Randomized controlled trials of mind-body interventions for posttraumatic stress disorder: a systematic review.

Mind-body interventions (MBIs) for posttraumatic stress disorder (PTSD) show promise but have inconsistent evidence. A review of 26 randomized controlled trials found low-strength evidence for mindfulness-based and meditation- or mantra-based interventions due to contradictory results and high risk of bias. Movement-based interventions (e.g., yoga, tai chi) had moderate-strength evidence, with individual studies consistently favoring the intervention across a relatively large number of studies and participants. Only two of the 26 studies used objective outcome measures. The review highlights the need for better comparator conditions, standardized measurement, and objective outcomes in future research.

Study at a glance

Abstract

Mind-body interventions (MBIs) include mindfulness-based interventions (MiBIs), meditation- and mantra-based interventions (MMIs), and movement-based interventions (MoBIs). These approaches have demonstrated preliminary efficacy in improving posttraumatic stress disorder (PTSD) symptoms. However, previous systematic reviews and meta-analyses have noted that this area of research is limited by inadequate comparator conditions, heterogeneity of measurement, and absence of objective outcome measures. For these reasons, an updated review of the highest-quality evidence available is warranted. We used the Agency for Healthcare Research and Quality (AHRQ)-funded evidence tables for the PTSD-Repository to identify relevant studies and assess the risk of bias as follows: The search was conducted between June 2018 and June 2022, and databases included PTSDpubs (formerly PILOTS), Ovid® MEDLINE®, Cochrane CENTRAL, Embase®, the Cumulative Index to Nursing and Allied Health Literature (CINAHL®), SCOPUS, and PsycINFO®. Twenty-six randomized controlled trials met our inclusion criteria. After identifying studies and retrieving risk of bias information from the PTSD-Repository evidence tables, we extracted additional data and synthesized the evidence. The strength of evidence was rated as low for MiBIs and MMIs, largely due to contradicting results, inconsistent use of active versus passive comparators, and high risk of bias. The strength of evidence for MoBIs was rated as moderate due to individual studies consistently favoring the intervention and a relatively large number of studies and participants. Of the 26 included studies, only two included objective outcome measures. Implications for future MBI research and clinical applications for treating PTSD are discussed.