A Pilot Study of a Trauma-Sensitive Mindfulness and Compassion Intervention

Study Overview
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Brief Summary
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This mixed-methods pilot study aim to assess the changes in symptoms of post-traumatic stress disorder (PTSD), complex post-traumatic stress disorder (CPTSD), dissociative symptoms, self-critique, and self-compassion following participation in a 16-week trauma-sensitive mindfulness and compassion (TMC) intervention. Adverse experiences of participation are also explored explicitly.

Detailed Description
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Seventeen clients most female with severe childhood abuse and PTSD and CPTSD participated in the TMC intervention. A mixed-methods design was used. All clients completed questionnaires before (pre) and after (post) the intervention to gain information on symptom change, self-critique, and self-compassion. Second, a qualitative interview addressing clients' experiences of participation, including an explicit focus on adverse experiences, was conducted.

Official Title
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A Mixed-Methods Pilot Study of a Trauma-Sensitive Mindfulness and Compassion Intervention

Conditions
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Complex Post-Traumatic Stress Disorder

Intervention / Treatment
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* Other: TMC Treatment Approach


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: report traumatic experiences and trauma related symptoms be between 18 and 65 years of age give informed consent to participate in the study Exclusion Criteria: acute suicidality serious psychotic symptoms substance abuse interfering with treatment crisis interfering with treatment violent behavior

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| TMC - group 1<br>TMC - group 1 was a closed group treated at a specialized outpatient facility for adult clients with CPTSD and complex dissociative disorders. Group 1 was led by two clinical psychologists | Other: TMC Treatment Approach<br>* The TMC approach consists of 16 weekly group sessions, each lasting 2 hours. The first 10 sessions focus mainly on building mindfulness capacities, and the last 6 sessions on developing compassion toward self and others. Between sessions, participants are encouraged to do exercises with the support of audio files. The approach was developed with a transdiagnostic perspective, including clients with a variety of trauma-related symptoms.<br>|
| TMC - group 2<br>TMC - group 2 was connected to specialized mental health services, but the intervention itself was carried out at a community centre. The community centre has collaborated with the District Psychiatric Centre (DPS) for many years, hosting an TMC group open to anyone attending the community centre in addition to clients connected to the DPS. This open concept was continued through the study intervention, but only clients connected to the DPS were included in the study. | Other: TMC Treatment Approach<br>* The TMC approach consists of 16 weekly group sessions, each lasting 2 hours. The first 10 sessions focus mainly on building mindfulness capacities, and the last 6 sessions on developing compassion toward self and others. Between sessions, participants are encouraged to do exercises with the support of audio files. The approach was developed with a transdiagnostic perspective, including clients with a variety of trauma-related symptoms.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| PTSD Checklist for Diagnostic Statistical Manual (DSM) -5 | The Posttraumatic checklist (PCL-5) is a measure of perceived PTSD symptom severity in the past month. It was used to assess the likelihood of a PTSD diagnosis given 20 symptom descriptions (items) reflecting the DSM-5 criteria. Clients rated the extent to which they were troubled by PTSD symptoms on a 5-point Likert-type scale (0 for Not at all to 4 for Extremely). | Change from pre-treatment to immediately after the intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The International Trauma Questionnaire (ITQ) | A 17-item self-report measure of ICD-11 PTSD and CPTSD were used to assess the CPTSD symptoms. Clients rated the extent to which they were troubled by CPTSD symptoms in the previous one month period on a 5-point Likert-type scale (0 for Not at all to 4 for Extremely), reflecting the three clusters of disturbances in self-organization (DSO) in CPTSD (affective dysregulation, negative self-concept, and disturbances in relationships). | Change from pre-treatment to immediately after the intervention | 
| Trauma-Related Altered States of Consciousness (TRASC): | A 10-item self-report measure was used to survey a spectrum of dissociative experiences. Clients rated the extent to which they were troubled by TRASC symptoms on a 5-point Likert-type scale (0 for Not at all to 4 for Extremely). A total score was calculated across the items 1, 3, 5, 6, and 10 . Two items assessed depersonalization and derealization as in the Dissociative-PTSD subtype and the other items assessed the phenomenology of TRASC more broadly in reference to the subjective dimensions of time, thought, body, and emotion as per the 4-D model of trauma-related dissociation | Change from pre-treatment to immediately after the intervention | 
| General Anxiety Disorder-7 (GAD-7) | This symptom assessment tool measures anxiety with seven items in GAD-7 on a 4-point scale that assesses the impact on daily life. | Change from pre-treatment to immediately after the intervention | 
| Patient Health Questionnaire-9 (PHQ 9) | This symptom assessment tool measures depression with nine items in PHQ-9 on a 4-point scale that assesses the impact on daily life. | Change from pre-treatment to immediately after the intervention | 
| Self-Compassion Scale (SCS) | The 26-item SCS consists of three positive subscales, namely Self-Kindness (5 items), Common Humanity (4 items), and Mindfulness (4 items) and three negative subscales, namely Self-Judgment (5 items), Isolation (4 items), and Over-Identification (4 items). Respondents rate their agreement with items on a 5-point Likert-type scale from Almost always (5) to Almost never (1). | Change from pre-treatment to immediately after the intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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mindfullness, treatment, compassion, trauma