Research Review: The effects of mindfulness-based interventions on cognition and mental health in children and adolescents - a meta-analysis of randomized controlled trials.

Darren L Dunning,Tim Dalgleish,Jenna Parker,Lucy Foulkes,Catherine Crane,Kirsty Griffiths,Willem Kuyken

doi:10.1111/jcpp.12980

Abstract

BackgroundMindfulness based interventions (MBIs) are an increasingly popular way of attempting to improve the behavioural, cognitive and mental health outcomes of children and adolescents, though there is a suggestion that enthusiasm has moved ahead of the evidence base. Most evaluations of MBIs are either uncontrolled or nonrandomized trials. This meta‐analysis aims to establish the efficacy of MBIs for children and adolescents in studies that have adopted a randomized, controlled trial (RCT) design.MethodsA systematic literature search of RCTs of MBIs was conducted up to October 2017. Thirty‐three independent studies including 3,666 children and adolescents were included in random effects meta‐analyses with outcome measures categorized into cognitive, behavioural and emotional factors. Separate random effects meta‐analyses were completed for the seventeen studies (n = 1,762) that used an RCT design with an active control condition.ResultsAcross all RCTs we found significant positive effects of MBIs, relative to controls, for the outcome categories of Mindfulness, Executive Functioning, Attention, Depression, Anxiety/Stress and Negative Behaviours, with small effect sizes (Cohen's d), ranging from .16 to .30. However, when considering only those RCTs with active control groups, significant benefits of an MBI were restricted to the outcomes of Mindfulness (d = .42), Depression (d = .47) and Anxiety/Stress (d = .18) only.ConclusionsThis meta‐analysis reinforces the efficacy of using MBIs for improving the mental health and wellbeing of youth as assessed using the gold standard RCT methodology. Future RCT evaluations should incorporate scaled‐up definitive trial designs to further evaluate the robustness of MBIs in youth, with an embedded focus on mechanisms of action.

Highlights

Mindfulness has been defined as intentionally directing attention to present moment experiences with an attitude of curiosity and acceptance (Bishop et al, 2004)
Based on the principles of Mindfulness-Based Stress Reduction (MBSR), other Mindfulness based interventions (MBIs) emerged in the years that followed, such as Mindfulness-Based Cognitive Therapy (MBCT; Segal et al, 2002), that focuses on helping to prevent the recurrence of depression
These are as follows: 1. Study design: the effects of mindfulness were compared against a control condition and the participants were randomly assigned to condition; 2

Summary

Introduction

Mindfulness has been defined as intentionally directing attention to present moment experiences with an attitude of curiosity and acceptance (Bishop et al, 2004). Mindfulness based interventions (MBIs) are an increasingly popular way of attempting to improve the behavioural, cognitive and mental health outcomes of children and adolescents, though there is a suggestion that enthusiasm has moved ahead of the evidence base. Most evaluations of MBIs are either uncontrolled or nonrandomized trials This meta-analysis aims to establish the efficacy of MBIs for children and adolescents in studies that have adopted a randomized, controlled trial (RCT) design. Thirty-three independent studies including 3,666 children and adolescents were included in random effects meta-analyses with outcome measures categorized into cognitive, behavioural and emotional factors. Results: Across all RCTs we found significant positive effects of MBIs, relative to controls, for the outcome categories of Mindfulness, Executive Functioning, Attention, Depression, Anxiety/Stress and Negative Behaviours, with small effect sizes (Cohen’s d), ranging from .16 to .30.

Methods

Results

Discussion

Conclusion