Is mindfulness protective against PTSD? A neurocognitive study of 25 Tsunami disaster survivors

Associations between mindfulness and mental health after collective trauma: results from a longitudinal, representative, probability-based survey

BACKGROUND/OBJECTIVES

Trait mindfulness (TM) may protect against post-trauma mental health ailments and related impairment. Few studies have evaluated this association in the context of collective traumas using representative samples or longitudinal designs.

DESIGN/METHOD

We explored relationships between TM and collective trauma-related outcomes in a prospective, representative, probability-based sample of 1846 U.S. Gulf Coast residents repeatedly exposed to catastrophic hurricanes, assessed twice during the COVID-19 outbreak (Wave 1: 5/14/20-5/27/20; Wave 2: 12/21/21-1/11/22). Generalized estimating equations examined longitudinal relationships between TM, COVID-19-related fear/worry, hurricane-related fear/worry, global distress, and functional impairment; ordinary least squares regression analyses examined the cross-sectional association between TM and COVID-19-related posttraumatic stress symptoms (PTSS) at Wave 1. Event-related stressor exposure was explored as a moderator.

RESULTS

In covariate-adjusted models including pre-event mental health ailments and demographics, TM was negatively associated with COVID-19-related fear/worry, hurricane-related fear/worry, global distress, and functional impairment over time; in cross-sectional analyses, TM was negatively associated with COVID-19-related PTSS. TM moderated the relationship between COVID-19 secondary stressor exposure (e.g., lost job/wages) and both global distress and functional impairment over time.

CONCLUSIONS

Results suggest TM may buffer adverse psychosocial outcomes following collective trauma, with some evidence TM may protect against negative effects of secondary stressor exposure.

Systematic Review of Dispositional Mindfulness and Posttraumatic Stress Disorder Symptomology: A Targeted Examination of Avoidance

High rates of nonresponse to evidence-based treatment for posttraumatic stress disorder (PTSD) have fueled the search for improved intervention. Evidence suggests that improvements in dispositional mindfulness (i.e., tendency to attend to the present with nonjudgment and nonreactivity) may help reduce PTSD symptoms. While some research suggests that transdiagnostic mindfulness-based interventions particularly target avoidance symptoms, the association between dispositional mindfulness and avoidance has yet to be systematically examined. To address this gap, we examined peer-reviewed studies that reported quantitative associations between avoidance and dispositional mindfulness among trauma-exposed adults, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 guidelines. Sixteen studies were identified for final review from PsycINFO and PubMed databases. Results suggest that mindfulness has a weak relationship with effortful avoidance. This weak relationship may be obscured in studies where effortful avoidance is measured among other symptoms (e.g., anhedonia). Mindfulness appeared to have stronger associations with symptoms of hyperarousal and negative alterations in cognition and mood. An important clinical implication is that high effortful avoidance may manifest among patients who report strong mindfulness skills. It may be helpful for clinicians to carefully assess how mindfulness is being used to cope.

Association between trait mindfulness and symptoms of post-traumatic stress: A meta-analysis

Mindfulness is characterized by skills such as heightened awareness and acceptance of internal experiences, which may be helpful for people who have experienced trauma. The consistency and strength of the relationship between trait mindfulness and PTSD symptomology, however, is unknown. Studies were included in this review if they were published in an English language peer-reviewed journal, reported on a correlational relationship between validated measures of mindfulness and PTSD, and all participants were over the age of 18. A random effects meta-analysis showed that there was a robust, pooled relationship between total mindfulness and PTSD (r₊ = -0.39, 95% CI [-0.47 to -0.30]), based on 35 datasets with 13,370 participants, with low risk of publication bias. Sixteen articles reported on facets of mindfulness and PTSD symptomology [5,206 to 5,600 participants]: the strongest associations were with Act with Awareness (r₊ = -0.37) and Non-judge (r₊ = -0.37), followed by Describe (r₊ = -0.22) and Non-react (r₊ = -0.21). Observe was not significantly associated with PTSD symptoms. Results from this analysis suggest that people who are more mindful also report fewer symptoms of PTSD ; the strength of the relationship varies across mindfulness facets. There was high heterogeneity across studies.

Mindful attention awareness and cognitive defusion are indirectly associated with less PTSD-like symptoms via reduced maladaptive posttraumatic cognitions and avoidance coping

Recently, the effects of mindfulness-based interventions for posttraumatic stress disorder (PTSD) have been studied. However, we lack knowledge of the processes or mechanisms through which mindfulness influences resilience or promotes recovery following exposure to trauma. In this study, we examine the process by which mindfulness and cognitive-behavioral factors such as posttraumatic negative cognition and avoidance behaviors are associated with reduced PTSD-like symptoms. A questionnaire survey was conducted with 885 university students, using the Trauma Experience Questionnaire, Mindful Attention Awareness Scale, Cognitive Fusion Questionnaire, Post-Traumatic Stress Disorder Checklist, revised Ways of Coping Checklist, and a brief version of the Posttraumatic Cognitions Inventory. Data from 254 participants who experienced trauma with PTSD-like symptoms were analyzed. The final model using SEM indicated no direct association of mindful attention awareness on PTSD-like symptoms, a small direct association of cognitive defusion on PTSD-like symptoms, and a large indirect association mediated by posttraumatic negative cognitions and avoidance coping. Owing to the study’s cross-sectional design, strong conclusions cannot be drawn regarding the causal relationship of mindfulness and cognitive-behavioral factors or generalizations. However, our findings suggest that it would be worthwhile to continue to clarify the mechanism of mindfulness and to investigate its use in the treatment of PTSD. In the future, a highly accurate study design will hopefully be used to examine the mechanisms of several different factors associated with improvement in posttraumatic stress symptoms, preferably including them in the same model.

Chronic Mental Health Sequelae of Climate Change Extremes: A Case Study of the Deadliest Californian Wildfire

Introduction. Weather-related disasters, such as wildfires exacerbated by a rise in global temperatures, need to be better studied in terms of their mental health impacts. This study focuses on the mental health sequelae of the deadliest wildfire in California to date, the Camp Fire of 2018. Methods. We investigated a sample of 725 California residents with different degrees of disaster exposure and measured mental health using clinically validated scales for post-traumatic stress disorder (PTSD), major depressive disorder (MDD) and generalized anxiety disorder (GAD). Data were collected at a chronic time-point, six months post-wildfire. We used multiple regression analyses to predict the mental health outcomes based on self-reported fire exposure. Additionally, we included vulnerability and resilience factors in hierarchical regression analyses. Results. Our primary finding is that direct exposure to large scale fires significantly increased the risk for mental health disorders, particularly for PTSD and depression. Additionally, the inclusion of vulnerability and resilience factors in the hierarchical regression analyses led to the significantly improved prediction of all mental health outcomes. Childhood trauma and sleep disturbances exacerbated mental health symptoms. Notably, self-reported resilience had a positive effect on mental health, and mindfulness was associated with significantly lower depression and anxiety symptoms. Conclusion. Overall, our study demonstrated that climate-related extreme events, such as wildfires, can have severe mental illness sequelae. Moreover, we found that pre-existing stressful life events, resilient personality traits and lifestyle factors can play an important role in the prevalence of psychopathology after such disasters. Unchecked climate change projected for the latter half of this century may severely impact the mental wellbeing of the global population, and we must find ways to foster individual resiliency.

The relationship between trait mindfulness and affective symptoms: A meta-analysis of the Five Facet Mindfulness Questionnaire (FFMQ)

Trait mindfulness appears to be related to lower levels of negative affective symptoms, but it remains uncertain which facets of mindfulness are most important in this relationship. Accordingly, the present meta-analysis examined studies reporting correlations between affective symptoms and trait mindfulness as assessed by the Five Facet Mindfulness Questionnaire. A comprehensive search yielded 148 eligible studies, comprising 157 distinct samples and 44,075 participants. The weighted mean correlation for affective symptoms and overall trait mindfulness was r = -0.53. Among mindfulness facets, Nonjudge (r = -0.48) and Act with Awareness (r = -0.47) demonstrated the largest correlations, followed by Nonreact (r = -0.33) and Describe (r = -0.29). Observe was not significantly correlated with affective symptoms. No significant differences in the strength of correlations were found between anxiety, depression and posttraumatic stress disorder (PTSD) symptoms, though symptoms of generalized anxiety disorder exhibited a weaker negative relationship with the Describe facet compared to PTSD symptoms. Describe also showed a stronger relationship with affective symptoms in Eastern samples compared to Western samples, whereas Western samples had a stronger relationship with Nonjudge. These results provide insight into the nature of the association between trait mindfulness and negative affect.