명상도서관
Self-Care Mindfulness Approaches for Refractory Posttraumatic Stress Disorder
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- 자료유형학술지논문
- 저자명Khusid, M.
- 학회/출판사/기관명SLACK INCORPORATED
- 출판년도2013
- 언어영어
- 학술지명/학위논문주기PSYCHIATRIC ANNALS
- 발행사항Vol.43No.7[2013]_x000D_
- ISBN/ISSN0048-5713
- 소개/요약C urrent first-line posttraumatic stress disorder (PTSD) therapies include trauma-focused cogni-tive behavioral psychotherapies, stress inoculation training such as prolonged exposure, and pharmacotherapies. 1 In recent years, however, the evidence base for mindfulness interventions has been rapidly expanding, as reflected in the 2010 Veterans Administration (VA)/ Department of Defense (DoD) Clinical Practice Guideline for Management of PTSD, and the 2011 systematic review by the VA evidence-based synthesis pro-gram. 1 Although the guidelines do not rec-ommend any mindfulness approaches as first-line treatments for PTSD, they are known to facilitate the patient's en-gagement in care, address hyperarousal symptoms, and comorbid conditions. Mindfulness-based approaches are in-creasingly employed to treat a variety of psychological, psychiatric, and physical problems, including anxiety, depression, PTSD, sleep difficulties, and chronic pain. 2 A 2012 survey of 125 VA-special-ized PTSD treatment programs indicated that 88% offered mindfulness practices including yoga and meditation. 3,4 Deployment to a war zone in Iraq or Afghanistan is associated with a three-fold increase in new-onset PTSD. 5 Since PTSD appears to be a risk factor for suicidal behavior, and often co-occurs with depression, anxiety, substance use disorders, and chronic pain, associated long-term personal and societal costs are high. 6-8 Considering the high preva-lence, and chronic debilitating nature of PTSD among US service members and veterans, the development of cost-effec-tive self-management of this condition carries great public health importance. 9 Engaging patients in collaborative care and educating them on how to self-manage their chronic diseases has been shown to lead to increased levels of functioning, reduced pain, improved health outcomes, and decreased health care costs. 10 Additionally, it supports the patient-centered partnership model of care, where responsibility shifts from the physician to the patient. Recent meta-analysis and efficacy data suggest that self-help interventions are accepted and effective for patients with PTSD and anxiety disorders. 11 They are useful in decreasing avoidance behavior, frequen-cy of intrusive symptoms, anxiety, and depressive symptoms; they also have been shown to increase coping and self-efficacy skills. 12 On Aug. 31, 2012, President Obama signed an executive order that directs the DoD, the VA, the Department of Health and Human Services, and the Depart-ment of Education to develop strategies
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