Longitudinal Changes in Cortisol Associated with a Brief Mindfulness Intervention among Veterans with PTSD
Speaker: Dessa Bergen-Cico, PhD; Wilfred Pigeon, PhD; Kyle Posematto, PhD; Scot Treatman, DO, MPH
Format: Audio & Slides

Objective: This study investigated the efficacy of MBSR versus treatment as usual (TAU) for veterans PTSD symptom severity and co-occurring conditions. Non-exposure based treatments for PTSD are needed, one such promising approach is mindfulness based stress reduction (MBSR).

Methods. This research was conducted at the Syracuse Veterans Administration Medical Center (VAMC) encompassing veterans' primary care providers (PC) and the VA Center for Integrated Healthcare (CIH). Veterans identified by their PC as having PTSD were referred to the CIH and randomized into TAU active control or participation in a brief 4 –week MBSR program. Psychometric measures and biomarkers (salivary cortisol) were collected for baseline and post MBSR program to serve as measures of changes in PTSD related symptoms.

Results: Veterans (n=40) (mean age 48 + 16 years; 90% men) with at PTSD and sub-threshold PTSD were randomized into TAU (n=20 ) or PC-MBSR (n=20 ). Analyses showed that significant changes in coritsol from pretest to posttest are associated with engagement in MBSR, with notable differences associated with the number of MBSR sessions veterans completed. Veterans who participated in all 4 MBSR sessions significantly reduced their cortisol awakening response (CAR) p =.042; whereas TAU veterans significantly increased their daily cortisol output as indicated by their AUCi p =.02.

Conclusions: The relationship between longitudinal changes in cortisol measures and number of MBSR sessions, indicate that MBSR has a beneficial physiological impact on veterans with PTSD. Moreover measurement of salivary cortisol may be a useful biological marker for identification of improvements in PTSD related physiological dysregulation for veterans participating in MBSR programs.