1. Acupuncture and Mindfulness-Based Stress Reduction among Female Child Abuse Survivors: A Randomized Waitlist-Controlled Pilot Study Catherine L. Dempsey PhD, MPH 1*, Margaret Chesney PhD 2, Lixing Lao MD, PhD,LAc 3-4, Trish Magyari, MS 4, Mary Bahr-Robertson 4, Patti Vegella MS., MA.1, Brian Berman MD 4, and Elizabeth Kimbrough PhD, MPH 4 ** 1 Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University, 2 Osher Center for Integrative Medicine, University of California San Francisco, 3 University of Hong Kong, School of Chinese Medicine, 4 Center for Integrative Medicine, Department of Family and Community Medicine, University of Maryland School of Medicine Acupuncture and Mindfulness and PTSD Symptomatology (Mixed Linear Regression Models) Population: Eighty-three (N = 83) adult survivors were randomized to either mindfulness- Based Stress Reduction (MBSR), acupuncture treatment (AT) or a Wait-List Control (WLC). Demographics: Mean Age: 45.8 years (range 21-72) Bachelor’s or graduate degree: 56% (N = 47) Married: 47% (N = 39) Employment: Full and part-time: 51% (N = 63%); homemaker 12% (N=10); disabled 17% (N = 14) White: 50% (N = 50); African American: 29% (N = 24) Household Income: < $20k 28% (N= 23%); $20-49k 24% (N= 20); $50-99k 33% (N=27) Treatment: MBSR. Mindfulness-based stress reduction (MBSR). MBSR therapy comprised eight, 2.5-hour classes for 8 weeks, plus a one-day retreat. MBSR includes guided meditation, gentle hatha yoga, progressive body relaxation, and mindful awareness skills (Kabat-Zinn, Massion, and Kristeller et al., 1995). Acupuncture. Participants received 2 treatments per week over 8 weeks for 35- 40 min ea. Acupuncture adhered to the national standard of the ’Clean Needle Technique’ safety procedure. Participants were treated with 10 body and 2 ear points: 7 major points on either the front or back of the body: Sishencong (4 points a set), Yintang, Du20, LI4, LR3, CV4, ST36 (front treatment) or Sishencong (4 points a set), Du20, GB20, SP6, BL15, BL18, BL23 (back treatment). (Berman, Lao, Langenberg, Lee, Gilpin, and Hochberg, 2004). Measures: Beck Depression Inventory (BDI). The 21-item BDI-II addresses affective, behavioral, biological, cognitive, and motivational symptoms of depression. PTSD Checklist (PCL). Self-report measure of PTSD symptoms which assesses frequency of occurrence on a 1- 5 scale of the 17 symptoms of PTSD. Pittsburgh Sleep Quality Inventory (PSQI). A 19 item self report inventory of sleep latency, duration, disturbance, quality and efficiency. The Mindfulness Attention Awareness Scale (MAAS). The MAAS measures mindfulness as receptive awareness and attention to the present moment. Analyses: The SAS PROC MIXED procedures for repeated measures was used to compute fixed effects (Little, Milliken, Stroup, Wolfinger & Schabenger, 2006). Results Analyses indicate a significant interaction of time and groups. MBSR and AT significantly improved mindfulness (F= 5.85; p=.00101). AT significantly improved PTSD symptoms (F= 3.37; p =0052) and Sleep Quality (F =3.74; p =0076). MBSR and AT significantly improved depressive symptoms (F= 2.78; p=.0165), but this effect was not sustained at 8 or 12 weeks. CONCLUSIONS and REFERENCES Adult survivors of childhood sexual abuse can suffer psychological consequences, including Post Traumatic Stress Disorder (PTSD), depression, and pain throughout their lifetime. The present study examined the efficacy of MBSR and Acupuncture (AT) compared to Wait-List Control (WLC) among female child abuse survivors to reduce psychological distress. METHODS BACKGROUND RESULTS Table 1: Predicted least square means of MAAS scores at four time points for three treatment groups Time Point Types of Treatment AcupunctureMBSR Wait List Control Baseline3.263.683.59 4 Weeks3.713.973.60 8 Weeks4.164.363.60 12 Weeks3.834.503.89 Table 3: Significance tests on differences in mean PTSD scores between three treatment groups at four times points Time Point Estimate of Difference Standard Error T ValueP Value Acupuncture versus MBSR Baseline 0.823.23 0.250.80 4 Weeks 1.453.74 0.390.70 8 Weeks -4.844.01-1.210.23 12 Weeks -2.543.91-0.650.52 Acupuncture versus Control Baseline 4.313.26 1.320.19 4 Weeks -4.133.64-1.140.26 8 Weeks -8.84**3.87-2.280.03 12 Weeks -6.98*3.78-1.850.07 MBSR versus Control Baseline 3.483.26 1.070.29 4 Weeks -5.583.73-1.500.14 8 Weeks -4.003.990.32 12 Weeks -4.443.89-1.140.26 *0.05 < P < 0.10; **0.01 < P < 0.05; *** P < 0.01 MBSR=Mindfulness Based Stress Reduction Study results provide evidence for the relief of PTSD symptoms with Acupuncture and warrant further investigation of Acupuncture and MBSR for PTSD symptoms. Particularly interesting is the effectiveness of Acupuncture for mindfulness, as well as PTSD symptoms and sleep quality. The results warrant further investigation of Acupuncture for mindfulness, and perhaps studies of the combination of these two approaches for this important patient population. Selected References: Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AM, Hochberg MC. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Ann Intern Med 2004;141(12):901-10. Kabat-Zinn J, Massion AO, Kristeller J, et al. Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry 1992;149(7):936-43 **Deceased. Dr. Kimbrough was the PI of this project and we dedicate our efforts in her memory. Funding: Mental Insight Foundation Table 2: Predicted least square means of PTSD scores at four time points for three treatment groups Time Point Types of Treatment AcupunctureMBSR Wait List Control Baseline 49.7548.9345.44 4 Weeks 41.3539.9045.48 8 Weeks 32.7937.6341.63 12 Weeks 35.0937.6442.07 * The opinions are that of the author's and not an official representation of the views of the DOD or USUHS