| ObjectivesMeditation has become a hot topic worldwide in over half a century.Not only an increasing number of people practice meditation as a way of mind-body exercise to relieve stress and heal the mind,but also researchers from medicine and psychology have employed meditation as a novel psychological-behavioral intervention technique to manage diverse physical and mental diseases,as well as to improve health and well-being.Furthermore,meditation has been also used in military area and reported to have promising effects.However,related researches have mainly been reported by western scholars so far.There is a relative lack of research on the application of meditation in Chinese army,particularly research about the use of meditation as a treatment for military-related posttraumatic stress disorder(PTSD).Therefore,the current study focused on mindfulness meditation--a widely researched meditation,to explore its effectiveness and feasibility in the intervention for military-related PTSD symptoms among Chinese sailors,so as to provide empirical evidence for the application and promotion of mindfulness meditation in Chinese army.MethodsThe current study consisted of three parts,adopting the method of literature research,randomized controlled study and cross-sectional study,respectively.The literature research provided evidence for the effectiveness of mindfulness meditation on military-related PTSD from the point of evidence-based medicine by systematical review and meta-analysis.The randomized controlled study employed an 8-week mindfulness-based cognitive therapy(MBCT)program by setting up experimental and control group,to explore the influence of systematical MBCT training on military-related PTSD symptoms and related psychological conditions of Chinese navy officers and soldiers.The above psychological conditions were assessed at 0,5,8 and 12 weeks of the program.The cross-sectional study used a questionnaire survey to estimate the present status of military-related PTSD symptoms and related psychological conditions among Chinese navy officers and soldiers,to further explore the influencing factors for the intervention effect of mindfulness meditation on military-related PTSD symptoms.Results1.Nineteen eligible articles with 1,326 participants were included in the literature research.The results revealed that mindfulness meditation had a significantly greater effect on alleviating military-related PTSD symptoms compared with control conditions,yielding a significant effect size in a small to medium range(SMD =-0.33,95% CI [-0.45,-0.21],p< 0.0001).Interventions with different control conditions(active or non-active control),formats of delivery(group-based or individual-based)and intervention durations(short-term or standard duration)were equally effective in improving military-related PTSD symptoms.2.In the randomized controlled trial,after 8-week MBCT training,there were significant interaction effects between time and group on military-related PTSD symptoms(β =-3.173,SE = 0.818,p < 0.001),indicating that there were significant differences on military-related PTSD symptoms among the meditation and control group over time,and the meditation group had more significant improvements in military-related PTSD symptoms.Furthermore,All the four clusters of PTSD symptoms of meditation group improved more significantly.There were significant interaction effects between time and group on mindfulness(β = 3.902,SE = 0.995,p < 0.001),indicating that there were significant differences on mindfulness among the meditation and control group over time,and the meditation group had more significant increase in mindfulness.Further analysis revealed that MBCT training improved military-related PTSD symptoms mediated by increased mindfulness.Besides,there were significant interaction effects between time and group on general health(β =-0.534,SE = 0.250,p = 0.036),indicating that there were significant differences on general health among the meditation and control group over time,and the meditation group had more significant improvements in general health.As for sleep quality,the interaction effects between time and group were not significant(β =-0.183,SE = 0.281,p = 0.517),indicating that there was no significant difference on sleep quality among the meditation and control group over time.3.To explore the influencing factors of military-related PTSD symptoms,hierarchical regression analysis was conducted.The results revealed that gender(β = 0.114,p = 0.007),medication history of psychological and mental disorders(β = 0.238,p < 0.001),traumatic experience(β = 0.137,p = 0.001),whether or not having contact with meditation(β =0.102,p = 0.021),whether or not having interest in meditation(β = 0.114,p = 0.014),general health(β = 0.369,p < 0.001)and sleep quality(β = 0.248,p < 0.001)have statistically significant influence on military-related PTSD symptoms,while mindfulness(β =-0.092,p = 0.053)had marginally significant influence on military-related PTSD symptoms.The above factors accounted for 48.5% of the total variance(F = 54.234,p <0.01).4.To further explore the relationship between sleep quality,general health,mindfulness and military-related PTSD symptoms,a two-factor mediation model was performed.The results revealed that the total effect of mindfulness on military-related PTSD symptoms was significant(β =-0.315,Z =-4.701,Bias-corrected 95%CI [-0.436,-0.164],Percentile 95%CI [-0.437,-0.166]),the direct effect was marginally significant(β=-0.089,Z =-1.978,Bias-corrected 95%CI [-0.171,0.002],Percentile 95%CI [-0.169,0.003]),and the total indirect effect was significant(β =-0.226,Z =-4.520,Bias-corrected95%CI [-0.330,-0.134],Percentile 95%CI [-0.316,-0.134]).Furthermore,both sleep quality(β =-0.052,Z =-3.250,Bias-corrected 95%CI [-0.093,-0.026],Percentile 95%CI[-0.090,-0.023])and general health(β =-0.174,Z =-3.783,Bias-corrected 95%CI [-0.259,-0.090],Percentile 95%CI [-0.254,-0.087])significantly mediated the relationship between mindfulness and military-related PTSD symptoms.Conclusions1.The results of meta-analysis revealed that mindfulness meditation can significantly relieve military-related PTSD symptoms.2.Eight-week mindfulness meditation training can significantly improve military-related PTSD symptoms,mediated by increased mindfulness.3.Further research revealed that sleep quality and mindfulness mediated the relationship between mindfulness and military-related PTSD symptoms. |
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