title: Mindfulness-Based Stress Reduction for Posttraumatic Stress Disorder Among Veterans: A Randomized Clinical Trial.
abstract: OBJECTIVE
  Mindfulness-based interventions may be acceptable to veterans who have poor adherence to existing evidence-based treatments for posttraumatic stress disorder (PTSD).
  
  
  OBJECTIVE
  To compare mindfulness-based stress reduction with present-centered group therapy for treatment of PTSD.
  
  
  METHODS
  Randomized clinical trial of 116 veterans with PTSD recruited at the Minneapolis Veterans Affairs Medical Center from March 2012 to December 2013. Outcomes were assessed before, during, and after treatment and at 2-month follow-up. Data collection was completed on April 22, 2014.
  
  
  METHODS
  Participants were randomly assigned to receive mindfulness-based stress reduction therapy (n = 58), consisting of 9 sessions (8 weekly 2.5-hour group sessions and a daylong retreat) focused on teaching patients to attend to the present moment in a nonjudgmental, accepting manner; or present-centered group therapy (n = 58), an active-control condition consisting of 9 weekly 1.5-hour group sessions focused on current life problems.
  
  
  METHODS
  The primary outcome, change in PTSD symptom severity over time, was assessed using the PTSD Checklist (range, 17-85; higher scores indicate greater severity; reduction of 10 or more considered a minimal clinically important difference) at baseline and weeks 3, 6, 9, and 17. Secondary outcomes included PTSD diagnosis and symptom severity assessed by independent evaluators using the Clinician-Administered PTSD Scale along with improvements in depressive symptoms, quality of life, and mindfulness.
  
  
  RESULTS
  Participants in the mindfulness-based stress reduction group demonstrated greater improvement in self-reported PTSD symptom severity during treatment (change in mean PTSD Checklist scores from 63.6 to 55.7 vs 58.8 to 55.8 with present-centered group therapy; between-group difference, 4.95; 95% CI, 1.92-7.99; P=.002) and at 2-month follow-up (change in mean scores from 63.6 to 54.4 vs 58.8 to 56.0, respectively; difference, 6.44; 95% CI, 3.34-9.53, P < .001). Although participants in the mindfulness-based stress reduction group were more likely to show clinically significant improvement in self-reported PTSD symptom severity (48.9% vs 28.1% with present-centered group therapy; difference, 20.9%; 95% CI, 2.2%-39.5%; P = .03) at 2-month follow-up, they were no more likely to have loss of PTSD diagnosis (53.3% vs 47.3%, respectively; difference, 6.0%; 95% CI, -14.1% to 26.2%; P = .55).
  
  
  CONCLUSIONS
  Among veterans with PTSD, mindfulness-based stress reduction therapy, compared with present-centered group therapy, resulted in a greater decrease in PTSD symptom severity. However, the magnitude of the average improvement suggests a modest effect.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT01548742.
authors.affiliation: Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota2Center for Chronic Disease Outcomes Research, Minneapolis, Minnesota3Department of Psychiatry, University of Minnesota, Minneapolis.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Polusny
authors.affiliation: Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota2Center for Chronic Disease Outcomes Research, Minneapolis, Minnesota3Department of Psychiatry, University of Minnesota, Minneapolis.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Erbes
authors.affiliation: Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota3Department of Psychiatry, University of Minnesota, Minneapolis.
authors.forename: Paul
authors.initials: P
authors.lastname: Thuras
authors.affiliation: Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota.
authors.forename: Amy
authors.initials: A
authors.lastname: Moran
authors.affiliation: Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota3Department of Psychiatry, University of Minnesota, Minneapolis.
authors.forename: Greg J
authors.initials: GJ
authors.lastname: Lamberty
authors.affiliation: Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota.
authors.forename: Rose C
authors.initials: RC
authors.lastname: Collins
authors.affiliation: Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota.
authors.forename: John L
authors.initials: JL
authors.lastname: Rodman
authors.affiliation: Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota3Department of Psychiatry, University of Minnesota, Minneapolis.
authors.forename: Kelvin O
authors.initials: KO
authors.lastname: Lim
mesh_terms: D000368:Aged; D003863:Depression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness; D011615:Psychotherapy, Group; D011788:Quality of Life; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*; D013315:Stress, Psychological; D016896:Treatment Outcome; D014728:Veterans