Trial Outcomes & Findings for A Multisite Randomized Controlled Trial of Mindfulness Meditation Therapy for PTSD (NCT NCT01532999)

NCT ID: NCT01532999

Last Updated: 2015-04-08

Results Overview

Clinician Administered PTSD Scale (CAPS) is a 17-item standard rating scale that measures PTSD severity with scores ranging from 0-136 (higher score = more severe). Scores of frequency and intensity are summed for the 17-items to yield the total CAPS score.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

254 participants

Primary outcome timeframe

Baseline to week 9

Results posted on

2015-04-08

Participant Flow

254 participants signed informed consent; 214 participants were randomized; and 191 randomized participants attended at least one MBSR or PCGT session and were included in the modified intent-to-treat analysis for which results are displayed.

Participant milestones

Participant milestones
Measure
Mindfulness Based Stress Reduction
Mindfulness Based Stress Reduction (MBSR) is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes. Mindfulness Based Stress Reduction: MBSR is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes.
Present Centered Group Therapy
Present Centered Group Therapy (PCGT) serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness). Present Centered Group Therapy: The comparison control group will be PCGT, which was initially developed for use as a control group in a VA multi-site study that tested the effects of Trauma-Focused Group Therapy. Correspondingly, PCGT serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness).
Overall Study
STARTED
96
95
Overall Study
COMPLETED
65
77
Overall Study
NOT COMPLETED
31
18

Reasons for withdrawal

Reasons for withdrawal
Measure
Mindfulness Based Stress Reduction
Mindfulness Based Stress Reduction (MBSR) is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes. Mindfulness Based Stress Reduction: MBSR is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes.
Present Centered Group Therapy
Present Centered Group Therapy (PCGT) serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness). Present Centered Group Therapy: The comparison control group will be PCGT, which was initially developed for use as a control group in a VA multi-site study that tested the effects of Trauma-Focused Group Therapy. Correspondingly, PCGT serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness).
Overall Study
Lost to Follow-up
14
8
Overall Study
Physician Decision
1
2
Overall Study
Withdrawal by Subject
5
0
Overall Study
Relocated
2
0
Overall Study
should not have been randomized
1
0
Overall Study
substantial noncompliance
2
0
Overall Study
no show for week 9 assessments
6
4
Overall Study
Adverse Event
0
1
Overall Study
incarcerated
0
1
Overall Study
New job
0
2

Baseline Characteristics

A Multisite Randomized Controlled Trial of Mindfulness Meditation Therapy for PTSD

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Mindfulness Based Stress Reduction
n=96 Participants
Mindfulness Based Stress Reduction (MBSR) is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes. Mindfulness Based Stress Reduction: MBSR is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes.
Present Centered Group Therapy
n=95 Participants
Present Centered Group Therapy (PCGT) serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness). Present Centered Group Therapy: The comparison control group will be PCGT, which was initially developed for use as a control group in a VA multi-site study that tested the effects of Trauma-Focused Group Therapy. Correspondingly, PCGT serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness).
Total
n=191 Participants
Total of all reporting groups
Age, Continuous
52 years
STANDARD_DEVIATION 11 • n=5 Participants
51 years
STANDARD_DEVIATION 8.3 • n=7 Participants
51 years
STANDARD_DEVIATION 11 • n=5 Participants
Sex: Female, Male
Female
16 Participants
n=5 Participants
15 Participants
n=7 Participants
31 Participants
n=5 Participants
Sex: Female, Male
Male
80 Participants
n=5 Participants
80 Participants
n=7 Participants
160 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
63 Participants
n=5 Participants
59 Participants
n=7 Participants
122 Participants
n=5 Participants
Race (NIH/OMB)
White
30 Participants
n=5 Participants
31 Participants
n=7 Participants
61 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
3 Participants
n=5 Participants
3 Participants
n=7 Participants
6 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
CAPS Total
84.3 units on a scale
STANDARD_DEVIATION 19.5 • n=5 Participants
80.7 units on a scale
STANDARD_DEVIATION 16.7 • n=7 Participants
83 units on a scale
STANDARD_DEVIATION 18.2 • n=5 Participants

PRIMARY outcome

Timeframe: Baseline to week 9

Population: All participants who were randomized and attended at least one intervention session.

Clinician Administered PTSD Scale (CAPS) is a 17-item standard rating scale that measures PTSD severity with scores ranging from 0-136 (higher score = more severe). Scores of frequency and intensity are summed for the 17-items to yield the total CAPS score.

Outcome measures

Outcome measures
Measure
Mindfulness Based Stress Reduction
n=96 Participants
Mindfulness Based Stress Reduction (MBSR) is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes. Mindfulness Based Stress Reduction: MBSR is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes.
Present Centered Group Therapy
n=95 Participants
Present Centered Group Therapy (PCGT) serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness). Present Centered Group Therapy: The comparison control group will be PCGT, which was initially developed for use as a control group in a VA multi-site study that tested the effects of Trauma-Focused Group Therapy. Correspondingly, PCGT serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness).
Change From Baseline in Clinician Administered PTSD Scale
-22.4 units on a scale
Standard Deviation 27
-15.9 units on a scale
Standard Deviation 22.9

SECONDARY outcome

Timeframe: Baseline to week 9

Population: All participants who were randomized and attended at least one intervention session.

PTSD Checklist (PCL) is a 17-item self-report scale intended to measure PTSD symptom severity. The PCL has demonstrated excellent internal consistency (alpha = .94-.97), and test-retest reliability over 2 to 3 days was .96 for Vietnam veterans. Respondents rate each item from 1 ("not at all") to 5 ("extremely") to indicate the degree to which they have been bothered by that particular symptom over the past month. Thus, total possible scores (items summed) range from 17 to 85 (higher score is more severe). A cut-off score of 50 indicates a probable diagnosis of PTSD.

Outcome measures

Outcome measures
Measure
Mindfulness Based Stress Reduction
n=96 Participants
Mindfulness Based Stress Reduction (MBSR) is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes. Mindfulness Based Stress Reduction: MBSR is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes.
Present Centered Group Therapy
n=95 Participants
Present Centered Group Therapy (PCGT) serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness). Present Centered Group Therapy: The comparison control group will be PCGT, which was initially developed for use as a control group in a VA multi-site study that tested the effects of Trauma-Focused Group Therapy. Correspondingly, PCGT serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness).
Change From Baseline in PTSD Checklist (PCL)
-8.6 units on a scale
Standard Deviation 15.8
-6.7 units on a scale
Standard Deviation 12

SECONDARY outcome

Timeframe: Baseline to week 9

Population: All participants who were randomized and attended at least one intervention session.

Five Facet Mindfulness Questionnaire (FFMQ) is used to evaluate the effects of MBSR vs. PCGT on mindfulness (S1). The FFMQ is a 39-item self-report instrument that assesses the general tendency to be mindful in daily life through 5 facets: observing, describing, acting with awareness, non-judging of inner experience, non-reactivity to inner experience. Increases in FFMQ mediate improvements in well being in observational studies of MBSR. Each item is rated 1 to 5 ("never or very rarely true" to "very often or always true"). Some of the items are reverse scored (R). Scoring Information: Observe items:1, 6, 11, 15, 20, 26, 31, 36; Describe items: 2, 7, 12R, 16R, 22R, 27, 32, 37; Act with Awareness items: 5R, 8R, 13R, 18R, 23R, 28R, 34R, 38R; Nonjudge items: 3R, 10R, 14R, 17R, 25R, 30R, 35R, 39R; Nonreact items: 4, 9, 19, 21, 24, 29, 33. Total all subscales for score (higher score = greater degree of mindfulness). Score range 39-195 with higher=more mindfulness.

Outcome measures

Outcome measures
Measure
Mindfulness Based Stress Reduction
n=96 Participants
Mindfulness Based Stress Reduction (MBSR) is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes. Mindfulness Based Stress Reduction: MBSR is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes.
Present Centered Group Therapy
n=95 Participants
Present Centered Group Therapy (PCGT) serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness). Present Centered Group Therapy: The comparison control group will be PCGT, which was initially developed for use as a control group in a VA multi-site study that tested the effects of Trauma-Focused Group Therapy. Correspondingly, PCGT serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness).
Change From Baseline in Five Facet Mindfulness Questionnaire (FFMQ)
5.2 units on a scale
Standard Deviation 16.6
2.1 units on a scale
Standard Deviation 13.2

SECONDARY outcome

Timeframe: Baseline to week 9

Population: All participants who were randomized and attended at least one intervention session.

Patient Health Questionnaire (PHQ-9) is a brief 9-item measure of depressive symptoms that has established reliability and validity in community and clinical populations. All items are summed for total score ranging from 0 to 27 (higher score = more severe depression).

Outcome measures

Outcome measures
Measure
Mindfulness Based Stress Reduction
n=96 Participants
Mindfulness Based Stress Reduction (MBSR) is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes. Mindfulness Based Stress Reduction: MBSR is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes.
Present Centered Group Therapy
n=95 Participants
Present Centered Group Therapy (PCGT) serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness). Present Centered Group Therapy: The comparison control group will be PCGT, which was initially developed for use as a control group in a VA multi-site study that tested the effects of Trauma-Focused Group Therapy. Correspondingly, PCGT serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness).
Change From Baseline in Patient Health Questionnaire (PHQ-9)
-3.2 units on a scale
Standard Deviation 6.6
-1.6 units on a scale
Standard Deviation 6.3

SECONDARY outcome

Timeframe: Baseline to week 9

Population: All participants who were randomized and attended at least one intervention session.

Clinician Administered PTSD Scale (CAPS) B subscale measures the re-experiencing cluster (i.e. B criterion) of PTSD symptoms and includes the first 5 items of the CAPS, which is a clinician-administered assessment of posttraumatic stress disorder (PTSD) symptoms. Frequency and intensity scores for each item is summed for a range of 0 to 40 (higher score = more severe PTSD).

Outcome measures

Outcome measures
Measure
Mindfulness Based Stress Reduction
n=96 Participants
Mindfulness Based Stress Reduction (MBSR) is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes. Mindfulness Based Stress Reduction: MBSR is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes.
Present Centered Group Therapy
n=95 Participants
Present Centered Group Therapy (PCGT) serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness). Present Centered Group Therapy: The comparison control group will be PCGT, which was initially developed for use as a control group in a VA multi-site study that tested the effects of Trauma-Focused Group Therapy. Correspondingly, PCGT serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness).
Change From Baseline in CAPS B Subscale
-7.7 units on a scale
Standard Deviation 10.4
-6.2 units on a scale
Standard Deviation 8.9

SECONDARY outcome

Timeframe: Baseline to week 9

Population: All participants who were randomized and attended at least one intervention session.

Clinician Administered PTSD Scale (CAPS) C subscale measures the avoidance and emotional numbing cluster (i.e. C criterion) of PTSD symptoms and includes the items 6 - 12 items of the CAPS, which is a clinician-administered assessment of posttraumatic stress disorder (PTSD) symptoms. Frequency and intensity scores for each item is summed for a range of 0 to 56 (higher score = more severe PTSD).

Outcome measures

Outcome measures
Measure
Mindfulness Based Stress Reduction
n=96 Participants
Mindfulness Based Stress Reduction (MBSR) is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes. Mindfulness Based Stress Reduction: MBSR is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes.
Present Centered Group Therapy
n=95 Participants
Present Centered Group Therapy (PCGT) serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness). Present Centered Group Therapy: The comparison control group will be PCGT, which was initially developed for use as a control group in a VA multi-site study that tested the effects of Trauma-Focused Group Therapy. Correspondingly, PCGT serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness).
Change From Baseline in CAPS C Subscale
-8.8 units on a scale
Standard Deviation 12.6
-6.8 units on a scale
Standard Deviation 10.8

SECONDARY outcome

Timeframe: Baseline to week 9

Population: All participants who were randomized and attended at least one intervention session.

Clinician Administered PTSD Scale (CAPS) D subscale measures the hyperarousal cluster (i.e. D criterion) of PTSD symptoms and includes the items 13 - 17 of the CAPS, which is a clinician-administered assessment of posttraumatic stress disorder (PTSD) symptoms. Frequency and intensity scores for each item is summed for a range of 0 to 40 (higher score = more severe PTSD).

Outcome measures

Outcome measures
Measure
Mindfulness Based Stress Reduction
n=96 Participants
Mindfulness Based Stress Reduction (MBSR) is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes. Mindfulness Based Stress Reduction: MBSR is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes.
Present Centered Group Therapy
n=95 Participants
Present Centered Group Therapy (PCGT) serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness). Present Centered Group Therapy: The comparison control group will be PCGT, which was initially developed for use as a control group in a VA multi-site study that tested the effects of Trauma-Focused Group Therapy. Correspondingly, PCGT serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness).
Change From Baseline in CAPS D Subscale
-5.9 units on a scale
Standard Deviation 9.3
-3 units on a scale
Standard Deviation 7.6

SECONDARY outcome

Timeframe: Baseline to week 9

Population: All participants who were randomized and attended at least one intervention session.

Greater than or equal to 30% improvement on PTSD CAPS scale

Outcome measures

Outcome measures
Measure
Mindfulness Based Stress Reduction
n=96 Participants
Mindfulness Based Stress Reduction (MBSR) is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes. Mindfulness Based Stress Reduction: MBSR is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes.
Present Centered Group Therapy
n=95 Participants
Present Centered Group Therapy (PCGT) serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness). Present Centered Group Therapy: The comparison control group will be PCGT, which was initially developed for use as a control group in a VA multi-site study that tested the effects of Trauma-Focused Group Therapy. Correspondingly, PCGT serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness).
PTSD Response
45.2 percentage of participants
37.7 percentage of participants

SECONDARY outcome

Timeframe: Week 9

Population: All participants who were randomized and attended at least one intervention session.

Total CAPS score of less than or equal to 45 at week 9 (single observation point)

Outcome measures

Outcome measures
Measure
Mindfulness Based Stress Reduction
n=96 Participants
Mindfulness Based Stress Reduction (MBSR) is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes. Mindfulness Based Stress Reduction: MBSR is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes.
Present Centered Group Therapy
n=95 Participants
Present Centered Group Therapy (PCGT) serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness). Present Centered Group Therapy: The comparison control group will be PCGT, which was initially developed for use as a control group in a VA multi-site study that tested the effects of Trauma-Focused Group Therapy. Correspondingly, PCGT serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness).
PTSD Remission
30.7 percentage of participants
27.3 percentage of participants

Adverse Events

Mindfulness Based Stress Reduction

Serious events: 4 serious events
Other events: 0 other events
Deaths: 0 deaths

Present Centered Group Therapy

Serious events: 4 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Mindfulness Based Stress Reduction
n=96 participants at risk
Mindfulness Based Stress Reduction (MBSR) is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes. Mindfulness Based Stress Reduction: MBSR is a manualized program involving 8 weekly classes and a single 6-hour silent retreat session based on a systematic procedure to develop enhanced non-reactive awareness of the moment-to-moment experience of perceptible mental processes.
Present Centered Group Therapy
n=95 participants at risk
Present Centered Group Therapy (PCGT) serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness). Present Centered Group Therapy: The comparison control group will be PCGT, which was initially developed for use as a control group in a VA multi-site study that tested the effects of Trauma-Focused Group Therapy. Correspondingly, PCGT serves as a credible control for the nonspecific effects of a group-based intervention (i.e. controls for time, attention, expectation of recovery, and recognition of the illness).
Infections and infestations
wisdom tooth infection
1.0%
1/96 • Number of events 1 • Adverse events were collected during the 17 week follow-up period for each participant.
0.00%
0/95 • Adverse events were collected during the 17 week follow-up period for each participant.
Psychiatric disorders
suicidal and homicidal feelings
3.1%
3/96 • Number of events 3 • Adverse events were collected during the 17 week follow-up period for each participant.
2.1%
2/95 • Number of events 2 • Adverse events were collected during the 17 week follow-up period for each participant.
Cardiac disorders
Hypotension
0.00%
0/96 • Adverse events were collected during the 17 week follow-up period for each participant.
1.1%
1/95 • Number of events 1 • Adverse events were collected during the 17 week follow-up period for each participant.
Reproductive system and breast disorders
swollen scrotum
0.00%
0/96 • Adverse events were collected during the 17 week follow-up period for each participant.
1.1%
1/95 • Number of events 1 • Adverse events were collected during the 17 week follow-up period for each participant.

Other adverse events

Adverse event data not reported

Additional Information

Lori L. Davis, MD

Tuscaloosa VA Medical Center

Phone: 205-554-2000

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place