Adolescent health brief
Effects of the Youth Empowerment Seminar on Impulsive Behavior
Dara G. Ghahremani, Ph.D.a,*, Eugene Y. Oha, Andrew C. Dean, Ph.D.a, Kristina Mouzakisa,
Kristen D. Wilson, R.N.a, and Edythe D. London, Ph.D.a,b
aDepartment of Psychiatry and Biobehavioral Sciences, University of CaliforniaeLos Angeles, Los Angeles, California
bDepartment of Molecular and Medical Pharmacology, University of CaliforniaeLos Angeles, Los Angeles, California
Article history: Received August 23, 2012; Accepted February 8, 2013
Keywords: Adolescents; Impulsivity; Risk taking; Yoga; Sudarshan Kriya; Meditation; School health programs; Prevention programs;
Emotion regulation; Breathing
A B S T R A C T
interventions that attenuate impulsivity may offer protection. We evaluated effects of the Youth
management, emotion regulation, conflict resolution, and attentional focus, on impulsive behavior.
Methods: High school students (14e18 years of age) in the United States participated in YES!
during their physical education classes. Students in a control group attended their usual curric-
ulum and were tested in parallel. We used items from the Barratt Impulsiveness Scale (framed to
reflect recent behavior) to assess students’ behavior before and after they underwent the program.
Results: Compared with the control group, YES! participants reported less impulsive behavior after
Conclusions: The results suggest that YES! can promote mental health in adolescents, potentially
protecting them from harmful coping behaviors.
? 2013 Society for Adolescent Health and Medicine. All rights reserved.
The study indicates that
the YES! program show
reduced impulsive beha-
between impulsivity and
harmful coping behavior,
behavior detrimental to
Impulsivity, the tendency to act without thinking, is linked to
risky behaviors during adolescence [1e3] that can become
difficult to modify over time . Interventions that reduce
impulsive behavior may therefore have a significant impact in
deterring its negative consequences.
YES! is a workshop designed for 12- to 18-year-olds that aims
to promote emotional and physical wellbeing via psychosocial
education combined with yoga and meditation. Although no
empirical studies of YES! have been published, anecdotal reports
from school administrators suggest that it reduces externalizing
problem behaviors. We hypothesized that this effect may be
attributable to the program reducing impulsivity. To determine
the effect of YES! on impulsive behavior, we obtained structured
self-reports from high school students undergoing YES! and
a control group that attended their usual curriculum. We ex-
pected YES! participants to show reduced impulsive behavior.
The University of CaliforniaeLos Angeles Institutional Review
Board and the Los Angeles Unified School District Research and
Planning Division approved this study.
Participants were drawn from three Los Angelesearea high
schools between spring 2010 and fall 2011. In total, 788 students
(524 YES! and 264 controls) participated and submitted at least
* Address correspondence to: Dara G. Ghahremani, Ph.D., Department of
Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience
and Human Behavior, 760 Westwood Plaza #C8-528, UCLA, Los Angeles, CA
E-mail address: firstname.lastname@example.org (D.G. Ghahremani).
1054-139X/$ e see front matter ? 2013 Society for Adolescent Health and Medicine. All rights reserved.
Journal of Adolescent Health 53 (2013) 139e141
one of the questionnaire packets from the pre/post-YES! testing
sessions. Because of scheduling limitations, we were not able to
balance sample sizes across groups. Nevertheless, the final
sample sizes provided sufficient statistical power for group
YES! (www.youthempowermentseminar.org) is a life skills
workshop that the International Association for Human Values
has taught to over 35,000 students in the United States since
2004. It is composed of three modules: Healthy Body, Healthy
Mind, and Healthy Lifestyle. The Healthy Body module consists of
physical activity that includes yoga stretches, mindful eating
processes, and interactive discussions about food and nutrition.
The Healthy Mind module includes stress management and
relaxation techniques. Breathing exercises (e.g., Sudarshan Kriya
) and mindfulness techniques are used to calm the mind,
bringing awareness to the moment and enhancing concentra-
tion. Group processes promote personal responsibility, respect,
honesty, and service to others. In the Healthy Lifestyle module,
students learn strategies for handling challenging emotional and
social situations, especially peer pressure. Mindful decision
making and leadership skills are taught via interactive games.
Classes were either placed into YES! (about 1 hour per day) or
continued their standard curriculum (control group). Instruction
occurred over 4 weeks (about 20 hours). Both groups completed
questionnaires 1 week before and 1 week after the program.
Participants completed a 20-item version of the Barratt
measurement in adolescents. Ten questions from the BIS-11
regarding employment and financial security were removed
because they were not age appropriate. Questions were framed
to reflect behavior in the preceding week (e.g., “In the past week,
I have done things without thinking”).
responses (e.g., lack of variability in responses despite reverse-
coded questions) were excluded from analyses. To accommo-
date occasional missing data (maximum of two missing items),
we used mean scores instead of summed scores. Both mean total
score and three traditional BIS-11 subscales were examined.
All students completed a demographics questionnaire,
including information about age, sex, language, mother’s
education, and ethnicity (Table 1). We evaluated questions
regarding students’ primary language to determine exclusion
owing to potential lack of comprehension. Indications of
comprehension problems (e.g., “I don’t understand” or question
marks written in the margins) resulted in exclusion of student
responses. We assessed socioeconomic status with the Mac-
Arthur Scale of Subjective Social Status , assessing both their
own standing within the school community and their family’s
standing in the community, and by questions regarding living
situation and parents’ occupations and education.
, adaptedfor repeated
Demographics of participants in study
Sex 1.51 (1,445) .22
Male (n [%])
Female (n [%])
Mean age (mean [SD]) (years)
Age range (years)
Hispanic/Latino (n [%])
Mixed (n [%])
Asian-American (n [%])
African-American (n [%])
Native American (n [%])
Caucasian (n [%])
Other (n [%])
English (n [%])
Other (n [%])
<7th grade (n [%])
8th or 9th grade (n [%])
10th or 11th grade (n [%])
High school graduate or Graduate Equivalency Diploma (n [%])
Some college (n [%])
College education (n [%])
Graduate degree (n [%])
MacArthur subjective social status
Family standing, (mean [SD])
School standing (mean [SD])
Bedrooms per tenant
8.16 (6,270) .23
df ¼ degrees of freedom; SD ¼ standard deviation.
D.G. Ghahremani et al. / Journal of Adolescent Health 53 (2013) 139e141
Results Download full-text
We analyzed data from 327 YES! and 118 control participants
(Table 1). The groups did not differ significantly on demographic
variables (assessed using unpaired t-tests and chi-square tests
where appropriate) except for age, which was included as
a nuisance covariate in all models. Although data were not ob-
tained from control participants in one school, all reported
analyses remained significant when excluding data from that
Univariate analysis of variance showed that before imple-
menting YES!, students from the three schools did not differ
significantly on mean total impulsiveness (F[2, 442]¼ .26; p > .75),
nor did the groups differ at baseline (F[1, 443]¼ 1.14; p > .25).
Group ? Time interactions
Doubly repeated multivariate analysis of variance revealed
a significant Group ? Time interaction for mean total impul-
siveness in both an uncorrected model (F[1, 443]¼ 13.24; p < .001)
and a model correcting for age, sex, and school (F[1, 439]¼ 12.94;
p < .001). Paired t-tests comparing mean total impulsiveness
over time revealed a significant reduction for the YES! group and
no difference for controls (Table 2).
Tests of the three BIS subscales (doubly repeated multivariate
analysis of variance) indicated a significant Group ? Time
interaction (F[3, 300]¼ 3.07; p < .03) (correcting for age, sex, and
school). Post hoc univariate models testing each subscale
revealed significant Group ? Time interactions for the Motor (F[1,
302]¼ 4.96; p < .03) and Non-Planning (F[1, 443]¼ 4.78; p < .03)
subscales. Paired t-tests revealed a significant reduction in mean
scores for Non-Planning in the YES! group only (Table 2) and
indicated that the significant interaction for the Motor subscale
was driven by a marginally significant increase in the control
group. To investigate the possibility of unequal sample sizes
influencing the results, we examined random subsamples of the
YES! group that were equal to the size of the control group, and
found no change in results.
These results indicate divergence in impulsive behavior
between high school students who participate in the YES!
program and those who do not, especially concerning lack of
planning. Because impulsive behavior is often linked to adoles-
cent substance abuse, the intervention may help prevent such
risky behavior. Specifically, it may fulfill a need for bio-
psychosocial interventions that address behavioral antecedents
to substance abuse . The program may also help ameliorate
impulsivity-related externalizing behaviors, such as those linked
to attention deficitehyperactivity disorder.
Given the association between poor executive function and
impulsive behavior , further studies may determine whether
the program aids development of executive function, similar to
other interventions for youth , and may also evaluate its
long-term efficacy. Because YES! uses multiple approaches (e.g.,
group processes, yoga), future research may identify specific
aspects that most strongly target impulsivity and its subcom-
ponents. Moreover, subsequent studies may benefit from
examining other relevant factors, including depression, anxiety,
stress, mindfulness, and social connectedness. Because the
current study included adolescents of primarily Hispanic descent
from low- to middle-income communities, examination of more
diverse samples is warranted.
Overall, the findings suggest that programs such as YES!,
which combine psychosocial education and yoga-based prac-
tices, including breathing exercises and meditation, can reduce
impulsive behavior during adolescence, a period when impulsive
actions may have lifelong consequences.
Funding was provided by an endowment from the Thomas P.
and Katherine K. Pike Chair in Addiction Studies and a gift from
the Marjorie M. Greene Trust. Preliminary results from the
and Life Summer Research Institute, Garrison, NY, in July 2010.
 Nigg JT, Wong MM, Martel MM, et al. Poor response inhibition as
a predictor of problem drinking and illicit drug use in adolescents at risk
for alcoholism and other substance use disorders. J Am Acad Child Adolesc
 Tarter RE, Kirisci L, Mezzich A, et al. Neurobehavioral disinhibition in
childhood predicts early age at onset of substance use disorder. Am J
 Ivanov I, Schulz KP, London ED, et al. Inhibitory control deficits in child-
hood and risk for substance use disorders: A review. Am J Drug Alcohol
 Irwin Jr CE, Burg SJ, Uhler Cart C. America’s adolescents: Where have we
been, where are we going? J Adolesc Health 2002;31(Suppl 6):91e121.
 Kjellgren A, Bood SA, Axelsson K, et al. Wellness through a comprehensive
yogic breathing programda controlled pilot trial. BMC Complement Altern
 Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt Impul-
siveness Scale. J Clin Psychol 1995;6:768e74.
 Goodman E, Adler NE, Kawachi I, et al. Adolescents’ perceptions of social
status: Development and evaluation of a new indicator. Pediatrics 2001;
 Schepis TS, Rao U. Smoking cessation for adolescents: A review of phar-
macological and psychosocial treatments. Curr Drug Abuse Rev 2008;1:
 Crews FT, Boettiger CA. Impulsivity, frontal lobes and risk for addiction.
Pharmacol Biochem Behav 2009;93:237e47.
 Diamond A, Lee K. Interventions shown to aid executive function devel-
opment in children 4 to 12 years old. Science 2011;333:959e64.
Barratt Impulsiveness Scale results: total and subscale means and standard
deviations, by group
Mean (Standard Deviation)
Mean (Standard Deviation)
Protected post hoc paired t-tests (i.e., comparing pre- and post-YES!) after
omnibus doubly repeated multivariate analysis of variance. Higher scores indi-
cate greater impulsiveness.
** p < .0005.
*** p < .11.
D.G. Ghahremani et al. / Journal of Adolescent Health 53 (2013) 139e141