A Mindfulness-Based Intervention Pilot Feasibility Study for Elementary School Students With Severe Learning Difficulties: Effects on Internalized and Externalized Symptoms From an Emotional Regulation Perspective

Improving Self-Regulation: Resiliency Skills in the Classroom

PURPOSE

The impact of daily living often results in unimaginable stress for children, which can be exhibited as lack of self-control. Children with decreased self-regulation are often not successful in school. Many schools do not have the resources needed to employ professionals who could provide programs to improve self-regulation. Creative programs that can be implemented into the classroom without disrupting the school day are needed. The current article describes a resiliency program that was implemented in a school setting to increase self-regulation.

METHOD

This pilot project used descriptive statistics to analyze the feasibility of incorporating resiliency skills into an elementary school curriculum and the resulting impact on self-regulation among school-aged children.

RESULTS

Improvements were identified in self-esteem, compassion, and classroom behavior.

CONCLUSION

Implementing resiliency skills into the curriculum can result in positive outcomes by improving self-regulation in school-aged children. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

The Effect of a Short-Term Mindfulness Program on Motor Skills and on Psychological and Social Behavior in Preschool Children: A Randomized Controlled Trial

We assessed the effect of a one-week mindfulness-based intervention on resilience, social behavior, and motor skills in four to five-year-old children. In this randomized controlled trial, 45 children (22 females; 23 males; M age = 4.5, SD = 0.4 years) from the same preschool were randomly assigned to three groups: (a) a mindfulness group (MG; n = 15) that participated in five 30-min mindfulness sessions; (b) a physical activity group (PAG; n = 15) that engaged in five 45-min physical exercise sessions; and a control group (CG; n = 15) that received no intervention. Training sessions were held on five consecutive days. Prior to (T0) and after the five mindfulness sessions (T1), all participants blindly completed the Movement Assessment Battery for Children-2 (to assess their motor skills), the Strength and Difficulties Questionnaire (to evaluate their behavior), and the Child and Youth Resilience Measure-28 (to measure their resilience). At baseline (T0), there were no significant differences between the groups. The mindfulness group experienced the strongest positive effects after the intervention (T1), with improvements in both motor skills and social behavior, though there was no significant effect on resilience. Our results suggest that a brief mindfulness training intervention is a promising strategy for improving motor skills and social behavior in early childhood settings.

Impact of a mindfulness-based intervention on well-being and mental health of elementary school children: results from a randomized cluster trial

Prevention programs, such as mindfulness-based interventions (MBIs), are often implemented in schools to prevent psychological disorders from emerging in children and to support their mental health. This study used a randomized cluster design to evaluate the impact of a MBI, called Mission Méditation, on the well-being and the mental health of elementary school children's. 13 classrooms of an elementary school were randomly allocated to the experimental condition (7 classrooms, n = 127 students) or the waitlist control condition (6 classrooms, n = 104 students). Participants in the experimental condition received a 10-week MBI. Regression analyses revealed significant differences between conditions for inattention. Participants in the MBI condition reported no change in pre- to post-intervention, whereas participants in the control condition reported pre- to post-intervention increases. Results also showed significant differences in perceived competence. Participants in the MBI condition reported a non-significant decrease in perceive competence, whereas participants in the control condition reported significantly higher perceive competence scores from pre- to post-intervention. Results do not indicate that the MBI had a significant impact on participant's well-being and mental health. This suggests that MBIs may not have an added value when compared to other preventive interventions geared towards well-being and mental health promotion in school settings.

Effects of mindfulness on depression in college students: mediating role of psychological resilience and moderating role of gender

OBJECTIVE

A questionnaire was administered to 936 college students to investigate the mediating effect of psychological resilience in the association between mindfulness and college student depression, as well as the moderating role of gender.

METHODS

For this study, data was collected between 20 April and 1 May 2023 at three universities in Jiangxi Province using a random sampling method. 963 Chinese university students were surveyed using the Adolescent Mindfulness Scale, the Psychological Resilience Scale, and the Depression Self-Rating Scale.SPSS24.0 software was used for correlation analysis and linear regression analysis, and PROCESS v3.4 model 7 was used to analyze this mediated model with moderating effects.

RESULTS

In the mediated effects model, the direct effect of mindfulness on college depression levels was significant (95% CI -0.43, -0.31); the indirect effect of mindfulness on college depression through psychological resilience was also significant (95% CI -0.34, -0.23); the interaction effect of mindfulness and gender was also found to be significant (95% CI 0.03, 0.16) in the mediated model with moderation.

CONCLUSION

Mindfulness not only affect depression directly, but also indirectly through the mediating effect of psychological resilience. At the same time, the prediction of psychological resilience by mindfulness was also moderated by gender, with girls' psychological resilience being more affected by the level of mindfulness compared to boys.

School Mindfulness-Based Interventions for Youth, and Considerations for Anxiety, Depression, and a Positive School Climate-A Systematic Literature Review

Mindfulness-based interventions (MBIs) are growing in popularity, with research concerning their efficacy with youth populations. Following a preliminary analysis of the existing literature, and given the positive effects of such programs, we felt it relevant to assess whether research has considered the implications for MBIs on children and adolescents, with regard to depression, anxiety, and school climate.

OBJECTIVES

We aim to estimate the effect of MBIs as innovative interventions addressing youths in school settings, with special consideration for anxiety, depression, and school climate outcomes.

METHOD

This review investigates the existing literature in the field of mindfulness, using quasi-experimental and randomized control trial (RCT) models, targeted at youth (5-18 years) in school settings. A search was carried out in four databases-WebofScience, Google Scholar, PubMed, and PsycARTICLES. This resulted in 39 articles, which were sorted based on predetermined inclusion criteria; 12 articles qualified.

RESULTS

The results show discrepancies in terms of methodological and implementation variables, types of interventions, instructor trainings, assessment measures, and choice of practices and exercises, which make the effects of existing school MBIs difficult to compare. Consistencies were observed in emotional and behavioral regulation, prosocial behaviors, and reducing stress and anxiety in students. The results of this systematic review also suggest that MBIs could be potential mediators in improving student well-being and environmental factors, such as school and class climates. Specifically, children's sense of safety and community can be improved by an improved quality of relationships between students, their peers, and teachers. Future research should consider incorporating school climate perspectives, such as implementing whole-school MBI approaches and using replicable and comparable study designs and methods, whilst considering the capacities and limitations of the academic and institutional context.

Mindfulness-based school interventions: A systematic review of outcome evidence quality by study design

Objective

The purpose of this systematic review was to assess the current literature on mindfulness-based school interventions (MBSIs) by evaluating evidence across specific outcomes for youth.

Methods

We evaluated 77 studies with a total sample of 12,358 students across five continents, assessing the quality of each study through a robust coding system for evidence-based guidelines. Coders rated each study numerically per study design as 1++ (RCT with a very low risk of bias) to 4 (expert opinion) and across studies for the corresponding evidence letter grade, from highest quality ('A Grade') to lowest quality ('D Grade') evidence.

Results

The highest quality evidence ('A Grade') across outcomes indicated that MBSIs increased prosocial behavior, resilience, executive function, attention and mindfulness, and decreased anxiety, attention problems/ADHD behaviors and conduct behaviors. The highest quality evidence for well-being was split, with some studies showing increased well-being and some showing no improvements. The highest quality evidence suggests MBSIs have a null effect on depression symptoms.

Conclusion

This review demonstrates the promise of incorporating mindfulness interventions in school settings for improving certain youth outcomes. We urge researchers interested in MBSIs to study their effectiveness using more rigorous designs (e.g., RCTs with active control groups, multi-method outcome assessment, and follow-up evaluation), to minimize bias and promote higher quality-not just increased quantity-evidence that can be relied upon to guide school-based practice.

Listen to the Children: Elementary School Students' Perspectives on a Mindfulness Intervention

In recent years, mindfulness-based practices in grade schools have been associated with students' improved cognitive skills and general classroom behavior. In the majority of studies, however, only teacher and parent feedback are elicited, omitting a considerably significant voice - that of the students. Our study aims to fill this gap by exploring student opinions and perceptions regarding the implementation of a classroom-based mindfulness program. Elementary school students (N = 51) took part in teacher-facilitated mindfulness activities which were incorporated into their daily classroom routines. Over the course of the 8-week intervention period, students participated in focus groups about their perceptions of the program. Through qualitative content analysis, two major findings emerged from the focus group data: student opinions about the mindfulness program varied substantially and the mindfulness activities were not always liked and enjoyed. Critically, if students do not enjoy classroom-based mindfulness programs, they may be less motivated to engage in mindful activities and in turn may not experience the benefits that mindfulness has to offer. To maximize student engagement with mindfulness while addressing their concerns, the following recommendations are made: A balance between the entertaining and educational aspects of the program, flexible program delivery, and encouraging students to pursue mindful living outside of the classroom. This research is important to educational and clinical practitioners as student insight will benefit the development and modification of classroom-based mindfulness programs to ensure that students are better able to engage with and benefit from these programs.

A Feasibility Study on an Ultra-Brief Intervention for Improving Freshmen's Emotional Intelligence

In 1990, Salovey and Mayer introduced emotional intelligence (EI). Thirty-one years later, a proliferation of interventions to improve people's EI has taken place. A literature review of studies focused on enhancing the EI of college students revealed a notable gap. When educational material for training sessions included all of the skills in an EI model, researchers usually utilized lengthy durations (i.e., 11-56 h). Few successful investigations employed an ultra-brief (i.e., ≤1 h) approach. The present study examined the feasibility of training using a minimalistic timeframe and a sample of freshmen; their transitional challenges from high school to college mark them as an appropriate target population. Employing a quasi-experimental one-group pretest-posttest design, the recruited participants (n = 75) experienced an ultra-brief intervention highlighting the complete skill-set in the Ability Emotional Intelligence model. Findings from a one-way repeated measures MANOVA indicated improvement transpired in two of four MSCEIT scores (i.e., perception and facilitation). The merit of the present study is delineated using Orsmond and Cohn's five objectives for feasibility investigations. In addition, implications of the results and possible applications are proposed.

Somatic interventions to improve self-regulation in children and adolescents

TOPIC

Children and adolescents who are exposed to stress and trauma often experience, as a result, an inability to regulate their emotions. Self-regulation is necessary to accurately respond to situations and ensure success in the academic setting. Self-regulation skills have been identified as improving resiliency and mitigating the effects of trauma on children and adolescents.

PURPOSE

The purpose of this review of the literature is to synthesize the available research on somatic interventions to improve self-regulation in the child and adolescent population.

SOURCES USED

A scoping review of literature utilizing the Arksey and O'Malley framework was conducted by a university health science librarian from 2006 to 2018 using PubMed, Scopus, CINAHL, ERIC, and Web of Science to identify studies that examined somatic self-regulation skills in children and adolescents. Search terms included were mindfulness, yoga, deep breathing exercises, and self-regulation. The PRISMA methodology was utilized to synthesize the available research on somatic interventions to improve self-regulation in the child and adolescent population.

CONCLUSION

Somatic interventions have been shown to improve self-regulation in the child and adolescent population. Future research is needed to identify dose-specific interventions and opportunities to improve self-regulation for children and adolescents.

Gender Differences in Adolescents' Exposure to Stressful Life Events and Differential Links to Impaired School Functioning

Gender differences in exposure and reactivity to specific stressful life events (SLE) contribute to explaining adolescent boys' and girls' differential susceptibility to common adjustment difficulties like depression and behavioral problems. However, it is unclear whether these gender differences are also relevant to understanding another key marker of adolescent maladjustment: high school dropout. A state-of-the-art interview protocol was used to assess recent SLE in a sample of academically vulnerable Canadian adolescents (N = 545, 52% boys). The sample was comprised of three groups in approximately equal proportions: 1) students who had recently dropped out; 2) matched students at risk of dropping out but who persevered nevertheless; and 3) "normative" students with an average level of risk. When SLE of all types were considered together, overall exposure was similar for adolescent boys and girls, and the SLE-dropout association did not vary as a function of gender. However, gender differences emerged for specific events. Boys were especially exposed to SLE related to performance (e.g., school failure, suspension) and conflicts with authority figures (e.g., with teachers or the police), whereas girls were particularly exposed to SLE involving relationship problems with family members, peers, or romantic partners. In terms of specific SLE-dropout associations, one consistent result emerged, showing that performance/authority-related SLE were significantly associated with dropout only among boys. It therefore seems that considering gendered exposure and sensitivity to SLE is important for understanding the emergence of educational difficulties with long-ranging consequences for future health and well-being.

Impact of a Mindfulness-Based Intervention on Basic Psychological Need Satisfaction and Internalized Symptoms in Elementary School Students With Severe Learning Disabilities: Results From a Randomized Cluster Trial

Background

Mindfulness is hypothesized to lead to more realistic appraisals of the three basic psychological needs, which leads people to benefit from high levels of need satisfaction or helps them make the appropriate changes to improve need satisfaction. Mindfulness-based interventions (MBIs) have also shown promise to foster greater basic psychological need satisfaction in students with learning disabilities (LDs).

Objective

The goal of the present study was to evaluate the impact of a MBI on the satisfaction of the basic psychological needs and on internalized symptoms in students with severe LDs. A randomized cluster trial was implemented to compare the progression of need satisfaction, anxiety, and depression symptoms in participants pre- to post-intervention and at follow-up.

Method

Elementary school students with severe LDs (N = 23) in two special education classrooms took part in this study and were randomly attributed to either an experimental or an active control group.

Results

Mixed ANOVAs first showed that the experimental condition did not moderate change over time such that similar effects were observed in the experimental and active control groups. Looking at main effects of time on participants’ scores of autonomy, competence, and relatedness across time, we found a significant within-person effect for the competence need (p = 0.02). Post hoc analyses showed that for both groups, competence scores were significantly higher at post-intervention (p = 0.03) and at follow-up (p = 0.04), when compared to pre-intervention scores. A significant main effect was also found for anxiety levels over time (p = 0.008). Post hoc analyses showed that for both groups, scores were significantly lower at post-intervention (p = 0.01) and at follow-up (p = 0.006), when compared to pre-intervention scores.

Conclusion

Although the MBI seemed useful in increasing the basic psychological need of competence and decreasing anxiety symptoms in students with severe LDs, it was not more useful than the active control intervention that was used in this project. Future studies should verify that MBIs have an added value compared to other types of interventions that can be more easily implemented in school-based settings.

Impact of a Combined Philosophy and Mindfulness Intervention on Positive and Negative Indicators of Mental Health Among Pre-kindergarten Children: Results From a Pilot and Feasibility Study

Background: Fostering greater resiliency to stress, optimal psychosocial development and promoting better mental health and well-being in youth is an important goal of the Canadian and American elementary school systems (1, 2). Recent research on mindfulness and philosophy for children (P4C) has yielded promising results regarding innovative interventions that may be implemented in elementary school settings to foster greater child resiliency and well-being (3-5). Goal: The goal of this feasibility study was to pilot a new intervention, which combines mindfulness meditation and P4C activities, with the goal of improving mental health in pre-kindergarten children, assessed with positive (i.e., social skills and adaptability) and negative (i.e., internalized symptoms, comprises depression, anxiety, inattention; and hyperactivity) indicators. Methods: A randomized cluster trial with a wait-list control group was employed to evaluate the impact of the combined MBI and P4C intervention on child mental health. Two classrooms of pre-kindergarten children (N = 38, mean age = 4.6 years old) took part in this study and were randomly allocated to the experimental or wait-list control conditions. Teachers completed pre- and post-intervention questionnaires. Results: ANCOVAs did not reveal a significant effect of condition on internalized symptoms, controlling for baseline levels. Sensitivity analyses indicated that for the whole sample, internalized symptom scores were statistically significantly lower at post-intervention, when compared to pre-intervention scores. No impact of group on levels of hyperactivity was found, however, sensitivity analyses indicated that for both the experimental and control groups, hyperactivity scores were statistically significantly lower at post-intervention, when compared to pre-intervention scores. Finally, no impact of group on levels of social skills and adaptability were found. Sensitivity analyses conducted using paired t-tests did not indicate statistically significant pre-to-post changes in scores for both variables. Conclusion: These preliminary results suggest that mindfulness and philosophy for children may not be the most effective intervention to foster short-term resiliency, well-being and better mental health in children. Yet, group differences were often small and past research suggested the effectiveness of this type of intervention. Further research considering the impact of moderators such as age or baseline levels of psychopathology, using longer time frames and comparing the effectiveness of this combined intervention with other types of school-based interventions with similar aims (such as, e.g., P4C or MBI alone) is warranted, to evaluate if mindfulness and P4C interventions have an added value compared to other types of interventions implemented in school settings.

Feasibility evaluation of a mindfulness-based stress reduction program for primary care professionals in Brazilian national health system

BACKGROUND AND PURPOSE

In the last decades, an increasing body of scientific studies has shown mindfulness-based interventions as efficacious for reducing stress, including among primary care professionals. Despite the strength of the evidence, mindfulness-based interventions still are not widely adopted as a clinical practice in national health systems. The aim of the present study was to conduct a feasibility evaluation of a mindfulness-based stress reduction program for primary care professionals in Brazilian national health system.

MATERIALS AND METHODS

A pilot mindfulness program was conducted through the course of four weekly encounters in the municipality of Biguaçu with the participation of 26 primary care professionals. Data was collected through direct observations and four self-report questionnaires. The information was used to complete an evaluation matrix and reach a value judgment about the feasibility level of the components of the mindfulness-based program.

RESULTS

The subdimensions Integration, Demand, and Acceptability were judged as "Highly Feasible", the subdimension Practicality was judged as "Feasible" and the subdimension Adaptation was judged as "Lowly Feasible". The results indicated that there is a high demand for stress-reduction interventions within the context of primary care and the acceptability by the stakeholders (participants and management) was excellent. However, the two main barriers found were the need for a brief version of the program to accommodate the restrictive timetable of the primary care professionals and the low retention rates.

CONCLUSION

The implementation of a mindfulness-based program for primary care professionals in Brazilian national health system was judged as "Feasible". Further studies need to conduct the feasibility evaluation in other municipalities and with larger sample sizes to ensure the generalizability of these results.

Metaanalyse zur Wirksamkeit achtsamkeitsbasierter Interventionen bei ADHS im Kindes- und Jugendalter

Zusammenfassung. Die vorliegende Metaanalyse berechnet die Wirksamkeit achtsamkeitsbasierter Interventionen bei Kindern und Jugendlichen mit ADHS gemäß empirischer Studien aus den Jahren 2008 – 2018. Als abhängige Maße werden die ADHS-Symptomatik, kognitive Leistungen (Aufmerksamkeitsleistungen in standardisierten Tests) sowie ADHS-spezifische Komorbiditäten berücksichtigt. Insgesamt wurden 16 Studien einbezogen. Im Ergebnis zeigt sich hinsichtlich der Reduktion der gesamten ADHS-Symptomatik eine große Effektstärke von d = 1.08. Zudem konnten eine Verringerung der Unaufmerksamkeitssymptomatik ( d = 0.47), mittlere Effekte auf Hyperaktivität / Impulsivität sowie moderate bis große Effekte auf komorbide internalisierende Störungen (Depressionen, Angststörungen) festgestellt werden. Die Metaanalyse liefert Hinweise darauf, dass achtsamkeitsbasierte Interventionen bei Kindern und Jugendlichen mit ADHS wirksam sind. Jedoch bestehen auf Ebene der Einzelstudien beträchtliche methodische Limitationen.

In-Person Versus eHealth Mindfulness-Based Intervention for Adolescents With Chronic Illness: Protocol for a Randomized Controlled Trial

Background

Eight-week mindfulness-based interventions (MBIs) have a beneficial impact on mental health and well-being in adolescents with chronic health conditions. Usually delivered in person in a group setting, these programs are difficult to access for teens with disabilities or who do not have in-person MBIs available in their communities.

Objective

This paper outlines the rationale, development, and design of a randomized controlled trial comparing the effects of an MBI delivered in person or via eHealth in adolescents with a chronic illness. Quantitative outcomes will include mindfulness skills acquisition (primary outcome), effects of the MBI on self-reported mood, anxiety, self-esteem, illness perception, and physiological stress (via salivary cortisol), and qualitative outcomes will include individual practice, participant appreciation, and adaptation of the MBI for eHealth.

Methods

This is a randomized noninferiority mixed methods study comparing 2 MBI arms: in-person and eHealth. Participants are eligible to participate if they are aged 13 to 18 years, have a diagnosis of chronic medical condition, live close enough to the recruitment hospital to participate in the in-person arm of the study, and are currently followed by a health care provider. Each participant will receive an adapted 8-week MBI delivered either in person at a tertiary pediatric hospital or via a secure audio-visual platform allowing group interactions in real time. Groups will be facilitated by 2 experienced mindfulness providers. Quantitative and qualitative data will be collected through standardized research questionnaires administered via a secure, youth-friendly online platform and through semistructured interviews, participant log books, facilitator log books, and salivary cortisol analysis. Qualitative data will be analyzed using a grounded theory model.

Results

Data collection is currently underway. Data analysis, manuscript writing, and additional publications are expected to be completed in the winter and spring of 2018.

Conclusions

Based on previous results from in-person trials conducted in adolescents and eHealth trials conducted in adults, we anticipate that both modes of delivery will significantly improve mindfulness skills acquisition, mood, anxiety, self-esteem, illness perception, and stress and that the magnitude of the effects will be correlated to the level of home practice. We predict that participants in both arms will show similar levels of home practice and that both modes of delivery will have high levels of feasibility and acceptability. If successful, this study could provide evidence for the use of eHealth in the delivery of 8-week MBIs in clinical adolescent populations, potentially increasing availability to MBIs for a large group of youth with mobility issues or living away from large urban centers.

Trial Registration

ClinicalTrials.org NCT03067207; https://clinicaltrials.gov/ct2/show/NCT03067207 (archived by WebCite at http://www.webcitation.org/6v4ZK8RBH)