Mindfulness-based interventions for military veterans: A systematic review and analysis of the literature

Author: William R Marchand1, Kristin Sandoval2, Ryan Lackner2, Suzanne C Parker2, Tracy Herrmann2, Brandon Yabko3, Tania Velasquez4, Lacey Lewis2, Jorie Butler2
Affiliation:
1 VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, 500 Foothill, Salt Lake City, UT, 84148, USA; University of Utah School of Medicine Department of Psychiatry, 501 Chipeta Way, Salt Lake City, UT, 84108, USA. Electronic address: william.marchand@va.gov.
2 VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, 500 Foothill, Salt Lake City, UT, 84148, USA.
3 VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, 500 Foothill, Salt Lake City, UT, 84148, USA; University of Utah School of Medicine Department of Psychiatry, 501 Chipeta Way, Salt Lake City, UT, 84108, USA.
4 VISN 19 Whole Health Flagship Site Located at VA Salt Lake City Health Care System, 500 Foothill, Salt Lake City, UT, 84148, USA; Informatics, Decision Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA, Salt Lake City Health Care System, Salt Lake City, UT, 84148, USA.
Conference/Journal: Complement Ther Clin Pract
Date published: 2020 Nov 23
Other: Volume ID: 42 , Pages: 101274 , Special Notes: doi: 10.1016/j.ctcp.2020.101274. , Word Count: 288


Background:
In recent years, mindfulness-based interventions (MBIs) have experienced exponential growth in terms of development, application, and research. However, few studies have examined implementation and efficacy of these interventions in particular populations, such as military Veterans. Such studies are needed as one cannot assume that the literature on MBIs implemented with the general population or other specific populations apply equally well to Veterans. This population is unique regarding professional competencies, military ethos, high degrees of medical comorbidities and barriers to treatment. The aim of this work was to review and summarize the literature over the previous five years (2014-2020) assessing the use of MBIs among military Veterans to guide clinical care and future research.

Methods:
Systematic literature review.

Results:
A total of 88 articles were found. Screening titles and abstracts resulted in 49 articles being excluded. The remaining 39 articles were read in full, and of these, 12 were excluded due to not fully meeting the inclusion criteria. Thus, the present review included a total of 27 articles, 3 of which used qualitative methods and 24 of which used quantitative methods.

Conclusions:
MBIs hold promise as complementary adjunctive interventions for Veterans with PTSD and possibly other psychiatric disorders. Currently there are significant gaps in the literature that must be addressed to move the field forward. The main deficiency is, with a few exceptions, the lack of rigorous RCTs. Another major concern is the lack of generalizability to female and non-white Veterans given that the subject samples across all studies reviewed were 85% male and 76% white. At this time, MBSR, PCBMT and MBCT can be recommended as adjunctive complementary interventions for the reduction of PTSD symptoms. Research recommendations to move the field forward are provided.

Keywords: Mindfulness; Posttraumatic stress disorder; Systematic review; Veterans.

PMID: 33276226 DOI: 10.1016/j.ctcp.2020.101274

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