Trauma-Integrated Mindfulness-Based Relapse Prevention for Women with Comorbid Post-Traumatic Stress Disorder and Substance Use Disorder: A Cluster Randomized Controlled Feasibility and Acceptability Trial

Somohano, Vanessa C.; Bowen, Sarah

doi:10.1089/jicm.2021.0306

Cited by 8 publications

(4 citation statements)

References 82 publications

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“…Another MiBI study ( Niles et al, 2012 ) compared an MBSR-based telehealth intervention to a psychoeducation control. Of these studies, two were rated as having low ROB ( Polusny et al, 2015 ; Bremner et al, 2017 ), two had some concerns ( Kearney et al, 2016 ; Davis et al, 2019 ), and four had high ROB ( Niles et al, 2012 ; Kearney et al, 2013 ; Gallegos et al, 2020 ; Somohano and Bowen, 2022 ) (see Table 5 ).…”

Section: Resultsmentioning

confidence: 99%

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Randomized controlled trials of mind–body interventions for posttraumatic stress disorder: a systematic review

Kaplan,

Somohano,

Zaccari

et al. 2024

Front. Psychol.

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Mind–body interventions (MBIs) include mindfulness-based interventions (MiBIs), meditation- and mantra-based interventions (MMIs), and movement-based interventions (MoBIs). These approaches have demonstrated preliminary efficacy in improving posttraumatic stress disorder (PTSD) symptoms. However, previous systematic reviews and meta-analyses have noted that this area of research is limited by inadequate comparator conditions, heterogeneity of measurement, and absence of objective outcome measures. For these reasons, an updated review of the highest-quality evidence available is warranted. We used the Agency for Healthcare Research and Quality (AHRQ)-funded evidence tables for the PTSD-Repository to identify relevant studies and assess the risk of bias as follows: The search was conducted between June 2018 and June 2022, and databases included PTSDpubs (formerly PILOTS), Ovid® MEDLINE®, Cochrane CENTRAL, Embase®, the Cumulative Index to Nursing and Allied Health Literature (CINAHL®), SCOPUS, and PsycINFO®. Twenty-six randomized controlled trials met our inclusion criteria. After identifying studies and retrieving risk of bias information from the PTSD-Repository evidence tables, we extracted additional data and synthesized the evidence. The strength of evidence was rated as low for MiBIs and MMIs, largely due to contradicting results, inconsistent use of active versus passive comparators, and high risk of bias. The strength of evidence for MoBIs was rated as moderate due to individual studies consistently favoring the intervention and a relatively large number of studies and participants. Of the 26 included studies, only two included objective outcome measures. Implications for future MBI research and clinical applications for treating PTSD are discussed.

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Section: Resultsmentioning

confidence: 99%

“…The authors reported no time-by-group interaction for any results. Somohano and Bowen (2022) measured PTSD symptoms via PCL-5 in a study of Trauma-Integrated Mindfulness-Based Relapse Prevention (TI-MBRP). These authors reported significant improvement in PTSD symptoms across conditions.…”

Section: Resultsmentioning

confidence: 99%

Randomized controlled trials of mind–body interventions for posttraumatic stress disorder: a systematic review

Kaplan,

Somohano,

Zaccari

et al. 2024

Front. Psychol.

Self Cite

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“…Data were missing completely at random (MCAR) [ 29 ]; thus, listwise deletion was employed, which is recommended for MCAR, and is known to produce unbiased estimates and conservative results [ 30 ]. Multiple linear regression analyses were used to assess whether formal and informal mindfulness practice during the intervention period predicted 6-month substance craving and PTSD symptom severity.…”

Section: Methodsmentioning

confidence: 99%

Formal mindfulness practice predicts reductions in PTSD symptom severity following a mindfulness-based intervention for women with co-occurring PTSD and substance use disorder

Somohano

Kaplan

Newman

et al. 2022

Addict Sci Clin Pract

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Background Women with co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) experience systemic barriers that place them in danger of poorer treatment outcomes. Some mindfulness-based interventions (MBIs) have demonstrated efficacy in reducing PTSD and SUD symptoms. Mindfulness practice is a core component of MBIs, thought to elicit and maintain positive behavioral change; however, no research to our knowledge has assessed the role of mindfulness practice on sustained treatment gains among women with co-occurring PTSD-SUD. Such research is necessary to better inform MBIs for dually diagnosed women. Methods This secondary analysis assessed whether post-intervention formal and informal mindfulness practice predicted reductions in PTSD symptoms and substance craving 6 months following an 8-session mindfulness-based relapse prevention intervention for women diagnosed with co-occurring PTSD-SUD ( N = 23). Data were derived from a pilot randomized controlled trial evaluating the feasibility and preliminary efficacy of a trauma-integrated mindfulness-based relapse prevention program for women with co-occurring PTSD-SUD. Results Greater duration of formal mindfulness practice (i.e., minutes per practice) predicted reduced total PTSD symptoms ( = − .670, p < .00), trauma-related avoidance ( = − .564, p = .01), arousal and reactivity ( = − .530, p = .02), and negative cognitions and mood ( = − .780, p < .01) six months following treatment. Informal practice did not predict any outcomes. Conclusions This research highlights the potential role of formal mindfulness practice in sustaining reductions in PTSD symptoms over time among women with co-occurring PTSD-SUD. Further study of strategies to promote ongoing formal mindfulness practice in this population following a MBI are warranted. Trial registration The parent trial was registered with ClinicalTrials.gov (Identifier: NCT03505749).

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“…For example, one recent meta-analysis suggested some mindfulness-based interventions were effective as evidence-based treatments for SUD (Korecki et al, 2020). Further, participation in a mindfulness-based relapse prevention program resulted in reductions in craving and PTSD symptoms in women with symptoms of PTSD/SUD (Somohano & Bowen, 2022). This is important for WEH since they experience high rates of PTSD (Gluck et al, 2021), as well as SUD (Fazel et al, 2016) and incarceration, a risk factor for additional trauma exposure (Sartor et al, 2012).…”

Section: Mindfulness-based Interventions For Those Experiencing Ptsd ...mentioning

confidence: 99%

Adaptation of a mindfulness-based intervention for trauma-exposed, unhoused women with substance use disorder.

Garfin¹,

Amador²,

Osorio³

et al. 2024

Psychological Trauma: Theory, Research, Practice, and Policy

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Objective: Women experiencing homelessness (WEH) report exceedingly high rates of trauma exposure, posttraumatic stress disorder (PTSD), and substance use disorder (SUD). Mindfulness-based interventions including Mindfulness-based Stress Reduction (MBSR) may help lower traumatic stress-related symptoms and reduce SUD, but have been underexplored in community-based settings serving WEH with symptoms of PTSD and SUD. Method: We used a mixed-method, community-engaged approach that implemented a Community Advisory Board and the ADAPT-ITT (assessment, decision, adaptation, production, topical experts, integration, training, testing) framework, including intervention demonstrations, to adapt and refine MBSR for WEH experiencing symptoms of PTSD/SUD. Trauma-exposed WEH (N = 28) living at a drug treatment site provided perspectives and feedback on an MBSR demonstration via quantitative questionnaires and four focus groups. Results: Quantitative measures indicated high perceived acceptability and feasibility: Nearly all WEH reported MBSR activities (including yoga, meditation, body scans, class discussion, and home practice) would be at least “somewhat helpful”; between 71.43% to 89.29% reported each activity would be “a great deal helpful.” Most reported the focus group sessions were useful for providing feedback relevant for improving program design and administration. Qualitative findings revealed four themes aligning with quantitative findings that provided useful suggestions to guide MBSR implementation with trauma-exposed WEH: (a) perception of feasibility and effectiveness of MBSR, (b) strategies for successful recruitment, (c) strategies for successful retention, and (d) characteristics of the MBSR trainer. Conclusions: Focus group recommendations could bolster intervention compliance, engagement, and completion for MBSR and community-based programs for WEH more generally. Results provide suggestions for implementing a trauma-sensitive approach when administering MBSR to trauma-exposed WEH.

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Trauma-Integrated Mindfulness-Based Relapse Prevention for Women with Comorbid Post-Traumatic Stress Disorder and Substance Use Disorder: A Cluster Randomized Controlled Feasibility and Acceptability Trial

Cited by 8 publications

References 82 publications

Randomized controlled trials of mind–body interventions for posttraumatic stress disorder: a systematic review

Randomized controlled trials of mind–body interventions for posttraumatic stress disorder: a systematic review

Formal mindfulness practice predicts reductions in PTSD symptom severity following a mindfulness-based intervention for women with co-occurring PTSD and substance use disorder

Adaptation of a mindfulness-based intervention for trauma-exposed, unhoused women with substance use disorder.

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