Outcomes include PTSD symptom severity, measures of well-being and psychological distress. Limitations of the studies will be addressed. Implications for future studies include other modes of delivery such as tele-health, smart phone applications, and/or text-messaging for sustainability