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Meta-Analysis
. 2021 Jul;24(4):221-230.
doi: 10.1016/j.cjtee.2021.05.003. Epub 2021 May 18.

Military-related posttraumatic stress disorder and mindfulness meditation: A systematic review and meta-analysis

Lu-Na Sun  1 , Jing-Wen Gu  2 , Li-Jun Huang  3 , Zhi-Lei Shang  1 , Yao-Guang Zhou  1 , Li-Li Wu  1 , Yan-Pu Jia  1 , Nian-Qi Liu  1 , Wei-Zhi Liu  4
Affiliations
Meta-Analysis

Military-related posttraumatic stress disorder and mindfulness meditation: A systematic review and meta-analysis

Lu-Na Sun et al. Chin J Traumatol. 2021 Jul.

Abstract

Purpose: Posttraumatic stress disorder (PTSD) is a significant global mental health concern, especially in the military. This study aims to estimate the efficacy of mindfulness meditation in the treatment of military-related PTSD, by synthesizing evidences from randomized controlled trials.

Methods: Five electronic databases (Pubmed, EBSCO Medline, Embase, PsychINFO and Cochrane Library) were searched for randomized controlled trials focusing on the treatment effect of mindfulness meditation on military-related PTSD. The selection of eligible studies was based on identical inclusion and exclusion criteria. Information about study characteristics, participant characteristics, intervention details, PTSD outcomes, as well as potential adverse effects was extracted from the included studies. Risk of bias of all the included studies was critically assessed using the Cochrane Collaboration's tool. R Statistical software was performed for data analysis.

Results: A total of 1902 records were initially identified and screened. After duplicates removal and title & abstract review, finally, 19 articles in English language with 1326 participants were included through strict inclusion and exclusion criteria. The results revealed that mindfulness meditation had a significantly larger effect on alleviating military-related PTSD symptoms compared with control conditions, such as treatment as usual, present-centered group therapy and PTSD health education (standardized mean difference (SMD) = -0.33; 95% CI [-0.45, -0.21]; p < 0.0001). Mindfulness interventions with different control conditions (active or non-active control, SMD = -0.33, 95% CI [-0.46, -0.19]; SMD = -0.49, 95% CI [-0.88, -0.10], respectively), formats of delivery (group-based or individual-based, SMD = -0.30, 95% CI [-0.42, -0.17], SMD = -0.49, 95% CI [-0.90, -0.08], respectively) and intervention durations (short-term or standard duration, SMD = -0.27, 95% CI [-0.46, -0.08], SMD = -0.40, 95% CI [-0.58, -0.21], respectively) were equally effective in improving military-related PTSD symptoms.

Conclusion: Findings from this meta-analysis consolidate the efficacy and feasibility of mindfulness meditation in the treatment of military-related PTSD. Further evidence with higher quality and more rigorous design is needed in the future.

Keywords: Meta-analysis; Military personnel; Mindfulness meditation; Posttraumatic stress disorder.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow diagram of study selection process.
Fig. 2
Fig. 2
Forest plot for PTSD post treatment effects (mindfulness meditation interventions vs. control conditions). Negative values indicate fewer PTSD symptoms in the experimental condition than the control condition. PTSD: posttraumatic stress disorder.
Fig. 3
Fig. 3
Subgroup analysis for PTSD treatment effect by control condition. PTSD: posttraumatic stress disorder.
Fig. 4
Fig. 4
Subgroup analysis for PTSD treatment effect by format of intervention delivery. PTSD: posttraumatic stress disorder.
Fig. 5
Fig. 5
Subgroup analysis for PTSD treatment effect by intervention duration. PTSD: posttraumatic stress disorder.
See this image and copyright information in PMC

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