colouring for test
anxiety in adolescents
McGill University, Canada
Nancy L. Heath
McGill University, Canada
The purpose of this study was to compare the effectiveness of a mindfulness art activity
(mandala) with a free draw/colouring activity on test anxiety in adolescents with an
examination of gender differences, and to assess the effect of dispositional mindfulness
on students’ experience of mindfulness and test anxiety states. Participants were 193
Grade 8 students (56.6% female; M
¼13.49 years, SD ¼0.50) randomly assigned to a
mandala (n¼97) or free draw/colouring condition (n¼96). Students completed stan-
dardized measures to assess test anxiety and state mindfulness pre- post-colouring
intervention, immediately prior to completing a test, in addition to a measure of dis-
positional mindfulness. Results showed a significant decrease in test anxiety and a sig-
nificant increase in state mindfulness following both activities; however, a gender by
group by time interaction was found such that females reported a greater decrease in
test anxiety in the free condition compared to males. Furthermore, the baseline meas-
ures (pre-intervention state mindfulness and test anxiety) were found to fully mediate
relations between dispositional mindfulness and the outcome measures (post-interven-
tion state mindfulness and test anxiety). Implications for educators and future research
and practice regarding the use of mindfulness activities in the classroom are discussed.
adolescents, art making, mandala, mindfulness, test anxiety
School Psychology International
!The Author(s) 2018
Reprints and permissions:
Dana Carsley, Department of Educational and Counselling Psychology, McGill University, 3700 McTavish
Street, Montreal, QC, H3A 1Y2, Canada.
Mindfulness-based programs have become increasingly popular school-based inter-
ventions for youth (Tan, 2016; Zenner, Herrnleben-Kurz, & Walach, 2015;
Zoogman, Goldberg, Hoyt, & Miller, 2014). Mindfulness involves the ability to
pay attention to the moment, on purpose, without judgement (Kabat-Zinn, 2003)
and can be regarded as a state or disposition; speciﬁcally, individuals can experi-
ence moments of mindfulness (state mindfulness) and/or maintain a general ability
to be mindful (dispositional mindfulness). Mindfulness-based interventions have
been incorporated in schools for anxiety reduction, and recently, studies have
examined the eﬀectiveness of mindfulness-based approaches to help elementary
(age 9- to 12-years-old) and secondary school students (age 13- to 15-years-old)
manage anxiety in test situations (e.g., Arjunan & Joseph, 2016; Carsley, Heath, &
Fajnerova, 2015; Napoli, Krech, & Holley, 2005). Despite these emerging studies,
there is limited research on the eﬀectiveness of feasible mindfulness-based
approaches for test anxiety in adolescence, when test anxiety is a growing problem
that needs to be addressed (von der Embse & Hasson, 2012).
Mindfulness-based art making has received attention in the literature and pop-
ular culture as a feasible activity for test anxiety, anxiety, and stress reduction
(Carsley et al., 2015; Carsley & Heath, 2018; Curry & Kasser, 2005). Colouring
structured mandalas (circles composed of small symmetrical shapes) has been
incorporated in schools, as colouring in these shapes is believed to encourage
focused attention and awareness of current experiences (Beckwith, 2014).
Recently, studies have examined the eﬀectiveness of structured mandala colouring
for test anxiety in children compared to free colouring (Carsley et al., 2015; Carsley
& Heath, 2018); however, results from these studies have shown that (1) it is
unclear whether the suggested mindfulness strategy of colouring mandalas is the
most beneﬁcial colouring technique for decreasing test anxiety, and (2) individual
diﬀerences may help explain students’ responses to this activity. The purpose of
this study is to examine the eﬀectiveness of mindfulness-based colouring for test
anxiety in adolescents, and individual factors that may explain students’ receptivity
to this activity.
Test anxiety, an individual’s response to test-taking, is a concern among
adolescents as testing requirements are increasing and students feel pressured to
succeed academically (Lowe, Grumbein, & Raad, 2011; Wren & Benson, 2004).
One-third of adolescents report experiences of test anxiety (Lowe & Lee, 2008;
Whitaker-Sena, Lowe, & Lee, 2007), which includes test anxiety states (immediate
concerns before a test) or individual traits (day-to-day concerns associated
with testing situations; Lowe & Lee, 2008). Adolescents report that their
greatest school-based worries and anxieties include test-taking and assessment
(Putwain, Chamberlain, Daly, & Sadreddini, 2014), and unlike other fears, test
anxiety increases with age as youth progress through school (McDonald, 2001;
Individuals reporting test anxiety may also experience other types of anxiety
disorders (King, Mietz, Tinney, & Ollendick, 1995; LeBeau et al., 2010), low
self-esteem (Pekrun, 2000), lower academic performance, grades, standardized
2School Psychology International
achievement scores (Eum & Rice, 2011; Everson, Millsap, & Rodriguez, 1991;
Segool, Carlson, Goforth, Von der Embse, & Barterian, 2013), challenges
with learning new material (Chapell et al., 2005), lack of motivation, negative
self-evaluation, struggles with concentration (Swanson & Howell, 1996), grade
retention (Hembree, 1988), and dropout (Chapell et al., 2005; Tobias, 1979).
Many test anxiety interventions for youth are time-consuming, (e.g., Bradley
et al., 2010; Gregor, 2005; Larson et al., 2010; Weems et al., 2009; Yahav &
Cohen, 2008), and continuous implementation of these programs poses a challenge
for educators due to existing curriculum demands. Given that adolescents report
tests as a critical source for worry throughout their school experience (Putwain
et al., 2014) and that there are many challenges associated with test anxiety, there is
a need for feasible and eﬀective test anxiety interventions.
Mindfulness has been shown to be a practical and feasible school-based inter-
vention for youth (Carsley, Khoury, & Heath, 2017). Originating from Eastern
perspectives, mindfulness consists of a comprehensive awareness and alertness on
the present moment (Bodhi, 2011; Dalai Lama & Berzin). Throughout the last 20
years, this construct has become prevalent in Western cultures as a way of focusing
attention and developing awareness of the moment (Miller, Fletcher, & Kabat-
Zinn, 1995). Speciﬁcally, mindfulness is considered to be a theoretical construct, a
practice, and a psychological state (Germer, 2005). In addition to the goal of being
mindful, mindfulness includes a practical element, in which individuals participate
in practices to experience focused attention and present-moment awareness
Mindfulness-based interventions have been incorporated in high schools
for general anxiety (Beauchemin, Hutchins, & Patterson, 2008; Burke, 2010;
Zenner et al., 2015), and test anxiety reduction (Arjunan & Joseph, 2016). In a
recent meta-analysis (Kallapiran, Kirubakaran, & Hancock, 2015), mindfulness-
based interventions were associated with reduced anxiety, among other mental
health concerns (e.g., depression, stress) in children and adolescents. Zoogman
and colleagues’ (2014) meta-analysis on mindfulness interventions for youth
demonstrated signiﬁcantly greater eﬀect sizes for mindfulness interventions target-
ing psychological symptoms compared to physiological and cognitive outcomes.
Mindfulness has been associated with a multitude of well-being beneﬁts for ado-
lescents (e.g., reduced anxiety, test anxiety, stress), and the Developmental
Contemplative Science (DCS; Roeser & Pinela, 2014) theory can help explain
how mindfulness functions in this population. DCS, part of the Social-
Emotional Learning (SEL) ﬁeld, focuses on the mechanisms by which individuals
use knowledge, attitudes, and skills for understanding and managing emotions, set
and accomplish positive goals, demonstrate empathy for others, create and sustain
positive relationships, and make sensible choices (CASEL, 2015). A focus of SEL,
DCS is concerned with understanding the mind-body system for use in a curricu-
lum of mental training in education (i.e., mindfulness) to enhance human develop-
ment within and across developmental periods (e.g., Frank, Jennings, &
Greenberg, 2013; Roeser, 2013; Roeser & Pinela, 2014; Roeser & Zelazo, 2012).
Carsley and Heath 3
Drawing on previous research, DCS proposes three core premises for the
mechanisms by which mindfulness functions. First, it has been suggested that
the brain adapts in response to experience, intentional training and/or education
(e.g., mindfulness activities); neuroplasticity leads to actual physiological changes.
Second, engaging in mindfulness activities will eventually lead to increases in mind-
fulness; secularized mindfulness training (i.e. skill acquisition and eventual devel-
opment of expertise) can signiﬁcantly alter day-to-day cognitive and emotional
processes. Finally, there are speciﬁc developmental periods in which particular
brain regions and networks are more likely to be modiﬁed, and developmental
stages (e.g., early adolescence) can predispose an individual to be open to training.
This theory suggests that response to mindfulness training diﬀers between devel-
opmental periods (Roeser & Pinela, 2014; Roeser & Zelazo, 2012) and adolescents
in early high school represent a developmental period in which mindfulness
activities can be particularly beneﬁcial.
Mindfulness-based activities have been incorporated in educational settings for
adolescents (Carsley et al., 2017); however, school demands limit the feasibility of
continuing to implement these programs within schools. Many existing mindful-
ness-based school programs require several sessions integrated into the school
schedule over multiple weeks (e.g., Britton, Lepp, Niles, Rocha, Fisher, & Gold,
2014; Johnson, Burke, Brinkman, & Wade, 2016). These programs include activ-
ities such as breath counting and awareness exercises, guided-mindfulness audio
ﬁles, body scans and sweeps, and can be incorporated in the classroom once a week
for 35–60 minutes over a number of weeks, or for shorter periods several times a
week. These programs have been found to be eﬀective in reducing anxiety in youth
(e.g., Bennet & Dorjee, 2016; Britton et al., 2014; Kallapiran et al., 2015; Zoogman
et al., 2014); however, the time commitment and participation from the teachers in
consistently implementing these activities in their classrooms poses a signiﬁcant
challenge as school-based programs requiring a lot of time are diﬃcult to imple-
ment and are not likely to be carried out over time (Bishop, Bryant, Giles, Hansen,
& Dusenbury, 2006; Fridrici & Lohaus, 2009). Research has found that single-
session 15-minute mindfulness meditations have been eﬀective in reducing negative
aﬀect (Arch & Craske, 2006; Hafenbrack, Kinias, & Barsade, 2014) and negativity
bias (Kiken & Shook, 2011); as such, it would be beneﬁcial to assess brief and
eﬀective mindfulness interventions for teachers to incorporate in their classrooms,
and that students could easily use to diminish anxiety resulting from test-taking.
Recently, there has been an increase in studies examining the eﬀectiveness of
brief mindfulness-based art activities for test anxiety and anxiety reduction in
elementary and college samples (Carsley et al., 2015; Carsley & Heath, 2018;
Curry & Kasser, 2005; Van der Vennet & Serice, 2012). Structured mandala colour-
ing is considered to be mindfulness-based as colouring in the detailed shapes is
believed to allow individuals to experience focused awareness of the present
moment, as they develop a mindfulness state (Beckwith, 2014; Carsley et al.,
2015; Curry & Kasser, 2005; Henderson, Rosen, & Mascaro, 2007). This interven-
tion has been shown to be eﬀective for reducing anxiety and test anxiety in
4School Psychology International
students, and feasible for implementation in schools, as unlike other mindfulness-
based programs, it requires limited resources, teacher demands, and training
(Carsley et al., 2015; Carsley & Heath, 2018; Curry & Kasser, 2005; Van der
Vennet & Serice, 2012). Colouring in the intricate shapes and patterns allows
students to experience a focused and aware state inherent to mindfulness, which
has also been found in other forms of meditation (Curry & Kasser, 2005).
The frontal lobes of the brain, which are essential for executive functions such as
planning and organizing, are potentially one of the last areas of the brain to
develop and may not even develop until later in life (Sowell, Thomson, Holmes,
Jernigan, & Toga, 1999); therefore, engaging in mandala colouring, which includes
a planned structured design, can help adolescents organize their experience as they
are provided with a sense of direction to guide their organization, unlike free
colouring. The lack of structure found in free colouring can be challenging and
stressful, and has been suggested to induce anxiety in students, as they feel required
to create their own structure (Curry & Kasser, 2005), particularly if their executive
functions are not fully developed. Although colouring mandalas has been found to
be eﬀective in reducing anxiety compared to unstructured colouring in university
students (Curry & Kasser, 2005; Van der Vennet & Serice, 2012), several studies
conducted with elementary school students have demonstrated that free colouring
can be as eﬀective as mandalas for decreasing test anxiety, as well as increasing
mindfulness states (Carsley et al., 2015; Carsley & Heath, 2018).
In Curry and Kasser’s (2005) and Van der Vennet & Serice’s (2012) studies,
university students participated in structured mandala, unstructured free, or struc-
tured plaid form colouring for 20 minutes following an anxiety induction. Anxiety
was assessed using the State-Trait Anxiety Inventory at baseline, pre-colouring,
and post-colouring activity. Participants in Curry and Kasser’s study (N¼84; 65%
female) demonstrated signiﬁcantly greater decreases in anxiety in the mandala and
structured plaid form groups compared to the free group. In Van der Vennet and
Serice’s replication study (N¼50; 82% female), students in the mandala condition
reported greater decreases in anxiety compared to the free condition; however,
participants in the free condition also demonstrated decreases in anxiety; as
such, further examination of these activities was required.
In the ﬁrst study examining the eﬀectiveness of structured mandala versus free
unstructured colouring for test anxiety in children, both activities were found to be
eﬀective in reducing test anxiety (Carsley et al., 2015). Participants were 52 students
in grades 4 to 6 (53.8% female), randomly assigned to one of two colouring
activities, which were completed before a spelling test. Although signiﬁcant overall
decreases in test anxiety for both groups were found, males reported signiﬁcantly
greater decreases in test anxiety in the free condition, compared to females
¼0.058). According to Carsley et al. (2015), these diﬀering responses could
possibly be due to inherent gender diﬀerences between males and females in
response to mindfulness activities. It is also possible that males’ ﬁne motor skill
development occurs later than females, which would explain their signiﬁcant
decreases in test anxiety following the free activity, unlike females. These ﬁndings
Carsley and Heath 5
may also suggest underlying individual diﬀerences in dispositional mindfulness,
which might inﬂuence students’ ability to respond mindfully to mindfulness-
To further examine the underlying factors contributing to this gender diﬀerence,
Carsley and Heath (2018) assessed the eﬀectiveness of these colouring activities
on test anxiety and state mindfulness with children in grades 4 to 6 (N¼152;
50% female), randomly assigned to a structured mandala or a free draw/colouring
group, matched for gender. Students completed the State-Trait Anxiety Inventory
for Children-State form and an adapted version of the Mindful Attention
Awareness Scale, state version, before and after colouring. Participants then com-
pleted a spelling test and the Child and Adolescent Mindfulness Measure to assess
dispositional mindfulness. Consistent with Carsley et al. (2015), results revealed
overall signiﬁcant decreases in test anxiety (Z
¼0.178), and signiﬁcant increases in
state mindfulness pre–post-intervention (Z
¼0.084) for both groups; however,
there were no gender diﬀerences.
In addition, Carsley and Heath (2018) found a signiﬁcant positive correlation
between dispositional mindfulness and pre-intervention state mindfulness;
however, there was a ceiling eﬀect such that children with higher dispositional
mindfulness also indicated high reports of state mindfulness pre-intervention,
demonstrating there was little room for them to improve in their mindfulness
post-intervention. Dispositional mindfulness has been shown to contribute to
psychological well-being outcomes from mindfulness interventions, including test
anxiety (Cunha & Paiva, 2012; Napoli et al., 2005), can develop over time, and is
associated with the experiencing of state mindfulness following an intervention
(Kiken, Garland, Bluth, Palsson, & Gaylord, 2015; Shapiro, Oman, Thoresen,
Plante, & Flinders, 2008). Carsley and Heath’s (2018) study revealed that indivi-
duals with higher dispositional mindfulness already report high state-mindfulness
pre-intervention and may not experience the mindfulness beneﬁts compared to
those with lower dispositional mindfulness. Although signiﬁcant increases in
mindfulness states were found following the colouring activities, this change was
found for participants who reported lower pre-intervention state mindfulness
and dispositional mindfulness; therefore, it appears as if dispositional mindfulness
is inﬂuencing pre-intervention state mindfulness, which in turn is determining
whether participants are able to report beneﬁts/changes post-intervention.
It would be important to examine the eﬀect of dispositional mindfulness on
adolescents’ post-intervention state mindfulness through their pre-intervention
reports, as well as the eﬀect of dispositional mindfulness on post-intervention
test anxiety through reports of pre-intervention test anxiety, to determine whether
this individual diﬀerence can impact students’ response to the intervention.
The results from the elementary studies provide additional information on the
eﬀectiveness of these art activities and preliminary explanations for the contribu-
tion of dispositional mindfulness for a mindfulness intervention. Given that (1)
adolescence is a period in which test anxiety is highly prevalent, (2) response to
mindfulness training may be particularly beneﬁcial for adolescents, (3) there is a
6School Psychology International
need for brief and feasible test anxiety and mindfulness-based interventions in high
schools, and (4) the role of dispositional mindfulness on participants’ response to
the intervention through their pre-intervention reports requires further examina-
tion, it is critical to examine the eﬀectiveness of these activities with adolescents, as
well as the individual diﬀerences (e.g., mindfulness dispositions, gender) that might
impact response to the activity.
Mindfulness-based art making for anxiety and/or test anxiety has been studied
in elementary and university populations; yet, there have been no studies con-
ducted that assess the eﬀectiveness of this activity in adolescence, a developmen-
tal period in which test anxiety is prevalent and mindfulness activities are
theorized to be particularly helpful. The previously conducted elementary studies
found that mandalas and free/draw colouring were associated with reductions in
test anxiety pre–post intervention (Carsley et al., 2015; Carsley & Heath, 2018);
however, the university studies revealed that mandala colouring is more beneﬁcial
than free colouring at this age (Curry & Kasser, 2005; Van der Vennet & Serice,
2012). Based on the DCS theory that early adolescence represents a developmen-
tal period in which students will experience mindfulness beneﬁts associated with a
mindfulness-based activity, and that the potential beneﬁts of mindfulness-based
art making for adolescents has yet to be investigated, the purpose of this
study was to address this gap and expand on the previously conducted studies
by examining the eﬀectiveness of a mindfulness-based art activity for test anxiety
in high school students. Given the diﬀerences in executive functioning
throughout development (Sowell et al., 1999), one might expect diﬀerential ﬁnd-
ings with mindfulness-based art compared to free colouring during adolescence.
This research will help advance the previously conducted research in this area
and elucidate possible developmental diﬀerential responses to this intervention
in adolescents. The ﬁrst objective is to compare the eﬀectiveness of a structured
mindfulness colouring (mandala) with a control free/draw colouring activity on
reducing test anxiety and increasing state mindfulness in adolescents prior to a
test, with an examination of possible gender diﬀerences. We hypothesize that
students in the mandala condition will report greater decreases in test anxiety
(H1) and greater increases in state mindfulness (H2) compared to participants in
the free condition. Based on the mixed gender ﬁndings in previous literature, the
absences of reported gender diﬀerences in adolescence, and because there is no
identiﬁable mechanism as to why such a diﬀerence might occur, no directional
hypotheses regarding gender are proposed. The second objective is to assess the
eﬀect of dispositional mindfulness on students’ mindfulness and test anxiety
states post-intervention. Drawing on the literature that showed a relation between
dispositional mindfulness and pre-intervention state mindfulness (Carsley &
Heath, 2018), and the likelihood that dispositional mindfulness inﬂuences pre-
intervention state mindfulness, which in turn is determining participants’ ability
to report beneﬁts post-intervention, we hypothesize that pre-intervention state
mindfulness would mediate relations between dispositional mindfulness and
post-intervention state mindfulness (H3), and that pre-intervention test anxiety
Carsley and Heath 7
would mediate the relation between dispositional mindfulness and post-interven-
tion test anxiety (H4).
Participants were 193 Grade 8 students (56.6% female; M
SD ¼0.50) from public co-ed elementary schools in Montreal, Quebec, Canada.
These particular schools have rigorous entrance requirements, thus this study
included a sample of high achieving students. Once university ethics, school
board and governing board approvals were obtained, an oral script describing
the study was read and consent forms were provided to the students to take
home to their parents. Students agreeing to participate returned the forms.
Of the 265 consent forms distributed, 195 approved consent forms were received
(74% consent); two students were not able to participate due to absence. The ﬁnal
sample included 193 participants. Random assignment revealed that the groups
did not diﬀer according to gender (mandala: n¼97; 54.6% female; free: n¼96;
State-Trait Anxiety Inventory–State Anxiety Scale. The State Anxiety Scale from the
State-Trait Anxiety Inventory (STAI) is a widely used self-report measure assessing
adolescents’, college students’, and adults’ current state of anxiety (Spielberger,
1989). The state scale contains 20 items for individuals to indicate how they feel
in a particular moment in time and takes 5–10 minutes to complete. Items include
statements such as ‘I am worried’ or ‘I feel upset’ and participants indicate their
response on a four-point scale (0 ¼not at all; 4 ¼very much so). This measure has
been shown to have high internal consistency (¼0.86–0.96) and test–retest
reliability ranging from 0.65 to 0.76 (Spielberger, Gorsuch, Lushene, Vagg, &
Jacobs, 1983). In the present study, Cronbach alphas ranged from 0.88 to 0.90
pre-post-intervention, with a test–retest correlation of 0.65.
Mindful Attention Awareness Scale, state version. The Mindful Attention Awareness
Scale, state version (state MAAS) measures current mindfulness states, and is
based on the original Mindful Attention Awareness Scale, which measures trait
mindfulness (Brown & Ryan, 2003). The state MAAS includes ﬁve items modiﬁed
from the original MAAS. The state MAAS contains items directed toward a pre-
vious state-mindfulness experience (e.g., ‘I was rushing through something without
being really attentive to it’). For this study, items were adapted to measure immedi-
ate mindfulness experiences pre–post-intervention (e.g., ‘Right now, I am rushing
through this without really paying attention to it’). Participants report how they
feel in a particular moment in time with a six-point scale (0 ¼not at all; 6 ¼very
8School Psychology International
much). Scores for this measure are reversed, such that lower scores demonstrate
lower state mindfulness. In the current study, Cronbach alphas ranged from 0.74 to
0.84 pre–post-intervention, with a test–retest correlation of 0.74.
Child and Adolescent Mindfulness Measure. The Child and Adolescent Mindfulness
Measure (CAMM) is a ten-item reverse-scored self-report measure of dispositional
mindfulness for children and adolescents (Greco, Baer, & Smith, 2011). Items on
this measure include present moment awareness (e.g., ‘I keep myself busy so I don’t
notice my thoughts or feelings’) and non-judgmental acceptance (e.g., ‘I stop
myself from having feelings that I don’t like’). Using a ﬁve-point scale (0 ¼never
true; 4 ¼always true), participants report how often an item is true for them. In the
present study, the CAMM was shown to have a Cronbach alpha of 0.84.
The researcher and assistants arrived at the schools and entered the students’
classrooms to conduct the study. Students were randomly assigned to an
intervention (mandala) or control (free) group. The researcher and assistants pro-
vided all students with blank envelopes that included the questionnaires and either
a structured mandala or blank sheet of paper for the colouring activities. The
papers in the envelopes were only visible and opened by students once the study
began to ensure the distribution procedure was completely random. Students were
informed that their parents would receive their spelling test results upon comple-
tion of the study. This method of eliciting test anxiety is an eﬀective method that
has been used in previous studies (Carsley et al., 2015; Carsley & Heath, 2018).
Students completed the STAI and the state MAAS. To ensure all instructions
and items were clear, the researcher read through each item on the measures, and
students were instructed to respond to each item truthfully. Following completion
of the pre-intervention measures, students were provided with coloured pencils and
the intervention group coloured in the same structured mandalas while the control
group was asked to free draw/colour on a blank sheet of paper for 15 minutes.
All participants then completed the STAI and state MAAS to evaluate
post-intervention test anxiety and state mindfulness. To ensure consistency in the
measures at the diﬀerent time points, the researcher read through the question-
naires with the students.
All students then completed the spelling section of the Wide Range Achievement
Test (WRAT-4) over a 15-minute period. To assess dispositional mindfulness,
students ﬁlled out the CAMM. Participants were then provided with a debrieﬁng
on the purpose of the study and the opportunity to ask questions. They received a
debrieﬁng sheet to take home to their parents, and a $10 gift card to a local coﬀee
shop. Once the data was entered, schools were given summarized group scores for
the spelling test and test anxiety questionnaires. Each student’s spelling and test
anxiety scores were summarized and given to their parents, as well as resources for
literacy and writing development, and anxiety management.
Carsley and Heath 9
Data were analysed with SPSS version 20. A total of ten missing values were found.
Examination of missing data revealed that all variables had less than 5% of missing
values. The Estimation Maximization (EM) procedure was conducted to impute
missing data so that the sample size was maintained within each group.
Nine univariate outliers were identiﬁed and transformed to values that were
1-unit lower or higher than the next lowest or higher value that was not an identi-
ﬁed outlier (Tabachnick & Fidell, 2007).
All relevant assumptions were checked and veriﬁed. As demonstrated in Table 1,
the mandala and free group were not signiﬁcantly diﬀerent according to gender,
age, and pre-intervention test anxiety and state mindfulness scores; therefore, these
variables were not controlled for in all further analyses.
To test the eﬀect of the colouring activities and gender on post-intervention test
anxiety and state mindfulness, two separate repeated measures ANOVAs were
conducted. Results for the repeated measures ANOVA for state mindfulness
showed a signiﬁcant main eﬀect for time, F(1, 189) ¼42.26, p<0.01, Wilk’s
¼0.817, partial Z
¼0.183; examination of the means revealed that state mind-
fulness scores increased pre- to post-intervention for all conditions, regardless of
gender (see Table 2). Results for the test anxiety analysis also showed a signiﬁcant
main eﬀect for time, F(1, 189) ¼91.88, p<0.01, Wilk’s ¼0.673, partial
¼0.327; however, signiﬁcant interactions were found between time and
gender, F(1, 189) ¼6.58, p¼0.011, Wilk’s ¼0.966, partial Z
time, colouring activity, and gender, F(1, 189) ¼8.81, p¼0.003, Wilk’s
¼0.955, partial Z
¼0.045. Students in the mandala condition reported signiﬁ-
cant decreases in test anxiety pre- post-intervention; however, females in the free
condition reported signiﬁcantly greater decreases in test anxiety compared to males
in the free condition (see Figure 1.1 and 1.2).
To assess the role of pre-intervention state mindfulness in the relation between
dispositional mindfulness and post-intervention state mindfulness, Preacher and
Hayes’ (2004) procedure was used to perform the mediation analysis. The eﬀect
of dispositional mindfulness on pre-intervention state mindfulness was signiﬁcantly
positive (path a; b¼0.060, p<0.001, CI[0.040, 0.081]); higher levels of disposi-
tional mindfulness were associated with higher levels of pre-intervention
Table 1. Demographic information and pre-intervention test anxiety and state mindfulness
scores across participant group.
Variable Mandala group Free group Significance test
Gender, % female 54.6% 58.3%
(1) ¼3.24, p¼0.072
Age, M(SD) 13.46 (.50) 13.52 (.50) t(191) ¼0.79, p¼0.68
Test anxiety (pre), M(SD) 37.04 (10.74) 37.34 (9.79) t(191) ¼0.20, p¼0.84
State mindfulness (pre), M(SD) 4.38 (1.18) 4.33 (1.09) t(191) ¼0.26, p¼0.80
10 School Psychology International
state mindfulness. Similarly, the eﬀect of pre-intervention state mindfulness on
post-intervention state mindfulness was signiﬁcantly positive (path b; b¼0.752,
p<0.001, CI[0.647, 0.858]). The total eﬀect of dispositional mindfulness on post-
intervention state mindfulness was signiﬁcant (path c; b¼0.046, p<0.001,
Test anxiety scores
Figure 1.2. Pre- to post-intervention test anxiety scores in the free condition.
Test anxiety scores
Figure 1.1. Pre- to post-intervention test anxiety scores in the mandala condition.
Table 2. Means (and Standard Deviations) for test anxiety and state mindfulness levels in the
mandala and free colouring groups.
Group NM(SD) M(SD) M(SD) M(SD)
Mandala 97 37.04 (10.74) 31.29 (8.68) 4.38 (1.18) 4.74 (1.19)
Free 96 37.34 (9.79) 31.81 (8.43) 4.33 (1.09) 4.75 (1.11)
Carsley and Heath 11
CI[0.024, 0.067]). When controlling for pre-intervention state mindfulness, the
direct eﬀect of dispositional mindfulness on post-intervention state mindfulness
was not signiﬁcant (path c’; b¼0.001, p¼0.955, CI[0.016, 0.017). Additionally,
the indirect eﬀect of dispositional mindfulness on post-intervention state mindful-
ness through pre-intervention state mindfulness was signiﬁcant (ab ¼0.045,
CI[0.027, 0.065). These results show that pre-intervention state mindfulness fully
mediates the relationship between dispositional mindfulness and post-intervention
state mindfulness (see Table 3 and Figure 2.1).
Preacher and Hayes’ (2004) procedure was also used to perform the mediation
analysis assessing the role of pre-intervention test anxiety in mediating the relation
between dispositional mindfulness and post-intervention test anxiety. The eﬀect of
dispositional mindfulness on pre-intervention test anxiety was signiﬁcantly negative
(path a; b¼0.710, p<0.001, CI[0.884, 0.536]); higher levels of dispositional
mindfulness were associated with lower levels of pre-intervention test anxiety. The
eﬀect of pre-intervention test anxiety on post-intervention test anxiety was signiﬁ-
cantly positive (path b; b¼0.508, p<0.001, CI[0.404, 0.612]). The total eﬀect of
dispositional mindfulness on post-intervention test anxiety was signiﬁcant (path c;
b¼0.459, p<0.001, CI[0.618, 0.305]). When controlling for pre-
intervention test anxiety, the direct eﬀect of dispositional mindfulness on
Table 3. Correlations between dispositional mindfulness, pre-intervention
state mindfulness, and post-intervention state mindfulness.
1. Dispositional mindfulness r1
2. Pre-intervention state mindfulness r0.39* 1
3. Post-intervention state mindfulness r0.29* 0.74* 1
DM Post SM
Figure 2.1. The mediating effect of pre-intervention state mindfulness in the association
between dispositional mindfulness and post-intervention state mindfulness.
12 School Psychology International
post-intervention test anxiety was not signiﬁcant (path c’; b¼0.098, p¼0.189,
CI[0.245, 0.049]). In addition, the indirect eﬀect of dispositional mindfulness on
post-intervention test anxiety through pre-intervention test anxiety was signiﬁcant
(ab ¼0.361, CI[0.487, 0.258]; therefore, there is evidence that pre-intervention
test anxiety fully mediates the relationship between dispositional mindfulness and
post-intervention test anxiety (see Table 4 and Figure 2.2).
The purpose of this study was to assess the eﬀectiveness of mindfulness-based art
for test anxiety in adolescents. Speciﬁc objectives were to evaluate the eﬀective-
ness of structured mandala colouring compared to free colouring for test anxiety
and state mindfulness in adolescents prior to a test, and to assess the role of
students’ pre-intervention mindfulness states and test anxiety in mediating rela-
tions between dispositional mindfulness and post-intervention state mindfulness
and test anxiety.
DM Post TA
Figure 2.2. The mediating effect of pre-intervention test anxiety in the association between
dispositional mindfulness and post-intervention test anxiety.
Notes: Standardized path coefficients are shown in parentheses. DM ¼dispositional mindfulness;
Pre SM ¼pre-intervention state mindfulness; Post SM ¼post-intervention state mindfulness; Pre
TA ¼pre-intervention test anxiety; Post TA ¼post-intervention test anxiety. N ¼193. *p <.001.
Table 4. Correlations between dispositional mindfulness, pre-intervention
test anxiety, and post-intervention test anxiety.
1. Dispositional mindfulness r1
2. Pre-intervention test anxiety r.50* 1
3. Post-intervention test anxiety r.39* .65* 1
Carsley and Heath 13
Consistent with the elementary studies (Carsley et al., 2015; Carsley & Heath,
2018), participants in both conditions revealed signiﬁcant decreases in test anxiety
pre–post-intervention, and signiﬁcant increases in state mindfulness. These results
demonstrate that both activities are equally eﬀective for test anxiety reduction and
further support ﬁndings from previously conducted elementary studies that both
activities can be considered as mindfulness-based art.
Although colouring structured mandalas has typically been deﬁned as mind-
fulness-based colouring activities for anxiety reduction and promoted as such
throughout popular culture, free draw/colouring may also be considered as mind-
fulness-based or include mindfulness components, as youth are reporting increases
in state mindfulness following completion of both activities. These ﬁndings are
important for educators looking to reduce test anxiety in their classrooms through
mindfulness-based approaches, as a variety of simple colouring activities can be
potentially beneﬁcial, and not solely the suggested mandala strategy.
Although both genders beneﬁtted in terms of test anxiety reduction from the
mandala condition, females in the free condition reported greater decreases in test
anxiety compared to males in the free condition. These ﬁndings diﬀer from the ﬁrst
elementary study (Carsley et al., 2015), which found that males experienced greater
test anxiety reduction in the free condition while females only beneﬁtted from the
mandala condition. A number of possible explanations might account for these
unexpected gender diﬀerences.
Throughout childhood, males experience slower development of ﬁne motor
skills compared to females, which may make colouring structured mandalas
more challenging for males than free colouring; thus, males beneﬁt more from
free colouring than the mandala (Hanlon, Thatcher, & Cline, 2000; Kail, &
Cavanaugh, 2015). During middle childhood, females’ ﬁne motor skills are gener-
ally more developed than males and they are likely able to colour in the mandala’s
small shapes with greater ease than males, making the mandala eﬀective for them at
this age. In adolescence, females may have reached a developmental period in
which they may no longer require the direction and intricacies of colouring in
structured mandalas to help them remain focused and aware; it is possible that
their more developed cognitive ability helps them create a mindfulness state from
free colouring. Furthermore, males are no longer lagging behind in ﬁne motor
development during adolescence; they have essentially ‘caught up’ to their female
counterparts and can experience the beneﬁts associated with mandala colouring as
well as free draw/colouring.
Anecdotally, the educators mentioned that mandala colouring clubs are held
after school, and students practice mindfulness through a variety of diﬀerent
approaches during the year. Given the increased promotion of colouring mandalas
in the media, it is possible that females may be more familiar with mandala colour-
ing and engage in repeated practice, and the lack of novelty of the mandalas are
resulting in the free colouring being more eﬀective. In line with the DCS theory,
participating in regular mindfulness activities can lead to skill acquisition and
eventual development of expertise in this developmental period (Roeser &
14 School Psychology International
Pinela, 2014; Roeser & Zelazo, 2012), and perhaps adolescent females are now able
to translate these skills from mindfulness activities to unstructured free
colouring. It would be important to assess students’ experiences with mandalas
to determine if this can impact their response to the intervention.
Another explanation––which builds on Carsley and Heath’s (2018) ﬁnding––
could be that personal preference might help determine who beneﬁts from the
activities. Although females demonstrated greater reductions in test anxiety follow-
ing free drawing/colouring compared to males, decreases in test anxiety were still
found for males in the free, as well as the mandala condition. These results suggest
that the deﬁnition of an anti-stress or anti-anxiety activity might depend on stu-
dents’ preference and/or drawing ability. Given the lack of theoretical basis for
these gender diﬀerences, and the mixed ﬁndings in previously conducted studies,
replication of this study is required to assess the generalizability of the ﬁndings.
This study’s second objective was to determine if pre-intervention state mind-
fulness mediates the relationship between participants’ dispositional mindfulness
and post-intervention state mindfulness, and whether pre-intervention test
anxiety mediates the relationship between participants’ dispositional mindfulness
and post-intervention test anxiety. The relation between dispositional mindfulness
and post-intervention outcomes were fully mediated by baseline measures,
such that dispositional mindfulness’ beneﬁts for post-intervention state mindful-
ness and test anxiety occurs through its eﬀect on pre-intervention state mindfulness
and test anxiety.
In Carsley and Heath’s (2018) study, participants with higher dispositional
mindfulness demonstrated the highest possible levels of pre-intervention state
mindfulness and were thus unable to report increases in state mindfulness post-
intervention. The present study’s ﬁndings suggest that dispositional mindfulness
aﬀects how participants respond to an intervention; if students report a general
tendency to be mindful day-to-day, they are already entering the intervention with
a certain baseline level of state mindfulness and associated lower test anxiety,
and these baseline reports are determining to some degree the extent of changes
in post-intervention state mindfulness or test anxiety.
If students with high dispositional mindfulness and high pre-intervention state
mindfulness or low pre-intervention test anxiety are not able to experience the ben-
eﬁts of the intervention, it is important to determine if there is a beneﬁt to including
mindfulness interventions for these students in educational settings. It would be
interesting to examine if there is a way to assess ‘deepening of’ or ‘enhancing’ mind-
fulness states, regardless of individual dispositions. As a result, students who already
maintain a general tendency to be mindful should in theory also be able to beneﬁt
from ongoing mindfulness interventions, although this requires further investigation.
The current ﬁndings are promising and provide directions for future research;
however, this study is not without limitations. First, given that both colouring
activities were associated with decreases in test anxiety and increases in state mind-
fulness, the free condition may not be functioning as a control group. Future
research would beneﬁt from including a third non-colouring condition, in which
Carsley and Heath 15
participants engage in an alternative activity to compare changes in test anxiety
and mindfulness to ensure the observed changes are not due to repeated measure-
ment eﬀects. Second, although participants were from public schools in the city, the
schools in this sample have rigorous entrance requirements, thus the students are
unusually high achieving relative to general school samples. Given this convenience
sample and the original cross-sectional design developed by the researchers, further
replication is required with a diverse group of students representing a variety of
backgrounds. Third, given the increase in popularity of mindfulness colouring,
some students’ previous exposure to mandalas may have impacted their response
to the activity; future research should include a question acknowledging students’
previous experience with this activity. Finally, as mentioned in Carsley and Heath
(2018), the ﬁeld struggles with how to measure mindfulness. To remain consistent
with the earlier work on pre-adolescent students, the state MAAS was employed as
a measure of state mindfulness; however, due to the ﬁnding that reports of pre-
intervention state mindfulness are explaining the relation between dispositional
mindfulness and post-intervention state mindfulness, it would be helpful to ﬁnd
methods to assess ‘enhancing’ or ‘deepening of’ mindfulness for participants who
maintain strong general mindfulness tendencies.
Despite these limitations, this research provides important information for edu-
cators and future research on mindfulness activities for test anxiety with adoles-
cents. Both colouring activities demonstrate reductions in test anxiety and increases
in mindfulness; therefore, it would be helpful for educators to implement these
activities before a test. Although structured mandala colouring has been receiving
attention in the media and throughout popular culture as a mindfulness-based
activity for anxiety reduction, females reported greater decreases in test anxiety
from free colouring. As such, it may not be necessary to focus on colouring in
mandalas to experience beneﬁts; adolescents, especially girls, may beneﬁt equally, if
not more, from free colouring, which is accessible and easy to implement. These
activities may also be useful for students and teachers to implement during situa-
tions in which arousal or anxiety may be heightened in the classroom. Speciﬁcally,
teachers could include mindfulness colouring as a class routine or calming moment
when required. Given the high level of acceptability of this activity relative to other
mindfulness practices, it can be easily tolerated in larger classrooms, in addition to
individual sessions with school psychologists.
This activity is also feasible in diﬀerent contexts where resources may be limited.
Unlike complex mindfulness interventions that require training, materials, and
greater time commitments, this research shows that simple mindfulness-based
activities can be eﬀective, accessible, and integrated into a variety of international
contexts. Implementation of this mindfulness-based colouring activity requires no
training, minimal resources and tools, and is feasible to implement beyond privi-
leged school environments.
Given that pre-intervention state mindfulness and test anxiety explained rela-
tions between dispositional mindfulness and post-intervention state mindfulness
and test anxiety, it is important for future studies to address how to enhance
16 School Psychology International
mindfulness for students with high dispositional mindfulness. If educators
include mindfulness-based activities in their classrooms through a universal
classroom-based approach, it is important to ensure all students are provided
with opportunities to experience the associated beneﬁts, regardless of individual
This study is the third study conducted in schools that demonstrates that free
colouring is an equally eﬀective mindfulness-based activity for test anxiety com-
pared to structured mandalas in youth. Given the diﬀerent ﬁndings in university
studies that mandalas are considered to be more eﬀective for anxiety compared to
free colouring, it would be helpful to re-examine the eﬀectiveness of these activities
in university students with an additional non-colouring control group to determine
if there is a diﬀerence between the three diﬀerent developmental periods.
Declaration of Conflicting Interests
The author(s) declared no potential conﬂicts of interest with respect to the research, author-
ship, and/or publication of this article.
All procedures performed in studies involving human participants were in accordance with
the ethical standards of the institutional and/or national research committee and with the
1964 Helsinki declaration and its later amendments or comparable ethical standards.
The author(s) received no ﬁnancial support for the research, authorship, and/or publication
of this article.
Informed consent was obtained from all individual participants included in the study.
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Dana Carsley, MEd, is currently a PhD candidate in Human Development at
McGill University in the Faculty of Education, Department of Educational and
Counselling Psychology. She is a also a Tomlinson Scholar and recipient of the
Joseph-Armand Bombardier Canada Graduate Doctoral Scholarship from the
Social Sciences and Humanities Research Council of Canada. Dana has worked
as a teacher and special needs tutor for students at all levels. Her research focuses
Carsley and Heath 21
on classroom interventions to promote mental health, speciﬁcally teacher-led mind-
fulness and stress management programs. Her commitment to enhancing student
well-being has resulted in 10 publications related to mental health in schools and
30+ presentations at academic and practitioner conferences and community out-
Nancy L. Heath, PhD, is a James McGill Professor in the Department of
Educational and Counselling Psychology at McGill University. Her research cen-
ters on understanding and enhancing intrapersonal resilience in youth and young
adults with a focus on factors related to emotion regulatory processes. She has
published and presented extensively in this area and more broadly on issues per-
taining to mental health in schools. Professor Heath conducts both basic and
applied research, always with a strong knowledge translation and service emphasis.
She has worked for over 25 years in partnership with schools to address mental
health concerns in the schools.
22 School Psychology International