ABSTRACT Mindfulness-based interventions (MBIs), with postures, breath, relaxation, and meditation, such as Mindfulness-based Stress Reduction (MBSR) and yoga, are complex interventions increasingly used for trauma-related psychiatric conditions. Prior reviews have adopted a disorder-specific focus. However, trauma is a risk factor for most psychiatric conditions. We adopted a transdiagnostic approach to evaluate the efficacy of MBIs for the consequences of trauma, agnostic to diagnosis. AMED, CINAHL, Central, Embase, Pubmed/Medline, PsycINFO, and Scopus were searched to 30 September 2018 for controlled and uncontrolled trials of mindfulness, yoga, tai chi, and qi gong in people specifically selected for trauma exposure. Of >12,000 results, 66 studies were included in the systematic review and 24 controlled studies were meta-analyzed. There was a significant, pooled effect of MBIs (g = 0.51, 95%CI 0.31 to 0.71, p < .001). Similar effects were observed for mindfulness (g = 0.45, 0.26 to 0.64, p < .001), yoga (g = 0.46, 0.26 to 0.66, p < .001), and integrative exercise (g = 0.94, 0.37 to 1.51, p = .001), with no difference between interventions. Outcome measure or trauma type did not influence the effectiveness, but interventions of 8 weeks or more were more effective than shorter interventions (Q = 8.39, df = 2, p = .02). Mindfulness-based interventions, adjunctive to treatment-as-usual of medication and/or psychotherapy, are effective in reducing trauma-related symptoms. Yoga and mindfulness have comparable effectiveness. Many psychiatric studies do not report trauma exposure, focusing on disorder-specific outcomes, but this review suggests a transdiagnostic approach could be adopted in the treatment of trauma sequelae with MBIs. More rigorous reporting of trauma exposure and MBI treatment protocols is recommended to enhance future research.

中文翻译：

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心理创伤的正念和瑜伽：系统评价和荟萃分析

摘要 基于正念的干预 (MBI)，包括姿势、呼吸、放松和冥想，如基于正念的减压 (MBSR) 和瑜伽，是越来越多地用于与创伤相关的精神疾病的复杂干预措施。先前的审查采用了针对特定疾病的重点。然而，创伤是大多数精神疾病的危险因素。我们采用跨诊断方法来评估 MBI 对创伤后果的疗效，与诊断无关。AMED、CINAHL、Central、Embase、Pubmed/Medline、PsycINFO 和 Scopus 被搜索到 2018 年 9 月 30 日，以在专门选择用于创伤暴露的人群中进行正念、瑜伽、太极和气功的受控和非受控试验。在超过 12,000 项结果中，66 项研究被纳入系统评价，24 项对照研究进行了荟萃分析。MBI 有显着的汇总效应（g = 0.51，95% CI 0.31 至 0.71，p < .001）。对于正念（g = 0.45、0.26 至 0.64，p < .001）、瑜伽（g = 0.46、0.26 至 0.66，p < .001）和综合运动（g = 0.94、0.37 至 1.51，p）也观察到了类似的效果= .001)，干预之间没有差异。结果测量或创伤类型不影响有效性，但 8 周或更长时间的干预比更短的干预更有效（Q = 8.39，df = 2，p = .02）。基于正念的干预，作为药物和/或心理治疗的常规治疗的辅助手段，可有效减少与创伤相关的症状。瑜伽和正念具有相当的效果。许多精神病学研究不报告创伤暴露，重点关注特定疾病的结果，但这篇综述表明可以采用跨诊断方法来治疗 MBI 的创伤后遗症。建议对创伤暴露和 MBI 治疗方案进行更严格的报告，以加强未来的研究。