Top

Mindfulness

Gepubliceerd in:

09-08-2021 | ORIGINAL PAPER

App-Based Mindfulness Training for Adolescent Rumination: Predictors of Immediate and Cumulative Benefit

Auteurs: Christian A. Webb, Caroline M. Swords, Laura Murray, Lori M. Hilt

Gepubliceerd in: Mindfulness | Uitgave 10/2021

Abstract

Objectives

Rumination is a transdiagnostic risk factor for depression and anxiety, which surge during the adolescent years. Mindfulness training—with its emphasis on metacognitive awareness and present-moment attention—may be effective at reducing rumination. Mindfulness apps offer a convenient, engaging, and cost-effective means for accessing mindfulness training for teens. Despite their increasing popularity among adolescents, no study to date has investigated which teens are well-suited to app-based mindfulness training.

Methods

Eighty adolescents (M age = 14.01 years, 45% girls) with elevated rumination were enrolled in a 3-week trial of app-based mindfulness training. Repeated daily ecological momentary assessment (EMA) surveys assessed problem-focused and emotion-focused rumination immediately prior to and following each mindfulness exercise. Elastic net regularization (ENR) models tested baseline predictors of “immediate” (post-mindfulness exercise) and “cumulative” (post-3-week intervention) benefit from app-based mindfulness training.

Results

Ninety percent (72/80) of adolescents completed the 3-week trial, and the mean number of mindfulness exercises completed was 28.7. Baseline adolescent characteristics accounted for 14–25% of the variance in outcomes (i.e., reduction in problem-focused or emotion-focused rumination). Higher baseline rumination, and lower emotional suppression, predicted better immediate and cumulative outcomes. In contrast, female gender and older age predicted better immediate, but not cumulative, outcomes. Differences in results across outcome timeframes (immediate vs. cumulative) are discussed.

Conclusions

Findings from this study highlight the potential of data-driven approaches to inform which adolescent characteristics may predict benefit from engaging with an app-based mindfulness training program. Additional research is needed to test these predictive models against a comparison (non-mindfulness) condition.

vorige artikel Examining Practice Effects in a Randomized Controlled Trial: Daily Life Mindfulness Practice Predicts Stress Buffering Effects of Mindfulness Meditation Training

volgende artikel Positive Self-Compassion, Self-Coldness, and Psychological Outcomes in College Students: a Person-Centered Approach

Alleen toegankelijk voor geautoriseerde gebruikers

Abela, J. R. Z., & Hankin, B. L. (2011). Rumination as a vulnerability factor to depression during the transition from early to middle adolescence: A multiwave longitudinal study. Journal of Abnormal Psychology, 120(2), 259–271. https://doi.org/10.1037/a0022796CrossRefPubMed

Abela, J. R. Z., Brozina, K., & Haigh, E. P. (2002). An examination of the response styles theory of depression in third- and seventh-grade children: A short-term longitudinal study. Journal of Abnormal Child Psychology, 30(5), 515–527. https://doi.org/10.1023/A:1019873015594CrossRefPubMed

Abela, J. R., Vanderbilt, E., & Rochon, A. (2004). A test of the integration of the response styles and social support theories of depression in third and seventh grade children. Journal of Social and Clinical Psychology, 23(5), 653–674.CrossRef

Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237. https://doi.org/10.1016/j.cpr.2009.11.004CrossRefPubMed

Avenevoli, S., Swendsen, J., He, J.-P., Burstein, M., & Merikangas, K. R. (2015). Major depression in the national comorbidity survey–adolescent supplement: Prevalence, correlates, and treatment. Journal of the American Academy of Child & Adolescent Psychiatry, 54(1), 37-44.e2. https://doi.org/10.1016/j.jaac.2014.10.010CrossRef

Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45. https://doi.org/10.1177/1073191105283504CrossRefPubMed

Baiocco, R., Manzi, D., Lonigro, A., Petrocchi, N., Laghi, F., Ioverno, S., & Ottaviani, C. (2017). A kid-friendly tool to assess rumination in children and early adolescents: Relationships with mother psychopathology and family functioning. Journal of Child and Family Studies, 26(10), 2703–2715.CrossRef

Baldwin, J. S., & Dadds, M. R. (2007). Reliability and validity of parent and child versions of the multidimensional anxiety scale for children in community samples. Journal of the American Academy of Child and Adolescent Psychiatry, 46(2), 252–260. https://doi.org/10.1097/01.chi.0000246065.93200.a1

Craighead, W. E., Curry, J. F., & Ilardi, S. S. (1995). Relationship of children’s depression inventory factors to major depression among adolescents. Psychological Assessment, 7(2), 171–176. https://doi.org/10.1037/1040-3590.7.2.171

Cohen, Z. D., & DeRubeis, R. J. (2018). Treatment selection in depression. Annual Review of Clinical Psychology, 14(1), 209–236. https://doi.org/10.1146/annurev-clinpsy-050817-084746CrossRefPubMed

Derryberry, D., & Reed, M. A. (2002). Anxiety-related attentional biases and their regulation by attentional control. Journal of Abnormal Psychology, 111(2), 225.CrossRef

Deyo, M., Wilson, K. A., Ong, J., & Koopman, C. (2009). Mindfulness and rumination: Does mindfulness rraining lead to reductions in the ruminative thinking associated with depression? EXPLORE, 5(5), 265–271. https://doi.org/10.1016/j.explore.2009.06.005CrossRefPubMed

Friedman, J. H., Hastie, T., & Tibshirani, R. (2010). Regularization paths for generalized linear models via coordinate descent. Journal of Statistical Software, 33(1), 1–22.CrossRef

Gibb, B. E., Grassia, M., Stone, L. B., Uhrlass, D. J., & McGeary, J. E. (2012). Brooding rumination and risk for depressive disorders in children of depressed mothers. Journal of Abnormal Child Psychology, 40(2), 317–326. https://doi.org/10.1007/s10802-011-9554-yCrossRefPubMedPubMedCentral

Gross, J. J. & John, O. P. (2003). Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85, 348–362.

Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clinical Psychology Review, 37, 1–12. https://doi.org/10.1016/j.cpr.2015.01.006CrossRefPubMed

Gullone, E., Hughes, E. K., King, N. J., & Tonge, B. (2010). The normative development of emotion regulation strategy use in children and adolescents: A 2-year follow-up study. Journal of Child Psychology and Psychiatry, 51(5), 567–574.CrossRef

Hambour, V. K., Zimmer-Gembeck, M. J., Clear, S., Rowe, S., & Avdagic, E. (2018). Emotion regulation and mindfulness in adolescents: Conceptual and empirical connection and associations with social anxiety symptoms. Personality and Individual Differences, 134, 7–12.CrossRef

Hampel, P., & Petermann, F. (2005). Age and gender effects on coping in children and adolescents. Journal of Youth and Adolescence, 34(2), 73–83. https://doi.org/10.1007/s10964-005-3207-9CrossRef

Hilt, L. M., Cha, C. B., & Nolen-Hoeksema, S. (2008). Nonsuicidal self-injury in young adolescent girls: moderators of the distress-function relationship. Journal of Consulting and Clinical Psychology, 76(1), 63.

Hilt, L. M., & Pollak, S. D. (2012). Getting out of rumination: Comparison of three brief interventions in a sample of youth. Journal of Abnormal Child Psychology, 40(7), 1157–1165. https://doi.org/10.1007/s10802-012-9638-3CrossRefPubMedPubMedCentral

Hilt, L. M., McLaughlin, K. A., & Nolen-Hoeksema, S. (2010). Examination of the response styles theory in a community sample of young adolescents. Journal of Abnormal Child Psychology, 38(4), 545–556.CrossRef

Hilt, L. M., Sladek, M.R., Doane, L.D., & Stroud, C.B., (2017). Daily and trait rumination: diurnal cortisol patterns in adolescent girls, Cognition and Emotion, 31(8), 1757–1767. https://doi.org/10.1080/02699931.2016.1262332

Hilt, L. M., & Swords, C. M. (2021). Acceptability and preliminary effects of a mindfulness mobile application for ruminative adolescents. Behavior Therapy. https://doi.org/10.1016/j.beth.2021.03.004.

Hollenstein, T., McNeely, A., Eastabrook, J., Mackey, A., & Flynn, J. (2012). Sympathetic and parasympathetic responses to social stress across adolescence. Developmental Psychobiology, 54(2), 207–214.CrossRef

Jain, S., Shapiro, S. L., Swanick, S., Roesch, S. C., Mills, P. J., Bell, I., & Schwartz, G. E. R. (2007). A randomized controlled trial of mindfulness meditation versus relaxation training: Effects on distress, positive states of mind, rumination, and distraction. Annals of Behavioral Medicine, 33(1), 11–21. https://doi.org/10.1207/s15324796abm3301_2CrossRefPubMed

John, O. P., & Gross, J. J. (2004). Healthy and unhealthy emotion regulation: Personality processes, individual differences, and life span development. Journal of Personality. Blackwell Publishing Ltd. https://doi.org/10.1111/j.1467-6494.2004.00298.x

Johnstone, J. M., Ribbers, A., Jenkins, D., Atchley, R., Gustafsson, H., Nigg, J. T., Wahbeh, H., & Oken, B. (2020). Classroom-based mindfulness training reduces anxiety in adolescents: Acceptability and effectiveness of a cluster-randomized pilot study. Journal of Restorative Medicine, 10(1), 1–16.

Jose, P. E., & Brown, I. (2008). When does the gender difference in rumination begin? Gender and age differences in the use of rumination by adolescents. Journal of Youth and Adolescence, 37(2), 180–192.CrossRef

Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. Hyperion.

Kabat-Zinn, J. (2013). Full catastrophe living (revised edition): Using the wisdom of your body and mind to face stress, pain, and illness (Revised, Updated edition). Bantam.

Klein, D. N., Dougherty, L. R., & Olino, T. M. (2005). Toward guidelines for evidence-based assessment of depression in children and adolescents. Journal of Clinical Child and Adolescent Psychology. https://doi.org/10.1207/s15374424jccp3403_3

Kovacs, M. (1992). Children’s depression inventory manual. Toronto: Multi-Health Systems.

Kuhn, M. (2008). Caret package. Journal of Statistical Software, 28(5), 1–26.CrossRef

Lyubomirsky, S., Tucker, K. L., Caldwell, N. D., & Berg, K. (1999). Why ruminators are poor problem solvers: Clues from the phenomenology of dysphoric rumination. Journal of Personality and Social Psychology, 77(5), 1041.CrossRef

MacLean, K. A., Ferrer, E., Aichele, S. R., Bridwell, D. A., Zanesco, A. P., Jacobs, T. L., King, B. G., Rosenberg, E. L., Sahdra, B. K., Shaver, P. R., Wallace, B. A., Mangun, G. R., & Saron, C. D. (2010). Intensive meditation training improves perceptual discrimination and sustained attention. Psychological Science, 21(6), 829–839. https://doi.org/10.1177/0956797610371339CrossRefPubMed

Mani, M., Kavanagh, D. J., Hides, L., & Stoyanov, S. R. (2015). Review and evaluation of mindfulness-based iPhone apps. JMIR MHealth and UHealth, 3(3). https://doi.org/10.2196/mhealth.4328.

March, J. S., Parker, J. D. A., Sullivan, K., Stallings, P., & Conners, C. K. (1997). The multidimensional anxiety scale for children (MASC): Factor structure, reliability, and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36(4), 554–565. https://doi.org/10.1097/00004583-199704000-00019

March, J. S., Sullivan, K., & Parker, J. (1999). Test-retest reliability of the multidimensional anxiety scale for children. Journal of Anxiety Disorders, 13(4), 349–358. https://doi.org/10.1016/S0887-6185(99)00009-2

Martin, L. L., & Tesser, A. (1996). Some ruminative thoughts. Advances in Social Cognition, 9, 1–47.

McLaughlin, K. A., & Nolen-Hoeksema, S. (2011). Rumination as a transdiagnostic factor in depression and anxiety. Behaviour Research and Therapy, 49(3), 186–193. https://doi.org/10.1016/j.brat.2010.12.006CrossRefPubMed

Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., Benjet, C., Georgiades, K., & Swendsen, J. (2010). Lifetime prevalence of mental disorders in US adolescents: Results from the national comorbidity study-adolescent supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980–989. https://doi.org/10.1016/j.jaac.2010.05.017CrossRefPubMedPubMedCentral

Moberly, N. J., & Watkins, E. R. (2008). Ruminative self-focus and negative affect: An experience sampling study. Journal of Abnormal Psychology, 117(2), 314.CrossRef

Muris, P., Roelofs, J., Meesters, C., & Boomsma, P. (2004). Rumination and worry in nonclinical adolescents. Cognitive Therapy and Research, 28(4), 539–554. https://doi.org/10.1023/B:COTR.0000045563.66060.3eCrossRef

Nock, M. K., Holmberg, E. B., Photos, V. I., & Michel, B. D. (2007). Self-injurious thoughts and behaviors interview: Development, reliability, and validity in an adolescent sample. Psychological Assessment, 19(3), 309–317. https://doi.org/10.1037/1040-3590.19.3.309

Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology, 100(4), 569.CrossRef

Nolen-Hoeksema, S., & Watkins, E. R. (2011). A heuristic for developing transdiagnostic models of psychopathology: Explaining multifinality and divergent trajectories. Perspectives on Psychological Science, 6(6), 589–609. https://doi.org/10.1177/1745691611419672CrossRefPubMed

Nolen-Hoeksema, S., Wisco, B. E., & Lyubomirsky, S. (2008). Rethinking rumination. Perspectives on Psychological Science, 3(5), 400–424. https://doi.org/10.1111/j.1745-6924.2008.00088.xCrossRefPubMed

Ramler, T. R., Tennison, L. R., Lynch, J., & Murphy, P. (2016). Mindfulness and the college transition: The efficacy of an adapted mindfulness-based stress reduction intervention in fostering adjustment among first-year students. Mindfulness, 7(1), 179–188. https://doi.org/10.1007/s12671-015-0398-3CrossRef

Rideout, V., & Fox, S. (2018). Digital health practices among teens and young adults—Hopelab. https://www.hopelab.org/report/a-national-survey-by-hopelab-and-well-being-trust-2018/digital-health-practices/digital-health-practices-among-teens-and-young-adults/. Accessed 7 Mar 2019.

Rideout, V., & Robb, M. B. (2019). The common sense census: Media use by tweens and teens, 2019 | Common Sense Media. https://www.commonsensemedia.org/research/the-common-sense-census-media-use-by-tweens-and-teens-2019. Accessed 19 Aug 2020.

Rood, L., Roelofs, J., Bögels, S. M., Nolen-Hoeksema, S., & Schouten, E. (2009). The influence of emotion-focused rumination and distraction on depressive symptoms in non-clinical youth: A meta-analytic review. Clinical Psychology Review, 29(7), 607–616. https://doi.org/10.1016/j.cpr.2009.07.001CrossRefPubMed

Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2012). Mindfulness-based cognitive therapy for depression, Second Edition (2nd edition). The Guilford Press.

Shaw, Z. A., Hilt, L. M., & Starr, L. R. (2019). The developmental origins of ruminative response style: An integrative review. Clinical Psychology Review, 74, 101780. https://doi.org/10.1016/j.cpr.2019.101780CrossRefPubMed

Stekhoven, D. J., & Bühlmann, P. (2012). MissForest—Non-parametric missing value imputation for mixed-type data. Bioinformatics, 28(1), 112–118. https://doi.org/10.1093/bioinformatics/btr597CrossRef

Swords, C. M., Breitenstein, R. S., Doane, L. D., & Hilt, L. M. (2021). Mechanisms of mindfulness training: Ecological momentary assessment with adolescents. Department of Psychology, Lawrence University.

Tang, R., & Braver, T. S. (2020). Towards an individual differences perspective in mindfulness training research: Theoretical and empirical considerations. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.00818.

Twenge, J. M., Cooper, A. B., Joiner, T. E., Duffy, M. E., & Binau, S. G. (2019). Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005–2017. Journal of Abnormal Psychology, 128(3), 185–199. https://doi.org/10.1037/abn0000410CrossRefPubMed

van der Velden, A. M., Kuyken, W., Wattar, U., Crane, C., Pallesen, K. J., Dahlgaard, J., Fjorback, L. O., & Piet, J. (2015). A systematic review of mechanisms of change in mindfulness-based cognitive therapy in the treatment of recurrent major depressive disorder. Clinical Psychology Review, 37, 26–39. https://doi.org/10.1016/j.cpr.2015.02.001CrossRefPubMed

Villa, C. D., & Hilt, L. M. (2014). Brief instruction in mindfulness and relaxation reduce rumination differently for men and women. International Journal of Cognitive Therapy, 7(4), 320–333. https://doi.org/10.1521/ijct_2014_07_02CrossRef

Wasil, A. R., Gillespie, S., Shingleton, R., Wilks, C. R., & Weisz, J. R. (2020). Examining the reach of smartphone apps for depression and anxiety. American Journal of Psychiatry, 177(5), 464–465. https://doi.org/10.1176/appi.ajp.2019.19090905CrossRef

Watkins, E. R., & Nolen-Hoeksema, S. (2014). A habit-goal framework of depressive rumination. Journal of Abnormal Psychology, 123(1), 24–34. https://doi.org/10.1037/a0035540CrossRefPubMed

Watkins, E. R., & Roberts, H. (2020). Reflecting on rumination: Consequences, causes, mechanisms and treatment of rumination. Behaviour Research and Therapy, 127, 103573. https://doi.org/10.1016/j.brat.2020.103573CrossRefPubMed

Webb, C. A., Trivedi, M. H., Cohen, Z. D., Dillon, D. G., Fournier, J. C., Goer, F., Fava, M., McGrath, P. J., Weissman, M., Parsey, R., Adams, P., Trombello, J. M., Cooper, C., Deldin, P., Oquendo, M. A., McInnis, M. G., Huys, Q., Bruder, G., Kurian, B. T., … Pizzagalli, D. A. (2019). Personalized prediction of antidepressant v. placebo response: Evidence from the EMBARC study. Psychological Medicine, 49(7), 1118–1127. https://doi.org/10.1017/S0033291718001708

Webb, C. A., Swords, C. M., Lawrence, H., & Hilt, L. M. (2021). Which adolescents are well-suited to app-based mindfulness training? A randomized clinical trial and data-driven approach for personalized recommendations. PsyArXiv. https://doi.org/10.31234/osf.io/7gbjd

Wong, K. F., Massar, S. A. A., Chee, M. W. L., & Lim, J. (2018). Towards an objective measure of mindfulness: Replicating and extending the features of the breath-counting task. Mindfulness, 9(5), 1402–1410. https://doi.org/10.1007/s12671-017-0880-1CrossRef

Titel: App-Based Mindfulness Training for Adolescent Rumination: Predictors of Immediate and Cumulative Benefit
Auteurs: Christian A. Webb
Caroline M. Swords
Laura Murray
Lori M. Hilt
Publicatiedatum: 09-08-2021
Uitgeverij: Springer US
Gepubliceerd in: Mindfulness / Uitgave 10/2021
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI: https://doi.org/10.1007/s12671-021-01719-0

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Objectives

Methods

Results

Conclusions

Log in om toegang te krijgen

Andere artikelen Uitgave 10/2021

Correction to: Somatics of Early Buddhist Mindfulness and How to Face Anxiety

Exploratory and Confirmatory Bayesian Networks Identify the Central Role of Non-judging in Symptoms of Depression

A Person-Centered Approach in Investigating a Mindfulness-Based Program for Adolescents with Autism Spectrum Disorder

Reflections of a Mindful Teacher’s Shift from In-Person to Online Courses

Correction to: Dependent Arising and Interdependence

The Effects of Mindfulness and Meditation on the Cingulate Cortex in the Healthy Human Brain: A Review