The purpose of this study was to evaluate the feasibility, acceptability, and helpfulness of Mindfulness-Based Cognitive Therapy for Children (MBCT-C) for the treatment of internalizing and externalizing symptoms in a sample of nonreferred children. Twenty-five children, ages 9 to 12, participated in the 12-week intervention. Assessments were conducted at baseline and posttreatment. Open trial analyses found preliminary support for MBCT-C as helpful in reducing internalizing and externalizing symptoms within subjects on the parent report measure. The high attendance rate (Intent-to-Treat sample, 78%; Completer sample, 94%), high retention rate (68%), and positive ratings on program evaluations supported treatment feasibility and acceptability. Overall, this pilot study offers feasibility and acceptability data for MBCT-C as a potential treatment for internalizing and externalizing symptoms in children. Further research is needed to test the efficacy of the intervention with a larger sample of children who meet diagnostic criteria for clinical disorders.
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Mindfulness-based interventions (MBIs) in schools have positive effects on cognitive and socio-emotional processes, but do not improve behavior and academic achievement. The use of mindfulness-based interventions (MBIs) in schools has been on the rise. Schools are using MBI's to reduce student stress and anxiety and improve socio-emotional competencies, student behavior and academic achievement. MBIs have small, positive effects on cognitive and socio-emotional processes but these effects were not seen for behavioral or academic outcomes. The studies are mostly of moderate to low quality. Therefore, further evidence from independent evaluators is needed to be able to evaluate the effectiveness of this type of intervention. With the diverse application and findings of positive effects of mindfulness practices with adults, as well as the growing popularity with the public, MBIs are increasingly being used with youth. Over the past several years, MBIs have received growing interest for use in schools to support socioemotional development and improve behavior and academic achievement. This review examines the effects of school-based MBIs on cognitive, behavioral, socio-emotional and academic achievement outcomes with youth in a primary or secondary school setting. MBIs are interventions that use a mindfulness component, broadly defined as "paying attention in a particularly way: on purpose, in the present moment, non-judgmentally," often with other components, such as yoga, cognitive-behavioral strategies, or relaxation skills training. Included studies used a randomized controlled trial, quasi-experimental, single group pre-post test or single subject design and reported at least one of these outcomes: cognition, academic performance, behavior, socio-emotional, and physiological. Study populations include preschool, primary and secondary school students. A total of 61 studies are included in the review, but only the 35 randomized or quasi-experimental studies are used in the meta-analysis. Most of the studies were carried out in North America, and others in Asia, Europe and Canada. All interventions were conducted in a group format. Interventions ranged in duration (4-28 weeks) and number of sessions (6-125 sessions) and frequency of meetings (once every two weeks to five times a week). MBIs have a small, statistically significant positive effect on cognitive and socio-emotional outcomes. But there is not a significant effect on behavioral and academic outcomes. There was little heterogeneity for all outcomes, besides behavioral outcomes, suggesting that the interventions produced similar results across studies on cognitive, socio-emotional and academic outcomes despite the interventions being quite diverse. Findings from this review indicate mixed effects of MBIs in schools. There is some indication that MBIs can improve cognitive and socio-emotional outcomes, but no support for improvement in behavior or academic achievement. Despite the growing support of MBIs for adults, youth may not benefit in the same ways or to the same extent as adults. While not well studied, anecdotal evidence indicates costs and adverse effects of these types of interventions that should be better studied and weighed against the small to no effects on different types of outcomes when considering adoption of MBIs in schools. These findings should be read with caution given the weakness of the evidence produced by the studies. The high risk of bias present in the studies means that further evidence is needed to evaluate the effectiveness of this type of intervention. The evidence from this review urges caution in the widespread adoption of MBIs and encourages rigorous evaluation of the practice should schools choose to implement it. The following are appended: (1) Documentation of search strategies in electronic databases; (2) Data extraction form; (3) Characteristics of included studies: RCT and QED studies; (4) Characteristics of single group pre-post test studies; (5) Characteristics of single subject design studies; (6) Excluded studies; (7) Risk of bias table; (8) Cognitive outcomes by study included in meta-analysis; (9) Academic outcomes by study included in meta-analysis; (10) Behavioral outcomes by study included in meta-analysis; (11) Socioemotional outcomes by study included in meta-analysis; (12) Risk of bias by study; and (13) Funnel plots. [The Campbell Collaboration Education Coordinating Group provided financial support for this report.]
Mindfulness meditation is a well-validated intervention for symptoms of depression and anxiety disorders in adults, with meta-analyses showing moderate effect sizes. This study marks the first published meta-analysis of the burgeoning literature on mindfulness meditation with youth (conducted between 2004 and 2011) and identifies specific outcomes and sub-populations for whom mindfulness may be particularly helpful. Inclusion criteria were peer-reviewed journal articles published in English, study participants under 18 years of age, and a description in the methods section of mindfulness as the chief component of an intervention. A systematic search was conducted, of which upon review, 20 articles met inclusion criteria. Mindfulness interventions with youth overall were found to be helpful and not to carry iatrogenic harm, with the primary omnibus effect size (del) in the small to moderate range (0.23, p < .0001), indicating the superiority of mindfulness treatments over active control comparison conditions. A significantly larger effect size was found on psychological symptoms compared to other dependent variable types (0.37 vs. 0.21, p = .028), and for studies drawn from clinical samples compared to non-clinical sample (0.50 vs. 0.20, p = .024). Mindfulness appears to be a promising intervention modality for youth. Although to date the majority of studies on mindfulness with youth engage generally healthy participants recruited from schools, the findings of this meta-analysis suggest that future research might focus on youth in clinical settings and target symptoms of psychopathology.
BACKGROUND: Parents and teachers of children with attention-deficit/hyperactivity disorder (ADHD) are at-risk for a range of suboptimal psychosocial outcomes, including mental health difficulties and heightened stress, problems perhaps ameliorated through mindfulness-based programming.OBJECTIVE: To show pilot data from an investigation of the outcomes of a purpose-built mindfulness training for parents and teachers of children with ADHD (N = 26).
METHODS: The program represents a purpose-driven modification of the Mindfulness-Based Stress Reduction (MBSR) curriculum. Namely, we reduced participant time commitment and added psychoeducation about ADHD with brief parent training. The measurement protocol included measures of stress, anxiety, depression, and mindfulness.
RESULTS: Following the 8-week program, parents and teachers reported reduced perceived stress, reduced self-reported anxiety, and improvements in some facets of mindfulness.
CONCLUSION: The work highlights the promise of specialized mindfulness-based interventions in promoting positive psychosocial outcomes in specific at-risk groups, such as the carers of children with ADHD.
BACKGROUND: Parents and teachers of children with attention-deficit/hyperactivity disorder (ADHD) are at-risk for a range of suboptimal psychosocial outcomes, including mental health difficulties and heightened stress, problems perhaps ameliorated through mindfulness-based programming.OBJECTIVE: To show pilot data from an investigation of the outcomes of a purpose-built mindfulness training for parents and teachers of children with ADHD (N = 26).
METHODS: The program represents a purpose-driven modification of the Mindfulness-Based Stress Reduction (MBSR) curriculum. Namely, we reduced participant time commitment and added psychoeducation about ADHD with brief parent training. The measurement protocol included measures of stress, anxiety, depression, and mindfulness.
RESULTS: Following the 8-week program, parents and teachers reported reduced perceived stress, reduced self-reported anxiety, and improvements in some facets of mindfulness.
CONCLUSION: The work highlights the promise of specialized mindfulness-based interventions in promoting positive psychosocial outcomes in specific at-risk groups, such as the carers of children with ADHD.
The spontaneous oscillatory activity in the human brain shows long-range temporal correlations (LRTC) that extend over time scales of seconds to minutes. Previous research has demonstrated aberrant LRTC in depressed patients; however, it is unknown whether the neuronal dynamics normalize after psychological treatment. In this study, we recorded EEG during eyes-closed rest in depressed patients (N = 71) and healthy controls (N = 25), and investigated the temporal dynamics in depressed patients at baseline, and after attending either a brief mindfulness training or a stress reduction training. Compared to the healthy controls, depressed patients showed stronger LRTC in theta oscillations (4-7 Hz) at baseline. Following the psychological interventions both groups of patients demonstrated reduced LRTC in the theta band. The reduction of theta LRTC differed marginally between the groups, and explorative analyses of separate groups revealed noteworthy topographic differences. A positive relationship between the changes in LRTC, and changes in depressive symptoms was observed in the mindfulness group. In summary, our data show that aberrant temporal dynamics of ongoing oscillations in depressive patients are attenuated after treatment, and thus may help uncover the mechanisms with which psychotherapeutic interventions affect the brain.
The aim of this study was to assess the acceptability and feasibility of Vinyasa yoga as an adjunctive treatment for depressed patients who were not responding adequately to antidepressant medication. The authors also planned to ask participants for qualitative feedback on their experience of the class and to assess change over time in depression and in possible mediating variables. The authors recruited 11 participants in 1 month for an 8-week open trial of yoga classes. They found that 10 participants completed follow-up assessments, 9 of 10 were positive about their experience, and all provided feedback about what was and was not helpful about yoga, as well as barriers to class attendance. Over the 2-month period, participants exhibited significant decreases in depression symptoms and significant increases in an aspect of mindfulness and in behavior activation. This pilot study provided support for continuing to investigate Vinyasa yoga as an adjunct treatment for depression. The next step required is a rigorous randomized clinical trial.
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The majority of parents in the United States recognize that social and emotional skills are a high priority for their children's success (Princeton Survey Research Associates International, 2015), but most cannot readily articulate how they are utilizing or promoting these skills in their own families (Zero to Three, 2016). Even professionals in the field of social and emotional learning (SEL) may struggle in making the translation between their professional knowledge and their personal parenting practices. In the present study, we aimed to understand the connection between the scholarly field of SEL and the lived experiences of parents who engage with SEL in a practical setting. Specifically, we studied SEL professionals who were also parents to determine how they see the overlap between school-based SEL and the role of SEL in families. Survey items assessed their priorities for their children's development and their parenting. Responses were analyzed for the degree to which they aligned with a prominent SEL framework created by the Collaborative for Academic and Social and Emotional Learning. This framework has not yet been applied extensively to parenting, but results from this study suggest that even when terminology differs, underlying social and emotional priorities for children and parenting show substantial overlap. The purpose of this investigation--built upon the research base of SEL in schools--is to raise questions, offer a model for further inquiry, and draw connections between our knowledge of school-based social and emotional learning and parenting.
Longitudinal social network analysis (SNA) was used to examine how a social-emotional learning (SEL) intervention may be associated with peer socialization on academic performance. Fifth graders (N = 631; 48 % girls; 9 to 12 years) were recruited from six elementary schools. Intervention classrooms (14) received a relationship building intervention (RBI) and control classrooms (8) received elementary school as usual. At pre- and post-test, students nominated their friends, and teachers completed assessments of students' writing and math performance. The results of longitudinal SNA suggested that the RBI was associated with friend selection and peer influence within the classroom peer network. Friendship choices were significantly more diverse (i.e., less evidence of social segregation as a function of ethnicity and academic ability) in intervention compared to control classrooms, and peer influence on improved writing and math performance was observed in RBI but not control classrooms. The current findings provide initial evidence that SEL interventions may change social processes in a classroom peer network and may break down barriers of social segregation and improve academic performance.
Longitudinal social network analysis (SNA) was used to examine how a social-emotional learning (SEL) intervention may be associated with peer socialization on academic performance. Fifth graders (N = 631; 48 % girls; 9 to 12 years) were recruited from six elementary schools. Intervention classrooms (14) received a relationship building intervention (RBI) and control classrooms (8) received elementary school as usual. At pre- and post-test, students nominated their friends, and teachers completed assessments of students' writing and math performance. The results of longitudinal SNA suggested that the RBI was associated with friend selection and peer influence within the classroom peer network. Friendship choices were significantly more diverse (i.e., less evidence of social segregation as a function of ethnicity and academic ability) in intervention compared to control classrooms, and peer influence on improved writing and math performance was observed in RBI but not control classrooms. The current findings provide initial evidence that SEL interventions may change social processes in a classroom peer network and may break down barriers of social segregation and improve academic performance.
OBJECTIVES: To understand depressed individuals' experiences in a 10-week hatha yoga program. DESIGN: In a randomized controlled trial, participants were assigned to either 10 weeks of hatha yoga classes or a health education control group. This report includes responses from participants in yoga classes. At the start of classes, average depression symptom severity level was moderate. MAIN OUTCOME MEASURES: After 10 weeks of yoga classes, we asked participants (n=50) to provide written responses to open-ended questions about what they liked about classes, what they did not like or did not find helpful, and what they learned. We analyzed qualitative data using thematic analysis. RESULTS AND CONCLUSIONS: Elements of yoga classes that may increase acceptability for depressed individuals include having instructors who promote a non-competitive and non-judgmental atmosphere, who are knowledgeable and able to provide individualized attention, and who are kind and warm. Including depression-related themes in classes, teaching mindfulness, teaching breathing exercises, and providing guidance for translating class into home practice may help to make yoga effective for targeting depression. Participants' comments reinforced the importance of aspects of mindfulness, such as attention to the present moment and acceptance of one's self and one's experience, as potential mechanisms of action. Other potential mechanisms include use of breathing practices in everyday life and the biological mechanisms that underlie the positive impact of yogic breathing. The most serious concern highlighted by a few participants was the concern that the yoga classes were too difficult given their physical abilities.
OBJECTIVES: To understand depressed individuals' experiences in a 10-week hatha yoga program.DESIGN: In a randomized controlled trial, participants were assigned to either 10 weeks of hatha yoga classes or a health education control group. This report includes responses from participants in yoga classes. At the start of classes, average depression symptom severity level was moderate.
MAIN OUTCOME MEASURES: After 10 weeks of yoga classes, we asked participants (n=50) to provide written responses to open-ended questions about what they liked about classes, what they did not like or did not find helpful, and what they learned. We analyzed qualitative data using thematic analysis.
RESULTS AND CONCLUSIONS: Elements of yoga classes that may increase acceptability for depressed individuals include having instructors who promote a non-competitive and non-judgmental atmosphere, who are knowledgeable and able to provide individualized attention, and who are kind and warm. Including depression-related themes in classes, teaching mindfulness, teaching breathing exercises, and providing guidance for translating class into home practice may help to make yoga effective for targeting depression. Participants' comments reinforced the importance of aspects of mindfulness, such as attention to the present moment and acceptance of one's self and one's experience, as potential mechanisms of action. Other potential mechanisms include use of breathing practices in everyday life and the biological mechanisms that underlie the positive impact of yogic breathing. The most serious concern highlighted by a few participants was the concern that the yoga classes were too difficult given their physical abilities.
While the field of empirical study on religion and spirituality in relation to mental health has rapidly expanded over the past decade, little is known about underlying dimensions of spirituality cross-culturally conceived. We aimed to bridge this gap by inductively deriving potential universal dimensions of spirituality through a large-scale, multi-national data collection, and examining the relationships of these dimensions with common psychiatric conditions. Five-thousand five-hundred and twelve participants from China, India, and the United States completed a two-hour online survey consisting of wide-ranging measures of the lived experience of spirituality, as well as clinical assessments. A series of inductive Exploratory Factor Analysis (EFA) and cross-validating Exploratory Structural Equation Modeling (ESEM) were conducted to derive common underlying dimensions of spirituality. Logistic regression analyses were then conducted with each dimension to predict depression, suicidal ideation, generalized anxiety, and substance-related disorders. Preliminary EFA results were consistently supported by ESEM findings. Analyses of 40 spirituality measures revealed five invariant factors across countries which were interpreted as five dimensions of universal spiritual experience, specifically: love, in the fabric of relationships and as a sacred reality; unifying interconnectedness, as a sense of energetic oneness with other beings in the universe; altruism, as a commitment beyond the self with care and service; contemplative practice, such as meditation, prayer, yoga, or qigong; and religious and spiritual reflection and commitment, as a life well-examined. Love, interconnectedness, and altruism were associated with less risk of psychopathology for all countries. Religious and spiritual reflection and commitment and contemplative practice were associated with less risk in India and the United States but associated with greater risk in China. Education was directly associated with dimensions of spiritual awareness in India and China but inversely associated with dimensions in the United States. Findings support the notion that spirituality is a universal phenomenon with potentially universal dimensions. These aspects of spirituality may each offer protective effects against psychiatric symptoms and disorders and suggest new directions for treatment.
<p>In this article, Miller examines theories of modern linguistics apparent in the work of Tibetan grammarians, particularly with regard to their treatment of concepts analogous to phonemics and phonetics. (Ben Deitle 2005-11-01)</p>
We conducted a pilot randomized controlled trial (RCT) comparing a prenatal yoga intervention to perinatal-focused health education in pregnant women with depression. Findings document acceptability and feasibility of the yoga intervention: no yoga-related injuries were observed, instructors showed fidelity to the yoga manual, and women rated interventions as acceptable. Although improvements in depression were not statistically different between groups, they favored yoga. This study provides support for a larger scale RCT examining prenatal yoga to improve mood during pregnancy.
The objective of this study was to compare a Tibetan traditional medicine (the uterotonic Zhi Byed 11 [ZB11]) to oral misoprostol for prophylaxis of postpartum hemorrhage (PPH). We conducted a double-blind randomized controlled trial at three hospitals in Lhasa, Tibet, People''s Republic of China. Women (N = 967) were randomized to either ZB11 or misoprostol groups. Postpartum blood loss was measured in a calibrated blood collection drape. The primary combined outcome was incidence of PPH, defined as measured blood loss (MBL) ≥ 500 mL, administration of open label uterotonics, or maternal death. We found that the rate of the combined outcome was lower among the misoprostol group (16.1% versus 21.8% for ZB11; P = .02). Frequency of PPH was lower with misoprostol (12.4% versus 17.4%; P = .02). There were no significant differences in MBL > 1000 mL or mean or median MBL. Fever was significantly more common in the misoprostol group (P = .03). The rate of combined outcome was significantly lower among women receiving misoprostol. However, other indices of obstetric hemorrhage were not significantly different.
Mindfulness-based cognitive therapy for children (MBCT-C) is a manualized group psychotherapy for children ages 9–13 years old, which was developed specifically to increase social-emotional resiliency through the enhancement of mindful attention. Program development is described along with results of the initial randomized controlled trial. We tested the hypotheses that children randomized to participate in MBCT-C would show greater reductions in (a) attention problems, (b) anxiety symptoms, and (c) behavior problems than wait-listed age and gender-matched controls. Participants were boys and girls aged 9–13 (N = 25), mostly from low-income, inner-city households. Twenty-one of 25 children were ethnic minorities. A randomized cross-lagged design provided a wait-listed control group, a second trial of MBCT-C, and a 3-month follow-up of children who completed the first trial. Measures included the Child Behavior Checklist, State-Trait Anxiety Inventory for Children, and Multidimensional Anxiety Scale for Children. Participants who completed the program showed fewer attention problems than wait-listed controls and those improvements were maintained at three months following the intervention [F (1, 1, 18) = 5.965, p = .025, Cohen’s d = .42]. A strong relationship was found between attention problems and behavior problems (r = .678, p < .01). Reductions in attention problems accounted for 46% of the variance of changes in behavior problems, although attention changes proved to be a non-significant mediator of behavior problems (p = .053). Significant reductions in anxiety symptoms and behavior problems were found for those children who reported clinically elevated levels of anxiety at pretest (n = 6). Results show that MBCT-C is a promising intervention for attention and behavior problems, and may reduce childhood anxiety symptoms.
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