Concurrent Session 3 – Mindfulness and SelfCompassion-Based Exposure Therapy for Combat Veterans with Posttraumatic Stress Disorder: Clinical Outcome and Neuroimaging Studies

Pilot work (thanks to a Mind and Life Varela grant) found significant symptom
reduction following MBCT adapted for combat-related posttraumatic stress
disorder (PTSD). Our subsequent fouryear, federally funded project developed a novel 16-week PTSD group intervention for veterans returning from Afghanistan (OEF) and Iraq (OIF), utilizing mindfulness and self-compassion meditation (Mindfulness-Based Exposure Therapy, or MBET). PTSD patients (42 OEF/OIF veterans) were assigned to either MBET or a comparison group therapy. MBET showed significantly greater retention than comparison therapy; PTSD symptoms improved following MBET in completer and intent-to-treat analysis, but not in comparison therapy. Pre-post neuroimaging (3T fMRI functional connectivity, emotion regulation paradigms) in 28 of these PTSD patients found that following MBET, patients showed decreased amygdala and basal ganglia (caudate globus pallidus) reactivity to negative emotion induction and increased amygdala functional connectivity to rostral and dorsal anterior cingulate cortex. A PTSD intervention, including mindfulness and self-compassion meditation, appears well tolerated by OEF/OIF veterans, and provides clinically meaningful improvement in PTSD symptoms. fMRI neuroimaging suggest emotional neurocircuitry that may accompany clinical change.