Mindfulness for Stressor-Related Disorders: From Neurobiology to Evidence-Based Treatments.

Number

67

Assigned to session

Field of research

Complex PTSD, comorbidities, grief
(Sub)clinical interventions or treatment (innovations)
Biological or medical
Methodological

Overview of symposium

A minority of people may develop stressor-related disorders after trauma exposure and bereavement, including posttraumatic stress disorder (PTSD) and/or prolonged grief disorder (PGD). Pharmacological and psychosocial interventions are efficacious, but may not work for everyone and availability is limited. Mindfulness-based practices have gained interest by the research field and the public for its promising role as therapeutic interventions for stressor-related disorders, possibly by reducing biological stress, and can be easily implemented. This symposium focusses on the possible underlying neurobiology of efficacy of mindfulness-based programs, potential adaptations for PTSD/PGD, testing their efficacy, and potential implementation in trauma-exposed and bereaved communities.

Authors

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Resting-state functional connectivity for the anterior cingulate cortex, insula and amygdala in bereaved older adults.

MSc Thomas Le François
Normandie Univ, UNICAEN, INSERM U1237, PhIND, NEUROPRESAGE Team (Institut Blood and Brain @ Caen-Normandie), GIP Cyceron, Bd Henri Becquerel, 14000, Caen, France

Summary

Most people successfully adapt after the loss of a loved one. However, around 10% of individuals are unable to integrate the loss and may develop prolonged grief disorder (PGD). Some previous studies found dysfunctioning brain regions related to emotion regulation processes in PGD, for instance for the anterior cingulate cortex (ACC), insula and amygdala. Yet, little is known about functional connectivity (FC) between these regions and their link with PGD-related symptom severity. We aimed to investigate the link between PGD symptom severity and FC for the ACC, insula and amygdala in N=81 bereaved older adults one-year post-loss, using functional magnetic resonance imaging (fMRI) during a state of rest. PGD symptom severity was based on the total score of the Inventory of Complicated Grief (ICG) and resting-state fMRI scans were acquired. Resting-state FC (rsFC) was established on a whole-brain level based on seed-to-voxel analyses for the ACC, insula and amygdala. Subsequently, the link between PGD symptom severity and rsFC was analyzed using multiple regression models. During this presentation, preliminary results will be presented on the associations between PGD symptom severity and rsFC for the ACC, insula and amygdala, and findings will be interpreted.

Authors

Thomas Le François

Prolonged grief disorder, posttraumatic stress disorder, and depression following traffic accidents among bereaved Balinese family members.

Dr. Manik Djelantik¹, Putu Aryani², Paul A. Boelen^{3, 4}, Cokorda Bagus Jaya Lesmana⁵, Rolf J. Kleber^{6, 4
1}Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
²Department of Community and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Indonesia
³ARQ National Psychotrauma Centre, Diemen, Netherlands
⁴Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands
⁵Department of Psychiatry, Faculty of Medicine, Udayana University, Denpasar, Indonesia
⁶ARQ National Psychotrauma Centre, Utrecht, Netherlands

Summary

This study aimed to estimate the prevalence of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD) and depression among 301 bereaved individuals after traffic deaths in Bali and the relations between subgroups sharing the same symptoms and cultural and socio-demographic characteristics. The purpose of the rituals was examined by a thematic qualitative analysis. We performed latent class analyses and subsequently calculated the odds ratios between membership of classes and characteristics with a multivariate 3step analysis. Prevalence rates of PGD (0%), PTSD (1%) and moderate depression (2%) were remarkably low. Most participants followed the bereavement rituals characteristic for Balinese culture. The purpose of these rituals was mainly the expression of caring for the deceased. We found a large resilient class (76%) and two smaller classes, one characterized by elevated PGD symptoms (11%) and one by elevated PTSD symptoms (13%). Loss of close kin was associate with membership of the PTSD class. It could be that certain aspects of the Balinese culture might protect bereaved individuals for developing mental health issues.

Authors

Manik Djelantik

Putu Aryani

Paul A. Boelen

Cokorda Bagus Jaya Lesmana

Rolf J. Kleber

From Neurobiology to Evidence-Based Treatments of Mindfulness for Stressor-Related Disorders.

Professor Eric Bui
Normandie Univ, UNICAEN, INSERM U1237, PhIND, NEUROPRESAGE Team (Institut Blood and Brain @ Caen-Normandie), GIP Cyceron, Bd Henri Becquerel, 14000, Caen, France
Centre Hospitalier Universitaire Caen Normandie, Caen, France
Massachusetts General Hospital,, Boston, MA, United States

Summary

Over the past few decades, mind-body interventions including tai-chi, yoga, and mindfulness meditation have become popular and widely available. We will describe some recent evidence showing the efficacy of these interventions to reduce stress, and to effectively treat disorders related to stress such as generalized anxiety disorder, and other anxiety disorders, including a large randomized controlled trial of yoga vs. cognitive behavioral therapy vs. stress education, and a large randomized controlled trial of mindfulness based stress reduction training vs. escitalopram. Further, we will review recent research from our group aiming to adapt these interventions to treat two stressor-related conditions including stress and posttraumatic stress disorder in veterans, and prolonged grief disorder in older adults.

Authors

Eric Bui

Coping After Loss through Mindfulness: a Neuroimaging Pilot Study.

Dr. Charlotte Hilberdink
Normandie Univ, UNICAEN, INSERM U1237, PhIND, NEUROPRESAGE Team (Institut Blood and Brain @ Caen-Normandie), GIP Cyceron, Bd Henri Becquerel, 14000, Caen, France

Summary

A core symptom of prolonged grief disorder (PGD) is heightened reactivity to reminders of the death, which is associated with increased mental health risk if exaggerated and persisting. No efficacious intervention for reducing bereavement-related stress responses exist to prevent the negative health outcomes of adults who lost a loved one. Mindfulness Training has shown efficacy to decrease stress reactivity, supposedly by improving emotional regulation, and therefore has the potential to target bereavement-related stress-reactivity in grievers. However, it is unknown whether mindfulness meditation may also decrease bereavement-specific stress reactivity and little is known about the neurobiological changes that underlie the decrease in stress reactivity that results from Mindfulness Training. In general, there are very limited data available about PGD’s pathophysiology and neurobiology, and in particular how treatments can intervene on it. Dr. Hilberdink will present preliminary results of a first ever trial on efficacy of an adapted 8-week standardized group Mindfulness Training program, adapted for the Stress Management and Resiliency Training – SMART, on decreasing PGD symptoms and its potential mechanism of action (neurobiological biomarkers of bereavement-related stress reactivity) in adults with PGD, compared to a 12-week waitlist control group. Furthermore, the design of a randomized efficacy trial underway will be presented.

Authors

Charlotte Hilberdink