Effects of group trauma-sensitive yoga on inflammatory markers and psychological well-being in women veterans with PTSD: A randomized controlled trial

Belle Zaccari , Ursula A. Kelly , Travis I. Lovejoy , Kimberly Hubbard , Aurora Newman , Jennifer M. Loftis
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Abstract

Background

Lifetime prevalence of post-traumatic stress disorder (PTSD) is double among veterans compared to civilians and women compared to men. Inflammatory factors are increasingly implicated in symptoms of PTSD. Yoga shows promise to reduce psychological symptoms of PTSD and positively impact inflammatory responses. The present study aimed to examine the effectiveness of yoga to reduce symptoms of PTSD and depression in addition to investigating the impact of treatment on inflammatory markers in women veterans with PTSD secondary to military sexual trauma.

Methods

We collected dried blood spot samples, self-report and clinician administered measures of PTSD, and self-reported depression symptoms at baseline, 2 weeks, and 3 months post-intervention from a subset of women veterans diagnosed with PTSD (N = 27) who were randomized to either Trauma Center Trauma-Sensitive Yoga (TCTSY; a movement therapy) or cognitive processing therapy (CPT; a talk therapy) as part of a larger multisite RCT. Concentrations of interleukin (IL)-6, IL-10, and C-reactive protein (CRP) were measured using multiplex bead-based immunoassay at baseline and post-intervention (2 weeks and 3 months). Generalized estimating equations examined changes in symptoms of PTSD, depression, and inflammatory markers over time. We hypothesized decreases in IL-6 and CRP and increases in IL-10 in TCTSY participants compared to CPT participants and that PTSD and depression symptoms would improve over time in both groups.

Results

From baseline to 3 months post-intervention, IL-6 (β = 0.10, p < 0.05), IL-10 (β = 0.68, p < 0.05), and CRP (β = 0.77, p < 0.05) increased in TCTSY participants relative to those randomized to CPT. PTSD and depression symptoms reduced in both groups over time (CAPS-5 β = −3.96, PCL-5 β = −4.66, and BDI-II β = −2.70, all p < 0.05); groups did not differ in magnitude of symptom reduction.

Conclusions

Findings indicate that TCTSY has the potential to improve symptoms of PTSD and depression and alter inflammatory markers. The findings are limited by our sample size and the immune factors we examined. Future directions for related research would benefit from measuring a wider array of stress response components.

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群体创伤敏感瑜伽对创伤后应激障碍女性退伍军人炎症标志物和心理健康的影响:一项随机对照试验
退伍军人一生中创伤后应激障碍(PTSD)的患病率是平民的两倍,女性是男性的两倍。炎症因素与创伤后应激障碍症状的关系日益密切。瑜伽有望减少创伤后应激障碍的心理症状,并对炎症反应产生积极影响。本研究旨在研究瑜伽在减少创伤后应激障碍和抑郁症状方面的有效性,并调查治疗对军中性创伤后应激障碍女性退伍军人炎症标志物的影响。方法:在干预后基线、2周和3个月,我们从诊断为PTSD的女性退伍军人(N = 27)中收集干血斑样本、自我报告和临床医生给予的PTSD测量以及自我报告的抑郁症状,这些女性退伍军人被随机分配到创伤中心创伤敏感瑜伽(TCTSY;运动疗法)或认知加工疗法(CPT;(谈话治疗)作为一个更大的多地点随机对照试验的一部分。在基线和干预后(2周和3个月)使用多重头部免疫分析法测量白细胞介素(IL)-6、IL-10和c反应蛋白(CRP)的浓度。广义估计方程检查了PTSD症状、抑郁和炎症标志物随时间的变化。我们假设与CPT参与者相比,TCTSY参与者的IL-6和CRP降低,IL-10升高,并且两组的PTSD和抑郁症状会随着时间的推移而改善。结果从基线到干预后3个月,IL-6 (β = 0.10, p <0.05), IL-10 (β = 0.68, p <0.05), CRP (β = 0.77, p <0.05) TCTSY参与者相对于随机分配到CPT的参与者增加。两组PTSD和抑郁症状均随时间减轻(CAPS-5 β = - 3.96, PCL-5 β = - 4.66, BDI-II β = - 2.70,均p <0.05);各组在症状减轻的程度上没有差异。结论TCTSY有改善PTSD和抑郁症状和改变炎症标志物的潜力。研究结果受限于我们的样本量和我们检查的免疫因素。未来相关研究的方向将受益于测量更广泛的应力反应成分。
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