Meditation-Based Mantram Intervention Shows Potential as Adjunctive Therapy for Veterans with PTSD
BACKGROUND:
Standard treatments for PTSD include medication, prolonged exposure therapy, cognitive processing therapy, eye movement desensitization and reprocessing, relaxation training, and combinations of these therapies. However, only half of those who need treatment seek it. Many Veterans want to avoid the stigma of mental illness or prefer not to participate in trauma-focused treatment. Meditation-based interventions offer an alternative to traditional medicine and may be more acceptable to Veterans, but few have been empirically tested. This single-blind randomized trial compared the Mantram Repetition Program (MRP) plus treatment as usual (TAU) to TAU alone at pre- and post-treatment for 136 Veterans diagnosed with PTSD. A third time-point (six-week follow-up) was assessed in the MRP group to examine changes over time. The MRP is a portable (does not require a special place to perform), private, brief meditation-based intervention that teaches three skills: 1) concentrative meditation practice that involves silently repeating a sacred word or phrase called a mantram; 2) slowing down, which refers to thinking/acting deliberately, intentionally, and carefully; and 3) one-pointed attention — focusing on one thing at a time (sometimes called mindfulness). Measures included demographics, self-reported and clinician-rated PTSD symptom severity, depression, anxiety, quality of life, spiritual well-being, adherence to treatment, and patient satisfaction.
FINDINGS:
- The Mantram Repetition Program shows potential when used as an adjunct to TAU for mitigating chronic PTSD symptoms in Veterans. In this study, twice as many Veterans in the MRP + TAU group had clinically meaningful reductions in PTSD symptoms compared to Veterans in the TAU alone group: 24% vs. 12%, respectively, and PTSD symptoms continued to improve in the MRP + TAU group at six-week follow-up.
- Compared to Veterans in the TAU alone group, Veterans in the MRP + TAU group also experienced significant reductions in depression and greater improvements in mental health-related quality of life and spiritual well-being. Reductions in anxiety were equivalent between groups.
- Of Veterans in the MRP + TAU group, 97% reported moderate or high satisfaction with MRP, and dropout rates were equivalent and low (7%) in both groups.
- Sociodemographic characteristics of participants were: 97% male; 58% white, 25% African American, 10% Hispanic; mean age was 57; 51% were married or partnered; 61% were unemployed; 44% had been wounded; 83% were on antidepressants; 83% self-identified as religious.
LIMITATIONS:
- Veterans were self-selected and knew the study was about mantram repetition.
- Findings cannot be generalized to Veterans who are women, who have experienced sexual trauma, or have active substance abuse or dependency.
- The presence or absence of personality disorder diagnoses was not assessed.
AUTHOR/FUNDING INFORMATION:
This study was funded by HSR&D (NRI 04-041). All authors are part of the VA San Diego Healthcare System.
Bormann JE, Thorp S, Wetherell JL, Golshan S, and Lang AJ. Meditation-Based Mantram Intervention for Veterans with Post-Traumatic Stress Disorder: A Randomized Trial. Psychological Trauma: Theory, Research, Practice, and Policy March 12, 2012;e-pub ahead of print.