Article

State of the Research: Physical and Mental Health Benefits of Mindfulness-Based Interventions for Children and Adolescents

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Abstract

Background: Research support for a variety of health benefits of mindfulness-based interventions for adults is robust. These include management of stress, anxiety, and depression; as a supportive treatment for eating disorders, PTSD, and psychosis; improved sleep; chronic pain management; support for tobacco, alcohol, and substance abstinence; and as adjunctive treatments for serious or chronic medical illnesses such as HIV, cancer, and heart conditions. As is typical with newer interventions, mindfulness intervention research that evaluates similar benefits for youth began later and is less advanced. This paper presents an in-depth, critical analysis of the state of the research on mental and physical health benefits of mindfulness-based interventions for children and adolescents. Method: Electronic databases and other resources were searched for the period from January 2000 to July 2018 to locate empirical studies of mindfulness-based interventions for children or adolescents that primarily assessed physical or mental health outcomes. Results: Data from 25 published studies and 5 meta-analyses or systematic reviews are presented, along with a critical evaluation of the strengths and limitations of these studies. Conclusion: Mindfulness research for youth has progressed considerably over the past decade. Nevertheless, the methodological limitations of many studies are significant. This, along with the heterogeneous nature of the studies, makes it difficult to arrive at any firm conclusions. However, the generally positive findings across many studies appear promising. Considered as a whole, current evidence suggests that mindfulness may be effective in improving the health and well-being of children and adolescents. Well-designed and carefully implemented studies will continue to advance our knowledge of mindfulness-based interventions for youth.

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... There are growing efforts to introduce mindfulness-based programs into schools, yet there is a paucity of research related to mindfulness training with children and youth due to a number of constraints, including important ethical considerations involved in working with young people, in obtaining accurate measurements and control data, and Canadian Journal of Education / Revue canadienne de l'éducation 45:2 (2022) www.cje-rce.ca in the sheer variety evident in the programs studied (Burke, 2009;Carsley et al., 2018;Greenberg & Harris, 2012;Semple & Burke, 2019;Zenner et al., 2014). Of the studies that have been carried out, overall findings are promising (Burke, 2009;Gouda et al., 2016;Semple & Burke, 2019), connecting mindfulness training programs for children and adolescents to improvements in anxiety and stress, in mood and overall well-being, in social skills, in attentional and executive functioning skills, and in emotional regulation (Beauchemin et al., 2008;Black et al., 2009;Broderick & Metz, 2009;Flook et al., 2010;Gouda et al., 2016;Napoli et al., 2005;Semple et al., 2005Semple et al., , 2010Schonert-Reichl & Lawlor, 2010;Zylowska et al., 2008). ...
... There are growing efforts to introduce mindfulness-based programs into schools, yet there is a paucity of research related to mindfulness training with children and youth due to a number of constraints, including important ethical considerations involved in working with young people, in obtaining accurate measurements and control data, and Canadian Journal of Education / Revue canadienne de l'éducation 45:2 (2022) www.cje-rce.ca in the sheer variety evident in the programs studied (Burke, 2009;Carsley et al., 2018;Greenberg & Harris, 2012;Semple & Burke, 2019;Zenner et al., 2014). Of the studies that have been carried out, overall findings are promising (Burke, 2009;Gouda et al., 2016;Semple & Burke, 2019), connecting mindfulness training programs for children and adolescents to improvements in anxiety and stress, in mood and overall well-being, in social skills, in attentional and executive functioning skills, and in emotional regulation (Beauchemin et al., 2008;Black et al., 2009;Broderick & Metz, 2009;Flook et al., 2010;Gouda et al., 2016;Napoli et al., 2005;Semple et al., 2005Semple et al., , 2010Schonert-Reichl & Lawlor, 2010;Zylowska et al., 2008). Broderick and Metz (2009) caution, however, that "the work of bringing mindfulness to children and adolescents in schools is just beginning" (p. ...
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The purpose of this ethnographically informed research study was to explore the integration of making and mindfulness pedagogies in a single curricular intervention (“MakerMinds”) and, in particular, how making engages students in mindfulness content and encourages their independent use of mindfulness tools. Mindfulness programs have long been used to promote mental health in clinical and non-clinical settings. Related research with school-aged children is limited, however, and the problem of how to fully engage them in mindfulness programming remains unsolved. Here, we report on the experiences of 24 Grade 4 students in MakerMinds over an eight-week period. Qualitative data from multiple sources revealed a program successful in engaging students and encouraging their application of mindfulness tools as needed in their daily lives. It also positively impacted conceptual and experiential knowledge of mindfulness and developed students’ agentic awareness of themselves as problem-solving makers and nascent mindfulness practitioners.
... Parallel to the progression of mindfulness-based models for adults, which began in the late 1970s, a surge of initiatives has emerged since the end of the 1990s relating to the potential benefits of mindfulness in educational settings. Some of these programs mirror the clinical MBSR and MBCT models, albeit with adaptations for children and youth (Felver, Doerner, Jones, Kaye, & Merrell, 2013;Semple & Burke, 2019). However, most of the schoolbased programs use a non-clinical orientation, designed to enhance children's wellbeing, social-emotional development, coping strategies, and resilience. ...
... Despite the heterogeneous nature of the mindfulness in education field, the positive findings across many studies, examining different models, in different countries, and with diverse age groups, appear promising. The evidence suggests that well-conducted programs appear to be welcomed by students and teachers, have positive impacts on the psychological, mental, and social health of the young, improve the wellbeing of children and adolescents, and reduce the overall burden of health spending by focusing on preventive interventions (Semple & Burke, 2019;Weare, 2019). Beyond that, the teachers' involvement with mindfulness can increase their sense of wellbeing and selfefficacy, contributing to a prosocial classroom and positive student outcomes . ...
Chapter
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The collective empirical and published data demonstrate that mindfulness in education can be framed and implemented in a variety of ways, applied towards various aims, deliver a multitude of potential outcomes, and support the betterment of both students and teachers. Embedded in these many approaches are assumptions about the goals of education, the role of mindfulness-based pedagogies in it, how mindfulness should be taught, who should deliver it, and how to evaluate outcomes. Mindfulness in education is in congruence with many principles and visions of positive psychology. This chapter presents an overview of mindfulness in education around the world and summarizes the knowledge accumulated from various perspectives and practices worldwide. The chapter centres mostly on the learners’ domain (school-age children, 6–18 years old), with reference to the role of educators. It describes the evolution of mindfulness in education and its role within a holistic and integrative future education paradigm. Relevant and conceivable relationship with positive education is discussed.
... In particular, the combination of positive psychology approaches and activities of both healing and redeeming content seemed to be effective and reinforce the literature that suggests that PPIs of purely positive content do not affect negative well-being indicators and that in order for the interventions to be effective, they should also deal with the "negative" (Kaplan et al., 2013). Thus, the present study contributed to the literature on the enhancement of the well-being of primary school students, which is incomplete (Semple & Burke, 2019). In more detail, the effectiveness of the intervention can be explained by the age of the participants, as a minimal body of literature points out that PPIs in children over eight years of age can lead to greater changes compared to adults due to the higher neuroplasticity of children's brain (Owens & Waters, 2020). ...
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The current study investigated the effectiveness of a 10-week group counseling positive psychological intervention (PPI) designed to enhance well-being of children whose parents are experiencing psychological economic hardship in primary schools in two areas of Greece. The sample consisted of 270 sixth graders (Mage = 11.07, S.D. = .26) allocated to experimental (n = 145) and control groups (n = 125). Self-report questionnaires were administered before and after the intervention, as well as two months later, measuring students’: demographic characteristics, negative life events, emotional and behavioral problems, affectivity, life satisfaction and psychological well-being. The results showed a statistically significant increase in the level of students’ well-being only in the experimental group. More specifically, the results showed significant decreases in emotional and behavioral problems, negative affect and significant increases in positive affect, life satisfaction and psychological well-being for the intervention group. Furthermore, the increased level was maintained during the follow-up measurement. The value of the findings for future research and practical implications are discussed.
... Therefore, just as much as mindfulness training (i.e., practice engaging the state of mindfulness) has been shown to increase the inherent capacity for mindfulness, what Brown et al. (2007) referred to as trait mindfulness, the use of smartphones in a cognitively and behaviorally involved way could decrease it, with young people particularly vulnerable to this effect. While the development of mindfulness remains understudied, trait mindfulness has been associated with important indicators of psychological well-being (Flett et al., 2020;Semple & Burke, 2019). In contrast, experiential avoidance, or the refusal to attend to or acknowledge a thought or emotion that arises Cardaciotto et. ...
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Objectives Previous research has shown the capacity for mindfulness to be strongly associated with psychological well-being, that components of mindfulness show significant growth through young adulthood, and that this developing, malleable capacity is vital as individuals learn to deal appropriately with negative thoughts and unwelcome emotions. Smartphones, typically used in an automatic or experientially avoidant way, can undermine this development, leading to a decreased capacity for mindfulness. The purpose of these studies were to examine the extent to which smartphone use is negatively associated with young adults’ mindfulness and the degree to which increased cognitive and behavioral involvement with smartphones may exacerbate this relation using a newly developed conceptual model. Method Study 1 was conducted using self-report measures of mindfulness among a cross-sectional sample of university students aged 18–20 years (n = 668). Study 2 augmented Study 1 using objective measures of smartphone screen time and the cognitive regulatory components of mindfulness in a planned missingness design. Results Results indicate smartphone involvement (a compulsive pattern of use and cognitive preoccupation with one’s smartphone) to be significantly associated with lower trait mindfulness. Additionally, exploratory analysis of smartphone involvement as a mediator of the effect of smartphone use on mindfulness demonstrated a significant estimated indirect effect. Conclusion These results provide preliminary empirical support for the newly proposed conceptual model which posits associations between mindfulness and the use of smartphones in a cognitively and behaviorally involved way. Preregistration This study is not preregistered.
... Kabat-Zinn menciona que existen dos elementos del Mindfulness: 1) la atención y 2) la conciencia, los cuales considera como como cualidades humanas, y que cuando estas son integradas a la vida diaria adquieren un papel muy importante; no obstante, para el fortalecimiento de estas dos habilidades se necesita de esfuerzo, disposición, paciencia y perseverancia (18); para lograrlo se requiere de ejercicio y práctica, con la finalidad de propiciar un cambio en la visión de sí mismo y del momento presente, del aquí y el ahora (19). Es a través del entrenamiento del Mindfulness que se puede contar con la capacidad de regulación psicológica, cuyos elementos fungen como moduladores de conductas con relación a la mejora de la salud mental (20). ...
Article
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Introducción: La adolescencia se caracteriza por una etapa de cambios que pueden implicar la aparición de conductas como el consumo de sustancias, las conductas sexuales de riesgo, la conducta suicida y la violencia, entre otras; es por ello que prácticas como el Mindfulness y la habilidad para percibir, comprender y regular emociones como la Inteligencia Emocional (IE) han mostrado efectos sobre dichas conductas. Objetivo: Analizar la evidencia científica disponible sobre el Mindfulness y la Inteligencia Emocional en los adolescentes. Material y métodos: Se realizó una revisión sistemática, para la estrategia de búsqueda se utilizaron descriptores en los idiomas inglés (Mindfulness, emotional intelligence, adolescent) y español (atención plena, inteligencia emocional, adolescente). Resultados: Se identificó que existe una relación y efecto positivo y significativo entre la práctica del Mindfulness y la Inteligencia Emocional. Conclusión: Los participantes con mayor nivel de atención plena son aquellos que tienen mejores capacidades de regulación emocional, de ser más conscientes de sus emociones, competentes para hacer frente a los problemas y tienen mejores relaciones interpersonales.
... There is a robust research literature (Baminiwatta & Solangaarachchi, 2021) showing the effectiveness of Mindfulness-Based Interventions (MBIs) for adults with a variety of challenges such as anxiety, depression, and stress (Goldberg et al., 2022). Research exploring the benefits of MBIs with young people can be characterized as emerging and growing considerably over the past decade, heterogeneous in nature, and encouraging regarding the improvement of well-being (Kostova et al., 2019;Semple & Burke, 2018). The goals of MBIs usually include becoming more aware of one's moment-tomoment stream of consciousness and to accept these experiences without judgment. ...
Article
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Research exploring the benefits of Mindfulness-Based Interventions (MBIs) with youth is emerging and promising for the improvement of resiliencies. We developed an arts-based mindfulness intervention to make learning mindfulness accessible for children who had experienced trauma. Arts-based methods are engaging, enjoyable, and developmentally relevant. Previously, we found benefits of participating in this MBI for children aged 8 to 12 years. Herein we discuss research in which we explored the benefits of this MBI for adolescents who were experiencing challenges with schooling; 146 youth completed the program. Our research question asked whether the MBI was beneficial and/or effective for these youth and, if so, what were these benefits and how did these benefits assist youth to cope? Benefits were explored via reflexive thematic analysis (TA) of pre/post-intervention, and follow-up individual interviews with youth. Effectiveness was assessed by analyzing pre- and post-intervention scores on youth self-report inventories measuring mindfulness and resilience, as well as responses from caregiver assessments of behavior/coping. To assess if there were changes in responses across timeperiods, a series of repeated measures ANOVA were employed. Quantitative findings were mixed in that the youths’ self-report scores measuring resilience showed limited improvement while mindfulness showed no significant change. However, parents’ perceptions regarding their child’s behaviors indicated significant improvements in social competence and both internalizing/externalizing behaviors. Similarly, the thematic analysis suggested improvements in youths’ self-awareness, self-judgment, thinking, mood, ability to make choices, social skills, coping, and emotion regulation. The results are promising and warrant further investigation of arts-based approaches to facilitating mindfulness with youth.
... 15 A research work comments that current evidence is in favor of mindfulness for improving the health and well-being of children and adolescents. 16 A meta-analysis reinforces the efficacy of using mindfulness-based interventions for improving the mental health and wellbeing of youth. 17 Mindfulness appears to influence the HRQoL of Indian children in this study, irrespective of the sociocultural difference with the West. ...
Article
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Background: COVID-19 pandemic is endangering the psychosocial health of Indian children and adolescent. The psychosocial morbidity can get manifested as psychiatric diseases if not addressed properly. This study aims to see the effects of an online Mindfulness-based intervention on the health-related quality of life (HRQoL) of apparently healthy but ‘vulnerable’ children in Indian community, during the COVID-19 pandemic. Methods: A randomized controlled trial with 43 children and one of their interactive parents as participants from the community. An online eight-week Mindfulness program was selected as the psychosocial intervention. 22 participants in group M attended the Mindfulness program (parents in group PM) while 21 participants in group C attended placebo sessions (parents in group PC). The quantitative measure was the HRQoL, measured by the KIDSCREEN10 questionnaire. Qualitative data was in form of a response to a question “Which aspect of the mindfulness program appealed to you the most from your child’s perspective?” The post-program parent responses were analyzed on basis of some emergent themes. The statistical analyses used were independent samples t-test, Chi-square test and one-way analysis of variance (ANOVA) for the outcome variables. Results: The KIDSCREEN10 score significantly improved (p value <0.0001) in the cases (group M and PM), compared to the control groups. ‘Calm’ and ‘focus’ were the prominent emergent themes, reported by the parents post-program. Conclusions: The online mindfulness-based intervention positively impacts the health-related quality of life of Indian children and adolescents during the COVID-19 pandemic. The results need to be substantiated by further studies.
... Scholars have been looking at the effectiveness of using a meditation app in reducing anxiety and improving well-being during the pandemic (e.g., [87]) demanding for more conclusive findings in this interesting study area. Mindfulness has also been recommended for children and adolescents for stress management and eating disorders [88]. It can be provided as supportive treatment to children and adolescents suffering from COVID-19 behavior disorders due to place confinement. ...
Article
Full-text available
The SARS-COV-2 virus has changed people’s lives and caused significant public health issues. The lockdown implemented by several governments across the globe has raised serious concerns on mental and physical wellbeing. Doctors, nurses and other COVID-19 frontline workers being put under extreme pressure to attend to patients’ health are being impacted by high stress levels which can result in burn-out and the inability to cope with the situation. This paper draws on multi-disciplinary research including complementary, traditional and integrative medicine, behavioral medicine, and social and environmental psychology to develop and propose a single integrative model of wellbeing encompassing dimensions of mental, physical and spiritual wellbeing in a pandemic context. The article discusses COVID-19 place confinement as a context to deliver body-mind medicine interventions in this challenging time. The aim is to provide the required support to promote behavior change for better public health outcomes. A range of cognitive behavioral therapies including psycho-social, psycho-educational, relaxation, meditation and nature therapies are discussed. Promoting alternative forms of traditional, complementary and integrative medicine in the local, global communities are discussed as preventive and sustainable measures to improve public health and wellbeing aligning with Global Health and the United Nations Sustainable Development Goals. This has important implications for people’s wellbeing and quality of life during and post the COVID-19 pandemic.
... 3). Many of these programs mirror the clinical MBSR and MBCT models, albeit with adaptations made for young people (Semple & Burke, 2019). Similar to MBSR and MBCT, the content of the courses includes breath awareness, present moment awareness, mindful movement, mindful eating, relaxation, and body awareness (Weare, 2012). ...
... Promoting the psychological well-being of children and adolescents is essential as it is related to physical health (Hernandez et al., 2018). Second, the focus has recently shifted toward children and adolescents in school settings, as well as universal prevention interventions (Semple & Burke, 2019). The school is the main activity setting for children and adolescents, and it is essential to evaluate the effect of MBIs on their stress, anxiety, and depression in this context. ...
Article
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Objectives Mindfulness-based interventions (MBIs) are being increasingly used toward improving mental health. Previous studies reached inconsistent conclusions regarding the effects of MBIs on the well-being and psychological distress of children and adolescents. Therefore, we conducted a meta-analysis summarizing the effects of MBIs on the well-being and psychological distress (i.e., anxiety, depression, and stress) of children and adolescents.Methods We searched electronic databases for reports on randomized controlled trials (RCTs) published until November 2020. Random effects models were used to calculate the overall effect size of each outcome variable for all participants. Subgroup and meta-regression analyses were conducted for categorical and continuous variables, respectively.ResultsA total of 28 RCT studies (48 independent samples), comprising 7943 participants, were included in the final synthesis. The MBIs had a small effect on anxiety (g = 0.39), depression (g = 0.28), and stress (g = 0.30), and no significant effect on well-being. Subgroup analyses showed intervention time, mindfulness type, control type, and intervention population to be significant moderators. However, meta-regression analyses indicated that effect sizes were not moderated by intervention duration or study quality.Conclusions Our results confirmed MBI to be an alternative intervention for reducing psychological distress among both children and adolescents. The development and application of a shorter MBI, adapted for adolescents, could be addressed in future studies.
... Mindfulness aims to teach skills to focus attention, non-judgementally, on moment-to-moment experiences and sensations, which can assist with defusion from unpleasant or painful feelings and thoughts. Regular mindful practice can also help teach skills of self-observation and distress tolerance (Semple & Burke, 2018). This research is, however, still in its infancy. ...
Article
Objective. Smartphone applications (‘apps’) have the potential to improve the scalability of mental health interventions for young people, however, the effectiveness of stand-alone apps in mental health management remains unclear. This systematic review, with meta-analysis, provides an up-to-date summary of the available high-quality evidence. Methods. Eleven randomized controlled trials, involving a pooled sample of 1706 adolescents and young adults (age range 10 to 35 years), were identified from the Cochrane Library, Embase, Google Scholar, PsycINFO and PubMed databases. The reporting quality of studies was evaluated using the Cochrane Risk of Bias Tool 2.0 (RoB 2.0). Hedges’ g effect sizes with 95% confidence intervals, p values and heterogeneity statistics were additionally calculated using a random effects model. Results. Study reporting quality was sound, with no trials characterized as ‘high’ risk. App interventions produced significant symptom improvement across multiple outcomes, compared to wait-list or attention control conditions (depression gw = 0.52 [CI: 0.18 -0.84], p = .01, k = 8; stress gw = 0.30 [CI: 0.06 to 0.53], p = .02, k = 2). Longer-term benefits could not be established (k = 4), although individual studies reported positive trends up to 6 months post. Age was not identified as a significant moderator. Conclusions. Smartphone apps hold promise as a stand-alone self-management tool in mental health service delivery. Further controlled trials with follow-up data are needed to confirm these findings as well as determine treatment engagement and effectiveness across diverse groups of participants.
... Scholars have been looking at the effectiveness of using a meditation app in reducing anxiety and improving well-being during the pandemic (e.g., [87]) demanding for more conclusive findings in this interesting study area. Mindfulness has also been recommended for children and adolescents for stress management and eating disorders [88]. It can be provided as supportive treatment to children and adolescents suffering from COVID-19 behavior disorders due to place confinement. ...
Article
Full-text available
The SARS-COV-2 virus has changed people’s lives and caused significant public health issues. The lockdown implemented by several governments across the globe has raised serious concerns on mental and physical wellbeing. Doctors, nurses and other COVID-19 frontline workers being put under extreme pressure to attend to patients’ health are being impacted by high stress levels which can result in burn-out and the inability to cope with the situation. This paper draws on multi-disciplinary research including complementary, traditional and integrative medicine, behavioral medicine, and social and environmental psychology to develop and propose a single integrative model of wellbeing encompassing dimensions of mental, physical and spiritual wellbeing in a pandemic context. The article discusses COVID-19 place confinement as a context to deliver body-mind medicine interventions in this challenging time. The aim is to provide the required support to promote behavior change for better public health outcomes. A range of cognitive behavioral therapies including psycho-social, psycho-educational, relaxation, meditation and nature therapies are discussed. Promoting alternative forms of traditional, complementary and integrative medicine in the local, global communities are discussed as preventive and sustainable measures to improve public health and wellbeing aligning with Global Health and the United Nations Sustainable Development Goals. This has important implications for people’s wellbeing and quality of life during and post the COVID-19 pandemic.
... The program teaches mindfulness techniques with the aim of enhancing selfmanagement of attention, intentional concentration, emotion self-regulation, and emotional resiliency . Although many studies have examined the feasibility of MBIs on internalizing and attention problems for children (see reviews and meta-analyses by Semple and Burke 2019;Zack et al. 2014;Zoogman et al. 2015), there is less research on the effectiveness of this approach for enhancing psychological well-being of children with serious medical illnesses. In addition, most studies have been conducted with outpatient, school, or community samples, and therefore have not considered the significant modifications that might be needed when treating hospitalized youth with comorbid medical conditions and mental health concerns. ...
Article
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Objectives Many youth diagnosed with cancer also suffer from anxiety, depression, posttraumatic distress, and attention problems, which can negatively affect their quality of life. Mindfulness-based Cognitive Therapy for Children (MBCT-C) aims to enhance self-management of attention, improve emotional self-regulation, and bolster social-emotional resiliency. A modified MBCT-C intervention was conducted with hospitalized pediatric cancer patients to evaluate its efficacy for reducing internalizing and attention problems. Methods Forty children (ages 11 to 13) diagnosed with cancer were randomly assigned to either a modified MBCT-C group (n = 20) or treatment as usual (TAU) control group (n = 20). To meet the needs of hospitalized participants, the manualized MBCT-C protocol was adapted to consist of 20 sessions, each lasting 45 min. Sessions were conducted 5 times weekly for 4 weeks. Primary outcome measures were the Child Behavior Checklist, Parent Report and its companion instrument, and the Youth Self-Report (YSR). Data were collected at pre-intervention, post-intervention, and at 2 months following the intervention. Results Repeated measures ANOVAs showed that, as compared with TAU controls, the MBCT-C group achieved significant reductions in internalizing and attention problems, and those gains were maintained at the 2-month follow-up. Reliable Change Index scores showed that the gains made by the MBCT-C group were both clinically significant and stable. Conclusions By reducing internalizing and attention problems, mindfulness-based interventions may improve the quality of life for children hospitalized with cancer. These promising results warrant further investigation into the efficacy of mindfulness-based interventions to remediate internalizing and attentional problems in youth diagnosed with serious medical illnesses.
... The main mechanism of mindfulness seems to be the self-control of attention. By focusing on a neutral stimulus, such as breathing, it creates a proper attention environment [18]. The concept of mindfulness is at the center of this therapy program, which means paying attention to a particular method, focusing on one goal in the present moment and without any judgment. ...
... Meditation for Children, Adolescents and College Students: Empirical meditation research with children and youth is less conducted compared to that in the adult population. Semple and Burke [23] presented their findings on the current state of research about the health benefits of MBI for this younger cohort. Promising evidence from 25 published studies and five systematic reviews/meta-analyses were found to support the effectiveness of mindfulness in improving the overall health and well-being of children and adolescents. ...
... With a curriculum that requires more facilitator experience to guide post meditative inquiry, issues regarding scalability of the intervention must be considered. However, the rapidly expanding dissemination in youth of current MBIs that "may be effective" (Semple & Burke, 2019) is also problematic. If we can find robust ways to universally and effectively embed strategies in young people addressing transdiagnostic risk, this remains a worthy pursuit that may justify extra training for core staff or external facilitators. ...
Article
Aim It is unclear how adult mindfulness‐based interventions (MBIs) should be modified for youth, and at what ages programmes should be implemented for optimal impact. Recent non‐replication with a 9‐week programme in early adolescence suggested abbreviated programme content might be insufficient and/or that this age group are less receptive. Method This controlled quasi‐experimental design tested a more intensive 8‐week MBI (longer meditation and session duration, plus inquiry) in Year 8 (Mage = 13.47; SD = 0.35) and Year 10 (Mage = 15.47; SD = 0.40) secondary students for feasibility and acceptability (N = 143, 45.9% female). Results Within this format students rated the content as agreeable, and school staff deemed content developmentally appropriate, across both age bands. Efficacy was tested in a small subsample (N = 90) to provide an estimate of effect size. Linear mixed modelling demonstrated significant between‐group differences in depression (Cohen's d = 0.61; 95% CI = 0.19 to 1.03) and anxiety (d = 0.52; 95% CI = 0.10 to 0.94) at 4‐month follow‐up, but not immediately post‐intervention. Conclusion An MBI more closely modelled on adult curricula was acceptable to students, although session duration was harder to timetable by schools. Promising effect sizes support further investigation in a larger sample.
... The program teaches mindfulness techniques with the aim of enhancing selfmanagement of attention, intentional concentration, emotion self-regulation, and emotional resiliency . Although many studies have examined the feasibility of MBIs on internalizing and attention problems for children (see reviews and meta-analyses by Semple and Burke 2019;Zack et al. 2014;Zoogman et al. 2015), there is less research on the effectiveness of this approach for enhancing psychological well-being of children with serious medical illnesses. In addition, most studies have been conducted with outpatient, school, or community samples, and therefore have not considered the significant modifications that might be needed when treating hospitalized youth with comorbid medical conditions and mental health concerns. ...
Article
Objectives Many youth diagnosed with cancer also suffer from anxiety, depression, posttraumatic distress, and attention problems, which can negatively affect their quality of life. Mindfulness-based Cognitive Therapy for Children (MBCT-C) aims to enhance self‐management of attention, improve emotional self‐regulation, and bolster social-emotional resiliency. A modified MBCT-C intervention was conducted with hospitalized pediatric cancer patients to evaluate its efficacy for reducing internalizing and attention problems. Methods Forty children (ages 11 to 13) diagnosed with cancer were randomly assigned to either a modified MBCT-C group (n = 20) or treatment as usual (TAU) control group (n = 20). To meet the needs of hospitalized participants, the manualized MBCT-C protocol was adapted to consist of 20 sessions, each lasting 45 minutes. Sessions were conducted 5 times weekly for 4 weeks. Primary outcome measures were the Child Behavior Checklist, Parent Report and its companion instrument, the Youth Self-Report (YSR). Data were collected at pre-intervention, post-intervention, and at 2 months following the intervention. Results Repeated measures ANOVAs showed that, as compared to TAU controls, the MBCT-C group achieved significant reductions in internalizing and attention problems, and those gains were maintained at the 2-month follow-up. Reliable Change Index scores showed that the gains made by the MBCT-C group were both clinically significant and stable. Conclusions By reducing internalizing and attention problems, mindfulness-based interventions may improve the quality of life for children hospitalized with cancer. These promising results warrant further investigation into the efficacy of mindfulness-based interventions to remediate internalizing and attentional problems in youth diagnosed with serious medical illnesses.
Article
Introduction Metaphors are commonly used linguistic devices that can encourage deep reflection and offer new insight. Metaphors have been used within the both the occupational therapy and mindfulness literature to describe complex phenomena. The aim of this phenomenological study was to identify, analyze, and interpret metaphors used by pediatric occupational therapists to describe mindfulness in their clinical practices with children and youth. Method Eight North American Occupational Therapists participated in semi-structured interviews which were transcribed verbatim. Transcripts were read to identify idiographic or naturally occurring metaphors used by participants. Metaphors of mindfulness were also elicited from participants as an interview question. Findings Three themes were identified within participants’ idiographic metaphors of mindfulness: mindfulness as a tool, mindfulness as exploration, and mindfulness as a support. Two additional themes were identified within participants’ idiographic metaphors of themselves as facilitators of mindfulness: therapist as a guide, and therapist as a gardener. Elicited metaphors generally aligned with the themes identified for idiographic metaphors while some offered additional unique insights. Conclusion The findings open conversations about therapists’ framing of the use of mindfulness within the context of pediatric occupational therapy.
Article
Purpose: While research into mindfulness practices is on the rise across populations, there is evidence to suggest that clinical practice has outpaced the literature with regard to mindfulness in pediatric rehabilitation. The aim of this study was to explore the perceptions of occupational therapists who opt to incorporate mindfulness into their clinical practices with children and youth. Methods: Hermeneutic phenomenology was the methodology of the study. The theoretical framework employed a Heideggerian-informed phenomenology of practice. Eight occupational therapists practicing in Canada and the United States participated in 90-120 min semi-structured interviews that elicited first-hand accounts of mindfulness in pediatric occupational therapy practice. Interviews were transcribed verbatim and analyzed using Finlay's four-step approach. Results: Six salient themes were identified in the data: drawing from personal practice, enhancing participation, fostering healthy habits, adapting for children, keeping it playful, and doing with. Conclusion: The findings of this study offer insights for therapists who are considering incorporating mindfulness into their practices with children and youth. Further, this research highlights a number of research priorities that require further inquiry.IMPLICATIONS FOR REHABILITATIONMindfulness is growing in popularity and may support occupational engagement in children and youth receiving rehabilitation services.Mindfulness practices may support rehabilitation providers in approaching their work with children and youth from a critical perspective.Further development of the child- and youth-centred mindfulness approaches may be warranted to enhance engagement and appropriateness for a range of ages and conditions.
Chapter
The integration of mindfulness-based interventions (MBIs) with traditional therapies is now found in a variety of clinical and institutional settings but is generally limited to adult populations. In the last decade, we have seen increasing research and application of MBIs with children. Mindfulness has been shown to improve the possibilities of prosocial behavior, positive relationships, and general well-being, as well as serving as a useful tool used in conventional with standardized therapies for physical and mental health challenges. Mindful interventions are a safe and useful approach to relieve suffering among youth dealing with life stress, illness, or externalized detriments to health.KeywordsMindfulnessMindfulness-Based InterventionAdolescents and Children
Article
Purpose To examine the effects of “ALL YOU NEED IS LOVE”, a novel six-week, self-directed patient education manual designed to improve chronic kidney disease knowledge/self-management, health care transition readiness, self-advocacy, and mindfulness skills among adolescents with chronic kidney disease. Design and methods We enrolled 49 adolescents aged 11–17 years (mean age 14.7 ± 1.9; 53.1% males) from a university hospital kidney center who had CKD stages 3 and greater, who were randomly assigned into the “ALL YOU NEED IS LOVE” patient education only group (n = 31) or the “ALL YOU NEED IS LOVE” patient education plus mindfulness training group (n = 18). Participants completed Qualtrics surveys at baseline, post-intervention, and three-month follow-up. The survey included measures of outcome variables (i.e., self-management/transition readiness, patient self-advocacy, and mindfulness), and an additional demographic questionnaire was included in the baseline survey. Multilevel model analyses were used to examine the effects of group and time on the outcome variables. Results Multilevel model analyses showed an overall significant time effect across all outcome variables in both groups. However, the group effects were not statistically significant across the outcome variables. Conclusions Both interventions significantly increased participants' self-management/HCT readiness, self-advocacy, and mindfulness over time. Mindfulness training may not bring additional benefits to the “ALL YOU NEED IS LOVE” education manual. Practice implications Pediatric nurses and clinicians may utilize the self-directed “ALL YOU NEED IS LOVE” manual to increase self-management/transition readiness, self-advocacy, and mindfulness among adolescents with chronic kidney disease.
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The prevalence of obesity among Chinese adolescents is rising rapidly, and theoretically informed, scalable weight management interventions are needed. We developed and evaluated the feasibility and preliminary effects of an mHealth nutrition education and mindful snacking intervention for weight loss and improved dietary practices among Chinese adolescents with overweight. We examined whether including implementation intention formation (using if–then plans) improved outcomes. With user consultation, we created a 3‐week mindful eating intervention delivered as 10 videos to user smartphones. Participants (n = 55) were randomly assigned to mindful eating or mindful eating + planning. Forty‐six (83.6%) participants (age = 16.35 ± 0.48 years; body mass index [BMI] = 25.79 ± 2.05 kg/m2) completed the intervention. Both groups exhibited significant pre‐ to post‐intervention weight loss (M = 1.42 and 1.79 kg, respectively); decreases in snacking frequencies, emotional eating, external eating, and trait craving; and significant increases in mindful eating and eating self‐efficacy. No significant intervention group differences were observed. User experience data (n = 16) indicated acceptability and meaningful behavior change. Findings suggest that a smartphone‐delivered mindfulness‐based intervention for Chinese adolescents living with overweight is feasible and efficacious.
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High mindfulness individuals have been found to perform better on motor tasks under various conditions, but it is unknown whether mindfulness and performance relate when performing under pressure or using different types of self-talk with different motor tasks. In this study, 46 male participants ( Mage = 21.4, SD = 1.72 years) with high mindfulness ( n = 23) and low mindfulness ( n = 23) performed dart-throwing and two-hand coordination tasks under pressure and non-pressure conditions and when using instructional and unrelated self-talk. First, on the two-hand coordination task, a three-way mixed ANOVA found: (a) a significant 3-way interaction in which a significantly poorer performance occurred under pressure (vs. without pressure), with low (vs. high) mindfulness and when using unrelated (vs. instructional) self-talk and (b) a significant interaction in which, both under pressure and not, both high and low mindfulness participants performed comparably when using instructional (vs. unrelated) self-talk. Second, on the dart-throwing task, mindfulness interacted with self-talk such that both high and low mindfulness participants performed better when using instructional self-talk, and pressure interacted with self-talk such that participants using instructional (vs. unrelated) self-talk performed better in both pressure and non-pressure conditions. We concluded that instructional self-talk was a useful cognitive strategy, perhaps particularly in pressure conditions and regardless of the degree of mindfulness, and its effectiveness extended to two different motor tasks. We discussed the theoretical implications of these findings, in terms of attention theory, self-talk, and motor control; and we highlighted our study’s limitations and practical applications and gave recommendations for future research.
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The presence of well-being is more important than the absence of illness. Well-being has usually been associated with the quality of life of a person. To achieve a good quality of life one needs to be healthy both physically and mentally. Today the term wellbeing can be extended to areas of emotional, physical, social, workplace, and societal well-being. Over the years the well-being of citizens has gained importance and each country has developed its laws to look after the wellbeing of the citizens. To have complete contentment the individual would seek to have a balance in all areas. Women's well-being has improved over decades but still has a long way to go. With increased workloads, stress, and other external factors the health and well-being of a woman are greatly compromised. For women, psychological wellbeing is as important an aspect as physical wellbeing and has been gaining a lot more attention over the last decade. Women due to family and external commitments have an innate nature of putting their well-being at the bottom of their priority list. Mindfulness is a technique used to become aware of thoughts, sensations, and emotions and understand that they are impermanent. This understanding is considered to be the key to relief from suffering. Women have benefited in a plethora of areas with Mindfulness-based interventions (MBI's). Educating women on the benefits of mindfulness and equipping them with necessary access to mindfulness training will result in better physical and mental health thus resulting in improvement in their overall well-being.
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The boundary between mindfulness and forest bathing, two conceptually related therapies, is un-clear. Accordingly, this study reports the strengths and challenges, similarities and differences, and barriers and facilitators for both. Semi-structured interviews were conducted with seven trained and experienced practitioners of both mindfulness and forest bathing. Reflexive thematic analysis revealed four main themes: (i) differences between approaches; (ii) forest bathing bene-fits; (iii) biophilia through forest bathing; and (iv) inward versus outward attentional focus as a distinction between the approaches. Both practices were found to benefit well-being, but practi-tioners revealed key barriers to mindfulness. For vulnerable groups experiencing mental health challenges or difficulties achieving a meditative state, mindfulness may introduce well-being risks. Forest bathing was found to overcome this barrier by offering a gentler, more intuitive ap-proach that encourages outward attentional focus. Including those with additional support needs, forest bathing is suitable for all groups, but adaptations are recommended for those expressing fear or discomfort in forested environments. The novel findings advance theoretical understand-ing from an applied perspective. They inform how to position both approaches in practice, as a first step towards policy recommendations. Wider implications concern forest bathing’s potential to impact environmental well-being. Future research must garner comparative data, involve young people, and explore the feasibility of a forest bathing social prescription.
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Students with specific learning disability (SLD) are at a greater risk for reading difficulties, academic stress, and deficits in self-efficacy. There are several research-supported interventions used in schools that are effective in increasing reading skills (e.g., reading fluency) but do not explicitly address academic stress or deficient self-efficacy. A possible solution may be the addition of mindfulness techniques, as they have been shown to support a wide range of related student outcomes. Incorporating mindfulness through an app-based delivery approach may be beneficial in this scenario as they are low cost, easily accessible, and a simple tool to help meet the unique social-emotional and academic needs of students with SLD. The current study examined the extent to which adding a brief, app-based mindfulness intervention to an already established evidence-based reading fluency intervention (paired reading) would improve reading fluency, academic stress, and self-efficacy for a student with an SLD in reading.
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Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common childhood disorders that can often continue through adolescence and adulthood. Different treatment methods have been used so far for treating this disorder. In recent years, mindfulness-based treatment approaches have attracted the attention of researchers. This research aims to investigate the effect of mindfulness-based treatment on the symptoms of ADHD and mindfulness score in adolescents suffering from ADHD. Materials and Methods: The present research is a clinical trial research with pretest-posttest design and control group (IRCT code: IRCT2016011826079N1). The study sample included 30 female first and second grade high school students in Gonabad suffering from ADHD. The tools used in the research included clinical interview, SNAP-IV Parent Rating Scale, and Mindful Attention Awareness Scale. The experimental group received eight 90-minute sessions of mindfulness-based treatments and the control group was assigned to a waiting list. The data was analyzed through descriptive statistics and univariate analysis of covariance by SPSS version 20 software. Results: According to our findings, the experimental group reported fewer symptoms of ADHD in posttest (P<0.001) compared to the control group. Moreover, the mindfulness of the experimental group improved in the posttest (P<0.001) compared to the control group. Conclusion: The results of the research show that mindfulness-based treatment improved the symptoms of ADHD and mindfulness in adolescents suffering from ADHD.
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Interest in applications of mindfulness-based approaches with adults has grown rapidly in recent times, and there is an expanding research base that suggests these are efficacious approaches to promoting psychological health and well-being. Interest has spread to applications of mindfulness-based approaches with children and adolescents, yet the research is still in its infancy. I aim to provide a preliminary review of the current research base of mindfulness-based approaches with children and adolescents, focusing on MBSR/MBCT models, which place the regular practice of mindfulness meditation at the core of the intervention. Overall, the current research base provides support for the feasibility of mindfulness-based interventions with children and adolescents, however there is no generalized empirical evidence of the efficacy of these interventions. For the field to advance, I suggest that research needs to shift away from feasibility studies towards large, well-designed studies with robust methodologies, and adopt standardized formats for interventions, allowing for replication and comparison studies, to develop a firm research evidence base. KeywordsMindfulness meditation-Children-Adolescents-Families-Schools
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Background: Mindfulness as a positive mental health intervention approach has been increasingly applied to address depression in young people. This systematic review and meta-analysis evaluated the effects of mindfulness-based stress reduction (MBSR) in the treatment of depression among adolescents and young adults. Methods: Electronic databases and references in articles were searched. Randomized controlled trials (RCTs) evaluating MBSR and reporting outcomes for depressive symptoms among young people aged 12 to 25 years were included. Data extraction and risk of bias assessment were conducted by two reviewers independently. Hedges’ g with a 95% confidence interval was calculated to represent intervention effect. Results: Eighteen RCTs featuring 2,042 participants were included in the meta-analysis. Relative to the control groups (e.g., no treatment, treatment as usual, or active control), MBSR had moderate effects in reducing depressive symptoms at the end of intervention (Hedges’ g = −0.45). No statistically significant effects were found in follow-up (Hedges’ g = −0.24) due to a lack of statistical power. Meta-regression found that the average treatment effect might be moderated by control condition, treatment duration, and participants’ baseline depression. Conclusion: MBSR had moderate effects in reducing depression in young people at posttest. Future research is needed to assess the follow-up effects of MBSR on depressive symptoms among adolescents and young adults.
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Several sessions of mindfulness practice can exert positive gains for child executive functions (EF); however, the evidence for effects of a mindfulness induction, on EF for adults, is mixed and this effect has not been tested in children. The immediate effect of an age appropriate 3-min mindfulness induction on EF of children aged 4–7 years was tested. Participants (N = 156) were randomly assigned to a mindfulness induction or dot-to-dot activity comparison group before completing four measures of EF. A composite score for EF was calculated from summed z scores of the four EF measures. A difference at baseline in behavioural difficulties between the mindfulness induction and comparison group meant that data was analysed using a hierarchical regression. The mindfulness induction resulted in higher average performance for the composite EF score (M = 0.12) compared to the comparison group (M = − 0.05). Behavioural difficulties significantly predicted 5.3% of the variance in EF performance but participation in the mindfulness or comparison induction did not significantly affect EF. The non-significant effect of a mindfulness induction to exert immediate effects on EF fits within broader evidence reporting mixed effects when similar experimental designs have been used with adults. The findings are discussed with consideration of the extent to which methodological differences may account for these mixed effects and how mindfulness inductions fit within broader theoretical and empirical understanding of the effects of mindfulness on EF.
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People with intellectual and developmental disabilities (IDD) face difficulties in making lifestyle changes because of lack of community and professional awareness and specialist services. Some services, such as for health wellness, are even more difficult for people with IDD to acquire if they live in remote areas or they cannot access specialist services in their community. Telehealth is beginning to be used to fill this service need. In this study, we assessed the effectiveness of providing telehealth training to parents on a mindfulness-based health wellness (MBHW) program that they then taught their children to implement. Thirty-two overweight or obese adolescents and young adults were taught a five-component MBHW program, and its effects on their body weight were assessed within a changing criterion design. The intervention included physical exercise, healthy eating and nutrition, mindful eating, mindful response to thoughts of hunger, and a mindfulness practice to control the urge to eat. The 30 participants who successfully completed the whole program had an average weight of 164.2 lb at baseline (pre-intervention), lost an average of 38.27 lb by the end of intervention, and maintained their target weight for four consecutive years at a mean weight of 127.37 lb. On average, they reduced their body mass index (BMI) from a mean of 29.54 at entry into the program to 22.80 by the end of intervention, and maintained their BMI at a mean of 23.03 during the 4-year follow-up. In addition, the participants’ social validity ratings showed great satisfaction with the program in meeting their desired weight goals, and they unanimously indicated that they would recommend the program to their peers. The data suggest that the MBHW program was effective with the participants and further evaluation using a randomized controlled trial appears warranted.
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Objective The purpose of the study was to assess the acceptability and feasibility of Mindfulness-Based Stress Reduction (MBSR), a group-delivered intervention, to reduce stress and improve illness management among urban, older adolescents, and young adults with poorly controlled type 1 diabetes (T1D). Method Ten older adolescents and young adults (9 females, 1 male) were recruited to participate in an MBSR group. Acceptability and feasibility were assessed based on recruitment and retention, treatment satisfaction, and changes in stress, diabetes management, and health status using a mixed-methods approach. Results Satisfaction with MBSR was high based on both quantitative and qualitative data. Preliminary evidence was found to suggest that MBSR reduced stress and improved blood glucose levels. Conclusions Findings from a small feasibility study suggest that MBSR could be delivered to urban older adolescents and young adults with T1D with high rates of satisfaction. Additional testing in adequately powered controlled clinical trials appears warranted.
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Chronic pain can lead to significant negative outcomes across many areas of life. Recently, mindfulness-based interventions (MBIs) have been identified as potentially effective tools for improved pain management among adolescents living with pain. This study aimed to explore the experience of adolescents who participated in an eight-week mindfulness group adapted for adolescents with chronic pain (MBI-A), and obtain their feedback and suggestions on group structure and content. A mixed method design was used employing qualitative data from focus groups and data from a satisfaction questionnaire. Focus group data were transcribed and analyzed using inductive simple descriptive content analysis. Of the total participants (n = 21), 90% (n = 19) provided feedback by completing satisfaction questionnaires and seventeen (n = 17) of those also participated across two focus groups. Analysis of the focus group transcripts uncovered six themes: mindfulness skills, supportive environment, group exercises (likes and dislikes), empowerment, program expectations, and logistics. Participants reported positive experiences in the MBI-A program, including support received from peers and mindfulness skills, including present moment awareness, pain acceptance, and emotion regulation. Group members suggested increasing the number of sessions and being clearer at outset regarding a focus on reduction of emotional suffering rather than physical pain.
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Despite widespread scientific and popular interest in mindfulness-based interventions, questions regarding the empirical status of these treatments remain. We sought to examine the efficacy of mindfulness-based interventions for clinical populations on disorder-specific symptoms. To address the question of relative efficacy, we coded the strength of the comparison group into five categories: no treatment, minimal treatment, non-specific active control, specific active control, and evidence-based treatment. A total of 142 non-overlapping samples and 12,005 participants were included. At post-treatment, mindfulness-based interventions were superior to no treatment (d=0.55), minimal treatment (d=0.37), non-specific active controls (d=0.35), and specific active controls (d=0.23). Mindfulness conditions did not differ from evidence-based treatments (d=-0.004). At follow-up, mindfulness-based interventions were superior to no treatment conditions (d=0.50), non-specific active controls (d=0.52), and specific active controls (d=0.29). Mindfulness conditions did not differ from minimal treatment conditions (d=0.38) and evidence-based treatments (d=0.09). Effects on specific disorder subgroups showed the most consistent evidence in support of mindfulness for depression, pain conditions, smoking, and addictive disorders. Results support the notion that mindfulness-based interventions hold promise as evidence-based treatments.
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Background Despite an exponential growth in research on mindfulness-based interventions, the body of scientific evidence supporting these treatments has been criticized for being of poor methodological quality. Objectives The current systematic review examined the extent to which mindfulness research demonstrated increased rigor over the past 16 years regarding six methodological features that have been highlighted as areas for improvement. These feature included using active control conditions, larger sample sizes, longer follow-up assessment, treatment fidelity assessment, and reporting of instructor training and intent-to-treat (ITT) analyses. Data sources We searched PubMed, PsychInfo, Scopus, and Web of Science in addition to a publically available repository of mindfulness studies. Study eligibility criteria Randomized clinical trials of mindfulness-based interventions for samples with a clinical disorder or elevated symptoms of a clinical disorder listed on the American Psychological Association’s list of disorders with recognized evidence-based treatment. Study appraisal and synthesis methods Independent raters screened 9,067 titles and abstracts, with 303 full text reviews. Of these, 171 were included, representing 142 non-overlapping samples. Results Across the 142 studies published between 2000 and 2016, there was no evidence for increases in any study quality indicator, although changes were generally in the direction of improved quality. When restricting the sample to those conducted in Europe and North America (continents with the longest history of scientific research in this area), an increase in reporting of ITT analyses was found. When excluding an early, high-quality study, improvements were seen in sample size, treatment fidelity assessment, and reporting of ITT analyses. Conclusions and implications of key findings Taken together, the findings suggest modest adoption of the recommendations for methodological improvement voiced repeatedly in the literature. Possible explanations for this and implications for interpreting this body of research and conducting future studies are discussed.
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HIV-infected youth experience many stressors, including stress related to their illness, which can negatively impact their mental and physical health. Therefore, there is a significant need to identify potentially effective interventions to improve stress management, coping, and self-regulation. The object of the study was to assess the effect of a mindfulness-based stress reduction (MBSR) program compared to an active control group on psychological symptoms and HIV disease management in youth utilizing a randomized controlled trial. Seventy-two HIV-infected adolescents, ages 14–22 (mean age 18.71 years), were enrolled from two urban clinics and randomized to MBSR or an active control. Data were collected on mindfulness, stress, self-regulation, psychological symptoms, medication adherence, and cognitive flexibility at baseline, post-program, and 3-month follow-up. CD4+ T lymphocyte and HIV viral load (HIV VL) counts were also pulled from medical records. HIV-infected youth in the MBSR group reported higher levels of mindfulness (P = .03), problem-solving coping (P = .03), and life satisfaction (P = .047), and lower aggression (P = .002) than those in the control group at the 3-month follow-up. At post-program, MBSR participants had higher cognitive accuracy when faced with negative emotion stimuli (P = .02). Also, those in the MBSR study arm were more likely to have or maintain reductions in HIV VL at 3-month follow-up than those in the control group (P = .04). In our sample, MBSR instruction proved beneficial for important psychological and HIV-disease outcomes, even when compared with an active control condition. Lower HIV VL levels suggest improved HIV disease control, possibly due to higher levels of HIV medication adherence, which is of great significance in both HIV treatment and prevention. Additional research is needed to explore further the role of MBSR for improving the psychological and physical health of HIV-positive youth.
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Mindfulness interventions have increasingly been incorporated in elementary and high school classrooms to support students’ mental health and well-being; however, there is little research examining the specific factors contributing to the effectiveness of the interventions. The purpose of this meta-analysis was to examine the specific effects of and moderators contributing to school-based mindfulness interventions for mental health in youth. A systematic review of studies published in PsycINFO, ERIC, Social Work Abstracts, Social Services Abstracts, and CINAHL was conducted. A total of 24 studies (n = 3977) were included in the meta-analysis. Overall, mindfulness interventions were found to be helpful, with small to moderate significant effects pre-post intervention compared to control groups (Hedges’ g = 0.24, p < .001); however, interventions that were delivered during late adolescence (15–18) and that consisted of combinations of various mindfulness activities had the largest effects on mental health and well-being outcomes. Furthermore, the effects on specific mindfulness and mental health outcomes differed according to whether the intervention was delivered by an outside facilitator compared to trained educators/teachers. These results suggest that individual differences and program characteristics can impact receptivity and effectiveness of mindfulness training. These findings represent a significant contribution as they can be used to inform future designs and applications of mindfulness interventions in the school setting.
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Adolescents with cardiac diagnoses face unique challenges that can cause psychosocial distress. This study compares a Mindfulness-Based Stress Reduction (MBSR) program to a video online support group for adolescents with cardiac diagnoses. MBSR is a structured psycho-educational program which includes yoga, meditation, cognitive restructuring, and group support. A published feasibility study by our group showed significant reduction in anxiety following this intervention. Participants were randomized to MBSR or video online support group, and completed measures of anxiety, depression, illness-related stress, and coping pre- and post-6-session interventions. Qualitative data were obtained from post-intervention interviews. A total of 46 teens participated (mean 14.8 years; 63% female). Participants had congenital heart disease and/or cardiac device (52%), or postural orthostatic tachycardia syndrome (48%). Illness-related stress significantly decreased in both groups. Greater use of coping skills predicted lower levels of depression in both groups post-study completion. Higher baseline anxiety/depression scores predicted improved anxiety/depression scores in both groups. Each group reported the benefits of social support. The MBSR group further expressed benefits of learning specific techniques, strategies, and skills that they applied in real-life situations to relieve distress. Both the MBSR intervention and video support group were effective in reducing distress in this sample. Qualitative data elucidated the added benefits of using MBSR techniques to manage stress and symptoms. The video group format is useful for teens that cannot meet in person but can benefit from group support. Psychosocial interventions with stress management techniques and/or group support can reduce distress in adolescents with cardiac diagnoses.
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Despite advances in psychological interventions for pediatric chronic pain, there has been little research examining mindfulness meditation for these conditions. This study presents data from a pilot clinical trial of a six-week manualized mindfulness meditation intervention offered to 20 adolescents aged 13–17 years. Measures of pain intensity, functional disability, depression and parent worry about their child’s pain were obtained at baseline and post-treatment. Results indicated no significant changes in pain or depression, however functional disability and frequency of pain functioning complaints improved with small effect sizes. Parents’ worry about child’s pain significantly decreased with a large effect size. Participants rated intervention components positively and most teens suggested that the number of sessions be increased. Three case examples illustrate mindfulness meditation effects and precautions. Mindfulness meditation shows promise as a feasible and acceptable intervention for youth with chronic pain. Future research should optimize intervention components and determine treatment efficacy.
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Interest in mindfulness-based interventions (MBIs) for youth continues to grow across academic, clinical, educational, and community settings. Conclusions regarding the effects of mindfulness training with youth are tempered by methodological issues. One common limitation is the availability of reliable and valid ways to measure mindfulness. This review identifies existing youth mindfulness measures, discusses key challenges to measurement, and offers suggestions for improving assessment research. A search of electronic databases, consultation with colleagues, and data from professional meetings yielded seven self-report measures: (a) Child and Adolescent Mindfulness Measure (CAMM); (b) Mindful Attention Awareness Scale for Adolescents (MAAS-A); (c) Mindful Attention Awareness Scale for Children (MAAS-C); (d) Comprehensive Inventory of Mindfulness Experiences-Adolescents (CHIME-A); (e) Mindful Thinking and Action Scale for Adolescents (MTASA); (f) Mindfulness Scale for Pre-Teens, Teens, and Adults (MSPTA); and (g) Mindfulness Inventory for Children and Adolescents (MICA). All seven assess trait mindfulness through self-report. We discuss methodological concerns regarding the near-exclusive use of self-report measures to assess youth mindfulness and offer suggestions for validating new measures and improving research studies that incorporate the assessment of mindfulness in youth.
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A pilot mindfulness home intervention was conducted for 6 weeks among 8–12-year-old children born with esophageal atresia and their parents. Participants were randomly assigned to a waiting list control (WLC) group (n = 8) and an experimental group (n = 12). When all participants had completed the mindfulness-based program, data were pooled and treated for the entire sample (n = 19). Self-assessment measures included the Mindful Attention Awareness Scale for Adolescents (MAAS-A), the Child and Adolescent Mindfulness Measure (CAMM), the modified Spielberger State-Trait Anxiety Inventory—Child (STAI-C), the Children’s Depression Inventory (CDI), and the Cognitive Emotion Regulation Questionnaire Kids version (CERQ-k). Parental assessment measures included the modified STAI-C. The results underlined the program’s feasibility and acceptability. Clinical effects of the mindfulness-based program were observed. Self-assessed data for children who had practiced mindfulness compared to the WLC group showed increased mindfulness and decreased depression. Reduced anxiety was found in all groups. Positive affect tended to improve from pre-test to post-test in children who had practiced mindfulness compared to the WLC group. Parental assessments showed significant improvement in positive affect and decreases in anxiety and negative affect in the intervention group compared to the WLC group. Cognitive emotion regulation strategies were also affected by the mindfulness-based program. Rumination scores significantly decreased from pre-test to post-test in the intervention group. This preliminary study suggests that regular mindfulness practice presents a promising approach to reducing the burden of this neonatal malformation.
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Objective: To assess the feasibility of a mindfulness-based stress reduction (MBSR) program for adolescents with widespread chronic pain and other functional somatic symptoms and to make preliminary assessments of its clinical utility. Study design: Three cohorts of subjects completed an 8-week MBSR program. Child- and parent-completed measures were collected at baseline and 8 and 12 weeks later. Measures included the Functional Disability Inventory (FDI), the Fibromyalgia/Symptom Impact Questionnaire-Revised (FIQR/SIQR), the Pediatric Quality of Life Inventory, the Multidimensional Anxiety Scale (MASC2), and the Perceived Stress Scale. Subjects and parents were interviewed following the program to assess feasibility. Results: Fifteen of 18 subjects (83%) completed the 8-week program. No adverse events occurred. Compared with baseline scores, significant changes were found in mean scores on the FDI (33% improvement, P = .026), FIQR/SIQR (26% improvement, P = .03), and MASC2 (child: 12% improvement, P = .02; parent report: 17% improvement, P = .03) at 8 weeks. MASC2 scores (child and parent) and Perceived Stress Scale scores were significantly improved at 12 weeks. More time spent doing home practice was associated with better outcomes in the FDI and FIQR/SIQR (44% and 26% improvement, respectively). Qualitative interviews indicated that subjects and parents reported social support as a benefit of the MBSR class, as well as a positive impact of MBSR on activities of daily living, and on pain and anxiety. Conclusions: MBSR is a feasible and acceptable intervention in adolescents with functional somatic syndromes and has preliminary evidence for improving functional disability, symptom impact, and anxiety, with consistency between parent and child measures. Trial registration: ClinicalTrials.gov: NCT02190474.
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Objective: To test the feasibility of a randomized-controlled trial measuring the impact of an adapted mindfulness-based intervention (MBI) in female adolescents with chronic pain. Methods: This was a single center, single-blind, prospective, experimental, longitudinal trial conducted in a pediatric tertiary care center. Participants had a history of chronic pain during at least three months. They were randomized into an intervention group or a wait-list control group. Both groups successively followed an adapted eight-week MBI designed specifically for adolescents with chronic pain. Pre-determined criteria were established to assess the feasibility, validity and acceptability of the study model. Data evaluating changes in quality of life, depression, anxiety, pain perception, psychological distress and salivary cortisol were collected throughout the 4-month study period. Results: Nineteen female participants completed the study and had a mean age of 15.8 years (range 13.9 -17.8). Attrition rate was low (17%). Attendance to mindfulness sessions (84%) and compliance to study protocol (100%) were high. All participants reported a positive change in the way they coped with pain. No changes in quality of life, depression, anxiety, pain perception, and psychological distress were detected. Significant reductions in pre-and post-mindfulness session salivary cortisol levels were observed (p<0.001). Conclusions: Mindfulness is a promising therapeutic approach for which limited data exist in adolescents with chronic pain. Our study indicates the feasibility of conducting such interventions in teenage girls. A large trial is needed to demonstrate the efficacy and bio-physiological impacts of MBIs in teenagers with chronic pain.
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The aim of this study was to conduct a comprehensive quantitative synthesis of the effects of mindfulness training interventions on weight-loss and health behaviours in adults with overweight and obesity using meta-analytic techniques. Studies included in the analysis (k = 12) were randomised controlled trials investigating the effects of any form of mindfulness training on weight loss, impulsive eating, binge eating, or physical activity participation in adults with overweight and obesity. Random effects meta-analysis revealed that mindfulness training had no significant effect on weight loss, but an overall negative effect on impulsive eating (d = −1.13) and binge eating (d = −.90), and a positive effect on physical activity levels (d = .42). Meta-regression analysis showed that methodological features of included studies accounted for 100% of statistical heterogeneity of the effects of mindfulness training on weight loss (R2 = 1,00). Among methodological features, the only significant predictor of weight loss was follow-up distance from post-intervention (β = 1.18; p < .05), suggesting that the longer follow-up distances were associated with greater weight loss. Results suggest that mindfulness training has short-term benefits on health-related behaviours. Future studies should explore the effectiveness of mindfulness training on long-term post-intervention weight loss in adults with overweight and obesity.
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The current study examined how a single-session mindfulness training influenced attentional control in preschool children. Based on previous work, a 15-min long mindfulness training program was developed. The training effect was examined via a within- and between-subject mixed design. Preschool children (N = 122; M age = 65.1 months, SD = 6.5) were randomly assigned to two intervention conditions, the mindfulness training and active control. Before and after the intervention, the Global–Local test and the Child version Attention Network Task (ANT) were conducted to measure children’s abilities to control the scope of attention and the content of attention, respectively. Results showed that the mindfulness training decreased the use of global processing in children who were initially predominated by global processing and also decreased the use of local processing among the children who were predominated by local processing, though the mindfulness training did not influence children’s performance on the ANT. Theoretical and practical implications were discussed.
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Background Attention-Deficit-Hyperactivity-Disorder (ADHD) is, with a prevalence of 5 %, a highly common childhood disorder, and has severe impact on the lives of youngsters and their families. Medication is often the treatment of choice, as it currently is most effective. However, medication has only short-term effects, treatment adherence is often low and most importantly; medication has serious side effects. Therefore, there is a need for other interventions for youngsters with ADHD. Mindfulness training is emerging as a potentially effective training for children and adolescents with ADHD. The aim of this study is to compare the (cost) effectiveness of mindfulness training to the (cost) effectiveness of methylphenidate in children with ADHD on measures of attention and hyperactivity/impulsivity. Methods/design A multicenter randomized controlled trial with 2 follow-up measurements will be used to measure the effects of mindfulness training versus the effects of methylphenidate. Participants will be youngsters (aged 9 to 18) of both sexes diagnosed with ADHD, referred to urban and rural mental healthcare centers. We aim to include 120 families. The mindfulness training, using the MYmind protocol, will be conducted in small groups, and consists of 8 weekly 1.5-h sessions. Youngsters learn to focus and enhance their attention, awareness, and self-control by doing mindfulness exercises. Parents will follow a parallel mindful parenting training in which they learn to be fully present in the here and now with their child in a non-judgmental way, to take care of themselves, and to respond rather than react to difficult behavior of their child. Short-acting methylphenidate will be administered individually and monitored by a child psychiatrist. Assessments will take place at pre-test, post-test, and at follow-up 1 and 2 (respectively 4 and 10 months after the start of treatment). Informants are parents, children, teachers, and researchers. Discussion This study will inform mental health care professionals and health insurance companies about the clinical and cost effectiveness of mindfulness training for children and adolescents with ADHD and their parents compared to the effectiveness of methylphenidate. Limitations and several types of bias that are anticipated for this study are discussed. Trial registration Dutch Trial Register: NTR4206. Registered 11 October 2013.
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Background: The core clinical symptoms of addiction include an enhanced incentive for drug taking (craving), impaired self-control (impulsivity and compulsivity), emotional dysregulation (negative mood) and increased stress reactivity. Symptoms related to impaired self-control involve reduced activity in anterior cingulate cortex (ACC), adjacent prefrontal cortex (mPFC) and other brain areas. Behavioral training such as mindfulness meditation can increase the function of control networks including those leading to improved emotion regulation and thus may be a promising approach for the treatment of addiction. Methods: In a series of randomized controlled trials (RCTs), we tested whether increased ACC/mPFC activity is related to better self-control abilities in executive functions, emotion regulation and stress response in healthy and addicted populations. After a brief mindfulness training (Integrative Body-Mind Training, IBMT), we used the Positive and Negative Affect Schedule (PANAS) and Profile of Mood States (POMS) to measure emotion regulation, salivary cortisol for the stress response and fMRI for brain functional and DTI structural changes. Relaxation training was used to serve as an active control. Results: In both smokers and nonsmokers, improved self-control abilities in emotion regulation and stress reduction were found after training and these changes were related to increased ACC/mPFC activity following training. Compared with nonsmokers, smokers showed reduced ACC/mPFC activity in the self-control network before training, and these deficits were ameliorated after training. Conclusions: These results indicate that promoting emotion regulation and improving ACC/mPFC brain activity can help for addiction prevention and treatment.
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Background: A large proportion of mindfulness-based therapy trials report statistically significant results, even in the context of very low statistical power. The objective of the present study was to characterize the reporting of "positive" results in randomized controlled trials of mindfulness-based therapy. We also assessed mindfulness-based therapy trial registrations for indications of possible reporting bias and reviewed recent systematic reviews and meta-analyses to determine whether reporting biases were identified. Methods: CINAHL, Cochrane CENTRAL, EMBASE, ISI, MEDLINE, PsycInfo, and SCOPUS databases were searched for randomized controlled trials of mindfulness-based therapy. The number of positive trials was described and compared to the number that might be expected if mindfulness-based therapy were similarly effective compared to individual therapy for depression. Trial registries were searched for mindfulness-based therapy registrations. CINAHL, Cochrane CENTRAL, EMBASE, ISI, MEDLINE, PsycInfo, and SCOPUS were also searched for mindfulness-based therapy systematic reviews and meta-analyses. Results: 108 (87%) of 124 published trials reported ≥1 positive outcome in the abstract, and 109 (88%) concluded that mindfulness-based therapy was effective, 1.6 times greater than the expected number of positive trials based on effect size d = 0.55 (expected number positive trials = 65.7). Of 21 trial registrations, 13 (62%) remained unpublished 30 months post-trial completion. No trial registrations adequately specified a single primary outcome measure with time of assessment. None of 36 systematic reviews and meta-analyses concluded that effect estimates were overestimated due to reporting biases. Conclusions: The proportion of mindfulness-based therapy trials with statistically significant results may overstate what would occur in practice.
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Mindfulness-based curricula are being implemented in K-12 schools across the nation. Many of these programs, although well considered and implemented, have little or no research support for their effectiveness. Recognizing the paucity of published research in this area, a sampling of school-based programs currently being implemented in the schools is reviewed. The programs reviewed are Inner Explorer, Master Mind and Moment Program, Mindfulness and Mind-Body Skills for Children, Mindful Schools, Resilient Kids, Still Quiet Place, Stress Reduction and Mindfulness Curriculum and Mindful Moment, and Wellness and Resilience Program. We offer a summary of research support for each program and discussion of unpublished, mostly qualitative indicators of feasibility, acceptability, efficacy, and effectiveness. Strengths and limitations of each program are described, along with suggestions for bolstering informative and useful research. We encourage researchers, educators, and mindfulness practitioners to work collaboratively to conduct rigorous program evaluations.
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Recurrent headaches cause significant burden for adolescents and their families. Mindfulness-based interventions (MBIs) have been shown to reduce stress and alter the experience of pain, reduce pain burden, and improve quality of life. Research indicates that MBIs can benefit adults with chronic pain conditions including headaches. A pilot nonrandomized clinical trial was conducted with 20 adolescent females with recurrent headaches. Median class attendance was 7 of 8 total sessions; average class attendance was 6.10 ± 2.6 . Adherence to home practice was good, with participants reporting an average of 4.69 (SD = 1.84) of 6 practices per week. Five participants dropped out for reasons not inherent to the group (e.g., extracurricular scheduling); no adverse events were reported. Parents reported improved quality of life and physical functioning for their child. Adolescent participants reported improved depression symptoms and improved ability to accept their pain rather than trying to control it. MBIs appear safe and feasible for adolescents with recurrent headaches. Although participants did not report decreased frequency or severity of headache following treatment, the treatment had a beneficial effect for depression, quality of life, and acceptance of pain and represents a promising adjunct treatment for adolescents with recurrent headaches.
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The aim of this study was to determine whether adolescents who were high in self-compassion self-reported different levels of emotional wellbeing than adolescents who were low in self-compassion, and to determine whether those high in self-compassion responded differently under a lab social stressor than those low in self-compassion. In a lab setting, participants (age 13–18; n = 28) completed the Trier Social Stress Test (TSST) and physiological stress was assessed via salivary cortisol, heart rate, blood pressure, and heart rate variability at baseline, during the TSST, and during recovery. After completing the lab protocol, an email was sent to participants that provided a link to an online survey which was composed of emotional wellbeing measures including perceived stress, life satisfaction, positive and negative affect. After conducting repeated measure ANOVAS to determine that the TSST induced a significant stress response, the sample was split at the median of self-compassion. T tests were conducted to determine meaningful differences (Hedges’ g > .20) between the groups. Findings indicated that those in the high self-compassion group (≥the median) self-reported greater emotional wellbeing than those in the low self-compassion group (<the median). Overall, those in the high self-compassion group also had a lower physiologic stress response when exposed to the TSST than those in the low self-compassion group. Regression analyses were also conducted; baseline self-compassion predicted self-reported emotional wellbeing, but did not predict physiological response to the TSST. Findings support the potential buffering effect that self-compassion may have in protecting adolescents from social stressors; yet more research needs to be conducted in larger samples to confirm and replicate these findings.
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Mindfulness-based interventions (MBIs) are at a pivotal point in their future development. Spurred on by an ever-increasing number of studies and breadth of clinical application, the value of such approaches may appear self-evident. We contend, however, that the public health impact of MBIs can be enhanced significantly by situating this work in a broader framework of clinical psychological science. Utilizing the National Institutes of Health stage model (Onken, Carroll, Shoham, Cuthbert, & Riddle, 2014), we map the evidence base for mindfulness-based cognitive therapy and mindfulness-based stress reduction as exemplars of MBIs. From this perspective, we suggest that important gaps in the current evidence base become apparent and, furthermore, that generating more of the same types of studies without addressing such gaps will limit the relevance and reach of these interventions. We offer a set of 7 recommendations that promote an integrated approach to core research questions, enhanced methodological quality of individual studies, and increased logical links among stages of clinical translation in order to increase the potential of MBIs to impact positively the mental health needs of individuals and communities. (PsycINFO Database Record
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Both basic science and clinical research on mindfulness, meditation, and related constructs have dramatically increased in recent years. However, interpretation of these research results has been challenging. The present article addresses unique conceptual and methodological problems posed by research in this area. Included among the key topics is the role of first-person experience and how it can be best studied, the challenges posed by intervention research designs in which true double-blinding is not possible, the nature of control and comparison conditions for research that includes mindfulness or other meditation-based interventions, issues in the adequate description of mindfulness and related trainings and interventions, the question of how mindfulness can be measured, questions regarding what can and cannot be inferred from self-report measures, and considerations regarding the structure of study design and data analyses. Most of these topics are germane to both basic and clinical research studies and have important bearing on the future scientific understanding of mindfulness and meditation. (PsycINFO Database Record
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A growing body of research has documented the psychological impact of cancer on adolescents (such as symptoms of depression, anxiety and withdrawal). Findings from the adult literature suggest that mindfulness based interventions (MBIs) are a promising treatment option for helping individuals manage cancer and alleviate the associated psychological symptoms. The aim of the present pilot study was to assess the feasibility and acceptability of a MBI for adolescents with cancer and examine its potential positive impact on sleep, mood, and quality of life. Over 9 months of recruitment, 481 youth were screened for participation in this project. Of these, 418 (86.9 %) were excluded because they lived further than 1 h from the intervention site, had no history of cancer, had died or were not reachable by telephone. Of the 63 who were contacted, only 7 (1.4 %) agreed to participate, gave their consent, and provided a complete dataset. A prospective quasi-experimental pretest–posttest design with two groups (experimental; n = 7 and no treatment; n = 7) was used to assess the MBI. Only participants from the experimental group completed follow-up measures at 6 months. Repeated-measure ANOVAs were conducted to assess the impact of the intervention. No significant differences between or within groups were found pre to post assessment and at follow-up. A narrow pool of eligible participants, a high refusal rate, school scheduling conflicts and absenteeism had a significant impact on the final sample size. Suggestions to conduct future trials are presented. Larger randomized-controlled trials are necessary to assess whether MBIs have significant beneficial effects in teenagers with cancer.
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Youth living with HIV have sub-optimal rates of adherence to antiretroviral therapy (ART). Mindfulness instruction interventions have shown promise for improving medication adherence, but the effects and mechanisms of these interventions are still being explored among people living with HIV, including youth. In the context of a randomized controlled trial of the efficacy of a Mindfulness-Based Stress Reduction (MBSR) program on ART adherence and viral suppression among youth living with HIV, we conducted 44 iterative, semi-structured, in-depth interviews with 20 study participants (13–24 years) recruited from clinics at two academic centers in Baltimore, Maryland. Interviews explored the social context and psychosocial dynamics of ART adherence in the context of the MBSR intervention, compared with those in a control arm. We employed thematic content analysis to systematically code and synthesize textual interview data. Participants’ challenges with ART adherence were often situated within an ongoing process of working to manage HIV as a stigmatized, chronic condition in addition to other intersecting social stigmas, inequalities, and stressors. Participation in the MBSR program and related group support allowed participants to non-judgmentally observe and accept difficult thoughts, feelings, and experiences associated with living with HIV and taking ART, which facilitated greater reported adherence. Mindfulness training may stimulate new perspectives and understanding, including greater self- and illness-acceptance among youth living with HIV, leading to improved HIV outcomes.
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Introduction: We aimed to determine the benefits/efficacy of mindfulness-based interventions (MBIs) implemented among adolescents with chronic diseases in clinical settings. Methods: An electronic search of PubMed, CINAHL, and PsycINFO databases was conducted in November 2017 to identify studies in which mindfulness was the primary intervention delivered for adolescents with chronic diseases to improve psychological and physical health. Results: Nineteen eligible studies were included in this review. Fifteen studies included adolescents with psychiatric or pain disorders, and four included adolescents with a chronic physical disorders. Psychological outcomes and pain were examined in most studies with effect sizes for MBIs ranging from small to large. Discussion: MBI studies conducted in clinical settings mainly engaged adolescents with psychiatric or pain disorders. The effectiveness of MBIs on improving psychological outcomes were inconsistent. Large randomized trials are needed to examine the effectiveness of MBIs and should expand to include adolescents with chronic physical diseases.
Article
Mindfulness has emerged as a new approach for treating mental disorders. The aim of this study is to investigate preliminary efficacy of group-based mindfulness meditation training for children on core symptoms, executive functioning and comorbidity symptoms in a children naïve Attention-Deficit Hyperactivity Disorder (ADHD) sample. Five children aged 7-12 years newly diagnosed with ADHD received an eight-week group-based mindfulness treatment. The program consisted of once-per-week sessions lasting 75 minutes and daily homework assignments. The study assessments included pre-and posttest measure of psychiatric symptoms and cognitive functioning. Data were analyzed using Wilcoxon signed-rank test. Pre-post improvements in ADHD symptoms and test performance on tasks measuring executive functioning were noted. Significant results were observed in total ADHD symptoms (p= .042), anxiety symptoms (p= .042), cognitive inhibition (p= .042) and processing speed (p= .043). In summary, although the sample size was small, our pilot study suggests that mindfulness training for children is a feasible intervention in at least a subset of ADHD children and may improve behavioral and neurocognitive impairments.
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Objective: Chronic pain is common in paediatric populations and many patients do not respond to the currently available evidence-based treatments. Mindfulness-based interventions (MBIs) have a growing evidence-base in adults, but evidence is limited in youth with chronic pain. Methods: We conducted an open-label pilot study to test the feasibility of an 8-week MBI for this population. Results: Seven adolescents (age range 14–17; median age 15; six female) completed the intervention. There were no dropouts. Median class attendance was seven of eight total sessions (SD = 0.76). Only one (14.3%) participant reported not finding it useful; five (71.4%) reported that they would recommend it to a friend; and the remaining two (28.6%) reported “maybe”. There was no worsening of internalizing symptoms. Secondary outcomes included significant reduction of pain intensity, which was maintained at three-month follow-up. Somatic symptoms and functional disability were both non-significantly lower immediately following the intervention; but were significantly improved at three-month follow-up. Conclusion: An eight-week group MBI is a feasible intervention for adolescents with chronic pain, and warrants further investigation as a potential alternative to cognitive behavioural therapy in this population.
Article
Objective: Mindfulness is being promoted in schools as a prevention program despite a current small evidence base. The aim of this research was to conduct a rigorous evaluation of the .b ("Dot be") mindfulness curriculum, with or without parental involvement, compared to a control condition. Method: In a randomized controlled design, students (Mage 13.44, SD 0.33; 45.4% female) across a broad range of socioeconomic indicators received the nine lesson curriculum delivered by an external facilitator with (N = 191) or without (N = 186) parental involvement, or were allocated to a usual curriculum control group (N = 178). Self-report outcome measures were anxiety, depression, weight/shape concerns, wellbeing and mindfulness. Results: There were no differences in outcomes between any of the three groups at post-intervention, six or twelve month follow-up. Between-group effect sizes (Cohen's d) across the variables ranged from 0.002 to 0.37. A wide range of moderators were examined but none impacted outcome. Conclusions: Further research is required to identify the optimal age, content and length of mindfulness programs for adolescents in universal prevention settings. Trial registration: ACTRN12615001052527.
Article
A number of studies have investigated the impact of mindfulness-based interventions on symptoms of post-traumatic stress (PTSD) compared to control conditions. The current meta-analysis consolidated findings from 18 studies reporting results for 21 samples of participants. Across studies, mindfulness-based treatments compared to control conditions were effective in ameliorating symptoms of PTSD, with Hedges' g = − 0.44. Hedges' g was − 0.59 for comparison of mindfulness-based interventions to waitlist control conditions. Changes in mindfulness may underpin the effect of mindfulness-based interventions on PTSD symptoms and thus the meta-analysis examined findings regarding increases in mindfulness. The 12 studies that assessed mindfulness found that the interventions significantly increased mindfulness, Hedges' g = 0.52. Moderator analyses indicated that interventions with longer mindfulness training were more efficacious in reducing symptoms of PTSD. Across studies, gender, age, veteran status, or length of time between the intervention and assessment of PTSD symptoms did not moderate the impact of mindfulness-based interventions. The results provide a foundation for future research directions and have implications for work with those impacted by trauma.
Article
Objective: (1) Evaluate feasibility and acceptability of a mindfulness-based group in adolescent girls at-risk for type 2 diabetes (T2D) with depressive symptoms, and (2) compare efficacy of a mindfulness-based versus cognitive-behavioral group for decreasing depressive symptoms and improving insulin resistance. Design and setting: Parallel-group, randomized controlled pilot trial conducted at a university. Participants: Thirty-three girls 12-17y with overweight/obesity, family history of diabetes, and elevated depressive symptoms were randomized to a six-week mindfulness-based (n=17) or cognitive-behavioral program (n=16). Interventions: Both interventions included six, one-hour weekly group sessions. The mindfulness-based program included guided mindfulness awareness practices. The cognitive-behavioral program involved cognitive restructuring and behavioral activation. Main outcome measures: Adolescents were evaluated at baseline, post-intervention, and six-months. Feasibility/acceptability were measured by attendance and program ratings. Depressive symptoms were assessed by validated survey. Insulin resistance was determined from fasting insulin and glucose, and dual energy x-ray absorptiometry was used to assess body composition. Results: Most adolescents attended ≥80% sessions (mindfulness: 92% versus cognitive-behavioral: 87%, p=1.00). Acceptability ratings were strong. At post-treatment and six-months, adolescents in the mindfulness condition had greater decreases in depressive symptoms than adolescents in the cognitive-behavioral condition (ps<.05). Compared to the cognitive-behavioral condition, adolescents in the mindfulness-based intervention also had greater decreases in insulin resistance and fasting insulin at post-treatment, adjusting for fat mass and other covariates (ps<.05). Conclusions: A mindfulness-based intervention shows feasibility and acceptability in girls at-risk for T2D with depressive symptoms. Compared to a cognitive-behavioral program, after the intervention, adolescents who received mindfulness showed greater reductions in depressive symptoms and better insulin resistance. ClinicalTrials.gov identifier: NCT02218138 clinicaltrials.gov.
Article
Background: Mindfulness-based interventions (MBIs) have emerged as a promising strategy for individuals with a chronic illness, given their versatility in targeting both physical and mental health outcomes. However, research to date has focused on adult or community-based populations. Objectives: To systematically review and critically appraise MBIs in clinical pediatric samples living with chronic physical illness. Data sources: Electronic searches were conducted by a Library Information Specialist familiar with the field by using EMBASE, PsycINFO, MEDLINE, CINAHL, Web of Science, and EBM Reviews databases. Study Eligibility, Participants, and Interventions: Published English peer-reviewed articles of MBIs in clinical samples of children and adolescents (3-18 years) with chronic physical illness. Study appraisal and synthesis methods: Two reviewers independently selected articles for review and extracted data. Results are narratively described, and the reporting quality of each study was assessed via the STROBE Checklist. Results: Of a total 4710 articles, 8 articles met inclusion criteria. All studies were small (n?<?20, except 1 study of n?=?59), included only outpatient adolescent samples, and focused on feasibility and acceptability of MBI; only 1 study included a comparison group (n?=?1). No studies included online components or remote attendance. All studies found that MBI was acceptable to adolescents, whereas feasibility and implementation outcomes were mixed. Many studies were underpowered to detect significant differences post-MBI, but MBI did demonstrate improvements in emotional distress in several studies. Conclusions and Implications of Key Findings: The literature on MBIs is preliminary in nature, focusing on adapting and developing MBI for adolescents. Although MBIs appear to be a promising approach to coping with symptoms related to chronic illness in adolescents, future research with adequate sample sizes and rigorous research designs is warranted.
Article
Objectives: Pediatric chronic pain is a major health issue which can lead to significant interference in daily functioning. Mindfulness-based interventions (MBI's), which emphasize acceptance rather than control of pain, have gained increasing attention as a viable treatment option among adults with chronic pain. The effectiveness of MBIs for chronic pain in pediatric populations remains largely unknown. This prospective pre-post interventional study was conducted to examine the feasibility, acceptability, and initial effectiveness of an 8-week group MBI for adolescents (MBI-A) with chronic pain. Materials and methods: Self-report measures assessing pain characteristics, anxiety, depression, disability, pain catastrophizing, perceived social support, mindfulness, and pain acceptance were administered at baseline, postintervention, and at a 3-month follow-up. In addition, session data were collected to assess each session's impact on patients' coping with pain and stress, body awareness, and sense of feeling less alone. Results: In total, 42 consecutive patients in a tertiary care chronic pain clinic met eligibility criteria to participate in the MBI-A group. Of these, 21 participated. A treatment completion rate of 90.5% was observed. Between session mindfulness practice was reported by 77% of participants. Participants were highly satisfied with the MBI-A and all participants reported they would recommend the group to a friend. Improvements in pain acceptance were observed between baseline and the 3-month follow-up, in domains of Pain Willingness and Activity Engagement. Session data revealed improved body awareness and improved ability to cope with stress across sessions. Discussion: The MBI-A is a feasible, well-received intervention for adolescents with chronic pain conditions. Findings support the need for further investigation of the efficacy of MBI-A through randomized-controlled trials.
Article
Purpose: Adolescent and young adult cancer (AYAC) survivors show an elevated risk of distress. Targeted psychosocial interventions for this distinct population are needed. This study examined the potential efficacy of a mindfulness-based intervention (MBI) to alleviate emotional distress and improve quality of life (QoL) in AYAC survivors. Methods: Participants were 16 AYAC survivors, aged 14-24, who had completed acute medical treatment. A two-baseline (8 and 1 week before the intervention), post- (1 week after the intervention) and 3 months follow-up within-subjects design was used. Each participant completed two baseline assessments, followed by an 8-week MBI. The primary outcome variables were emotional distress and QoL. Secondary outcomes were cognitive vulnerability factors and mindfulness skills. Results: Multilevel modeling showed (1) a significant reduction in emotional distress and improvement in QoL at 3 months of follow-up, (2) a significant reduction in negative attitudes toward self (i.e., a cognitive vulnerability factor), and (3) a significant improvement in mindfulness skills. Conclusion: MBI is a promising approach that is used to treat emotional distress and to improve QoL in AYAC survivors. Further research using randomized controlled trials is needed to generalize these findings. Trial registration information: www.trialregister.nl ; NTR4358.
Article
Unlabelled: While pediatric anti-obesity lifestyle interventions have received considerable attention, few show sustained impact on body mass index (BMI). Using the Information-Motivation-Behavioral Skills Theory as a framework, we examined the effects of a satiety-focused mindful eating intervention (MEI) on BMI, weight and mindful awareness. Method: Design and setting: Utilizing a two-group, repeated measures design, 37 adolescent females with a BMI >90th percentile, recruited from a public high school in a Latino community in the Southwestern United States, were randomized 2:1, one third to the group receiving a 6-week MEI and two thirds to the comparison group (CG) receiving the usual care (nutrition and exercise information). Intervention: During six weekly 90-min after school MEI group sessions, the behavioral skills of slow intentional eating were practiced with foci on satiety cues and triggers to overeat. Outcomes: Feasibility and acceptability were measured as participant retention (goal ≥55%) and evaluative comments from those in the MEI group, respectively. BMI and mindful awareness were measured on site at baseline, immediately post intervention, and at 4-week follow-up (week 10). Results: Fifty-seven and 65% of those in the MEI and CG were retained throughout the study, respectively. MEI participants showed significantly lowered BMI compared with CG participants, whose weight increased (p<0.001). At six weeks, the MEI group BMI decreased by 1.1kg/m(2) (BMI continued to decline to 1.4kg/m(2) by week 10); while CG BMI increased by 0.7kg/m(2) (consistent with BMI >90th percentile standard growth projections). Conclusions: Initial and sustained decline of BMI in the MEI group supports further study of this theory-guided approach, and the value of practicing satiety-focused mindful eating behavioral skills to facilitate health behavior change.
Article
This pilot randomized controlled trial with economically disadvantaged preschoolers investigated the feasibility and preliminary effects of a mindfulness intervention. We examined its effect on children’s empathy and self-regulation and explored how the curriculum might meet the needs of children attending federally subsidized preschools. Children in five preschool classrooms were randomly assigned by classroom to either a 12-week mindfulness intervention (two classrooms; n = 15) or a treatment as usual (TAU; three classrooms; n = 14) and assessed at three time points: pre-intervention (Time 1), immediately post-intervention (Time 2), and 3-month follow-up (Time 3). Children in the mindfulness intervention significantly increased their attentional focus from Time 1 to Time 2 compared to children in the TAU group. Similarly, compared to the TAU group, children in the mindfulness intervention significantly increased their self-regulation skills at Time 2, and these results were maintained at Time 3. There were no changes in empathy or compassion in either the TAU or mindfulness intervention group. Qualitative analysis of classroom observations and instructor interview data suggested that the intervention can be developmentally structured to meet the needs of economically disadvantaged children.
Background Mindfulness-based interventions (MBIs) are increasingly used in the management of various mental health disorders in children and adolescents. However, there is limited evidence about the efficacy of various interventions used.MethodA systematic review was performed to examine the effects of different MBIs on mental health symptoms and quality of life in both clinical and nonclinical samples of children and adolescents using data from only randomized control trials. The studies were also assessed for quality. Based on the type of MBI, study population, and control arm we had three comparisons for meta-analyses.ResultsFifteen studies were included in the qualitative analysis but only 11 trials with comparable interventions and controls were included for meta-analyses. Mindfulness-based stress reduction/mindfulness-based cognitive therapy arm was more effective than nonactive control in the nonclinical populations. Acceptance commitment therapy was comparable to active treatments in patients in the clinical range. Other MBIs were also effective improving anxiety and stress but not depression in nonclinical populations compared to nonactive control.Conclusions Mindfulness-based interventions can be effective in children and adolescents with mental symptoms. As there were significant limitations these results must be interpreted with caution.
Article
The progressively rigorous methodological requirements of conducting clinical trials of behavioral treatments has placed a large burden on individual investigators, as treatment manuals, methods of evaluating treatment quality and fidelity, and persuasive evidence of the treatment's promise are now virtual requirements of receiving support for conducting a clinical trial of a new or adapted treatment. A Stage Model of Behavioral Therapies research, by articulating the progressive stager of development and evaluation for behavioral treatments, recognizer the scientific merit and need for support for treatment development and initial evaluation designated as stage 1, This article describer the conduct of stage 1 research, including issues addressed in stage 1 research, major design decisions confronted by investigators, the close relationship of stage 1 to stage If research and proposes a time line for stage 1 research.
Article
Mindfulness-based stress reduction (MBSR) approaches are an effective treatment for individuals with chronic pain, however research has largely focused on adult populations. MBSR approaches should also help reduce pain and improve function among adolescents with chronic pain, particularly given the success of MBSR programs for adolescents with other health conditions. Objective: As part of a quality improvement initiative, two iterations of a mindfulness group intervention adapted for adolescents with chronic pain (MBSR-A) were examined to identify a) the acceptability and strengths and weaknesses of the intervention and b) refinement of group content in preparation for a pilot randomized controlled study. Methods: Sixteen adolescent females attending a hospital pediatric chronic pain clinic participated in an 8-week MBSR-A group intervention. Participants completed baseline measures and post-intervention qualitative evaluation of the MBSR-A. Results: At baseline, participants had an average pain duration of over 3 years and report moderate levels of pain 6.23 out of 10 (SD = 1.61), and functional disability. Lower disability was associated with greater trait mindfulness and less avoidant coping behaviour (p’s < .05). Detailed session content and adaptations for adolescent chronic pain populations are provided. All participants would recommend the MBSR-A to a friend. Strengths included the experiential exercises, being with other teens with pain, and learning new approaches to cope with pain. Limitations included barriers to attending sessions, lack of techniques to immediately improve pain flare-ups, and limited time to share pain stories. Conclusions: The MBSR-A offers a promising intervention for adolescent chronic pain populations and is refined according to areas identified for a future effectiveness study.
Article
We present a vision of clinical science, based on a conceptual framework of intervention development endorsed by the Delaware Project. This framework is grounded in an updated stage model that incorporates basic science questions of mechanisms into every stage of clinical science research. The vision presented is intended to unify various aspects of clinical science toward the common goal of developing maximally potent and implementable interventions, while unveiling new avenues of science in which basic and applied goals are of equally high importance. Training in this integrated, translational model may help students learn how to conduct research in every domain of clinical science and at each stage of intervention development. This vision aims to propel the field to fulfill the public health goal of producing implementable and effective treatment and prevention interventions.