Breathing-Based Meditation Decreases Posttraumatic Stress Disorder Symptoms in U.S. Military Veterans: A Randomized Controlled Longitudinal Study

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Abstract

Given the limited success of conventional treatments for veterans with posttraumatic stress disorder (PTSD), investigations of alternative approaches are warranted. We examined the effects of a breathing-based meditation intervention, Sudarshan Kriya yoga, on PTSD outcome variables in U.S. male veterans of the Iraq or Afghanistan war. We randomly assigned 21 veterans to an active ( n = 11) or waitlist control ( n = 10) group. Laboratory measures of eye-blink startle and respiration rate were obtained before and after the intervention, as were self-report symptom measures; the latter were also obtained 1 month and 1 year later. The active group showed reductions in PTSD scores, d = 1.16, 95% CI [0.20, 2.04], anxiety symptoms, and respiration rate, but the control group did not. Reductions in startle correlated with reductions in hyperarousal symptoms immediately postintervention ( r =. 93, p <. 001) and at 1-year follow-up ( r =. 77, p =. 025). This longitudinal intervention study suggests there may be clinical utility for Sudarshan Kriya yoga for PTSD.

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Meditation programs for psychological stress and well-being: a systematic review and meta-analysis.

P Ranasinghe, S. Saha, D Maron … (2014)

Many people meditate to reduce psychological stress and stress-related health problems. To counsel people appropriately, clinicians need to know what the evidence says about the health benefits of meditation. To determine the efficacy of meditation programs in improving stress-related outcomes (anxiety, depression, stress/distress, positive mood, mental health-related quality of life, attention, substance use, eating habits, sleep, pain, and weight) in diverse adult clinical populations. We identified randomized clinical trials with active controls for placebo effects through November 2012 from MEDLINE, PsycINFO, EMBASE, PsycArticles, Scopus, CINAHL, AMED, the Cochrane Library, and hand searches. Two independent reviewers screened citations and extracted data. We graded the strength of evidence using 4 domains (risk of bias, precision, directness, and consistency) and determined the magnitude and direction of effect by calculating the relative difference between groups in change from baseline. When possible, we conducted meta-analyses using standardized mean differences to obtain aggregate estimates of effect size with 95% confidence intervals. After reviewing 18 753 citations, we included 47 trials with 3515 participants. Mindfulness meditation programs had moderate evidence of improved anxiety (effect size, 0.38 [95% CI, 0.12-0.64] at 8 weeks and 0.22 [0.02-0.43] at 3-6 months), depression (0.30 [0.00-0.59] at 8 weeks and 0.23 [0.05-0.42] at 3-6 months), and pain (0.33 [0.03- 0.62]) and low evidence of improved stress/distress and mental health-related quality of life. We found low evidence of no effect or insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep, and weight. We found no evidence that meditation programs were better than any active treatment (ie, drugs, exercise, and other behavioral therapies). Clinicians should be aware that meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress. Thus, clinicians should be prepared to talk with their patients about the role that a meditation program could have in addressing psychological stress. Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health and stress-related behavior.

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SAS for Mixed Models

Ramon C. Littell (2006)

The indispensable, up-to-date guide to mixed models using SAS®. Discover the latest capabilities available for a variety of applications featuring the MIXED, GLIMMIX, and NLMIXED procedures in this valuable edition of the comprehensive mixed models guide for data analysis, completely revised and updated for SAS®9. The theory underlying the models, the forms of the models for various applications, and a wealth of examples from different fields of study are integrated in the discussions of these models: random effect only and random coefficients models split-plot, multilocation, and repeated measures models hierarchical models with nested random effects analysis of covariance models spatial correlation models generalized linear mixed models nonlinear mixed models Professionals and students with a background in two-way ANOVA and regression and a basic knowledge of linear models and matrix algebra will benefit from the topics covered. Includes a free CD-ROM with example SAS code!

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Sudarshan Kriya yogic breathing in the treatment of stress, anxiety, and depression: part I-neurophysiologic model.

Richard P. Brown, Patricia Gerbarg (2005)

Mind-body interventions are beneficial in stress-related mental and physical disorders. Current research is finding associations between emotional disorders and vagal tone as indicated by heart rate variability. A neurophysiologic model of yogic breathing proposes to integrate research on yoga with polyvagal theory, vagal stimulation, hyperventilation, and clinical observations. Yogic breathing is a unique method for balancing the autonomic nervous system and influencing psychologic and stress-related disorders. Many studies demonstrate effects of yogic breathing on brain function and physiologic parameters, but the mechanisms have not been clarified. Sudarshan Kriya yoga (SKY), a sequence of specific breathing techniques (ujjayi, bhastrika, and Sudarshan Kriya) can alleviate anxiety, depression, everyday stress, post-traumatic stress, and stress-related medical illnesses. Mechanisms contributing to a state of calm alertness include increased parasympathetic drive, calming of stress response systems, neuroendocrine release of hormones, and thalamic generators. This model has heuristic value, research implications, and clinical applications.

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Author and article information

Journal

Journal ID (nlm-ta): J Trauma Stress

Journal ID (iso-abbrev): J Trauma Stress

Journal ID (publisher-id): jts

Title: Journal of Traumatic Stress

Publisher: BlackWell Publishing Ltd (Oxford, UK )

ISSN (Print): 0894-9867

ISSN (Electronic): 1573-6598

Publication date (Print): August 2014

Publication date (Electronic): 26 August 2014

Volume: 27

Issue: 4

Pages: 397-405

Affiliations

[1 ]Center for Compassion and Altruism Research and Education, School of Medicine, Stanford University Stanford, California, USA

[2 ]Department of Psychology, University of Wisconsin-Madison Madison, Wisconsin, USA

[3 ]Department of Psychiatry, University of Wisconsin-Madison Madison, Wisconsin, USA

[4 ]Department of Internal Medicine, Biostatistics and Geriatric Psychiatry Neuroimaging Lab, University of Pittsburgh Pittsburgh, Pennsylvania, USA

[5 ]Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison Madison, Wisconsin, USA

[6 ]Department of Psychology, University of Arizona Tucson, Arizona, USA

Author notes

Correspondence concerning this article should be addressed to Emma M. Seppälä, Center for Compassion and Altruism Research and Education, School of Medicine, Stanford University, 1070 Arastradero Road, Palo Alto, CA 94304, or to Richard J. Davidson, Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI 53705. E-mail: emmas@ 123456stanford.edu or rjdavids@ 123456wisc.edu

Funds were provided by Disabled Veterans of America Charitable Service Trust. We gratefully acknowledge contributions by Diane Stodola, Jonathan Brumbaugh, Luke Hinsenkamp, Lauren Hazen, Maaheem Akhtar, and Timothy Rossomando.

[OnlineOpen was paid for by the authors on October 31, 2014. As such, the copyright and license for this article have been updated to reflect these changes.]

Article

DOI: 10.1002/jts.21936

PMC ID: 4309518

PubMed ID: 25158633

SO-VID: d9b39edd-816d-4d52-b810-89b1fe2c1db3

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This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Breathing-Based Meditation Decreases Posttraumatic Stress Disorder Symptoms in U.S. Military Veterans: A Randomized Controlled Longitudinal Study

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Most cited references 49

Meditation programs for psychological stress and well-being: a systematic review and meta-analysis.

SAS for Mixed Models

Sudarshan Kriya yogic breathing in the treatment of stress, anxiety, and depression: part I-neurophysiologic model.

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