Article

International Journal of Behavioral Medicine

, Volume 19, Issue 4, pp 496-502

Spiritual Wellbeing Mediates PTSD Change in Veterans with Military-Related PTSD

  • Jill E. BormannAffiliated withCenter of Excellence for Stress and Mental Health (CESAMH), Veterans Affairs San Diego Healthcare System (VASDHS)School of Nursing, College of Health and Human Services, San Diego State UniversityDepartment of Nursing and Patient Care Services, VA San Diego Healthcare System Email author 
  • , Lin LiuAffiliated withDepartment of Family and Preventive Medicine, University of California San Diego
  • , Steven R. ThorpAffiliated withCenter of Excellence for Stress and Mental Health (CESAMH), Veterans Affairs San Diego Healthcare System (VASDHS)Department of Psychiatry, University of California San Diego
  • , Ariel J. LangAffiliated withCenter of Excellence for Stress and Mental Health (CESAMH), Veterans Affairs San Diego Healthcare System (VASDHS)Department of Psychiatry, University of California San Diego

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Abstract

Background

A portable practice of repeating a mantram—a sacred word or phrase—has been shown to reduce the severity of posttraumatic stress disorder (PTSD) symptoms in veterans with military trauma. It is thought that the intervention re-directs attention and initiates relaxation to decrease symptom severity, but there may be other mechanisms that may contribute to this improvement.

Purpose

We tested the hypothesis that increases in existential spiritual wellbeing (ESWB) would mediate reductions in self-reported PTSD symptoms following a group mantram intervention.

Method

Veterans diagnosed with PTSD from war-related trauma completed 6 weeks of case management plus a group mantram intervention (n = 66) as part of a randomized trial. Measures included PTSD Checklist (PCL) and Functional Assessment of Chronic Illness Therapy–Spiritual Wellbeing. Path analysis was conducted on those who completed treatment to assess ESWB as a possible mediator of change in PCL from baseline to post-treatment.

Results

A significant indirect effect, −2.24, 95% CI (−4.17, −1.05) of the mantram intervention on PCL change was found. The path from the mantram intervention to ESWB change was significant and positive (B = 4.89, p < 0.0001), and the path from ESWB change to PCL change was significant and negative (B = −0.46, p = 0.001), thus supporting the hypothesis.

Conclusions

Findings suggest that one contributing mechanism that partially explains how the mantram intervention reduces PTSD symptom severity in veterans may be by increasing levels of ESWB.

Keywords

Meditation Mindfulness Posttraumatic stress disorder Spirituality Veterans