Spiritual Wellbeing Mediates PTSD Change in Veterans with Military-Related PTSD
- 1.5k Downloads
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.
KeywordsMeditation Mindfulness Posttraumatic stress disorder Spirituality Veterans
- 1.RAND. Invisible wounds of war: mental health and cognitive care needs of America’s returning veterans. Santa Monica, CA: RAND Corporation; 2008.Google Scholar
- 2.RAND. Invisible wounds of war: psychological and cognitive injuries, their consequences, and services to assist recovery. Santa Monica, CA: RAND Corporation; 2008.Google Scholar
- 12.Falsetti SA. Cognitive–behavioral therapy in the treatment of posttraumatic stress disorder. Prim Psychiatr. 2003;10(5):78–83.Google Scholar
- 16.Fontana A, Rosenheck R. Trauma, change in strength of religious faith, and mental health service use among veterans treated for PTSD. J Nerv Ment Disord. 2008;579–584.Google Scholar
- 17.Hughes B, Handzo G. Specialty interventions: spiritual mantram repetition. In: Dept. of Navy DoD, US Government, ed. 2010;80–84.Google Scholar
- 19.Bormann JE, Thorp S, Wetherell JL, Golshan S, Fellows I, Lang A, et al. (2009, February). Efficacy of a spiritually-based mantram intervention on quality of life in veterans with military-related PTSD. Poster session presented at the Health Services Research & Development National Meeting, Baltimore, MD.Google Scholar
- 20.Easwaran E. The mantram handbook. 4th ed. Tomales, CA: Nilgiri Press; 2001.Google Scholar
- 21.Bormann JE, Becker S, Gershwin M, Kelly A, Pada L, Smith TL, et al. Relationship of frequent mantram repetition to emotional and spiritual wellbeing in healthcare workers. J Educ Contin Nurs. 2006;37(5):218–24.Google Scholar
- 26.Bormann JE, Oman D. Mantram or holy name repetition: health benefits from a portable spiritual practice. In: Plante TG, Thoresen C, editors. Spirit, science and health: how the spiritual mind fuels physical wellness. Westport, CT: Praeger; 2007. p. 94–112.Google Scholar
- 30.Wachholtz A, Pargament K. Secular vs. spiritual meditation on mental health, spiritual health, and pain control. Ann Behav Med. 2006;31(Suppl):S074.Google Scholar
- 33.Weathers F. Pyschometric review of Clinician-Administered PTSD Scale (CAPS). In: Stamm BB, editor. Measurement of stress, trauma, and adaptation. Lutherville, MD: Sidran Press; 1996. p. 106–7.Google Scholar
- 34.Easwaran E. Strength in the storm: creating calm in difficult times. Tomales, CA: Nilgiri Press; 2005.Google Scholar
- 35.Bormann JE. Frequent, silent mantram repetition: a jacuzzi for the mind. Top Emerg Med. 2005;27(2):163–6.Google Scholar
- 36.Weathers FW, Litz BT, Herman JA, Huska JA, Keane TM. PTSD Checklist (PCL) (1993): reliability, validity and diagnostic utility. Proceedings of the 9th Annual Conference of International Society for Traumatic Stress Studies, Chicago, IL.Google Scholar
- 38.Spitzer RL, Williams JB, Gibbons M, First MB. Structured clinical interview for DSM-IV: patient version (SCID-P, version 2.0). Washington, DC: American Psychiatric Press; 1995.Google Scholar
- 41.Efron B, Tibshirani RJ. An introduction to the bootstrap. Palo Alto, California: Chapman and Hall/CRC; 1993.Google Scholar
- 43.R Development Core Team. R: a language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2008.Google Scholar
- 44.Bormann JE. Mantram repetition: a “portable contemplative practice” for modern times. In: Plante TG, editor. Contemplative practices in action: spirituality, meditation, and health. Santa Barbara, CA: ABC-CLIO; 2010. p. 78–99.Google Scholar