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. Bormann
  • Lin Liu
  • Steven R. Thorp
  • Ariel J. Lang

DOI: 10.1007/s12529-011-9186-1

Cite this article as:
Bormann, J.E., Liu, L., Thorp, S.R. et al. Int.J. Behav. Med. (2012) 19: 496. doi:10.1007/s12529-011-9186-1



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.


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


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.


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.


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.


MeditationMindfulnessPosttraumatic stress disorderSpiritualityVeterans

Copyright information

© International Society of Behavioral Medicine 2011

Authors and Affiliations

  • Jill E. Bormann
    • 1
    • 2
    • 5
  • Lin Liu
    • 3
  • Steven R. Thorp
    • 1
    • 4
  • Ariel J. Lang
    • 1
    • 4
  1. 1.Center of Excellence for Stress and Mental Health (CESAMH)Veterans Affairs San Diego Healthcare System (VASDHS)San DiegoUSA
  2. 2.School of Nursing, College of Health and Human ServicesSan Diego State UniversitySan DiegoUSA
  3. 3.Department of Family and Preventive MedicineUniversity of California San DiegoSan DiegoUSA
  4. 4.Department of PsychiatryUniversity of California San DiegoSan DiegoUSA
  5. 5.Department of Nursing and Patient Care ServicesVA San Diego Healthcare SystemSan DiegoUSA