Table 2.
Randomized Controlled Trials of Relaxation for Posttraumatic Stress Disorder
| Source | Population N = enrolled Age (% women) | Mind-Body Intervention(s) n (Frequency and Duration) | Comparison Intervention(s) n (Frequency and Duration) | PTSD Outcome Measures (Additional Measures) | Within Group Pre to Post Effect Sizes for Relaxation Condition |
|---|---|---|---|---|---|
| RELAXATION (7 ARTICLES) | |||||
| Carletto et al. (2016) | Patients with MS diagnosed with PTSD N = 50 Mean age = 40.1 (81% women) | Relaxation Therapy Randomized: n = 25 Completed: n = 22 (10 60-min sessions conducted over 12–15 weeks) | EMDR Randomized: n = 25 Completed: n = 20 (10 60-min sessions conducted over 12–15 weeks) | CAPS; IES-R; (SCID-IV; HADS; CMDI; FAMS; TAQ; FSS; EDSS) | Within Group: CAPS (= NR) IES-R (= NR) |
| Hinton et al. (2011) | Latino patients with treatment- resistant PTSD N = 24 Mean age = 49.5 (100% women) | Applied Muscle Relaxation Randomized: n = 12 Completed: n = 12 (14 weekly 60-min group sessions) | Culturally-Adapted Cognitive Behavioral Therapy Randomized: n = 12 Completed: n = 12 (14 weekly 60-min group sessions) | PCL-C (Emotion Regulation Scale; Nervios Scale; SCL-90-R) | Within Group: PCL-C (d = 0.80) |
| Markowitz et al. (2015) | Individuals with PTSD N = 110 Mean age = 40.10 (70% women) | Relaxation Therapy Randomized: n = 32 Completed: n = 21 (10 90-min group sessions over 14 weeks) | Prolonged Exposure Randomized: n = 38 Completed: n = 27 (10 90-min group sessions over 14 weeks) Interpersonal Psychotherapy Randomized: n = 40 Completed: n = 34 (14 weekly 50-min group sessions) | CAPS; PSS-SR (IIP; Q-LES-Q; SAS-SR; Self-initiated In Vivo Exposure Scale) | Within Group: CAPS (d = 1.32) PSS-SR (d = 0.71) |
| Marks et al. (1998) | Individuals with PTSD N = 87 Mean age = 38 (35.6% women) | Relaxation Randomized: n = 21 Completed: n = 20 (10 90-min sessions) | Prolonged Exposure Randomized: n = 23 Completed: n = 20 Cognitive Restructuring Randomized: n = 19 Completed: n = 18 (10 90-min individual sessions) Exposure + Cognitive Restructuring Randomized: n = 24 Completed: n = 19 (10 105-min sessions) | CAPS; IES; PSS (BDI; Fear Questionnaire; GHQ; STAI) | Within Group: CAPS (d = 0.60) IES (d = 0.08) PSS (NR) |
| Taylor et al. (2003) | Individuals with PTSD N = 60 Mean age = 37 (75% women) | Relaxation Training Randomized: n = 19 Completed: n = 15 (8 1 hr sessions) | Prolonged Exposure Randomized: n = 22 Completed: n = 15 EMDR Randomized: n = 19 Completed: n = 15 (All interventions: 8 1.5 hr sessions) | CAPS; PSS (SCID-IV; BDI; RTQ) | Within Group: CAPS (η2> 0.47) PSS (η2> 0.13) |
| Vaughan et al. (1994) | Individuals with PTSD N = 36 Mean age = 32 (63.9% women) | Applied Muscle Relaxation Randomized: n = 11 Completed: n = 11 (3–5 50 min sessions over 2–3 weeks) | Waitlist Control Group Randomized: n = 17 Completed: n = 17 EMD Randomized: n = 12 Completed: n = 12 Image Habituation Training Randomized: n = 13 Completed: n = 13 (Both interventions: 3–5 50 min sessions over 2–3 weeks) | IES; SI-PTSD (ADIS-R; STAI; BDI) | Within Group: SI-PTSD (NR) IES (NR) |
| Zucker et al. (2009) | Individuals in residential substance use treatment with PTSD symptoms N = 50 Age range = 18–60 (44.7% women) | Progressive Muscle Relaxation Randomized: n = NR Completed: n = 19 (At least 20-min daily for 4 weeks) | Respiratory Sinus Arrhythmia Biofeedback Randomized: n = NR Completed: n = 19 (At least 20-min daily for 4 weeks) | PCL-C; PTS-T scale from DAPS (BDI; ISI; SDNN; Substance Cravings Question) | Within Group: PCL-C (NR) PTS-T (NR) |
Note. All interventions contain individual treatment sessions unless otherwise noted.
Cohen’s d effect sizes: small = 0.1–0.3; moderate = 0.3–0.5; large = >0.5
Partial eta squared effect sizes: small = 0.01–0.06; moderate = 0.06–0.15; large = >0.15
Key: EMD (Eye Movement Desensitization); EMDR (Eye Movement Desensitization and Reprocessing); Multiple Sclerosis (MS); NR (Not Reported); NS (Not Significant); PTSD (Posttraumatic Stress Disorder); R (Relaxation/Relaxation Training)
Measures: ADIS-R (Anxiety Disorders Interview Schedule-Revised); BDI (Beck Depression Inventory); CAPS (Clinician Administered PTSD Scale); CMDI (Chicago Multiscale Depression Inventory); DAPS (Detailed Assessment of Posttraumatic States); EDSS (Expanded Disability Status Scale); FAMS (Functional Assessment of Quality of Life in Multiple Sclerosis); FSS (Fatigue Severity Scale); GHQ (General Health Questionnaire); HADS (Hospital Anxiety and Depression Scale); IES (Impact of Events Scale); IES-R (Impact of Events Scale-Revised); IIP (Inventory of Interpersonal Problems); ISI (Insomnia Severity Index); PCL-C (PTSD Checklist-Civilian); PSS (PTSD Symptoms Scale); PSS-SR (Posttraumatic Stress Scale-Self Report); PTS-T (Posttraumatic Stress-Total on the Detailed Assessment of Posttraumatic States); Q-LES-Q (Quality of Life Enjoyment and Satisfaction); RTQ (Reactions to Treatment Questionnaire); SAS-SR (Social Adjustment Scale-Self Report); SCID-IV (Structured Clinical Interview for DSM-IV); SCL (Symptom Checklist); SDNN (Standard Deviation of Normal-to Normal); SI-PTSD (PTSD Structured Interview); STAI (State-Trait Anxiety Inventory); TAQ (Trauma Antecedent Questionnaire)