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Аннотация
В статье рассматривается применение практик осознанности (майндфулнес) в терапии посттравматического стрессового расстройства (ПТСР). Представлен обзор зарубежных исследований, посвящённых эффективности программ, основанных на осознанности, таких как MBSR, TI-MBSR и MBCT, при работе с ветеранами боевых действий. Описаны механизмы воздействия практик осознанности на ключевые симптомы ПТСР: избегание, гипервозбуждение, интрузии, диссоциацию и эмоциональное оцепенение. Отмечается, что практики осознанности интегрируются в трёхфазную модель терапии травмы Джудит Херман, способствуя стабилизации, работе с травматическим материалом и консолидации изменений. Несмотря на ограниченность исследований по отдельным аспектам, MBI-интервенции рассматриваются как эффективное и доступное дополнение к существующим методам лечения ПТСР, особенно для пациентов с трудностями при использовании традиционных подходов.
Ключевые слова
Детали статьи
Илья Константинович Кияненко
Аспирант, стажер-исследователь Научно-учебной лаборатории психологии салютогенной среды, Национальный исследовательский университет «Высшая школа экономики», Москва, Россия
Литература
- Adams S.W., Bowler R.M., Russell K., et al. PTSD and comorbid depression: Social support and self-efficacy in World Trade Center tower survivors 14-15 years after 9/11 // Psychological Trauma. 2019. Vol. 11. №2. P. 156–164. DOI: 10.1037/tra0000404
- Boyd J.E., Lanius R.A., McKinnon M.C. Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence // Journal of Psychiatry & Neuroscience. 2018. Vol. 43. №1. P. 7–25. DOI: 10.1503/jpn.170021
- Bremner J.D., Mishra S., Campanella C., et al. A Pilot Study of the Effects of Mindfulness-Based Stress Reduction on Post-traumatic Stress Disorder Symptoms and Brain Response to Traumatic Reminders of Combat in Operation Enduring Freedom/Operation Iraqi Freedom Combat Veterans with Post-traumatic Stress Disorder // Frontiers in Psychiatry. 2017. Vol. 8. Art. 157. DOI: 10.3389/fpsyt.2017.00157
- Bryant R.A. Post-traumatic stress disorder: a state-of-the-art review of evidence and challenges // World Psychiatry. 2019. Vol. 18. №3. P. 259–269. DOI: 10.1002/wps.20656
- Davis L.L., Whetsell C., Hamner M.B., et al. A Multisite Randomized Controlled Trial of Mindfulness-Based Stress Reduction in the Treatment of Posttraumatic Stress Disorder // Psychiatric Research and Clinical Practice. 2019. Vol. 1. №2. P. 39-48. DOI: 10.1176/appi.prcp.20180002
- Herman J.L. Trauma and Recovery: The Aftermath of Violence – from Domestic Abuse to Political Terror. New York: Basic Books, 1997.
- Hoppen T.H., Morina N. The prevalence of PTSD and major depression in the global population of adult war survivors: a meta-analytically informed estimate in absolute numbers // European Journal of Psychotraumatology. 2019. Vol. 10. №1. P. 1-12. DOI: 10.1080/20008198.2019.1578637
- Kabat-Zinn J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: Random House Publishing Group, 2009.
- Kelly A., Garland E.L. Trauma-Informed Mindfulness-Based Stress Reduction for Female Survivors of Interpersonal Violence: Results From a Stage I RCT // Journal of Clinical Psychology. 2016. Vol. 72. №4. P. 311–328. DOI: 10.1002/jclp.22273
- King A.P., Erickson T.M., Giardino N.D., et al. A Pilot Study Of Group Mindfulness-Based Cognitive Therapy (MBCT) For Combat Veterans With Posttraumatic Stress Disorder (PTSD) // Depression and Anxiety. 2013. Vol. 30. P. 638-645. DOI: 10.1002/da.22104
- Li W.W., Nannestad J., Leow T., Heward C. The effectiveness of mindfulness-based stress reduction (MBSR) on depression, PTSD, and mindfulness among military veterans: A systematic review and meta-analysis // Health Psychology Open. 2024. Vol. 11. P. 1-17. DOI: 10.1177/20551029241302969
- Polusny M.A., Erbes C.R., Thuras P., et al. Mindfulness-based stress reduction for posttraumatic stress disorder among veterans: a randomized clinical trial // JAMA. 2015. Vol. 314. №5. P. 456-465. DOI: 10.1001/jama.2015.8361
- Possemato K., Bergen-Cico D., Treatman S., et al. A randomized clinical trial of primary care brief mindfulness training for veterans with PTSD // Journal of Clinical Psychology. 2016. Vol. 72. №3. P. 179-193. DOI: 10.1002/jclp.22241
- World Health Organization. Post-traumatic stress disorder // WHO. Fact Sheets. 2022. URL: https://www.who.int/news-room/fact-sheets/detail/post-traumatic-stress-disorder (дата обращения: 11.06.2025).
Литература
Adams S.W., Bowler R.M., Russell K., et al. PTSD and comorbid depression: Social support and self-efficacy in World Trade Center tower survivors 14-15 years after 9/11 // Psychological Trauma. 2019. Vol. 11. №2. P. 156–164. DOI: 10.1037/tra0000404
Boyd J.E., Lanius R.A., McKinnon M.C. Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence // Journal of Psychiatry & Neuroscience. 2018. Vol. 43. №1. P. 7–25. DOI: 10.1503/jpn.170021
Bremner J.D., Mishra S., Campanella C., et al. A Pilot Study of the Effects of Mindfulness-Based Stress Reduction on Post-traumatic Stress Disorder Symptoms and Brain Response to Traumatic Reminders of Combat in Operation Enduring Freedom/Operation Iraqi Freedom Combat Veterans with Post-traumatic Stress Disorder // Frontiers in Psychiatry. 2017. Vol. 8. Art. 157. DOI: 10.3389/fpsyt.2017.00157
Bryant R.A. Post-traumatic stress disorder: a state-of-the-art review of evidence and challenges // World Psychiatry. 2019. Vol. 18. №3. P. 259–269. DOI: 10.1002/wps.20656
Davis L.L., Whetsell C., Hamner M.B., et al. A Multisite Randomized Controlled Trial of Mindfulness-Based Stress Reduction in the Treatment of Posttraumatic Stress Disorder // Psychiatric Research and Clinical Practice. 2019. Vol. 1. №2. P. 39-48. DOI: 10.1176/appi.prcp.20180002
Herman J.L. Trauma and Recovery: The Aftermath of Violence – from Domestic Abuse to Political Terror. New York: Basic Books, 1997.
Hoppen T.H., Morina N. The prevalence of PTSD and major depression in the global population of adult war survivors: a meta-analytically informed estimate in absolute numbers // European Journal of Psychotraumatology. 2019. Vol. 10. №1. P. 1-12. DOI: 10.1080/20008198.2019.1578637
Kabat-Zinn J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: Random House Publishing Group, 2009.
Kelly A., Garland E.L. Trauma-Informed Mindfulness-Based Stress Reduction for Female Survivors of Interpersonal Violence: Results From a Stage I RCT // Journal of Clinical Psychology. 2016. Vol. 72. №4. P. 311–328. DOI: 10.1002/jclp.22273
King A.P., Erickson T.M., Giardino N.D., et al. A Pilot Study Of Group Mindfulness-Based Cognitive Therapy (MBCT) For Combat Veterans With Posttraumatic Stress Disorder (PTSD) // Depression and Anxiety. 2013. Vol. 30. P. 638-645. DOI: 10.1002/da.22104
Li W.W., Nannestad J., Leow T., Heward C. The effectiveness of mindfulness-based stress reduction (MBSR) on depression, PTSD, and mindfulness among military veterans: A systematic review and meta-analysis // Health Psychology Open. 2024. Vol. 11. P. 1-17. DOI: 10.1177/20551029241302969
Polusny M.A., Erbes C.R., Thuras P., et al. Mindfulness-based stress reduction for posttraumatic stress disorder among veterans: a randomized clinical trial // JAMA. 2015. Vol. 314. №5. P. 456-465. DOI: 10.1001/jama.2015.8361
Possemato K., Bergen-Cico D., Treatman S., et al. A randomized clinical trial of primary care brief mindfulness training for veterans with PTSD // Journal of Clinical Psychology. 2016. Vol. 72. №3. P. 179-193. DOI: 10.1002/jclp.22241
World Health Organization. Post-traumatic stress disorder // WHO. Fact Sheets. 2022. URL: https://www.who.int/news-room/fact-sheets/detail/post-traumatic-stress-disorder (дата обращения: 11.06.2025).