Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence

Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence

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J Psychiatry Neurosci 2018;43(1):7-25

Jenna E. Boyd, MSc; Ruth A. Lanius, MD, PhD; Margaret C. McKinnon, PhD, CPsyc

Mindfulness-based treatments for posttraumatic stress disorder (PTSD) have emerged as promising adjunctive or alternative intervention approaches. A scoping review of the literature on PTSD treatment studies, including approaches such as mindfulness-based stress reduction, mindfulness-based cognitive therapy and metta mindfulness, reveals low attrition with medium to large effect sizes. We review the convergence between neurobiological models of PTSD and neuroimaging findings in the mindfulness literature, where mindfulness interventions may target emotional under- and overmodulation, both of which are critical features of PTSD symptomatology. Recent emerging work indicates that mindfulness-based treatments may also be effective in restoring connectivity between large-scale brain networks among individuals with PTSD, including connectivity between the default mode network and the central executive and salience networks. Future directions, including further identification of the neurobiological mechanisms of mindfulness interventions in patients with PTSD and direct comparison of these interventions to first-line treatments for PTSD are discussed.


Submitted Jan. 23, 2017; Revised May 15, 2017; Accepted July 3, 2017; Online first Oct. 3, 2017

Acknowledgements: Support for this work was provided by grants from the Canadian Institutes of Health Research and the Canadian Institutes of Military and Veteran’s Health Research awarded to R. Lanius and M. McKinnon. J. Boyd was supported by a studentship from the Homewood Research Institute, an Ontario Graduate Scholarship, and by a Father Sean O’Sullivan Studentship Award from the Research Institute at St. Joseph’s Healthcare Hamilton.

Affiliations: From the Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ont., Canada (Boyd); the Mood Disorders Program, St. Joseph’s Healthcare, Hamilton, Ont., Canada (Boyd, McKinnon); the Homewood Research Institute, Guelph, Ont., Canada (Boyd, Lanius, McKinnon); the Department of Psychiatry, Western University, London, Ont., Canada (Lanius); the Department of Neuroscience, Western University, London, Ont., Canada (Lanius); the Imaging Division, Lawson Health Research Institute, London, Ont., Canada (Lanius); and the Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ont., Canada (McKinnon).

Competing interests: None declared.

Contributors: All authors designed the review, wrote and reviewed the article, approved the final version to be published and can certify that no other individuals not listed as authors have made substantial contributions to the paper.

DOI: 10.1503/jpn.170021

Correspondence to: M.C. McKinnon, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5th Street, Hamilton, ON, Canada; mmckinno@stjoes.ca