A Brief Mindfulness-Based Intervention for Stress, Pain, Emotion and
Attention Regulation in Military Service Members with Mild Traumatic
Aim The primary aim of this study was to conduct an open pilot
clinical trial of a brief mindfulness-based intervention for persistent
postconcussion symptoms that occur after mild traumatic brain injury in
military service members. For many service members, operational tempo
and other time constraints may prevent them from completing a standard
mindfulness-based stress reduction course. Thus, this study sought to
examine the effectiveness of a five-session intervention called
Mindfulness-Based Stress, Pain, Emotion, and Attention Regulation
(MSPEAR). Methods Participants were active duty service members
with a history of mild traumatic brain injury (TBI) and persisting
postconcussion symptoms, all of whom were recruited from an outpatient
TBI rehabilitation program at a military treatment facility. Of the 38
service members that were initially enrolled, 25 completed the 5-session
MSPEAR intervention, and 20 returned for a 5-week follow-up evaluation.
Questionnaires assessing perceived stress, positive affect, pain
interference and catastrophizing, sleep disturbances, perceived
behavioral and attention regulation, self-efficacy, and satisfaction
with life were administered at pre-intervention, post-intervention, and
at 5-week follow-up intervals. Neuropsychological testing at
pre-intervention and 5-week follow-up included performance validity
measures, attention, working memory, and executive function measures.
Results Improvements in perceived stress, positive affect,
behavioral regulation, metacognition, sleep disturbance, self-efficacy,
and satisfaction with life were found immediately after the MSPEAR
intervention and were maintained at the 5-week follow-up. Magnification
and helplessness aspects of pain catastrophizing improved when comparing
pre-intervention to the 5-week follow-up. Pain interference was not
significantly different across study assessment times.
Neuropsychological testing revealed improvements in sustained attention,
working memory, cognitive flexibility, and inhibitory control when
comparing pre-intervention to the 5-week follow-up assessment.
Conclusions The MSPEAR intervention appears to show promise as
a brief and effective therapy for specific postconcussion symptoms after
mild traumatic brain injury in military service members. Each of the
components of MSPEAR including stress, pain catastrophizing, emotion,
and attention regulation showed improvements in this study, and bears
further investigation in a larger scale, preferably randomized
controlled trial in those active duty military service members who
experience persisting symptoms after a mild traumatic brain injury.