NUR699 Evidence Based Practice Proposal Section C Literature Support

Literature Support

Name

Institution

Literature Support

Post-traumatic stress disorder (PTSD) is increasingly becoming a major problem among veterans who due to the trauma of combat have a high level of stress. This research aims to review the applicability of mindfulness-based interventions (MBI) in dealing with PTSD among veterans. Several authors and researchers have already engaged with the topic and they present interesting results from their study of MBI and veteran PTSD. This review of the literature focuses on the various studies which have been identified as credible and relevant in the field. From the review of the literature on the application of MBI for veterans with PTSD, it is evident that the interventions are useful and indeed they make a positive change among the research participants.

The review of literature was limited to veterans who have PTSD and the use of MBI as the main intervention to counter the PTSD signs. Therefore, the keywords used were PTSD, veterans, and MBI. Any study with a combination of these words was considered candidate for the review. Another criterion applied in the selection of articles to review was that the literature had to be current; it had to have been published in the last five years. The credibility of the articles was reviewed using the rapid critical appraisal checklist. The databases from which the articles were obtained included EMBASE, CINAHL Plus, Cochrane, and PubMed. Out of the inclusion criteria, the current collection of studies included five studies which look into veterans with PTSD and the use of MBI. Articles were excluded if they fit the above criteria but were not accessible as full texts on the stated databases.

The first study to consider in this review of literature is King et al. (2013) whereby the researchers conducted a pilot study of the effectiveness of mindfulness-based cognitive therapy (MBCT) among veterans who have PTSD. The researchers used an outpatient clinic whereby 20 participants were utilized for the PTSD treatment as usual (TAU) while 16 others were subjected to MBCT. The study was carried out for eight weeks and pre- and post-treatment assessments showed significant improvement for the MBCT treatment group when compared to the control (TAU) group. King et al. (2013) present a pilot trial using only 16 participants but this study could be utilized for a larger group to increase its credibility.

Additionally, the findings of King et al. (2013) have been supported by a randomized trial conducted by Polusny et al. (2015). In this randomized trial, participants were randomly selected to participate in MBI for 9 sessions which included 8 2.5 hour sessions and a day-long retreat or present-centered group therapy for 9 weekly sessions each 1.5 hours long. The number of participants was 116 so half (58) were assigned to the treatment and the other half to the control group. The researchers found that participants who undertook MBI showed greater improvement in self-reported PTSD symptom severity. From this study, it is evident that MBI is more effective compared to present-centered group therapy when dealing with PTSD among veterans.

Strauss et al. (2014) reviewed the effectiveness of using MBI to prevent relapse among people who had experienced episodes of PTSD but were well. In their review of literature concerning this objective, the authors included twelve studies and looked into the post-intervention benefits of MBIs. Strauss et al. (2014) found that effects of MBIs were evident among people who had a current depressive disorder. The authors, therefore, recommended the use of MBI as an intervention for people with current depressive or anxiety disorders.

Another study which has been reviewed and supports the use of MBI for veterans with PTSD is the randomized controlled longitudinal study by Seppala et al. (2014). As part of the mindfulness-based interventions, the authors used breathing-based meditation as the primary approach to dealing with PTSD among veterans. Similar to previous studies, the research suggested some utility in breathing-based MBI for PTSD among military veterans. The last study in this review was the research by Steinberg & Eisner (2015) which reviewed the effectiveness of MBI when utilized with more traditional approaches to PTSD among veterans. From the randomized study, the researchers found that when used to supplement traditional treatment approaches to PTSD, MBI was effective in significantly reducing the symptoms of PTSD among veterans.

From the review of literature, MBI has been portrayed as crucial in dealing with PTSD among veterans. Primarily, the reviewed studies show that it presents better results than treatment as usual and can indeed be used to supplement or even replace the traditional treatment approach to the disorder. The studies provide a high degree of internal validity mainly because they include thorough approaches to the inclusion of participants within the introduced criterion of selection. The external validity of the research is also high because the aim of this study is to apply MBI among veterans alone. Therefore, since the five studies deal with veterans, the findings obtained from the review are valid. From the review of literature, MBI presents significant utility when dealing with veterans with PTSD.

References

King, A. P., Erickson, T. M., Giardino, N. D., Favorite, T., Rauch, S. A., Robinson, E., … & Liberzon, I. (2013). A pilot study of group mindfulness‐based cognitive therapy (MBCT) for combat veterans with posttraumatic stress disorder (PTSD). Depression and anxiety, 30(7), 638-645.

Polusny, M. A., Erbes, C. R., Thuras, P., Moran, A., Lamberty, G. J., Collins, R. C., … & Lim, K. O. (2015). Mindfulness-based stress reduction for posttraumatic stress disorder among veterans: a randomized clinical trial. Jama, 314(5), 456-465.

Seppälä, E. M., Nitschke, J. B., Tudorascu, D. L., Hayes, A., Goldstein, M. R., Nguyen, D. T., … & Davidson, R. J. (2014). Breathing‐based meditation decreases posttraumatic stress disorder symptoms in US Military veterans: A randomized controlled longitudinal study. Journal of Traumatic Stress, 27(4), 397-405.

Steinberg, C. A., & Eisner, D. A. (2015). Mindfulness-based interventions for veterans with posttraumatic stress disorder. International Journal of Behavioral Consultation & Therapy, 9(4).

Strauss, C., Cavanagh, K., Oliver, A., & Pettman, D. (2014). Mindfulness-based interventions for people diagnosed with a current episode of an anxiety or depressive disorder: a meta-analysis of randomised controlled trials. PLOS one, 9(4), e96110.