Effectiveness of a school-based mindfulness program for transdiagnostic prevention in young adolescents

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Highlights

  • We investigated mindfulness as a prevention program for anxiety, depression and eating disorders in early secondary school.

  • In a moderately large RCT design, we did not replicate the improvements in mental health of earlier studies.

  • Further research is required to optimise key ingredients, dose and delivery formats of mindfulness interventions in schools.

Abstract

Anxiety, depression and eating disorders show peak emergence during adolescence and share common risk factors. School-based prevention programs provide a unique opportunity to access a broad spectrum of the population during a key developmental window, but to date, no program targets all three conditions concurrently. Mindfulness has shown promising early results across each of these psychopathologies in a small number of controlled trials in schools, and therefore this study investigated its use in a randomised controlled design targeting anxiety, depression and eating disorder risk factors together for the first time. Students (M age 13.63; SD = .43) from a broad band of socioeconomic demographics received the eight lesson, once weekly.b (“Dot be”) mindfulness in schools curriculum (N = 132) or normal lessons (N = 176). Anxiety, depression, weight/shape concerns and wellbeing were the primary outcome factors. Although acceptability measures were high, no significant improvements were found on any outcome at post-intervention or 3-month follow-up. Adjusted mean differences between groups at post-intervention were .03 (95% CI: −.06 to −.11) for depression, .01 (−.07 to −.09) for anxiety, .02 (−.05 to −.08) for weight/shape concerns, and .06 (−.08 to −.21) for wellbeing. Anxiety was higher in the mindfulness than the control group at follow-up for males, and those of both genders with low baseline levels of weight/shape concerns or depression. Factors that may be important to address for effective dissemination of mindfulness-based interventions in schools are discussed. Further research is required to identify active ingredients and optimal dose in mindfulness-based interventions in school settings.

Section snippets

Participants

A range of urban coeducational secondary schools in Adelaide, South Australia who were either known to the researchers, had expressed interest in being involved in research or were conveniently located were contacted by email with telephone follow up, and four schools (one private, three public) agreed to participate. One public primary school also expressed interest in taking part and was included in the study. Students in Year 7 (primary school) and 8 (secondary school) were targeted as

Description of participants

Fig. 1 shows the flow of participants through the study. Ten parents (2.4% of eligible students) actively requested that their child not be involved in the study, and of these, the four students in the mindfulness group undertook private study outside of the classroom during these lessons while the six students in the control group did not take part in survey analysis. Consent forms were not returned for a further 97 students (23.4% of eligible students), and these data were not included in the

Discussion

This study investigated an existing 8-week mindfulness curriculum in early adolescents within a randomised controlled design, with a wide range of outcome measures: depression, anxiety, wellbeing, eating disorder risk factors, emotional dysregulation, self-compassion and mindfulness. Unlike earlier promising studies in secondary schools (Atkinson and Wade, 2015, Kuyken et al., 2013, Raes et al., 2014, Sibinga et al., 2013), we found no improvements in any of the outcome variables either

Conclusion

In a tightly controlled experimental design, evaluating the impact of an existing and widely available school-based mindfulness program, no improvements were demonstrated on any outcome measure either immediately post intervention or at three month follow-up. Further research, including investigation of mediators and moderators in experimental designs, is required to identify active ingredients and optimal dose in mindfulness-based programs in school settings.

Acknowledgements

This study was funded by a Flinders University Australian Postgraduate Award and a scholarship provided by the Fraser Mustard Centre, Telethon Kids Institute and Department of Education and Child Development. There were no conflicts of interest.

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