The impact of yoga on posttraumatic stress disorder symptom clusters: A systematic review and meta-analysis of randomized controlled trials.

Posttraumatic stress disorder (PTSD) is a disruptive, multifaceted disorder with an estimated lifetime prevalence of 8.3% in the U.S. population. Yoga has been shown to reduce PTSD symptoms overall, though little is known about its efficacy relative to specific PTSD symptom clusters. In this systematic review and meta-analysis, we examined the associations between yoga and symptom change in each DSM-5 PTSD symptom cluster. We hypothesized that yoga participation would be associated with significant reductions in each cluster, particularly alterations in arousal and reactivity/hyperarousal (AAR/H), relative to controls. We searched PubMed, PsycInfo, CINAHL, and SPORTDiscus for eligible studies published through October 2025. Studies that were yoga intervention randomized controlled trials, enrolled trauma survivors, and reported PTSD subscale scores were included. We computed standardized mean difference scores and used an NIH tool to assess risk of bias. In direct models (k = 9 studies), yoga led to small-medium reductions in intrusions, d = -0.31, p = .027, and total PTSD symptoms, d = -0.29, p = .030. When including age as a moderator, yoga also improved avoidance, d = -2.28, p = .003, and AAR/H symptoms, d = -1.92, p = .007. There was a substantial risk of bias across studies. Yoga showed the most robust effects for reducing intrusions and total PTSD symptoms, with efficacy in reducing avoidance and AAR/H symptoms when age was added as a moderator. Yoga's emphasis on mindfulness in the present moment may allow for attentional awareness that is protective against intrusions.