Mindfulness-Based Cognitive Therapy For Children Research Articles

Prevention of internalizing difficulties in the middle years: Protocol for a noninferiority randomized trial of Mindfulness-Based Cognitive Therapy for Children and Cognitive Behavioural Therapy.

Mindfulness-based interventions have been tested as preventive programs for childhood internalizing difficulties, but most research has been at a 'universal' level with small to null effects. Mindfulness-Based Cognitive Therapy for Children (MBCT-C) has similar effects to Cognitive Behaviour Therapy (CBT) when used as a small-group, targeted preventive program. Knowledge gaps include the longer-term effectiveness of MBCT-C relative to CBT and the benefits of adding a parent module. This trial aims to compare MCBT-C to traditional CBT, including a parent module, to 15-months post-intervention and to test the feasibility and acceptability of adding a parent module. Participants will be recruited from primary schools in areas of socio-economic disadvantage in South Australia (n = 194). Children (aged 9-12) years with signs of internalizing difficulties (e.g., shy, withdrawn, worried), and their parents, will be eligible for this two-armed randomized controlled non-inferiority trial (RCT). Children will participate in 10 group sessions of MBCT-C or CBT, facilitated by psychologists, and parents from both conditions will participate in two parent-only group sessions. Child self-report measures include depression and anxiety, as well as attention, mindfulness and self-compassion. Parent measures include symptoms of depression and anxiety, mindfulness, and parent-child relationship strength. The primary outcome will be child anxiety and depression (Revised Child Anxiety and Depression Scale-25). Measures will be collected pre and post intervention, and at 3, 6, 12 and 15-month follow up. Schools will be recruited from October 2022. Nomination of children will commence from February 2023. Program implementation will begin May 2023. This trial will have implications for the feasibility of involving parents in preventative programs, as well as whether mindfulness-based interventions prevent internalizing difficulties over time.

The Atypical Emotional Processing in Bipolar Disorder and Relevant Interventions

Individuals with bipolar disorder (BD) demonstrate impaired functioning including cognitive deficits, neurological damage, and psychosocial dysfunction. Atypical emotional processing, the lack of normal functioning in identifying human emotions, is one of the most significant impairments observed in individuals with BD. Such abnormal emotional processing has different causes. Deficits in emotion perception and recognition can contribute to the impaired social functioning in separation or in combination, which can further impede social functioning. Both facial emotion recognition deficits (FERD) and alexithymia are proven to be powerful predictors of BD development. Relevant interventions including Mindfulness-Based Cognitive Therapy for Children (MBCT-C), Dialectical Behavior Therapy (DBT), and Positive emotion regulation (PRE) intervention are verified to be effective in treatment for BD patients with deficits in emotional processing. By examining recent literature, this review encapsulates the relationships between atypical emotion recognition and perception and impaired social functioning, the relationship between deficits in emotional processing and BD symptoms, and efficacy of the interventions focusing on mindfulness, presenting a more comprehensive understanding in this area. It can provide some guidance to the prevention and intervention studies and practices for at-risk adolescents.

The “what,” “why,” and “when” of using mindfulness in schools: Best practices and guidance for educators and policymakers

ABSTRACT Mindfulness-based interventions (MBIs) have recently proliferated among schools. Although MBIs show much promise in alleviating mental distress, their increase in school settings may outpace the evidence base for such implementation. In the present literature review, we define the different types of MBIs implemented in school settings: mindfulness-based stress reduction, mindfulness-based cognitive therapy for children, and mindfulness-based social-emotional learning programs. We next identify the outcomes most commonly addressed by MBIs in school settings, such as mental health, social-emotional, and academic outcomes. We conclude with a discussion of MBI implementation in schools and recommendations for educators and policymakers on best practices to maximize MBI effectiveness.

A preliminary study of the effects of mindfulness‐based cognitive therapy on structural brain networks in mood‐dysregulated youth with a familial risk for bipolar disorder

Mindfulness-based cognitive therapy for children (MBCT-C), as a psychotherapeutic intervention, has been shown to be effective for treating mood dysregulation (MD). While previous neuroimaging studies of MD have reported both pre-treatment structural and functional alterations, the effects of MBCT-C on brain morphological network organisation has not been investigated. We investigated brain morphological network organisation in 10 mood-dysregulated youth with familial risk for bipolar disorder and 15 matched healthy comparison youth (HC). Effects of 12 weeks of MBCT-C were examined in the mood-dysregulated youth. Topological properties of brain networks used for analyses were constructed based on morphological similarities in regional grey matter using a graph-theory approach using MRI data. At baseline, compared with the HC group, the mood-dysregulated group exhibited increased global efficiency (Eglob ), decreased path length (Lp ), and abnormal nodal properties, mainly in the limbic system. Right temporal pole alterations at baseline predicted change in Child and Adolescent Mindfulness Measure scores after treatment. The mood-dysregulated group showed significant decreases in both the Eglob and Lp metrics after MBCT-C, suggesting an improved capacity for optimal information processing. Changes in Lp were correlated with changes in Emotion Regulation Checklist scores. Our results show significant topological alterations in the mood-dysregulated group as compared to controls at baseline. After MBCT-C, disrupted topological properties in the mood-dysregulated group were significantly reduced. MBCT-C may facilitate clinically meaningful changes in the brain structural network in mood-dysregulated individuals.

Network-level functional topological changes after mindfulness-based cognitive therapy in mood dysregulated adolescents at familial risk for bipolar disorder: a pilot study

BackgroundGiven that psychopharmacological approaches routinely used to treat mood-related problems may result in adverse outcomes in mood dysregulated adolescents at familial risk for bipolar disorder (BD), Mindfulness-Based Cognitive Therapy for Children (MBCT-C) provides an alternative effective and safe option. However, little is known about the brain mechanisms of beneficial outcomes from this intervention. Herein, we aimed to investigate the network-level neurofunctional effects of MBCT-C in mood dysregulated adolescents.MethodsTen mood dysregulated adolescents at familial risk for BD underwent a 12-week MBCT-C intervention. Resting-state functional magnetic resonance imaging (fMRI) was performed prior to and following MBCT-C. Topological metrics of three intrinsic functional networks (default mode network (DMN), fronto-parietal network (FPN) and cingulo-opercular network (CON)) were investigated respectively using graph theory analysis.ResultsFollowing MBCT-C, mood dysregulated adolescents showed increased global efficiency and decreased characteristic path length within both CON and FPN. Enhanced functional connectivity strength of frontal and limbic areas were identified within the DMN and CON. Moreover, change in characteristic path length within the CON was suggested to be significantly related to change in the Emotion Regulation Checklist score.Conclusions12-week MBCT-C treatment in mood dysregulated adolescents at familial risk for BD yield network-level neurofunctional effects within the FPN and CON, suggesting enhanced functional integration of the dual-network. Decreased characteristic path length of the CON may be associated with the improvement of emotion regulation following mindfulness training. However, current findings derived from small sample size should be interpreted with caution. Future randomized controlled trials including larger samples are critical to validate our findings.

Correction to: A Randomized Clinical Trial of a Modified Mindfulness-Based Cognitive Therapy for Children Hospitalized with Cancer

In the original published version of this article, Dr. Randye J. Semple was captured as corresponding author instead of Dr. Mojtaba Habibi.

A Randomized Clinical Trial of a Modified Mindfulness-Based Cognitive Therapy for Children Hospitalized with Cancer

Many youth diagnosed with cancer also suffer from anxiety, depression, posttraumatic distress, and attention problems, which can negatively affect their quality of life. Mindfulness-based Cognitive Therapy for Children (MBCT-C) aims to enhance self-management of attention, improve emotional self-regulation, and bolster social-emotional resiliency. A modified MBCT-C intervention was conducted with hospitalized pediatric cancer patients to evaluate its efficacy for reducing internalizing and attention problems. Forty children (ages 11 to 13) diagnosed with cancer were randomly assigned to either a modified MBCT-C group (n = 20) or treatment as usual (TAU) control group (n = 20). To meet the needs of hospitalized participants, the manualized MBCT-C protocol was adapted to consist of 20 sessions, each lasting 45 min. Sessions were conducted 5 times weekly for 4 weeks. Primary outcome measures were the Child Behavior Checklist, Parent Report and its companion instrument, and the Youth Self-Report (YSR). Data were collected at pre-intervention, post-intervention, and at 2 months following the intervention. Repeated measures ANOVAs showed that, as compared with TAU controls, the MBCT-C group achieved significant reductions in internalizing and attention problems, and those gains were maintained at the 2-month follow-up. Reliable Change Index scores showed that the gains made by the MBCT-C group were both clinically significant and stable. By reducing internalizing and attention problems, mindfulness-based interventions may improve the quality of life for children hospitalized with cancer. These promising results warrant further investigation into the efficacy of mindfulness-based interventions to remediate internalizing and attentional problems in youth diagnosed with serious medical illnesses.

Mindfulness-Based Cognitive Therapy for Children (MBCT-C) for Prevention of Internalizing Difficulties: a Small Randomized Controlled Trial with Australian Primary School Children

The use of mindfulness-based programs (MBP) with children is rapidly growing, but calls for well-designed randomized controlled trials (RCTs) of existing programs. Mindfulness-Based Cognitive Therapy for Children (MBCT-C) has preliminary evidence for targeting internalizing symptoms in children. Within MBCT-C (and MBPs more broadly), attention is thought to be a key component of change, but mediation has been relatively unexplored. The overall aim of this small RCT was to compare MBCT-C to cognitive behavior therapy (CBT), as a preventive program for children experiencing internalizing difficulties. A mixed factorial design was used, with 2 (program group) by 2 (pre- and post-intervention) conditions. Children from 3 primary schools were randomized to MBCT-C (n = 45) or CBT (n = 44) using random permuted blocks, with stratification by school, gender, and age. Main analyses were multi-level mixed models. Contrary to the hypotheses, only limited differences were found between programs. Both programs had small effects on symptoms of anxiety and depression, quality of life, attention control, and parent- and teacher-SDQ Total Difficulties, as well as moderate-large effects on shifting attention. There were no statistically significant changes in mindfulness or sustained attention. This RCT provides a robust test of MBCT-C in a “real life” setting, demonstrating that it may be used as a clinically oriented preventive program in schools to reduce internalizing symptoms. The results challenge whether attention (as measured in this study) is a unique component of change for MBCT-C.

Mindfulness-Based Cognitive Therapy Enhances Emotional Resiliency in Children with Divorced Parents

The present study examines the hypotheses that children of divorce who participate in a 12-week mindfulness-training program (Mindfulness-Based Cognitive Therapy for Children, MBCT-C) would show greater reductions in depression, anxiety, and anger symptoms and would demonstrate enhanced emotional resiliency. This study utilized a semi-experimental prospective design with pre-, post-, and follow-up measures and a no-treatment control group. A sample of 83 children (ages 10 to 13) and living with a divorced parent were collected from six public schools in Tehran, Iran. The total sample, consisting of 33 boys and 50 girls, was randomly assigned to two groups: an experimental group (n = 42, 16 boys and 26 girls) and a no-treatment control group (n = 41, 17 boys and 24 girls). The experimental group received twelve 90-min sessions of MBCT-C, which was translated into Persian with minor cultural adaptations. All participants completed measures including the State-Trait Anxiety Inventory for Children (STAIC), State-Trait Anger Expression Inventory-2 (STAXI-2), Children’s Depression Inventory (CDI), and Child and Adolescent Mindfulness Measure (CAMM) at pre-test, post-test, and at 2-month follow-up. At the end of intervention, the experimental group showed significantly fewer symptoms of depression, trait anxiety, state anxiety, trait anger, and state anger in comparison with the control group. The intervention group also demonstrated an increase in emotional resiliency and significant enhancements in acceptance and mindfulness. The results provide support that MBCT-C can be an effective intervention to improve the emotional resiliency of children of divorce.

Neural Function Before and After Mindfulness-Based Cognitive Therapy in Anxious Adolescents at Risk for Developing Bipolar Disorder.

We sought to evaluate the neurophysiology of mindfulness-based cognitive therapy for children (MBCT-C) in youth with generalized, social, and/or separation anxiety disorder who were at risk for developing bipolar disorder. Nine youth (mean age: 13 ± 2 years) with a generalized, social, and/or separation anxiety disorder and a parent with bipolar disorder completed functional magnetic resonance imaging (fMRI) while performing a continuous processing task with emotional and neutral distractors (CPT-END) prior to and following 12 weeks of MBCT-C. MBCT-C was associated with increases in activation of the bilateral insula, lentiform nucleus, and thalamus, as well as the left anterior cingulate while viewing emotional stimuli during the CPT-END, and decreases in anxiety were correlated with change in activation in the bilateral insula and anterior cingulate during the viewing of emotional stimuli (p < 0.05, uncorrected; p < 0.005 corrected; cluster size, 37 voxels). MBCT-C treatment in anxious youth with a familial history of bipolar disorder is associated with increased activation of brain structures that subserve interoception and the processing of internal stimuli-functions that are ostensibly improved by this treatment.

Mindfulness‐based cognitive therapy for youth with anxiety disorders at risk for bipolar disorder: a pilot trial

Children and adolescents with bipolar parents have an elevated risk for anxiety disorders. However, antidepressant medications commonly used to treat symptoms of anxiety may accelerate the onset of mania in these already at-risk youth. Therefore, studies evaluating innovative non-pharmacologic treatments for anxiety in this population are urgently needed. Subjects participated in 12 weekly sessions of mindfulness-based cognitive therapy for children (MBCT-C), a manualized group psychotherapeutic intervention utilizing cognitive behavioural principles and mindfulness exercises to increase regulation of attention and non-judgmental acceptance of present moment thoughts, emotions and experiences. Independent raters administered symptoms rating scales prior to each treatment session. Spearman correlations and paired-samples signed rank tests were used to examine outcomes. After-intervention surveys and session transcripts were reviewed to assess feasibility and acceptability of the intervention. Participants included 10 youth (meanage = 13.2; 80% girls; 40% biracial) with generalized, social and/or separation anxiety disorders, and a parent with bipolar disorder. Clinician-rated anxiety was significantly reduced after intervention (meanbefore = 11.1; meanafter = 4.3; P < 0.01), as well as youth-rated trait anxiety (P = 0.03). Parent-rated emotion regulation significantly increased from before to after intervention (P = 0.05). Increases in mindfulness were associated with decreases in anxiety (P = 0.03). Finally, children and parents/guardians reported high levels of feasibility, acceptability and usefulness of the intervention. Findings support the feasibility, acceptability and preliminary efficacy of MBCT-C for treating anxiety in youth at risk for bipolar disorder. Future controlled and larger studies are needed to confirm these preliminary findings.

A Randomized Trial of Mindfulness-Based Cognitive Therapy for Children: Promoting Mindful Attention to Enhance Social-Emotional Resiliency in Children

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.

Mindfulness-Based Cognitive Therapy for Children: Results of a Pilot Study

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.