Assess the Effectiveness of Mindfulness Meditation (MM) Therapy in Women with Post-Traumatic Stress Disorder (PTSD) due to Childhood Sexual Abuse, and Comparison of Symptoms Reduction in both Women with PTSD who Utilize MM and those who do not Utilize MM in Georgia Open Access

Khan, Zehra (Spring 2021)

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Childhood sexual abuse (CSA) is a pervasive, persistent, and pernicious problem worldwide, with reported prevalence rates ranging from 3-8 percent in women and 3-17 percent in men (Steine et. al.,2019). In the United States, the ratio for those who experience sexual abuse at least once in their childhood is 1 in 4 within females and 1 in 13 within males (Center of Disease Control and Prevention 2019). In Georgia, there were 26,952 victims of child abuse or neglect in 2015, an increase of 21.6 percent from 2014 (Child Welfare League of America Annual report 2017). Of these children, 3.4 percent were sexually abused (U.S. Department of Health and Human Services 2016). Childhood sexual trauma can lead to several mental health issues later in women's lives, including post-traumatic stress disorder (PTSD), which causes negative effects on women’s quality of life. Due to PTSD’s complex psychopathology, significant co-morbidities, and functional impairments, treatment may require a combination of psychotherapies and pharmacotherapies.

Although these conventional PTSD treatments showed improvement in PTSD patients, they have a high percentage of treatment resistance, non-adherence, and drop-out. This is because of the chronic patterns of avoidance and an inability to tolerate the intense emotions often experienced with the conventional PTSD treatment approaches. For this reason, CAM practices, mindfulness meditation (MM) in particular, are gaining popularity among patients with PTSD because of its nature of treating PTSD symptoms without trauma recall and absence of side effects.

In recent years, mindfulness meditation interventions have received increased clinical and scholarly attention for the treatment of PTSD. However, the evidence of the efficacy of these modalities for PTSD is limited. There were limited studies done, mostly with veteran populations, to address the role of mindfulness meditation modalities for patients with PTSD. MM serves as an important gateway treatment that increases patient motivation, willingness, and ability to engage in additional full-length treatment. Despite the widespread popularity of mindfulness meditation modalities for the treatment of PTSD, the exact extent of MM efficacy and potency in symptoms reduction is not well evaluate. Recently, MM therapies are more attractive to patients because they use an alternative approach to healing and usually do not have reported side effects. To date, there has been little research performed in women who were sexually abused in their childhood with the utilization of MM intervention to treat their PTSD. Although all previous studies showed promising results, a randomized controlled comparative effectiveness trial is needed to assess the efficacy of MM intervention relative to conventional PTSD treatments in CSA women with documented PTSD.

Table of Contents

Chapter I: Introduction. 1

Problem Statement 2

Purpose Statement 2

Significant Statement 3

Definition of Terms. 4

Chapter II: Review of the Literature. 7

Review of the Literature. 7

Chapter III: Methodology. 21

Review of Funding Agencies. 21

Description of Grant Announcement 23

Review Criteria. 26

A.   Significance. 26

B.  Innovation. 28

B.   Approach. 30

Investigators. 39

Institutional Environment 42

Methodology of the Grant Review process. 44

Description of Grant Reviewer. 45

Chapter IV: Incorporation of Reviewer Comments. 51

Reviewer 1 comments. 51

Reviewer 2 comments. 57

Reviewer 4 comments. 62

Reviewer 5 comment 65

Chapter V: Final Version of Grant Proposal 68

Research Strategy. 71

Data Analysis. 87

Investigators. 89

Institutional Environment 93

Literature Cited. 96

Appendix. 118

Appendix A.. 118

Appendix B.. 124

Appendix C.. 125

Appendix D.. 127

Appendix E.. 145

Appendix F. 173

Appendix G.. 174

Appendix H.. 176

Appendix I. 180

Appendix J. 194

Appendix K.. 195

Appendix L  199

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