How-To Guides

Yes. In this randomized controlled trial, 16 of 31 participants in the yoga group (52%) no longer met PTSD diagnostic criteria at the final assessment, compared with 6 of 29 participants in the women's health education control group (21%) (n = 60, c7² = 6.17, P = .013). Both groups improved on clinician-rated PTSD symptoms, but the reduction was larger in the yoga group, with a large effect size on the CAPS (d = 1.07) versus a medium-to-large effect size in the control group (d = 0.66).

The intervention was a 10-week trauma-informed yoga program delivered as a 1-hour class once weekly. It incorporated the central elements of hatha yogabreathing, postures, and meditationand used simple, noninterpretive language, emphasized curiosity about bodily sensations, and encouraged choice and bodily control, such as modifying a posture, staying in it, or letting it go.

The study enrolled women aged 18 to 58 years with chronic, treatment-nonresponsive PTSD. PTSD had to be related to an index trauma that occurred at least 12 years before intake, and treatment unresponsiveness was defined as at least 3 years of prior therapy focused on PTSD.

Participants also had to be engaged in ongoing supportive therapy and continue any pharmacologic treatment they were already receiving. Exclusion criteria included unstable medical illness, pregnancy or breastfeeding, substance abuse or dependence in the prior 6 months, active suicide risk or life-threatening mutilation, 5 or more prior yoga sessions, and GAF score less than 40.

Yes. On the Davidson Trauma Scale, both groups improved from pretreatment to midtreatment, but only the yoga group maintained that improvement through the end of treatment. The yoga group showed a significant linear trend (d = -0.52), while the control group showed a significant quadratic trend (d = 0.46) and no significant linear trend (d = -0.29), indicating early improvement followed by relapse in the control group.

The group difference in trajectory was supported by a significant group d7 quadratic trend interaction (d = -0.34).

Both groups showed significant improvement in depressive symptoms, but the between-group difference was not statistically significant. On the Beck Depression Inventory-II, the yoga group had a medium effect size decrease (d = -0.60) and the control group had a small-to-medium effect size decrease (d = -0.39).

The authors noted that mood improvement in the control group did not translate into sustained PTSD improvement.

The study found some evidence that yoga may help affect regulation, but this was not as strong as the PTSD outcome findings. The yoga group showed a significant decrease on the tension reduction subscale of the Inventory of Altered Self-Capacities, with an effect size approaching medium (d = -0.44), whereas change in the control group did not approach statistical significance (d = 0.03).

The group d7 time interaction for this subscale approached statistical significance (P = .09; d = -0.31).

Yes. Dropout during the 10-week treatment phase was low, with 4 total dropouts among 64 randomized participants. There was no significant difference in dropout rates between groups: 1 participant in yoga (1.6%) and 3 participants in control (4.7%).

The study also found no significant baseline psychopathology differences between completers and dropouts.

The control condition was a 10-week women's health education class delivered for 1 hour weekly. It used an interactive, supportive format to improve knowledge and self-efficacy around health issues, including seeking medical care, discussing health concerns with clinicians, using body-related terminology, and performing self-care activities.

The control intervention did not include discussion of personal trauma or disclosure of abuse or trauma.

In this study, trauma-informed yoga functioned as an adjunctive treatment that significantly reduced PTSD symptomatology in women with chronic, treatment-resistant PTSD. The authors concluded that yoga may help traumatized individuals tolerate physical and sensory experiences associated with fear and helplessness and increase emotional awareness and affect tolerance.

The study does not establish yoga as a replacement for standard PTSD treatment, but it does support yoga as a widely available and relatively economical adjunct in the specific population studied.

The findings are limited by the study population and duration. The trial included only adult women with chronic, treatment-resistant PTSD related to interpersonal assault beginning in childhood, and participants were relatively well educated and all lived in the United States.

The study lasted only 10 weeks and had no formal follow-up. The authors also noted a baseline employment difference between groups and stated that the results need replication in younger, less educated, more acutely traumatized populations, in both genders, and in a wider range of cultural settings.