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Taylor A, Wright K, Roberts RM, Proeve M, Turner J, Miller C. Prevention of internalizing difficulties in the middle years: Protocol for a noninferiority randomized trial of Mindfulness-Based Cognitive Therapy for Children and Cognitive Behavioural Therapy. Early Interv Psychiatry 2024; 18:547-552. [PMID: 38318942 DOI: 10.1111/eip.13501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 10/04/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
AIM Mindfulness-based interventions have been tested as preventive programs for childhood internalizing difficulties, but most research has been at a 'universal' level with small to null effects. Mindfulness-Based Cognitive Therapy for Children (MBCT-C) has similar effects to Cognitive Behaviour Therapy (CBT) when used as a small-group, targeted preventive program. Knowledge gaps include the longer-term effectiveness of MBCT-C relative to CBT and the benefits of adding a parent module. This trial aims to compare MCBT-C to traditional CBT, including a parent module, to 15-months post-intervention and to test the feasibility and acceptability of adding a parent module. METHODS Participants will be recruited from primary schools in areas of socio-economic disadvantage in South Australia (n = 194). Children (aged 9-12) years with signs of internalizing difficulties (e.g., shy, withdrawn, worried), and their parents, will be eligible for this two-armed randomized controlled non-inferiority trial (RCT). Children will participate in 10 group sessions of MBCT-C or CBT, facilitated by psychologists, and parents from both conditions will participate in two parent-only group sessions. Child self-report measures include depression and anxiety, as well as attention, mindfulness and self-compassion. Parent measures include symptoms of depression and anxiety, mindfulness, and parent-child relationship strength. The primary outcome will be child anxiety and depression (Revised Child Anxiety and Depression Scale-25). Measures will be collected pre and post intervention, and at 3, 6, 12 and 15-month follow up. RESULTS Schools will be recruited from October 2022. Nomination of children will commence from February 2023. Program implementation will begin May 2023. CONCLUSIONS This trial will have implications for the feasibility of involving parents in preventative programs, as well as whether mindfulness-based interventions prevent internalizing difficulties over time.
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Affiliation(s)
- Amanda Taylor
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Kathleen Wright
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Rachel M Roberts
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Michael Proeve
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Jasmine Turner
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Caroline Miller
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
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Hooshmand Zaferanieh M, Shi L, Jindal M, Chen L, Zhang L, Lopes S, Jones K, Wang Y, Meggett K, Walker CB, Falgoust G, Zinzow H. Web-Based Mindfulness-Based Cognitive Therapy for Adults With a History of Depression: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e53966. [PMID: 38888958 PMCID: PMC11220437 DOI: 10.2196/53966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/03/2024] [Accepted: 03/21/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Depression poses a major threat to public health with an increasing prevalence in the United States. Mindfulness-based interventions, such as mindfulness-based cognitive therapy (MBCT), are effective methods for managing depression symptoms and may help fortify existing efforts to address the current disease burden. The in-person group format of MBCT, however, incurs barriers to care such as expenses, childcare needs, and transportation issues. Alternate delivery modalities such as MBCT delivered via the web can be investigated for their capacity to overcome these barriers and still reduce symptoms of depression with adequate feasibility and efficacy. OBJECTIVE This study protocol aims to examine the feasibility and efficacy of MBCT delivered via the web for the treatment of depression. METHODS To attain study aims, 2 phases will be implemented using a waitlist control design. A total of 128 eligible participants will be randomized into either an 8-week MBCT intervention group plus treatment as usual (MBCT + TAU; group 1) or an 8-week waitlist control group (group 2). In phase I (8 weeks), group 1 will complete the intervention and group 2 will proceed with TAU. In phase II (8 weeks), group 2 will complete the intervention and group 1 will continue with TAU until reaching an 8-week follow-up. TAU may consist of receiving psychotherapy, pharmacotherapy, or combined treatment. Data collection will be completed at baseline, 8 weeks (postintervention for group 1 and preintervention for group 2), and 16 weeks (follow-up for group 1, postintervention for group 2). The primary outcomes will include (1) current, residual, or chronic depression symptoms and (2) psychiatric distress. Secondary outcomes will include perceived stress and facets of mindfulness. The feasibility will be measured by assessing protocol adherence, retention, attendance, and engagement. Finally, the extent of mindfulness self-practice and executive functioning skills will be assessed as mediators of intervention outcomes. RESULTS This study began screening and recruitment in December 2022. Data collection from the first cohort occurred in January 2023. By November 2023, a total of 30 participants were enrolled out of 224 who received screening. Data analysis began in February 2024, with an approximate publication of results by August 2024. Institutional review board approval took place on September 11, 2019. CONCLUSIONS This trial will contribute to examining mindfulness-based interventions, delivered via the web, for improving current, residual, or chronic depression symptoms. It will (1) address the feasibility of MBCT delivered via the web; (2) contribute evidence regarding MBCT's efficacy in reducing depression symptoms and psychiatric distress; and (3) assess the impact of MBCT on several important secondary outcomes. Findings from this study will develop the understanding of the causal pathways between MBCT delivered via the web and depression symptoms further, elucidating the potential for future larger-scale designs. TRIAL REGISTRATION ClinicalTrials.gov NCT05347719; https://www.clinicaltrials.gov/ct2/show/NCT05347719. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53966.
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Affiliation(s)
| | - Lu Shi
- Department of Health Sciences, College of Health Professions, Pace University, New York, NY, United States
| | - Meenu Jindal
- Department of Internal Medicine, Prisma Health, Greenville, SC, United States
| | - Liwei Chen
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States
| | - Lingling Zhang
- Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, United States
| | - Snehal Lopes
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
| | - Karyn Jones
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
| | - Yucheng Wang
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
| | - Kinsey Meggett
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
| | - Cari Beth Walker
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
| | - Grace Falgoust
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
| | - Heidi Zinzow
- College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
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Vo DX, Tabi K, Bhullar M, Johnson A, Locke J, Wang S, Stewart SE, Marshall SK. Mindful awareness and resilience skills for adolescents (MARS-A): a mixed-methods study of a mindfulness-based intervention for a heterogeneous adolescent clinical population. Int J Adolesc Med Health 2024; 36:25-35. [PMID: 38298033 DOI: 10.1515/ijamh-2023-0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/15/2024] [Indexed: 02/02/2024]
Abstract
OBJECTIVES Mindful Awareness and Resilience Skills for Adolescents (MARS-A) is a mindfulness-based intervention adapted for the adolescent population. While previous studies have explored the benefits of MARS-A in various single-diagnosis populations, the aim of this study was to assess MARS-A for a heterogenous clinical adolescent population with mental health and/or chronic diagnoses, focusing on the underlying suffering present in all these conditions rather than its effects on a single diagnosis itself. METHODS Qualitative data was collected through interviews to understand post-intervention participant perspectives and experiences. Quantitative data was collected through measures to investigate preliminary secondary outcomes. RESULTS After participating in MARS-A, participants reported qualitative benefits in enhanced well-being, including coping with difficult emotions and managing sleep and/or pain. Quantitative results showed a reduction in functional disability, psychological distress, perceived stress, and depressive symptoms; increase in positive affect; and benefit in coping with pain and chronic conditions. CONCLUSIONS MARS-A shows great potential in a heterogeneous clinical adolescent population.
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Affiliation(s)
- Dzung X Vo
- Centre for Mindfulness, BC Children's Hospital, Vancouver, Canada
- BC Children's Hospital Research Institute, Vancouver, Canada
- BC Children's Hospital, Vancouver, Canada
- Division of Adolescent Health and Medicine, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Katarina Tabi
- Centre for Mindfulness, BC Children's Hospital, Vancouver, Canada
- BC Reproductive Mental Health Program, BC Women's Hospital and Health Centre, Vancouver, Canada
- Department of Psychiatry, The University of British Columbia, Vancouver, Canada
| | - Manreet Bhullar
- Centre for Mindfulness, BC Children's Hospital, Vancouver, Canada
- BC Reproductive Mental Health Program, BC Women's Hospital and Health Centre, Vancouver, Canada
| | - Andrea Johnson
- School of Social Work, The University of British Columbia, Vancouver, Canada
| | - Jake Locke
- BC Children's Hospital, Vancouver, Canada
| | - Sophia Wang
- Centre for Mindfulness, BC Children's Hospital, Vancouver, Canada
- BC Reproductive Mental Health Program, BC Women's Hospital and Health Centre, Vancouver, Canada
| | - S Evelyn Stewart
- Centre for Mindfulness, BC Children's Hospital, Vancouver, Canada
- BC Children's Hospital Research Institute, Vancouver, Canada
- Department of Psychiatry, The University of British Columbia, Vancouver, Canada
- BC Mental Health and Substance Use Research Institute, Vancouver, Canada
| | - Sheila K Marshall
- Division of Adolescent Health and Medicine, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- School of Social Work, The University of British Columbia, Vancouver, Canada
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Konrad AC, Engert V, Albrecht R, Dobel C, Döring N, Haueisen J, Klimecki O, Sandbothe M, Kanske P. A multicenter feasibility study on implementing a brief mindful breathing exercise into regular university courses. Sci Rep 2023; 13:7908. [PMID: 37193767 DOI: 10.1038/s41598-023-34737-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/06/2023] [Indexed: 05/18/2023] Open
Abstract
Practicing mindfulness is associated with stress reduction and with positive effects in the context of learning and teaching. Although effects on student populations have been studied extensively, there are few studies implementing mindfulness exercises in university courses directly. For this reason, we aimed to investigate whether the use of a brief mindfulness exercise in regular university courses, guided by the lecturers, is feasible and has immediate effects on the students' mental states. We conducted a preregistered multicenter study with one observational arm, following an ABAB design. In total, N = 325 students from 19 different university courses were included at baseline and n = 101 students at post measurement. Students were recruited by N = 14 lecturers located in six different universities in Germany. Lecturers started their courses either by guiding a brief mindfulness exercise (intervention condition) or as they regularly would, with no such exercise (control condition). In both conditions, the mental states of students and lecturers were assessed. Over the semester, n = 1193 weekly observations from students and n = 160 observations from lecturers were collected. Intervention effects were analyzed with linear mixed-effects models. The brief mindfulness exercise, compared to no such exercise, was associated with lower stress composite scores, higher presence composite scores, higher motivation for the courses, as well as better mood in students. Effects persisted throughout a respective course session. Lecturers also reported positive effects of instructing mindfulness. Implementing a brief mindfulness exercise in regular university teaching sessions is feasible and has positive effects on both students and lecturers.
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Affiliation(s)
- Annika C Konrad
- Clinical Psychology and Behavioral Neuroscience, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
| | - Veronika Engert
- Institute of Psychosocial Medicine, Psychotherapy, and Psychooncology, Jena University Hospital, Jena, Germany
| | - Reyk Albrecht
- Faculty of Social and Behavioral Sciences, Friedrich Schiller University Jena, Jena, Germany
| | - Christian Dobel
- Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany
| | - Nicola Döring
- Institute of Media and Communication Science, Ilmenau University of Technology, Ilmenau, Germany
| | - Jens Haueisen
- Institute of Biomedical Engineering and Informatics, Ilmenau University of Technology, Ilmenau, Germany
| | - Olga Klimecki
- Clinical Psychology and Behavioral Neuroscience, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Mike Sandbothe
- Department of Social Work, Ernst Abbe University of Applied Sciences Jena, Jena, Germany
| | - Philipp Kanske
- Clinical Psychology and Behavioral Neuroscience, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
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Dell'Aversana V, Tofani M, Valente D. Emotional Regulation Interventions on Developmental Course for Preterm Children: A Systematic Review of Randomized Control Trials. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10030603. [PMID: 36980161 PMCID: PMC10047217 DOI: 10.3390/children10030603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/14/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
Children born preterm (<37 weeks of gestation) are at increased risk of socio-emotional difficulties. This study aims to determine the effects of rehabilitation intervention on the emotional regulation of children born preterm through a systematic review. We conducted a systematic review according to PRISMA guidelines. The literature screening was carried out on PUBMED, SCOPUS and WEB OF SCIENCE in August 2022. An author identified eligible studies based on predefined inclusion criteria and extracted the data. RCT quality was assessed using the JADAD and PEDro scales. We selected five RCTs for qualitative synthesis, having the common objective of evaluating the changes in emotional regulation after a rehabilitation intervention. Evidence of benefits was found after parent training intervention (PCIT; p < 0.05). Moreover, there was an improvement in day-to-day executive life and fewer behavioral problems after mindfulness intervention. Clinical, but not statistical, efficacy was found for the group-based physiotherapy intervention. In conclusion, parent training and mindfulness interventions can be helpful rehabilitation techniques, but the relatively small sample limited statistical power, so the discovery needs to be interpreted cautiously. Further research on these aspects is recommended.
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Affiliation(s)
- Vincenza Dell'Aversana
- MSc in Rehabilitaiton Sciences for Healthcare Professions, Sapienza University of Rome, 00185 Rome, Italy
| | - Marco Tofani
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Donatella Valente
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
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Exploring personalized psychotherapy for depression: A system dynamics approach. PLoS One 2022; 17:e0276441. [PMID: 36301962 PMCID: PMC9612473 DOI: 10.1371/journal.pone.0276441] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 10/07/2022] [Indexed: 01/24/2023] Open
Abstract
Depressive disorders are the leading contributor to medical disability, yet only 22% of depressed patients receive adequate treatment in a given year. Response to treatment varies widely among individuals with depression, and poor response to one treatment does not signal poor response to others. In fact, half of patients who do not recover from a first-line psychotherapy will recover from a second option. Attempts to personalize psychotherapy to patient characteristics have produced better outcomes than usual care, but research on personalized psychotherapy is still in its infancy. The present study explores a new method for personalizing psychotherapy for depression through simulation modeling. In this study, we developed a system dynamics simulation model of depression based on one of the major mechanisms of depression in the literature and investigated the trend of depressive symptoms under different conditions and treatments. Our simulation outputs show the importance of individualized services with appropriate timing, and reveal a new method for personalizing psychotherapy to heterogeneous individuals. Future research is needed to expand the model to include additional mechanisms of depression.
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Back to Basics: Lifestyle Interventions for Adolescent Depression. Harv Rev Psychiatry 2022; 30:283-302. [PMID: 36103683 DOI: 10.1097/hrp.0000000000000343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
LEARNING OBJECTIVES After completing this activity, practitioners will be better able to:• Discuss and better understand the recently adopted screening standards for adolescents with depression and the potential advantages of using "lifestyle medicine"• Set up a process for providing effective interventions for the increased number of patients with adolescent depression• Design or update their toolbox of treatment options for adolescents with depression based on the new literature and increased demand. ABSTRACT Recently adopted quality standards recommend that pediatricians screen adolescents for depression and that they document follow-up plans for those who screen positive. As a result of these new recommendations, pediatricians and other pediatric providers, as well as psychiatrists and other mental health professionals, may face an increasing number of referrals and a growing need for effective interventions for adolescent depression. Given the widely acknowledged scarcity of traditional mental health resources, the current study reviewed the rapidly expanding array of evidence-based, but nontraditional, interventions applicable to outpatient pediatric and mental health care settings. Many of these interventions come from a lifestyle medicine framework. Lifestyle medicine interventions are congruent with the cultures of pediatrics and outpatient psychiatry, and offer additional evidence-based tools for providers managing adolescent depression. These interventions can be implemented individually or within group or community settings, and may be used in conjunction with more common interventions such as psychotherapy or psychotropic medications.
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Williams K, Hartley S, Langer S, Manandhar‐Richardson M, Sinha M, Taylor P. A systematic review and meta-ethnographic synthesis of Mindfulness-based Cognitive Therapy for people with major depression. Clin Psychol Psychother 2022; 29:1494-1514. [PMID: 35912665 PMCID: PMC9805101 DOI: 10.1002/cpp.2773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Mindfulness-based Cognitive Therapy (MBCT) is a relapse-prevention intervention for people experiencing major depression. Three qualitative meta-syntheses investigating experiences of taking part in MBCT and/or Mindfulness-based Stress Reduction (MBSR) across different diagnostic populations reported themes including control, choice, group processes, relationships and struggles. As multiple studies have been published since, we aimed to update, systematically review and synthesize the experiences of participants with depression taking part in MBCT. METHODS Four databases were searched systematically (PsycInfo, Web of Science, Medline and CINAHL) up to and including 12 November 2021. Twenty-one qualitative studies met the review criteria. All papers were rated as fair using a quality appraisal tool. Meta-ethnography was applied. RESULTS Across 21 studies of participants with current or previous depression who had participated in MBCT, three overarching themes were developed: 'Becoming skilled and taking action', 'Acceptance' and 'Ambivalence and Variability'. Participants became skilled through engagement in mindfulness practices, reporting increased awareness, perspective and agency over their experiences. Participants developed acceptance towards their experiences, self and others. There was variability and ambivalence regarding participants' expectations and difficulties within mindfulness practices. LIMITATIONS Many studies were conducted in MBCT-research centres that may hold conflicts of interest. Many studies did not address the impact of the participant-researcher relationship thus potentially affecting their interpretations. Studies were skewed towards the experiences of female participants. CONCLUSIONS Our findings help to enhance participant confidence in MBCT, alongside understanding the processes of change and the potential for difficulties. MBCT is beneficial and provides meaningful change for many but remains challenging for some.
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Affiliation(s)
- Kate Williams
- Division of Psychology & Mental Health, School of Health SciencesUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
- Greater Manchester Mental Health NHS Foundation TrustManchesterUK
- Department of Psychology, Faculty of Health, Psychology, and Social CareManchester Metropolitan UniversityManchesterUK
| | - Samantha Hartley
- Division of Psychology & Mental Health, School of Health SciencesUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
- Pennine Care NHS Foundation TrustAshton‐under‐LyneUK
| | - Susanne Langer
- Department of Psychology, Faculty of Health, Psychology, and Social CareManchester Metropolitan UniversityManchesterUK
| | | | - Melissa Sinha
- Division of Psychology & Mental Health, School of Health SciencesUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
- Greater Manchester Mental Health NHS Foundation TrustManchesterUK
| | - Peter Taylor
- Division of Psychology & Mental Health, School of Health SciencesUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
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Fàbregues S, Mumbardó-Adam C, Escalante-Barrios EL, Hong QN, Edelstein D, Vanderboll K, Fetters MD. Mixed methods intervention studies in children and adolescents with emotional and behavioral disorders: A methodological review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 126:104239. [PMID: 35526490 DOI: 10.1016/j.ridd.2022.104239] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/27/2022] [Accepted: 04/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Mixed methods intervention studies can improve the accuracy of interventional evaluations in the field of emotional and behavioral disorders by helping researchers gain a more nuanced understanding of how a particular intervention works. However, no studies to date have systematically examined the ways in which this type of studies have been carried out and reported. AIM To examine the methodological features and reporting practices found in mixed methods intervention studies in children and adolescents with emotional and behavioral disorders. METHOD Methodological review based on a systematic search from inception to July 2021 in Embase, Medline, PsycINFO, and SCOPUS, and a hand search in seven journals. RESULTS We found 30 studies, most of them published since 2019. These studies reported several patterns of mixed methods use which illustrated the unique insights that researchers can gain by using this approach. We identified several ways that authors could more clearly report the justification for using a mixed methods approach, the description of the design used, and the evidence of integration of the quantitative and qualitative components. CONCLUSION We make recommendations for improving the reporting quality of mixed methods intervention studies in the field of emotional and behavioral disorders.
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Affiliation(s)
- Sergi Fàbregues
- Department of Psychology and Education, Universitat Oberta de Catalunya, Spain.
| | - Cristina Mumbardó-Adam
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Spain
| | | | - Quan Nha Hong
- School of Rehabilitation, Université de Montréal, Canada
| | | | | | - Michael D Fetters
- Department of Family Medicine and Mixed Methods Program, University of Michigan, USA
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Cognitive mechanisms predicting resilient functioning in adolescence: Evidence from the CogBIAS longitudinal study. Dev Psychopathol 2022; 34:345-353. [DOI: 10.1017/s0954579420000668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractResilience is a dynamic process depicted by better than expected levels of functioning in response to significant adversity. This can be assessed statistically, by taking the residuals from a model of psychological functioning regressed onto negative life events. We report the first study to investigate multiple cognitive factors in relation to this depiction of resilient functioning. Life events, internalizing symptoms, and a range of cognitive risk and protective factors were assessed in a large sample of adolescents (N = 504) across three waves spaced 12–18 months apart. Adolescents who displayed fewer symptoms than expected, relative to negative life events, were considered more resilient. Adolescents who displayed more symptoms than expected, relative to negative life events, were considered less resilient. All cognitive factors were associated with resilient functioning to differing degrees. These included memory bias, interpretation bias, worry, rumination, self-esteem, and self-reported trait resilience. Regression models showed that memory bias was a key factor explaining unique variance in prospective resilient functioning. In a subsequent cross-lagged panel model, memory bias and resilient functioning were reinforcing mechanisms across time points, supporting cognitive models of emotional resilience. This study adds to the literature, by highlighting key cognitive mechanisms as potential intervention targets
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Hilt LM, Swords CM. Acceptability and Preliminary Effects of a Mindfulness Mobile Application for Ruminative Adolescents. Behav Ther 2021; 52:1339-1350. [PMID: 34656190 DOI: 10.1016/j.beth.2021.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/26/2021] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Abstract
Rumination is a transdiagnostic risk factor that appears to be reduced through mindfulness interventions. However, mindfulness mobile apps have not been tested for their effects on rumination, especially among adolescents. Thus, we aimed to test the acceptability and effects of a mindfulness mobile intervention among ruminative adolescents using a within-subjects pretest/posttest design. Participants were 80 adolescents ages 12-15, selected for moderate-to-high rumination (M age = 14.01, SD = .99; 46.2% girls; 86.25% White; 3.75% Hispanic). We asked adolescents to use our mindfulness app 3 times per day for 3 weeks. Participants and parents completed questionnaires at baseline, post-intervention, and 6 and 12 weeks later. Acceptability was assessed by tracking app use and asking adolescents and parents to report on their experiences post-intervention. We assessed repetitive negative thinking (i.e., rumination and worry) and internalizing symptoms via self- and parent-report. The intervention demonstrated acceptability, and there were significant reductions in rumination, worry, anxiety and parent-reported internalizing symptoms post-intervention. Effects on rumination, anxiety and internalizing symptoms persisted throughout the 12-week follow-up with large effect sizes using an intention-to-treat approach. Thus, a brief mindfulness mobile app intervention appeared to be both engaging and helpful in reducing negative repetitive thinking and internalizing symptoms among ruminative adolescents. It will be important to test this intervention in a randomized controlled trial to control for effects of time and attention.
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Siffredi V, Liverani MC, Smith MM, Meskaldji DE, Stuckelberger-Grobéty F, Freitas LGA, De Albuquerque J, Savigny E, Gimbert F, Hüppi PS, Merglen A, Borradori Tolsa C, Leuchter RHV. Improving executive, behavioural and socio-emotional competences in very preterm young adolescents through a mindfulness-based intervention: Study protocol and feasibility. Early Hum Dev 2021; 161:105435. [PMID: 34507019 DOI: 10.1016/j.earlhumdev.2021.105435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/17/2021] [Accepted: 07/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Very preterm (VPT) children and adolescents show executive, behavioural and socio-emotional difficulties that persist into adulthood. Despite the promising role of mindfulness-based intervention (MBI) in improving theses competences in children and adolescents, the effectiveness of an MBI has not been assessed in a VPT population so far. AIMS To describe the protocol and to evaluate the feasibility and acceptability of a clinical trial on an 8-week MBI program to enhance executive and socio-emotional competences in a cohort of VPT young adolescents. STUDY DESIGN A randomised controlled trial (RCT) and a pre-post intervention designs. PARTICIPANTS 164 VPT young adolescents from 10 to 14 years old, born before 32 gestational weeks, without major intellectual, sensory or physical impairments, and attending mainstream school, were invited to participate in an 8-week MBI program. OUTCOME MEASURES Completion rate of the study was recorded. Acceptability, satisfaction and attendance measures of the MBI were collected using self-reported questionnaires and registration of attendance. RESULTS Of the 63 participants who were enrolled in the study (38.2% of families invited to participate), 52 (82.5%) completed all assessments. Acceptability was high as shown by the high attendance rate in the sessions and the feedback evaluation questionnaire. CONCLUSIONS Our findings suggest that an MBI is feasible to implement and show a high acceptability among participants. The use of an RCT design in our study constitutes the gold standard for testing the efficacy of such intervention in VPT young adolescents. If effective, the MBI program could potentially be a valuable tool for improving executive and socio-emotional competences in the vulnerable VPT population. TRIAL REGISTRATION ClinicalTrials, NCT04638101. Registered 19 November 2020 - retrospectively registered, https://clinicaltrials.gov/show/NCT04638101.
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Affiliation(s)
- Vanessa Siffredi
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland; Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne, Switzerland; Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Switzerland
| | - Maria Chiara Liverani
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland; SensoriMotor, Affective and Social Development Laboratory, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Mariana Magnus Smith
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland; Division of General Paediatrics, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Djalel Eddine Meskaldji
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland; Institute of Mathematics, Ecole Polytechnique Fédérale de Lausanne, Switzerland
| | - Françoise Stuckelberger-Grobéty
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Lorena G A Freitas
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland; Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne, Switzerland; Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Switzerland
| | - Jiske De Albuquerque
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Emilie Savigny
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Fanny Gimbert
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland; SensoriMotor, Affective and Social Development Laboratory, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland; University of Grenoble Alpes, CNRS, LPNC, 38000 Grenoble, France
| | - Petra Susan Hüppi
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Arnaud Merglen
- Division of General Paediatrics, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Cristina Borradori Tolsa
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Russia Hà-Vinh Leuchter
- Division of Development and Growth, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals and University of Geneva, Switzerland.
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Hämäläinen T, Kaipainen K, Lappalainen P, Puolakanaho A, Keinonen K, Lappalainen R, Kiuru N. Usage activity, perceived usefulness, and satisfaction in a web-based acceptance and commitment therapy program among Finnish ninth-grade adolescents. Internet Interv 2021; 25:100421. [PMID: 34401380 PMCID: PMC8350586 DOI: 10.1016/j.invent.2021.100421] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 01/07/2023] Open
Abstract
Understanding adolescent usage activity and experiences in web-based psychological intervention programs helps in developing universal programs that can be adopted for promotion of adolescent well-being and prevention of mental health problems. This study examined the usage activity, perceived usefulness (i.e., learning of mindfulness, acceptance and value-related skills), and program satisfaction of 157 Finnish ninth-grade adolescents, who participated in a school-based five-week universal acceptance and commitment therapy web intervention called Youth Compass. Individual and growth environment-related antecedents were measured before the five-week intervention, adolescents' usage activity during the intervention, and perceived usefulness and satisfaction after the intervention. The results showed that female adolescents and adolescents with high self-regulation were more active program users and had more positive experiences of the program. Most of the adolescents used the program on at least a moderate level and perceived it to be moderately or highly useful and satisfactory. Four subgroups of adolescents were identified based on their usage activity, perceived usefulness, and satisfaction: adolescents in the satisfied group (41%) had average activity and high perceived usefulness and intervention satisfaction, the dissatisfied group (18%) had low activity and very low perceived usefulness and intervention satisfaction, the active group (8%) had very high activity and average perceived usefulness and intervention satisfaction, and the moderate group (33%) had average activity, perceived usefulness and intervention satisfaction. Gender, academic achievement, closeness to mother and teacher, and conflict with teacher were significantly related to subgroup membership. The results suggested that adolescent usage activity, perceived usefulness, and satisfaction with the Youth Compass program may to some extent be predicted based on different factors.
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Affiliation(s)
- Tetta Hämäläinen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Finland,Corresponding author at: Department of Psychology, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland.
| | - Kirsikka Kaipainen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Finland,Faculty of Information Technology and Communication Sciences, Tampere University, Finland
| | - Päivi Lappalainen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Finland
| | - Anne Puolakanaho
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Finland
| | - Katariina Keinonen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Finland
| | - Raimo Lappalainen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Finland
| | - Noona Kiuru
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Finland
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Rich BW, Stager SL. Mindful BALANCE (breathe act learn about 'now' care everyday): A pilot project for depressed female adolescents. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2021; 34:125-132. [PMID: 33616309 DOI: 10.1111/jcap.12308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 11/19/2020] [Accepted: 01/29/2021] [Indexed: 12/21/2022]
Abstract
PROBLEM Major depressive episodes in adolescent females have increased during the past decade, placing them at risk to engage in unhealthy lifestyle behaviors, unsafe thoughts, suicidal ideation, and lethal actions. Mindfulness, a tool for stress management, is underutilized. METHODS Mindful BALANCE (Breathe Act Learn About 'Now' Care Everyday), a group therapy pilot program introduced a variety of mindfulness activities. The extended mindfulness followed the Creating Opportunities for Personal Empowerment (COPE), a Cognitive Behavioral Therapy Skills Building (CBSB) Healthy Lifestyle program. The pilot program was offered in an outpatient mental health department for 7 weeks. FINDINGS Mindful BALANCE is a feasible program as an adjunct to individualized psychotherapy. Six subjects engaged without absence with a completion rate of 83%. Six subjects had pre- and post-scores for depression and anxiety decrease. Mindfulness practice was reported to decrease the perception of stress. CONCLUSION Mindful BALANCE decreased perceived depression and anxiety symptoms while positively impacting healthy activities in adolescent females. Further research is necessary to readdress feasibility and extended mindfulness components in improving global well-being and diminishing suicide risk.
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Affiliation(s)
- Beverly Waldman Rich
- Emma Pendleton Bradley Hospital, Providence, Rhode Island, USA.,Rhode Island College, Providence, Rhode Island, USA
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15
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Rumination as a Mediator of the Prospective Association Between Victimization and Bullying. Res Child Adolesc Psychopathol 2021; 49:339-350. [PMID: 33404941 PMCID: PMC7878240 DOI: 10.1007/s10802-020-00755-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 11/16/2022]
Abstract
Although there is evidence of concurrent associations between victimization and bully perpetration, it is still unclear how this relation unfolds over time. This study investigates whether victimization in childhood is a prospective risk factor for bully perpetration in early adolescence, and examines rumination as a socio-cognitive factor that may mediate this association. Participants included 553 third graders (43.2% boys; Mage = 9.85), with follow-up assessments when they were in fourth, seventh, and eighth grade. Results indicated that more frequent victimization in grades 3 and 4 was indirectly associated with bully perpetration in grade 8, through rumination in grade 7 about past victimization experiences in elementary school. This pattern remained regardless of whether the rumination elicited feelings of anger or sadness. Our findings demonstrate one pathway through which frequent victimization can lead to perpetration and underscore the important role of rumination in victims’ subsequent adjustment. Implications for future interventions are discussed.
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Effects of mindfulness interventions on depressive symptoms in adolescents: A meta-analysis. Int J Nurs Stud 2020; 115:103848. [PMID: 33383273 DOI: 10.1016/j.ijnurstu.2020.103848] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Depression among adolescents is rising globally and is the leading cause of illness and disability among adolescents. While antidepressants and psychotherapy are effective, only about 40% of depressed adolescents receive treatments due to lack of professionals and barriers such as cost and personal obstacles including stigma, lack of motivation, and negative perceptions of treatment. Use of alternative and complementary treatments for depression is growing. One such treatment is mindfulness meditation. OBJECTIVE We examined the effects of mindfulness interventions on depression among adolescents and explored the moderator effects of participants, methods, and intervention characteristics. METHODS We searched 17 databases from their inception to April 2019 to identify studies written in English. Search terms included depress* AND mindful* OR meditat* AND adolescen* OR student*; 29 studies met inclusion criteria. Two researchers independently coded data from all primary studies. Discrepancies were discussed with a third researcher to reach consensus. Using the random effects model, we computed the effect sizes (ESs) of mindfulness interventions on depression using standardized mean differences (Hedge's g) with 95% confidence intervals (CI). Funnel plot, Q statistics, and I2 were used to test the heterogeneity across studies. We examined moderators to explore sources of heterogeneity. RESULTS Across 29 studies (N=3688), 1839 adolescents participated in mindfulness interventions; 1849 served as controls. Mean ages ranged from 10.2 to 19.5 years. Mindfulness groups showed reduced depression compared to control groups (g=.14, 95%CI[.01-.28], p<.042). Funded studies showed greater improvement in depression (g=.34, 95%CI[.09-.58], p<.008) compared to unfunded (g=.05, 95%CI[-.12-.22], p<.554). Interestingly, while only two research teams studied mindfulness-based cognitive therapy, they showed trends toward improvement (p=0.09) in depression (g=.76, 95%CI[.18-1.34], p<.010, s=2) compared to adapted mindfulness interventions (g=.13, 95%CI[-.04-.30], p<.140, s=16) or mindfulness-based stress reduction (g=.07, 95%CI[-.16-.29], p<.559, s=11). Mindfulness interventions with individual counseling tended (p=0.09) to improve depression (g=.46, 95%CI[.07-.85], p<.021, s=3) more than without (g=.10, 95%CI[-.04-.24], p<.168, s=26). Depression improved more when follow-up measures occurred further from the intervention (Slope=.002, τ2=.74, Qbetween=4.10, p=.043, s=29). No quality indicators moderated the ES of mindfulness interventions on depression. CONCLUSION Mindfulness interventions are mildly effective interventions to reduce depressive symptoms among adolescents. Clinicians trained in mindfulness interventions might encourage mindfulness meditation as adjunctive/alternative treatment for adolescents with mild or moderate depressive symptoms as well as for at-risk adolescents to prevent depression. Funding, type of mindfulness interventions, individual counseling, and time to follow up were moderators of the effects of mindfulness interventions on depression in adolescents.
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Carlton CN, Sullivan-Toole H, Strege MV, Ollendick TH, Richey JA. Mindfulness-Based Interventions for Adolescent Social Anxiety: A Unique Convergence of Factors. Front Psychol 2020; 11:1783. [PMID: 32774320 PMCID: PMC7387717 DOI: 10.3389/fpsyg.2020.01783] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 06/29/2020] [Indexed: 11/17/2022] Open
Abstract
Social anxiety disorder (SAD) is a debilitating and often chronic psychiatric disorder that typically onsets during early adolescence. Cognitive behavior therapy (CBT), the current "gold-standard" treatment for SAD, tends to focus on threat- and fear-based systems hypothesized to maintain the disorder. Despite this targeted approach, SAD ranks among the least responsive anxiety disorders to CBT in adolescent samples, with a considerable proportion of individuals still reporting clinically significant symptoms following treatment, suggesting that the CBT-family of interventions may not fully target precipitating or maintaining factors of the disorder. This gap in efficacy highlights the need to consider new therapeutic modalities. Accordingly, this brief review critically evaluates the emergent literature supporting the use of mindfulness-based interventions (MBIs) for treating adolescent SAD. MBIs may be particularly relevant for addressing maintaining factors within this diagnosis, as they may target and interrupt cycles of avoidance and de-motivation. Despite limitations in the relative lack of randomized controlled trials (RCTs) on this topic, a unique convergence of factors emerge from the extant literature that support the notion that MBIs may hold particular promise for attenuating symptoms of SAD in adolescents. These factors include: (1) MBIs demonstrate the ability to directly engage symptoms of SAD; (2) MBIs also show consistent reduction of anxiety, including symptoms of social anxiety in adolescent populations; and (3) MBIs demonstrate high rates of feasibility and acceptability in anxious adolescent samples. We briefly review each topic and conclude that MBIs are an encouraging treatment approach for reducing symptoms of social anxiety in adolescents. However, given the lack of research within MBIs for adolescent SAD in particular, more research is needed to determine if MBIs are more advantageous than other current treatment approaches.
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Affiliation(s)
- Corinne N. Carlton
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - Holly Sullivan-Toole
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, United States
| | - Marlene V. Strege
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - Thomas H. Ollendick
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - John A. Richey
- Clinical Science Program, Department of Psychology, Virginia Tech, Blacksburg, VA, United States
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Shanok NA, Reive C, Mize KD, Jones NA. Mindfulness Meditation Intervention Alters Neurophysiological Symptoms of Anxiety and Depression in Preadolescents. J PSYCHOPHYSIOL 2020. [DOI: 10.1027/0269-8803/a000244] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Mindfulness meditation interventions (MMIs) are formal training programs which utilize mindfulness techniques to improve attentional control and reduce stress and anxiety. Past investigations have shown that mindfulness-based interventions are effective in improving symptoms of anxiety and depression in both adolescents and adults, making this a promising natural approach to treating mood disorders. The current study sought to examine the neurophysiological effects of a 10-week MMI, in a relatively unexplored age-range (7–10 years). The non-clinical participants demonstrated increases in interhemispheric alpha coherence, as well as increased theta, alpha, and beta power particularly in frontal and central areas; reflecting a lower neurological risk for anxiety development. However, two common measures linked to anxiety, frontal and posterior alpha asymmetry remained largely unchanged following the training period. Still, these preliminary results exemplify the potentially positive effects of mindfulness meditation on preadolescents; this time on neurophysiological functioning.
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Affiliation(s)
- Nathaniel A. Shanok
- Developmental Neuroscience Lab, Charles E. Schmidt College of Science, Florida Atlantic University, Boca Raton, FL, USA
| | - Carol Reive
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Krystal D. Mize
- Developmental Neuroscience Lab, Charles E. Schmidt College of Science, Florida Atlantic University, Boca Raton, FL, USA
| | - Nancy Aaron Jones
- Developmental Neuroscience Lab, Charles E. Schmidt College of Science, Florida Atlantic University, Boca Raton, FL, USA
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19
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Marino F, Crimi I, Carrozza C, Failla C, Sfrazzetto ST, Chilà P, Bianco M, Arnao AA, Tartarisco G, Cavallaro A, Ruta L, Vagni D, Pioggia G. A Novel Third Wave Contextual Approach of Positive Behavior Support in School for Adolescent at High Psychosocial Risk: Rationale, Feasibility, and First Pilot Outcomes. Front Psychol 2019; 10:2635. [PMID: 31849758 PMCID: PMC6896099 DOI: 10.3389/fpsyg.2019.02635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 11/07/2019] [Indexed: 11/23/2022] Open
Abstract
Adolescence is a stage in life when dramatic physical, cognitive and socio-emotional changes occur. When adolescents grow-up in deprived social environments, the chance of psychophysical well-being severely decreases and problems such as delinquency, substance abuse and mental health issues are much more likely to ensue. Third wave cognitive-behavioral interventions are increasingly becoming the chosen instruments to support psychological intervention for young people and adolescents. In this study, we aim to test the feasibility and the adequacy of the outcome measures of an intervention for adolescents at high psychosocial risk, using a modified Discoverer, Noticer, Advisor and Values (DNA-V) protocol aimed at increasing flexible and positive values. The project was conducted in a school located in a low Socio-Economic Status (SES) and severely deprived district of a metropolitan area in Messina, Italy, with 3 classes from 6th to 8th grade. All parents and teachers allowed participants to take part in the pilot study. However, the participants' willingness to engage in the study was low (1 out of 3 classes). Overall, 13 adolescents (72% of the enrolled class) participated in the pilot and only 2 out of 7 teachers and no parents were available for interviews. In its current form, a full RCT is not considered feasible due to general low motivation showed by the participants. Although the sample size was small, the intervention program showed a statistically significant main effect for students' self-report questionnaire, suggesting that those measures were appropriate. Modifications and additional measures are suggested to increase participants' engagement and to overcome the need for parents and teachers' interviews.
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Affiliation(s)
- Flavia Marino
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Ilaria Crimi
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Cristina Carrozza
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Chiara Failla
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Stefania Trusso Sfrazzetto
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Paola Chilà
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | | | - Antonino A. Arnao
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Gennaro Tartarisco
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Angelo Cavallaro
- Istituto Comprensivo “G. Catalfamo”, Secondary School, Messina, Italy
| | - Liliana Ruta
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - David Vagni
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
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Kechter A, Leventhal AM. Longitudinal Association of Sleep Problems and Distress Tolerance During Adolescence. Behav Med 2019; 45:240-248. [PMID: 30358501 PMCID: PMC6483882 DOI: 10.1080/08964289.2018.1514362] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 04/05/2018] [Accepted: 08/13/2018] [Indexed: 02/04/2023]
Abstract
The mechanism by which sleep problems adversely impacts adolescent health is poorly understood. Distress tolerance-a multifactorial trait indicative of one's ability to withstand negative emotions and persist toward long-term goals-is implicated in numerous emotional psychopathologies and an important target for research and practice. We hypothesized that the adverse psychobiological effects of sleep problems could disrupt the development of distress tolerance during adolescence. This longitudinal study examined whether sleep problems predicted changes in four facets of distress tolerance during adolescence: (1) absorption-feeling attention is captured by negative emotions, (2) appraisal-experiencing distress as unacceptable, (3) regulation-engaging in behaviors to terminate distress, and (4) tolerance-low perceived ability to tolerate distress. High school students (M baseline age = 15.5 years, N = 2,309, 56.1% female), completed self-report measures of sleep problems and distress tolerance at baseline and 1-year follow-up. In linear regression models adjusting for baseline distress tolerance, sleep problems predicted poorer distress tolerance at 1-year follow-up for each distress tolerance facet (βs = -0.10 to -0.24, ps ≤ 0.02). After additionally controlling for sociodemographics and emotional psychopathology, sleep problems were associated with poorer distress tolerance for absorption (β = -0.13, p = 0.004) and appraisal (β = -0.09, p = 0.049) facets, but not regulation or tolerance (ps ≥ 0.35) facets. Interventions targeting healthy sleep habits warrant consideration for improving adolescent development of certain facets of distress tolerance, and in turn various positive health outcomes improved by distress tolerance.
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Affiliation(s)
- Afton Kechter
- a Department of Preventive Medicine, Keck School of Medicine, University of Southern California , Los Angeles , California , USA
| | - Adam M Leventhal
- a Department of Preventive Medicine, Keck School of Medicine, University of Southern California , Los Angeles , California , USA
- b Department of Psychology, University of Southern California , Los Angeles , California , USA
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Testing the Feasibility of a Mindfulness-Based Intervention With Underserved Adolescents at Risk for Depression. Holist Nurs Pract 2018; 32:316-323. [PMID: 30320656 DOI: 10.1097/hnp.0000000000000295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study tested the feasibility, acceptability, and preliminary effects of a mindfulness-based intervention with at-risk adolescents from a predominantly Hispanic/Latino community. Seven adolescents (57% female, 85% Hispanic/Latino) completed the mindfulness-based intervention, demonstrating feasibility, and reported acceptability as well as sustained improvements in depressive symptoms, perceived stress, and self-esteem.
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22
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Sams DP, Handley ED, Alpert-Gillis LJ. Mindfulness-based group therapy: Impact on psychiatrically hospitalized adolescents. Clin Child Psychol Psychiatry 2018; 23:582-591. [PMID: 29781293 DOI: 10.1177/1359104518775144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The practice of mindfulness has long been incorporated into psychotherapy. Research on the therapeutic benefits of mindfulness exists within adult populations, and emerging empirical evidence demonstrates the benefit of such practices in the treatment of adolescents in both clinical and non-clinical settings. However, there are extremely limited data on the practice of mindfulness with adolescents in a psychiatric hospital. The iMatter ( Improve Mindful ATTention, Enhance Relaxation) group is a manualized program developed to provide adolescents on a short-term psychiatric inpatient unit with an opportunity to learn and practice relaxation strategies, mindfulness exercises, and simple yoga poses. Mindfulness skills are taught in the context of the group and include self-observation of thoughts and feelings, breathing exercises, self-validation of one's experience, loving-kindness toward self, non-judgmental stance toward self, and acceptance and observation of change within self. Participants included 65 adolescents aged 13-17 years ( M = 15.06, standard deviation ( SD) = 1.34) who took part in at least one session of the iMatter intervention. Improvements in self-reported mood were evident following participation in a mindfulness group. Also, participants' heart rate significantly decreased following participation in two groups. Future directions include improved integration of mindfulness into the milieu and other unit programming. Furthermore, comparing self-reported mood and physiological measures from this sample to findings obtained for other unit groups will further clarify the impact of the iMatter intervention.
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Affiliation(s)
- Deanna P Sams
- Department of Psychiatry, University of Rochester Medical Center, USA
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Abujaradeh H, Safadi R, Sereika SM, Kahle CT, Cohen SM. Mindfulness-Based Interventions Among Adolescents With Chronic Diseases in Clinical Settings: A Systematic Review. J Pediatr Health Care 2018; 32:455-472. [PMID: 29941236 DOI: 10.1016/j.pedhc.2018.04.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 04/11/2018] [Indexed: 11/16/2022]
Abstract
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.
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A Mindfulness Program Adapted for Adolescents With Chronic Pain: Feasibility, Acceptability, and Initial Outcomes. Clin J Pain 2018; 33:1019-1029. [PMID: 28328699 DOI: 10.1097/ajp.0000000000000490] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Pediatric chronic pain is a major health issue that 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 adapted 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.
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Parcover J, Coiro MJ, Finglass E, Barr E. Effects of a Brief Mindfulness Based Group Intervention On College Students. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2017. [DOI: 10.1080/87568225.2017.1407722] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
| | - Mary Jo Coiro
- Loyola University Maryland, Baltimore, Maryland, USA
| | | | - Emily Barr
- Loyola University Maryland, Baltimore, Maryland, USA
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Racey DN, Fox J, Berry VL, Blockley KV, Longridge RA, Simmons JL, Janssens A, Kuyken W, Ford TJ. Mindfulness-Based Cognitive Therapy for Young People and Their Carers: a Mixed-Method Feasibility Study. Mindfulness (N Y) 2017; 9:1063-1075. [PMID: 30100931 PMCID: PMC6061254 DOI: 10.1007/s12671-017-0842-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We aimed to evaluate whether mindfulness-based cognitive therapy (MBCT) was feasible and acceptable for young people, their parents and the clinicians working with them; whether a parallel course for parents was a useful addition; and whether attendance at MBCT was associated with improved outcomes. The design was a mixed-method service evaluation of an eight-session MBCT programme for young people who were recovering from depression. The course was a manualised eight-session group intervention. Both young people (n = 18) and parents (n = 21) completed validated measures before and after the course. Semi-structured interviews were completed with some group participants and clinical staff working in the service. Care records were searched for additional contact following the intervention. Qualitative data from young people, parents and clinicians suggested that MBCT was acceptable and feasible and provided strategies to cope. The parent course was reported to provide personal support to parents and helped them cope with their child's depression whilst also impacting the family, promoted shared understanding of depression and strategies to combat it and addressed intergenerational aspects of depression. Eighty-four per cent of participants attended at least 6/8 sessions, and 48% required no further intervention within the following year. Young people had statistically significant improvements across all outcome measures, whilst parents had statistically significant improvements in rumination, self-compassion and decentring.
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Affiliation(s)
- Daniel N. Racey
- Child Mental Health Group, University of Exeter Medical School, South Cloisters, St. Luke’s Campus, Heavitree Road, Exeter, EX1 1TE UK
| | - Jerry Fox
- AccEPT Clinic, Mood Disorders Centre, University of Exeter, Sir Henry Wellcome Building, Streatham Drive, Exeter, EX4 4QG UK
| | - Vashti L. Berry
- Child Mental Health Group, University of Exeter Medical School, South Cloisters, St. Luke’s Campus, Heavitree Road, Exeter, EX1 1TE UK
- NIHR CLAHRC South West Peninsula (PenCLAHRC), South Cloisters, St. Luke’s Campus, Heavitree Road, Exeter, EX1 1TE UK
| | - Kelly V. Blockley
- Child Mental Health Group, University of Exeter Medical School, South Cloisters, St. Luke’s Campus, Heavitree Road, Exeter, EX1 1TE UK
- NIHR CLAHRC South West Peninsula (PenCLAHRC), South Cloisters, St. Luke’s Campus, Heavitree Road, Exeter, EX1 1TE UK
| | - Rachel A. Longridge
- Child Mental Health Group, University of Exeter Medical School, South Cloisters, St. Luke’s Campus, Heavitree Road, Exeter, EX1 1TE UK
| | - Jennifer L. Simmons
- Devon Child and Adolescent Mental Health Service, Evergreen House, Victoria Park Road, Exeter, EX2 4NU UK
| | - Astrid Janssens
- Child Mental Health Group, University of Exeter Medical School, South Cloisters, St. Luke’s Campus, Heavitree Road, Exeter, EX1 1TE UK
| | - Willem Kuyken
- Oxford Mindfulness Centre, University of Oxford Department of Psychiatry, The Prince of Wales International Centre, Warneford Hospital, Oxford, OX3 7JX UK
| | - Tamsin J. Ford
- Child Mental Health Group, University of Exeter Medical School, South Cloisters, St. Luke’s Campus, Heavitree Road, Exeter, EX1 1TE UK
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Klingbeil DA, Renshaw TL, Willenbrink JB, Copek RA, Chan KT, Haddock A, Yassine J, Clifton J. Mindfulness-based interventions with youth: A comprehensive meta-analysis of group-design studies. J Sch Psychol 2017. [DOI: 10.1016/j.jsp.2017.03.006] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Moreira H, Canavarro MC. Is body shame a significant mediator of the relationship between mindfulness skills and the quality of life of treatment-seeking children and adolescents with overweight and obesity? Body Image 2017; 20:49-57. [PMID: 27936409 DOI: 10.1016/j.bodyim.2016.11.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 11/15/2016] [Accepted: 11/17/2016] [Indexed: 10/20/2022]
Abstract
This study aimed to examine (a) whether mindfulness skills were associated with higher quality of life through lower body shame for treatment-seeking children/adolescents with overweight and obesity and (b) whether this indirect effect was moderated by children/adolescents' age and gender. The sample included 153 children/adolescents with overweight/obesity followed in individual nutrition consultations. Participants completed self-report measures of mindfulness, body shame, and quality of life. Moderated mediation analyses showed that higher levels of mindfulness were associated with better perceived quality of life through lower body shame, but only among girls. For boys, higher levels of body shame did not translate into a poorer perception of quality of life, and the indirect effect of mindfulness on quality of life via lower body shame was not significant. These results suggest that body shame is an important mechanism to explain why mindfulness may help girls with overweight/obesity perceive a better quality of life.
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Affiliation(s)
- Helena Moreira
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
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Van Vliet KJ, Foskett AJ, Williams JL, Singhal A, Dolcos F, Vohra S. Impact of a mindfulness-based stress reduction program from the perspective of adolescents with serious mental health concerns. Child Adolesc Ment Health 2017; 22:16-22. [PMID: 32680409 DOI: 10.1111/camh.12170] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/06/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND While studies on mindfulness-based stress reduction (MBSR) for youth have recently emerged, there is a shortage of research on how adolescents from clinical populations experience MBSR. The purpose of this qualitative study was to explore the impact of MBSR from the subjective perspective of adolescents with serious mental health concerns. METHOD Adolescents (n = 28) from a residential treatment center participated in an adapted 8-week MBSR program in which they learned a range of mindfulness skills and were encouraged to apply the skills to their everyday lives. At the end of the program and at a 3-month follow-up, the youth participated in semistructured interviews in which they were asked to describe the impact of the program from their perspectives. Basic interpretive qualitative analysis methods were used to code the data and to group the codes into higher level themes. RESULTS Six main themes were found, including improved mood, enhanced relationship to self, increased self-control, improved problem-solving, awareness of the present, and enhanced interpersonal relationships. DISCUSSION Results from this study suggest that the MBSR program was perceived as beneficial both in the short-term and follow-up in several aspects of emotional, cognitive, and interpersonal functioning.
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Affiliation(s)
- K Jessica Van Vliet
- Department of Educational Psychology, University of Alberta, 6-102 Education North, Edmonton, AB, T6G 2G5, Canada
| | - Allison J Foskett
- Department of Educational Psychology, University of Alberta, 6-102 Education North, Edmonton, AB, T6G 2G5, Canada
| | - Jennifer L Williams
- Department of Educational Psychology, University of Alberta, 6-102 Education North, Edmonton, AB, T6G 2G5, Canada
| | - Anthony Singhal
- Department of Psychology, University of Alberta, Edmonton, AB, Canada
| | - Florin Dolcos
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Sunita Vohra
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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Abstract
Individuals with attention-deficit/hyperactivity disorder (ADHD) experience impairments in a number of functional domains. Although current evidence-based treatments for ADHD reduce symptoms and improve academic and behavioral functioning, they have minimal impact on social functioning or on risky behaviors (see Evans et al. in J Clin Child Adolesc Psychol, 43:527-551, 2014 for review). Preliminary evidence indicates that emotion dysregulation (ED) is associated with impairments across the developmental spectrum, such as social impairment and risky behaviors, and that its relative absence/presence is differentially associated with treatment response. It thus stands to reason that by incorporating a focus on ED in interventions targeting social impairment and risky behaviors, we may be able to increase the number of youth who respond to such interventions and decrease the prevalence or degree of these impairments and behaviors among youth and adults with ADHD. However, a number of questions remain unaddressed about the association between ADHD and ED, such as the portion of individuals with ADHD who experience ED, the extent to which ED is associated with the above impairments and behaviors, and whether or not ED is malleable. To begin addressing these questions, we summarize and critically evaluate the literature on the association between ADHD and ED and make recommendations for future basic, translational, and treatment outcome research.
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Miró J, Castarlenas E, de la Vega R, Roy R, Solé E, Tomé-Pires C, Jensen MP. Psychological Neuromodulatory Treatments for Young People with Chronic Pain. CHILDREN (BASEL, SWITZERLAND) 2016; 3:E41. [PMID: 27929419 PMCID: PMC5184816 DOI: 10.3390/children3040041] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 11/15/2016] [Accepted: 11/30/2016] [Indexed: 01/02/2023]
Abstract
The treatment of young people with chronic pain is a complex endeavor. Many of these youth do not obtain adequate relief from available interventions. Psychological neuromodulatory treatments have been shown to have potential benefit for adults with chronic pain. Here, we review and summarize the available information about the efficacy of three promising psychological neuromodulatory treatments-neurofeedback, meditation and hypnosis-when provided to young people with chronic pain. A total of 16 articles were identified and reviewed. The findings from these studies show that hypnotic treatments are effective in reducing pain intensity for a variety of pediatric chronic pain problems, although research suggests variability in outcomes as a function of the specific pain problem treated. There are too few studies evaluating the efficacy of neurofeedback or meditation training in young people with chronic pain to draw firm conclusions regarding their efficacy. However, preliminary data indicate that these treatments could potentially have positive effects on a variety of outcomes (e.g., pain intensity, frequency of pain episodes, physical and psychological function), at least in the short term. Clinical trials are needed to evaluate the effects of neurofeedback and meditation training, and research is needed to identify the moderators of treatment benefits as well as better understand the mechanisms underlying the efficacy of all three of these treatments. The findings from such research could enhance overall treatment efficacy by: (1) providing an empirical basis for better patient-treatment matching; and (2) identifying specific mechanisms that could be targeted with treatment.
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Affiliation(s)
- Jordi Miró
- Chair in Pediatric Pain URV-Fundación Grünenthal, Unit for the Study and Treatment of Pain, ALGOS, 43007 Tarragona, Catalonia, Spain.
- Research Center for Behavior Assessment (CRAMC), Department of Psychology, 43007 Tarragona, Catalonia, Spain.
- Institut d'Investigació Sanitària Pere Virgili, Reus 43202, Catalonia, Spain.
| | - Elena Castarlenas
- Chair in Pediatric Pain URV-Fundación Grünenthal, Unit for the Study and Treatment of Pain, ALGOS, 43007 Tarragona, Catalonia, Spain.
- Research Center for Behavior Assessment (CRAMC), Department of Psychology, 43007 Tarragona, Catalonia, Spain.
- Institut d'Investigació Sanitària Pere Virgili, Reus 43202, Catalonia, Spain.
| | - Rocío de la Vega
- Chair in Pediatric Pain URV-Fundación Grünenthal, Unit for the Study and Treatment of Pain, ALGOS, 43007 Tarragona, Catalonia, Spain.
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98105, USA.
| | - Rubén Roy
- Chair in Pediatric Pain URV-Fundación Grünenthal, Unit for the Study and Treatment of Pain, ALGOS, 43007 Tarragona, Catalonia, Spain.
- Research Center for Behavior Assessment (CRAMC), Department of Psychology, 43007 Tarragona, Catalonia, Spain.
- Institut d'Investigació Sanitària Pere Virgili, Reus 43202, Catalonia, Spain.
| | - Ester Solé
- Chair in Pediatric Pain URV-Fundación Grünenthal, Unit for the Study and Treatment of Pain, ALGOS, 43007 Tarragona, Catalonia, Spain.
- Research Center for Behavior Assessment (CRAMC), Department of Psychology, 43007 Tarragona, Catalonia, Spain.
- Institut d'Investigació Sanitària Pere Virgili, Reus 43202, Catalonia, Spain.
| | - Catarina Tomé-Pires
- Chair in Pediatric Pain URV-Fundación Grünenthal, Unit for the Study and Treatment of Pain, ALGOS, 43007 Tarragona, Catalonia, Spain.
- Research Center for Behavior Assessment (CRAMC), Department of Psychology, 43007 Tarragona, Catalonia, Spain.
- Institut d'Investigació Sanitària Pere Virgili, Reus 43202, Catalonia, Spain.
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98105, USA.
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Fedewa AL, Ahn S, Reese RJ, Suarez MM, Macquoid A, Davis MC, Prout HT. Does psychotherapy work with school-aged youth? A meta-analytic examination of moderator variables that influence therapeutic outcomes. J Sch Psychol 2016; 56:59-87. [PMID: 27268570 DOI: 10.1016/j.jsp.2016.03.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 11/23/2015] [Accepted: 03/16/2016] [Indexed: 11/30/2022]
Abstract
The present study is a quantitative synthesis of the available literature to investigate the efficacy of psychotherapy for children's mental health outcomes. In particular, this study focuses on potential moderating variables-study design, treatment, client, and therapist characteristics-that may influence therapeutic outcomes for youth but have not been thoroughly accounted for in prior meta-analytic studies. An electronic search of relevant databases resulted in 190 unpublished and published studies that met criteria for inclusion in the analysis. Effect sizes differed by study design. Pre-post-test designs resulted in absolute magnitudes of treatment effects ranging from |-0.02| to |-0.76| while treatment versus control group comparison designs resulted in absolute magnitudes of treatment effects ranging from |-0.14| to |-2.39|. Changes in youth outcomes larger than 20% were found, irrespective of study design, for outcomes focused on psychosomatization (29% reduction), school attendance (25% increase), and stress (48% reduction). The magnitude of changes after psychotherapy ranged from 6% (externalizing problems) to 48% (stress). Several moderator variables significantly influenced psychotherapy treatment effect sizes, including frequency and length of treatment as well as treatment format. However, results did not support the superiority of a single type of intervention for most outcomes. Implications for therapy with school-aged youth and future research are discussed.
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Affiliation(s)
- Alicia L Fedewa
- Department of Educational, School, and Counseling Psychology, University of Kentucky, United States.
| | - Soyeon Ahn
- Department of Educational and Psychological Studies, University of Miami, United States
| | - Robert J Reese
- Department of Educational, School, and Counseling Psychology, University of Kentucky, United States
| | - Marietta M Suarez
- Department of Educational and Psychological Studies, University of Miami, United States
| | - Ahjane Macquoid
- Department of Educational and Psychological Studies, University of Miami, United States
| | - Matthew C Davis
- Department of Educational, School, and Counseling Psychology, University of Kentucky, United States
| | - H Thompson Prout
- Department of Educational, School, and Counseling Psychology, University of Kentucky, United States
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Abstract
OBJECTIVES Previous research has demonstrated that mindfulness-based programmes improve psychological functioning in a myriad of adult domains. These include health care, marketing and sports industries. The efficacy of mindfulness-based programmes in the adult population is well established. Indeed, compared to adult empirical literature, mindfulness programmes for adolescents are relatively developmental and less articulated until now. It may be argued that mindfulness-based programmes could and should begin early and be applicable to young people at a time that is critical in their development. Hence, this article analyses the characteristics, objectives and outcomes of mindfulness interventions for adolescents, focusing on the mindfulness programme adjustments and adaptations made to the content for this target group. METHOD A critique of the literature that included published articles of mindfulness-based interventions (both clinical and universal programmes) for adolescents were sourced and reviewed. Conference papers and unpublished dissertations were excluded. RESULTS The review indicated that a majority of these were longitudinal and feasibility studies, with only one clinical randomised controlled trial study. CONCLUSION Preliminary evidence for the use of mindfulness-based with adolescents continues to be nascent, with many of the studies using inappropriate or no mindfulness process measures at all. In addition, a majority of the studies did not provide specific details of the mindfulness programmes for adolescents, nor discuss what modifications were undertaken--all of which makes comparison difficult. However, with the availability of recent and age-appropriate mindfulness measures for adolescents, more rigorous and robust research looks promising.
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Affiliation(s)
- Lucy B G Tan
- School of Medicine, The University of Queensland, Herston, AustraliaChildren's Health Queensland, Child & Youth Mental Health Services, South Brisbane, Australia
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The Role of Anxiety on the Experience of Peer Victimization and Eating Disorder Risk. SCHOOL MENTAL HEALTH 2016. [DOI: 10.1007/s12310-016-9178-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cheng FK. Is meditation conducive to mental well-being for adolescents? An integrative review for mental health nursing. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2016. [DOI: 10.1016/j.ijans.2016.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Kwan B, Rickwood DJ. A systematic review of mental health outcome measures for young people aged 12 to 25 years. BMC Psychiatry 2015; 15:279. [PMID: 26573269 PMCID: PMC4647516 DOI: 10.1186/s12888-015-0664-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 10/27/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Mental health outcome measures are used to monitor the quality and effectiveness of mental health services. There is also a growing expectation for implementation of routine measurement and measures being used by clinicians as a feedback monitoring system to improve client outcomes. The recent focus in Australia and elsewhere targeting mental health services to young people aged 12-25 years has meant that outcome measures relevant to this age range are now needed. This is a shift from the traditional divide of child and adolescent services versus adult services with a transitioning age at 18 years. This systematic review is the first to examine mental health outcome measures that are appropriate for the 12 to 25 year age range. METHODS MEDLINE and PsychINFO databases were systematically searched to identify studies using mental health outcome measures with young people aged 12 to 25 years. The search strategy complied with the relevant sections of the PRISMA statement. RESULTS A total of 184 published articles were identified, covering 29 different outcome measures. The measures were organised into domains that consisted of eight measures of cognition and emotion, nine functioning measures, six quality of life measures, and six multidimensional mental health measures. No measures were designed specifically for young people aged 12 to 25 years and only two had been used by clinicians as a feedback monitoring system. Five measures had been used across the whole 12 to 25 year age range, in a range of mental health settings and were deemed most appropriate for this age group. CONCLUSIONS With changes to mental health service systems that increasingly focus on early intervention in adolescence and young adulthood, there is a need for outcome measures designed specifically for those aged 12 to 25 years. In particular, multidimensional measures that are clinically meaningful need to be developed to ensure quality and effectiveness in youth mental health. Additionally, outcome measures can be clinically useful when designed to be used within routine feedback monitoring systems.
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Affiliation(s)
- Benjamin Kwan
- Faculty of Health, University of Canberra, Kirinari Street, Bruce, ACT, 2601, Australia.
| | - Debra J Rickwood
- Faculty of Health, University of Canberra, Kirinari Street, Bruce, ACT, 2601, Australia.
- Headspace National Youth Mental Health Foundation National Office, 485 La Trobe Street, Melbourne, VIC, 3000, Australia.
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Applications and adaptations of Acceptance and Commitment Therapy (ACT) for adolescents. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2015. [DOI: 10.1016/j.jcbs.2015.01.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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