Researchers from Syracuse University looked at how to reduce the adrenergized alarm state experienced by veterans with PTSD, a hypothalamic pituitary axis dysfunction that is reflected in measurable cortisol output.

Knowing that many veterans with PTSD are hesitant to engage in distressing, triggering trauma-focused exposure treatments, these investigators explored the impact that non-exposure-based treatments, briefer in duration might have.

One such promising approach is an abbreviated, Primary Care, 4-week, brief Mindfulness Program (PCbMP).

This study investigated the relationship between participation in a veterans' PCbMP program and diurnal cortisol. Again, cortisol reflects HPA function and PTSD is associated with HPA dysregulation.

Forty veterans with PTSD were identified and randomly assigned to treatment as usual (TAU, n=21) or participation in brief 4-week Mindfulness Based Stress Reduction program (n=19).

As an objective indicator of HPA function, salivary diurnal cortisol was measured from samples collected across 2 consecutive days at baseline and follow-up.

Analyses revealed that significant changes in cortisol were associated with PCbMP treatment engagement, and a direct function of dosing (number of mindfulness program sessions completed).

Veterans completing 4 mindfulness-based meditation sessions significantly reduced their cortisol awakening response (P≤0.05); and had significant changes in cortisol area under the curve increase compared with TAU participants (P≤0.05).

Results indicate that PCbMP has a beneficial physiological impact on veterans with PTSD with a minimum of 4 weeks of practice.

Citation: Bergen-Cico D1, Possemato K, Pigeon W. Reductions in cortisol associated with primary care brief mindfulness program for veterans with PTSD. Med Care. 2014 Dec;52(12 Suppl 5):S25-31. doi: 10.1097/MLR.0000000000000224.