Loving-Kindness Meditation vs Cognitive Processing Therapy for Posttraumatic Stress Disorder Among Veterans

Kearney, David J.; Malte, Carol A.; Storms, Meghan; Simpson, Tracy L.

doi:10.1001/jamanetworkopen.2021.6604

Cited by 37 publications

(42 citation statements)

References 60 publications

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“…Foa et al was one of the two trials reporting on causes of AEs, with about even percentages of treatment-related AEs for TF-CBT and present-centred therapy (39% v. 50% respectively). The other trial, Kearney et al, 52 did not deem any AEs to be treatment-related in either group (TF-CBT versus loving kindness meditation). Results remained by and large the same for the sensitivity analysis on trials exclusively delivering interventions individually, the only small difference being that incidences of AEs were marginally lower for both a.…”

Section: Pre-to Post-treatment Adverse Eventsmentioning

confidence: 96%

Safety of psychological interventions for adult post-traumatic stress disorder: meta-analysis on the incidence and relative risk of deterioration, adverse events and serious adverse events

Hoppen

Lindemann²,

Morina³

2022

Br J Psychiatry

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Background Attention on harmful effects of psychological interventions for adult post-traumatic stress disorder (PTSD) has increased, yet a comprehensive meta-analysis is lacking. Aims To summarise incidences and relative risks of deterioration, adverse events (AEs) and serious adverse events (SAEs) in trials of psychological interventions for adult PTSD. Method We searched MEDLINE, PsycInfo, Web of Science and PTSDpubs from inception to 21 April 2022 for sufficiently large (n ≥ 20) randomised controlled trials (RCTs) reporting on the incidence of harms. Results We included 56 RCTs (4230 patients). Incidences of harms were generally low (0–5%). Psychological interventions were associated with decreased risk of deterioration relative to passive (RR = 0.21, 95% CI 0.15–0.28) and active control conditions (RR = 0.36, 95% CI 0.14–0.92). Decreased risk was even more pronounced in sensitivity analyses on trials exclusively delivering treatments face to face. When compared with other psychological interventions, trauma-focused cognitive–behavioural therapy (TF-CBT) was associated with decreased risk of SAEs (RR = 0.54, 95% CI 0.31–0.95) and with no differential risk of deterioration and AEs. Conclusions The current evidence base suggests that psychological interventions are safe for most adults with PTSD. In none of the analyses were psychological interventions associated with an increased risk of harm compared with control conditions. TF-CBT was found at least as safe as other psychological interventions. Individual face-to-face delivery might be the safest delivery format. However, more data are needed to draw firmer conclusions. We encourage research teams to routinely and thoroughly assess and report the incidence of harms and their causes.

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Section: Pre-to Post-treatment Adverse Eventsmentioning

confidence: 96%

Safety of psychological interventions for adult post-traumatic stress disorder: meta-analysis on the incidence and relative risk of deterioration, adverse events and serious adverse events

Hoppen

Lindemann²,

Morina³

2022

Br J Psychiatry

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“…We conducted an analysis of baseline data from a randomized clinical trial comparing 2 behavioral interventions for veterans with PTSD. 21 Veterans with a diagnosis of PTSD were recruited from VA Puget Sound Health Care System through mailings. A telephone screener was used to assess eligibility.…”

Section: Study Design and Samplementioning

confidence: 99%

“…Full inclusion and exclusion criteria can be found in the primary study manuscript. 21 Briefly, the primary inclusion criterion was veterans who met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for PTSD for any reason (ie, not limited to combat-related trauma). Veterans were excluded if they met any of the following criteria: substance use dependence disorder other than alcohol, alcohol use that posed a safety concern, high risk of suicide, psychotic disorder, mania, diagnoses of borderline or antisocial personality disorder documented in the electronic health record, or a psychiatric admission in the past month.…”

Section: Study Design and Samplementioning

confidence: 99%

Prevalence of Gastrointestinal Symptoms and Irritable Bowel Syndrome Among Individuals With Symptomatic Posttraumatic Stress Disorder

Kearney¹,

Kamp²,

Storms³

et al. 2022

Journal of Clinical Gastroenterology

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Goals: Our aim was to describe the prevalence of irritable bowel syndrome (IBS) and other gastrointestinal symptoms in a sample of veterans with posttraumatic stress disorder (PTSD) and to examine the relationship between gastrointestinal symptoms, PTSD severity, depression severity, and number of prior traumatic events reported.Background: IBS and PTSD can co-occur; yet, little research has focused on describing the gastrointestinal symptoms and prevalence of IBS among veterans with PTSD. Materials and Methods:We examined baseline data from a randomized clinical trial of behavioral interventions for veterans with PTSD. Veterans completed questionnaires assessing gastrointestinal symptoms (Gastrointestinal Patient-Reported Outcome Measures Information Systems; PROMIS) and lifetime traumatic events. Multivariable regression analyses were performed to examine associations between gastrointestinal symptoms and the number of prior traumas reported PTSD severity, and depression symptom severity.Results: One hundred eighty-four veterans with a diagnosis of PTSD were included. Twenty-five percent met the Rome III criteria for IBS. Veterans reported gastrointestinal symptoms including abdominal/belly pain (36%), diarrhea (21%), constipation (18%), and bloating/gas (17%). In multivariable analyses, greater PTSD severity was associated with worse constipation (P = 0.008), diarrhea (P = 0.005), and gas/bloating (P = 0.001) when controlling for age and sex. Higher levels of depressive symptoms severity were associated with greater abdominal/belly pain (P = 0.04).Conclusions: Among a sample of veterans with PTSD, rates of IBS and abdominal/belly pain are greater than general US population reference values. Although levels of constipation and bloating/gas are lower than general US population reference values, increased severity of PTSD was associated with increased gastrointestinal symptoms.

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“…LKM procedures vary, yet it is generally a process of goodwill. For example, one might call to mind a particular person (e.g., a neighbor, a distant other) and silently repeat phrases that invoke goodwill, such as "may you be safe," "may you be happy," and "may you be healthy" [105,106]. Generally, the practice is intended to work in a stepwise fashion, initially directed at the self and loved ones, and outward toward acquaintances, strangers, and finally, all forms of life.…”

mentioning

confidence: 99%

Wise Ancestors, Good Ancestors: Why Mindfulness Matters in the Promotion of Planetary Health

et al. 2021

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The concept of planetary health blurs the artificial lines between health at scales of person, place, and planet. It emphasizes the interconnected grand challenges of our time, and underscores the need for integration of biological, psychological, social, and cultural aspects of health in the modern environment. Here, in our Viewpoint article, we revisit vaccine pioneer Jonas Salk’s contention that wisdom is central to the concept of planetary health. Our perspective is centered on the idea that practical wisdom is associated with decision-making that leads to flourishing—the vitality and fullest potential of individuals, communities, and life on the planet as a whole. The SARS-CoV-2 pandemic has illustrated the acute consequences of unwise and mindless leadership; yet, wisdom and mindfulness, or lack thereof, is no less consequential to grotesque biodiversity losses, climate change, environmental degradation, resource depletion, the global burden of non-communicable diseases (NCDs), health inequalities, and social injustices. Since mindfulness is a teachable asset linked to both wisdom and flourishing, we argue that mindfulness deserves much greater attention in the context of planetary health.

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Loving-Kindness Meditation vs Cognitive Processing Therapy for Posttraumatic Stress Disorder Among Veterans

Cited by 37 publications

References 60 publications

Safety of psychological interventions for adult post-traumatic stress disorder: meta-analysis on the incidence and relative risk of deterioration, adverse events and serious adverse events

Safety of psychological interventions for adult post-traumatic stress disorder: meta-analysis on the incidence and relative risk of deterioration, adverse events and serious adverse events

Prevalence of Gastrointestinal Symptoms and Irritable Bowel Syndrome Among Individuals With Symptomatic Posttraumatic Stress Disorder

Wise Ancestors, Good Ancestors: Why Mindfulness Matters in the Promotion of Planetary Health

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