Military-Tailored Yoga for Veterans with Post-traumatic Stress Disorder
Military-Tailored Yoga for Veterans with Post-traumatic Stress Disorder
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DOI：
10.1093/milmed/usx071
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发表时间：
2018-05-01
影响因子：
1.2
通讯作者：
Katz, Alan R.
中科院分区：
文献类型：
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作者：
Cushing, Robin E.;Braun, Kathryn L.;Katz, Alan R.
简介：在经历过 9/11 冲突后的退伍军人中，估计患有创伤后应激障碍 (PTSD) 的比例从部署返回后不久的 9% 到部署一年后的 31% 不等。临床和药物治疗未得到充分利用。这可能是由于对误工日的担忧，以及创伤后应激障碍 (PTSD) 患者担心因患有精神健康问题而蒙受耻辱。瑜伽已被证明可以减轻平民的创伤后应激障碍症状，但很少有研究测试瑜伽对 9/11 冲突后退伍军人的影响。本研究的目的是测试瑜伽对 9/11 后被诊断患有 PTSD 的退伍军人的影响。材料和方法：参与者均年满 18 岁，并且是 9/11 冲突后的退伍军人。他们患有与其战斗服役相关的亚阈值或诊断级创伤后应激障碍（PTSD），根据创伤后应激障碍检查表-军事版本（PCL-M）的分数为 30 或更高来确定。退伍军人每周参加 60 分钟的瑜伽课程，为期 6 周，课程由经过 Warriors at Ease 培训的瑜伽教练教授，该教练是 9/11 后的退伍军人。瑜伽课程结合了 Vinyasa 风格的瑜伽和对创伤敏感、军事文化丰富的方法，由两个独立组织倡导：Warriors at Ease 和 Meghan's Foundation。在基线时收集数据，并在 7 周后再次收集数据。主要结果是 PCL-M 评分。参与者还在两个时间点完成了患者健康问卷、贝克焦虑量表、匹兹堡睡眠质量指数和正念注意力意识量表。结果：18 名持久自由行动、伊拉克自由行动和新黎明行动退伍军人完成了干预前后的自我报告问卷。年龄范围为 26 至 62 岁（中位数 = 43 岁），工龄范围为 2 至 34 岁（中位数 = 18.8 岁），13 人 (72.2%) 完成了大学学业。 PCL-M 中代表的三种症状群（即过度觉醒、重新体验和回避）证明了 PTSD 症状的减轻。此外，通过统计和临床测量，PCL-M 的总分显着下降。参与者还表现出正念得分有所提高，并报告失眠、抑郁和焦虑症状有所减轻。结论：这项研究表明，创伤敏感瑜伽干预可能对患有 PTSD 症状的退伍军人有效，无论是作为独立治疗还是辅助治疗。创伤后应激障碍（PTSD）症状的显着下降可能是由于这种干预措施是针对军队量身定制的，而且该干预措施是由一位经历过 9/11 冲突后的老兵领导的。需要对更大的样本和更多样化的退伍军人群体进行更多的研究。
Introduction: Among veterans of post-9/11 conflicts, estimates of post-traumatic stress disorder (PTSD) range from 9% shortly after returning from deployment to 31% a year after deployment. Clinical and pharmaceutically based treatments are underutilized. This could be due to concerns related to lost duty days, as well as PTSD patients' fears of stigma of having a mental health condition. Yoga has been shown to reduce PTSD symptoms in the civilian population, but few studies have tested the impact of yoga on veterans of post-9/11 conflicts. The purpose of this study is to test the impact of yoga on post-9/11 veterans diagnosed with PTSD. Materials and Methods: Participants were 18 yr of age or older and veterans of post-9/11 conflicts. They had subthreshold or diagnostic-level PTSD related to their combat military service, as determined by a score of 30 or higher on the PTSD Checklist-Military version (PCL-M). Veterans participated in 60-min weekly yoga sessions for 6 wk taught by a Warriors at Ease-trained yoga instructor who is a, post-9/11 veteran. The yoga sessions incorporated Vinyasa-style yoga and a trauma-sensitive, military-culture informed approach advocated by two separate organizations: Warriors at Ease and Meghan's Foundation. Data were collected at baseline and again after 7 wk. The primary outcome was PCL-M score. Participants also completed the Patient Health Questionnaire, the Beck Anxiety Inventory, the Pittsburgh Sleep Quality Index, and the Mindful Attention Awareness Scale at both time points. Results: Eighteen Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans completed the pre- and post-intervention self-report questionnaires. Age ranged from 26 to 62 yr (median = 43 yr), length of service ranged from 2 to 34 yr (median = 18.8 yr), and 13 (72.2%) had completed college. Decreased PTSD symptomatology was demonstrated in the three-symptom clusters represented in the PCL-M (i.e., hyperarousal, re-experiencing, and avoidance). In addition, the total score on the PCL-M decreased significantly, by both statistical and clinical measures. The participants also demonstrated improved mindfulness scores and reported decreased insomnia, depression, and anxiety symptoms. Conclusion: This study demonstrates that a trauma-sensitive yoga intervention may be effective for veterans with PTSD symptoms, whether as stand-alone or adjunctive therapy. The impressive decrease in PTSD symptomatology may be due to the tailored military-specific nature of this intervention and the fact that it was led by a veteran of post-9/11 conflicts. More research is needed with a larger sample and a more diverse veteran population.