Abstract
Objectives: This study evaluates the effects of treatment with mindfulness-based stress reduction (MBSR) compared to the active control, present-centered group therapy (PCGT), on morning plasma cortisol, interleukin-6 (IL-6), and C-reactive protein (CRP) in veterans diagnosed with post-traumatic stress disorder (PTSD). Methods: In a post hoc exploratory analysis, we pooled biomarkers and clinical outcomes of mindfulness, PTSD, and depression from two randomized controlled trials comparing MBSR (n = 104) to PCGT (n = 106) in U.S. military veterans diagnosed with PTSD. Linear mixed-effects modeling was used to evaluate associations between changes in biomarkers and clinical outcomes from baseline to 9-week primary endpoint and 16-week follow-up endpoint. Results: Cortisol levels were inversely related to self-reported PTSD symptoms at baseline (p = 0.02). Cortisol increased from baseline to 9-week endpoint for both groups, but significantly less so in the MBSR group compared to PCGT group (mean difference 1.69 ± 0.8 SE; p = 0.035). Changes in IL-6 and CRP did not differ between groups at either baseline or week 9. From baseline to week 9, increased mindfulness was significantly associated with increased cortisol (p = 0.02) and decreased PTSD and depression severity (p < 0.01). Increased IL-6 and CRP were significantly associated with decreased PTSD severity (p < 0.05), but not depression. Pooled analysis corroborated earlier findings that MBSR is significantly better than PCGT in improving clinical outcomes. Increased mindfulness was strongly associated with improved symptoms. Conclusions: Increased mindfulness is associated with a recalibration of cortisol levels which may be indicative of therapeutic response, especially in patients with lower baseline cortisol. Furthermore, mindfulness-based practices improve symptoms of PTSD and depression in a significant correlation with self-reported levels of mindfulness. Clinical Trial Registration (clinicaltrials.gov): NCT01532999 and NCT01548742.
Original language | English (US) |
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Pages (from-to) | 2448-2460 |
Number of pages | 13 |
Journal | Mindfulness |
Volume | 13 |
Issue number | 10 |
DOIs | |
State | Published - Oct 2022 |
Bibliographical note
Funding Information:This work was supported by the Department of Veterans Affairs (VA) Office of Research and Development, Clinical Science Research and Development and National Institutes of Health.
Funding Information:
The research leading to these results received funding from the VA Office of Clinical Science Research & Development under Award No 1-I01-CX000687-01 and 1-I01-CX000683-01. Mr. Shapira received funding from a National Institute of Health (NIH) training grant (NIH T35 HL00747). Dr. Richman received research funding from VA and NIH. Dr. Pace received research funding from NIH. Dr. Lim received research funding from VA and NIH. Dr. Polusny received research funding from received research funding from VA and NIH National Center for Complementary and Integrative Health (NIH-NCCIH). Dr. Hamner received consulting fees from Otsuka, research funding from VA, National Institute of Mental Health, and Otsuka. Dr. Bremner received research funding from VA and NIH, and device support from ElectroCore LLC. Dr. Mumba received research funding from VA and NIH-NCCIH. Dr. Jacobs received research funding from VA. Dr. Pilkinton received research funding and/or materials from Department of Defense, VA, SAMSHA, Aptinyx, Tonix, and Avanir Pharmaceuticals. Dr. Davis received consulting fees from Otsuka, Lundbeck, Janssen, Boehringer Ingelheim and Signant Health, and research funding and/or materials from Department of Defense, VA, SAMSHA, Aptinyx, Alkermes, Avanir Pharmaceuticals, and Tonix.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Keywords
- Cortisol
- Inflammatory markers
- Meditation
- Mindfulness
- Mindfulness-based stress reduction
- Post-traumatic stress disorder
- Veterans