Military-related posttraumatic stress disorder and mindfulness meditation: A systematic review and meta-analysis


Author: Lu-Na Sun1, Jing-Wen Gu2, Li-Jun Huang3, Zhi-Lei Shang1, Yao-Guang Zhou1, Li-Li Wu1, Yan-Pu Jia1, Nian-Qi Liu1, Wei-Zhi Liu4

Affiliation: <sup>1</sup> Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China.

<sup>2</sup> The Battalion 3 of Cadet Brigade, School of Basic Medicine, Naval Medical University, Shanghai, 200433, China.

<sup>3</sup> Department of Radiology, Changshu Hospital Affiliated to Suzhou University, Changshu, 215500, China.

<sup>4</sup> Lab for Post-traumatic Stress Disorder, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China; The Emotion & Cognition Lab, Faculty of Psychology and Mental Health, Naval Medical University, Shanghai, 200433, China; Department of Radiology, Changshu Hospital Affiliated to Suzhou University, Changshu, 215500, China. Electronic address: 13024141970@163.com.
Conference/Journal: Chin J Traumatol
Date published: 2021 May 18
Other:
  Special Notes: doi: 10.1016/j.cjtee.2021.05.003.   ,  Word Count: 343  
    Purpose:

Posttraumatic stress disorder (PTSD) is a significant global mental health concern, especially in the military. This study aimed to estimate the efficacy of mindfulness meditation in the treatment of military-related PTSD, by synthesizing evidences from randomized controlled trials.



Methods:

Five electronic databases (Pubmed, EBSCO Medline, Embase, PsychINFO and Cochrane Library) were searched for randomized controlled trials focusing on the treatment effect of mindfulness meditation on military-related PTSD. The selection of eligible studies was based on identical inclusion and exclusion criteria. Information about study characteristics, participant characteristics, intervention details, PTSD outcomes, as well as potential adverse effects was extracted from the included studies. Risk of bias of all the included studies was critically assessed using the Cochrane Collaboration's tool. R Statistical software was performed for data analysis.



Results:

A total of 1902 records were initially identified and screened. After duplicates removal, 834 records were screened for title and abstract. Then, full-text of 115 related articles were retrieved and assessed for eligibility. Among them, 96 articles were excluded for no random assignment, article type of commentary, editorial, review, case report, etc. Finally, 19 articles in English language with 1326 participants were included through strict inclusion and exclusion criteria. The results revealed that mindfulness meditation had a significantly larger effect on alleviating military-related PTSD symptoms compared with control conditions, such as treatment as usual, present-centered group therapy and PTSD health education (standardized mean difference (SMD) = -0.33; 95% CI [-0.45, -0.21]; p < 0.0001). Mindfulness interventions with different control conditions (active or non-active control, SMD = -0.33, 95% CI [-0.46, -0.19]; SMD = -0.49, 95% CI [-0.88, -0.10], respectively), formats of delivery (group-based or individual-based, SMD = -0.30, 95% CI [-0.42, -0.17], SMD = -0.49, 95% CI [-0.90, -0.08], respectively) and intervention durations (short-term or standard duration, SMD = -0.27, 95% CI [-0.46, -0.08], SMD = -0.40, 95% CI [-0.58, -0.21], respectively) were equally effective in improving military-related PTSD symptoms.



Conclusion:

Findings from this meta-analysis consolidate the efficacy and feasibility of mindfulness meditation in the treatment of military-related PTSD. Further evidences with higher quality and more rigorous design are needed in the future.



Keywords: Meta-analysis; Military personnel; Mindfulness meditation; Post-traumatic; Stress disorders.



PMID: 34099359 DOI: 10.1016/j.cjtee.2021.05.003