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McCurdy BH, Bradley T, Matlow R, Rettger JP, Espil FM, Weems CF, Carrion VG. Program evaluation of a school-based mental health and wellness curriculum featuring yoga and mindfulness. PLoS One 2024; 19:e0301028. [PMID: 38574083 PMCID: PMC10994323 DOI: 10.1371/journal.pone.0301028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 03/01/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Interest in the effectiveness of mindfulness-based interventions such as yoga in primary schools has grown. Evidence shows promise, as youth who engage in yoga to promote mindfulness show improved coping skills, increased socio-emotional competence and prosocial skills, academic performance, attention span, and ability to deal with stress. OBJECTIVE This study reports the results of a program evaluation of a universal health and wellness curriculum, Pure Power, designed to teach youth yoga techniques, mindfulness, and emotion regulation. METHODS A non-randomized comparison design examined outcomes among participants from schools that completed the intervention with highest fidelity of implementation (n = 461) and from students in matched comparison schools (n = 420). Standard measures of coping, emotion regulation and emotion dysregulation, spelling, and math achievement were collected. RESULTS Analyses suggest the youth in the intervention schools demonstrated relative improvement on measures of emotion regulation, spelling, and math. CONCLUSIONS Challenges in implementation in real-life settings are vital to identify. The data provide some real-world evidence for the effectiveness of a universal health and wellness curriculum on emotion regulation and positive academic outcomes. Training school staff to deliver the intervention may foster implementation. Future research should test the effectiveness of who delivers the intervention; for example, teacher-delivered groups vs. other wellness personnel.
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Affiliation(s)
- Bethany H. McCurdy
- Human Development and Family Studies, Iowa State University, Ames, Iowa, United States of America
| | - Travis Bradley
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Ryan Matlow
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California, United States of America
| | - John P. Rettger
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Flint M. Espil
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California, United States of America
| | - Carl F. Weems
- Human Development and Family Studies, Iowa State University, Ames, Iowa, United States of America
| | - Victor G. Carrion
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, California, United States of America
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Maurel S, Giménez-Llort L, Alegre-Martin J, Castro-Marrero J. Hierarchical Cluster Analysis Based on Clinical and Neuropsychological Symptoms Reveals Distinct Subgroups in Fibromyalgia: A Population-Based Cohort Study. Biomedicines 2023; 11:2867. [PMID: 37893239 PMCID: PMC10604090 DOI: 10.3390/biomedicines11102867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/18/2023] [Accepted: 10/21/2023] [Indexed: 10/29/2023] Open
Abstract
Fibromyalgia (FM) is a condition characterized by musculoskeletal pain and multiple comorbidities. Our study aimed to identify four clusters of FM patients according to their core clinical symptoms and neuropsychological comorbidities to identify possible therapeutic targets in the condition. We performed a population-based cohort study on 251 adult FM patients referred to primary care according to the 2010 ACR case criteria. Patients were aggregated in clusters by a K-medians hierarchical cluster analysis based on physical and emotional symptoms and neuropsychological variables. Four different clusters were identified in the FM population. Global cluster analysis reported a four-cluster profile (cluster 1: pain, fatigue, poorer sleep quality, stiffness, anxiety/depression and disability at work; cluster 2: injustice, catastrophizing, positive affect and negative affect; cluster 3: mindfulness and acceptance; and cluster 4: surrender). The second analysis on clinical symptoms revealed three distinct subgroups (cluster 1: fatigue, poorer sleep quality, stiffness and difficulties at work; cluster 2: pain; and cluster 3: anxiety and depression). The third analysis of neuropsychological variables provided two opposed subgroups (cluster 1: those with high scores in surrender, injustice, catastrophizing and negative affect, and cluster 2: those with high scores in acceptance, positive affect and mindfulness). These empirical results support models that assume an interaction between neurobiological, psychological and social factors beyond the classical biomedical model. A detailed assessment of such risk and protective factors is critical to differentiate FM subtypes, allowing for further identification of their specific needs and designing tailored personalized therapeutic interventions.
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Affiliation(s)
- Sara Maurel
- Department of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain;
| | - Lydia Giménez-Llort
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain;
- Institut de Neurosciències, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Jose Alegre-Martin
- Division of Rheumatology, Clinical Unit in ME/CFS and Long COVID, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain;
- Division of Rheumatology, Research Unit in ME/CFS and Long COVID, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
| | - Jesús Castro-Marrero
- Division of Rheumatology, Research Unit in ME/CFS and Long COVID, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
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Pedrini L, Meloni S, Lanfredi M, Rossi R. School-based interventions to improve emotional regulation skills in adolescent students: A systematic review. J Adolesc 2022; 94:1051-1067. [PMID: 36082432 DOI: 10.1002/jad.12090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 06/07/2022] [Accepted: 08/25/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Emotional regulation (ER) is a core variable involved in the onset and maintenance of mental health disorders; therefore, interventions targeting ER in adolescence represent a promising preventive action. The current systematic review provides a synthesis of the evidence on school-based interventions on ER in adolescent students. METHODS Six electronic databases (Medline, Psychology Database, Embase, Scopus, Psychinfo, and Web of Science) were searched. The methodological quality of the included studies was assessed by the Methodological Index for Nonrandomized Studies. RESULTS A total of 36 studies were identified. The interventions were based on different theoretic frameworks and focused on different components of ER. There were universal interventions that addressed the entire class, as well as interventions for a selected population of at-risk students. Only one-third of the studies were based on manualized programs. Small to moderate effect sizes were found for mental health and ER skills. Only a few studies assessed risky behaviors, and these studies showed a reduction with moderate to large effect size. Studies conducted on high-risk populations showed medium-high effect sizes on ER skills. In contrast, studies conducted on unselected samples of students showed greater variability in the outcome estimates. Acceptability analysis and attendance rates suggested that the interventions were well received by students. The lack of follow-up assessments and the absence of sample-size calculation were the most frequent methodological weaknesses. CONCLUSIONS The content of the present review could be useful for professionals involved in the planning of school psychological services. Overall, the findings of the current review support the applicability and beneficial effect of school-based intervention for adolescents. Moreover, the results clearly point out the utility of a multitiered model to structure coordinated and integrated preventive interventions and to optimize resources.
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Affiliation(s)
- Laura Pedrini
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Serena Meloni
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Mariangela Lanfredi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Roberta Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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Systematic Review of Mindfulness-Based Interventions in Child-Adolescent Population: A Developmental Perspective. Eur J Investig Health Psychol Educ 2022; 12:1220-1243. [PMID: 36005234 PMCID: PMC9407079 DOI: 10.3390/ejihpe12080085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 11/17/2022] Open
Abstract
Human development implies deep changes in cognitive, attentional, emotional, and behavioral skills. Therefore, Mindfulness-Based Interventions (MBIs) should be adapted in terms of dose, frequency, kind of exercises, assessment methods, and expected effects regarding the abilities and limitations of each developmental period. The present review seeks to describe and compare MBIs characteristics, assessment methods, and effects in youth between 3 and 18 years old considering four developmental periods. A systematic review was carried out including experimental primary studies published during the last five years. Results show that the frequency of the sessions and program duration varies widely. Differences were observed in instructors’ training and in assessment strategies. Discrepancies were observed regarding the effects of MBIs both within and between periods in cognitive, socio-emotional, symptoms, and mindfulness variables. Consistency was observed in prosocial behaviors for preschoolers, and in emotional and behavioral problems and hyperactivity in ages between preschool and early adolescence. Nevertheless, it was impossible to compare most results and determine consistency or discrepancy due to the lack of studies. Regarding mindfulness, it is defined and assessed in different ways in each period. Orientations are suggested to move from a compartmentalized view of isolated MBIs, towards an integrative perspective that allows tracing developmental trajectories for mindfulness and other key cognitive and socioemotional skills for children and adolescents.
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Delgado-Suárez I, López-del-Hoyo Y, García-Campayo J, Pérez-Aranda A, Modrego-Alarcón M, Beltrán-Ruiz M, Gascón S, Montero-Marín J. Testing the Efficacy of ‘Unlearning’, a Mindfulness and Compassion-Based Programme for Cultivating Nonviolence in Teenagers: A Randomised Controlled Trial. Front Psychol 2021; 12:717736. [PMID: 34975612 PMCID: PMC8716809 DOI: 10.3389/fpsyg.2021.717736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Most programmes developed to reduce aggressive attitudes among teenagers are based on cultivating nonviolence, a construct that has been related to compassion and, more indirectly, mindfulness. This study aims at testing the efficacy of ‘Unlearning’, a mindfulness and compassion-based programme, for reducing aggressive attitudes in adolescents. Method: A sample of 164 students from three high schools in Zaragoza (Spain) participated in the study. They were randomly assigned to (1) ‘Unlearning’, or (2) relaxation programme. Three assessment points were established: baseline, post-treatment and a 4-month follow-up. The outcome variables were the subscales of the ‘Attitudes Toward Social Aggression Scale’. Mindfulness and compassion were assessed as secondary outcomes. Results: ‘Unlearning’ did not produce changes in the primary outcomes, but significant effects were observed post-treatment in self-compassion; and in the follow-up, in self-compassion and mindfulness. The control group did not experience any change post-treatment, but a significant effect in mindfulness was observed in the follow-up. The intergroup analyses indicated that ‘Unlearning’ improved self-compassion, both post-treatment (t = −2.48, p = 0.014) and after 4-months (t = −2.03, p = 0.044), although these results were not statistically significant after correcting for multiple comparisons. Conclusion: ‘Unlearning’ did not produce significant reductions in aggressive attitudes compared to the control group. The low baseline levels may have hindered the efficacy of the interventions. ‘Unlearning’ showed potential to improve self-compassion, which is related to nonviolence, and this may have positive implications for the adolescents. Future interventions should include teachers and families to enhance the effectiveness of the programmes.
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Affiliation(s)
- Irene Delgado-Suárez
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
| | - Yolanda López-del-Hoyo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | - Javier García-Campayo
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | - Adrián Pérez-Aranda
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Barcelona, Spain
- *Correspondence: Adrián Pérez-Aranda,
| | - Marta Modrego-Alarcón
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | - María Beltrán-Ruiz
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain
| | - Santiago Gascón
- Institute of Health Research of Aragon (IIS Aragón), Miguel Servet University Hospital, Zaragoza, Spain
| | - Jesús Montero-Marín
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
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