Potential Moderators of the Effects of a School-Based Mindfulness Program on Symptoms of Depression in Adolescents
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An essential step to wide-scale dissemination is to investigate moderators of intervention effectiveness. This study examined moderators of the effects of a universal school-based mindfulness program on adolescents’ depressive symptoms. Based on theory and previous research, we identified the following potential moderators: (1) severity of symptoms of depression at baseline, (2) gender, (3) age, and (4) school track. The study uses a pooled dataset from two consecutive randomized controlled trials in adolescents (13–18 years) in secondary schools in Belgium. Results on effectiveness based on the first trial were published in this journal (Raes et al. 2014). A second consecutive trial was conducted to obtain a more equal distribution between school tracks and to enlarge power, yielding a total of 605 students from nine schools. In each school, parallel classes were randomized to the mindfulness condition or usual curriculum control condition. Data were collected 1 week before and 1 week after delivery of the training and at 6-month follow-up. Moderation was tested longitudinally with multilevel models across the three repeated measures and across condition. We found no moderation effects of gender, age, and school track. Six months after the training, we found a marginally significant moderation effect for severity of symptoms of depression at baseline with greater decrease in symptoms for students with high levels of depression. The general absence of differential intervention effects for gender, age, and school track supports the broad scope of the school-based mindfulness group intervention.
KeywordsMindfulness Depression Prevention Moderators Adolescents Schools
This research was supported by a grant from the foundation “Go for Happiness.” We sincerely thank vzw Mindfulness, the trainers, the schools, and the students who participated in this project.
Compliance with Ethical Standards
This study was funded by a grant from the foundation “Go for Happiness.” The writing of this article has been facilitated by KU Leuven Center for Excellence on Generalization Research (GRIP*TT; PF/10/005) and by KU Leuven Research Council grant GOA/15/003.
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- Bellon, J. A., Moreno-Peral, P., Motrico, E., Rodriguez-Morejon, A., Fernandez, A., Serrano-Blanco, A., et al. (2015). Effectiveness of psychological and/or educational interventions to prevent the onset of episodes of depression: a systematic review of systematic reviews and meta-analyses. Preventive Medicine, 76, S22–S32. doi: 10.1016/j.ypmed.2014.11.003.PubMedCrossRefGoogle Scholar
- Beurs, E., Van Dyck, R., Marquenie, L. A., Lange, A., & Blonk, R. W. B. (2001). De DASS: een vragenlijst voor het meten van depressie, angst en stress. Gedragstherapie, 34, 35–53.Google Scholar
- Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2ed ed.). Hillsdale: Erlbaum.Google Scholar
- Crawford, J., Cayley, C., Lovibond, P. F., Wilson, P. H., & Hartley, C. (2011). Percentile norms and accompanying interval estimates from an Australian general adult population sample for self-report mood scales (BAI, BDI, CRSD, CES-D, DASS, DASS-21, STAI-X, STAI-Y, SRDS, and SRAS). Australian Psychologist, 46(1), 3–14.CrossRefGoogle Scholar
- Gard, T., Holzel, B. K., Sack, A. T., Hempel, H., Lazar, S. W., Vaitl, D., et al. (2012). Pain attenuation through mindfulness is associated with decreased cognitive control and increased sensory processing in the brain. Cerebral Cortex, 22(11), 2692–2702. doi: 10.1093/cercor/bhr352.PubMedCrossRefGoogle Scholar
- Hankin, B. L., Abramson, L. Y., Moffitt, T. E., Silva, P. A., McGee, R., & Angell, K. E. (1998). Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. Journal of Abnormal Psychology, 107(1), 128–140.PubMedCrossRefGoogle Scholar
- Horowitz, J. L., Garber, J., Ciesla, J. A., Young, J. F., & Mufson, L. (2007). Prevention of depressive symptoms in adolescents: a randomized trial of cognitive-behavioral and interpersonal prevention programs. Journal of Consulting and Clinical Psychology, 75(5), 693–706. doi: 10.1037/0022-006x.75.5.693.PubMedCrossRefGoogle Scholar
- Kabat-Zinn, J. (1990). Full catastrophe living: how to cope with stress, pain and illness using mindfulness meditation. New York: Delacorte.Google Scholar
- Kessler, R. C., Angermeyer, M., Anthony, J. C., de Graaf, R., Demyttenaere, K., Gasquet, I., et al. (2007). Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry, 6(3), 168–176.PubMedPubMedCentralGoogle Scholar
- Kuyken, W., Warren, F. C., Taylor, R. S., Whalley, B., Crane, C., Bondolfi, G., et al. (2016). Efficacy of mindfulness-based cognitive therapy in prevention of depressive relapse an individual patient data meta-analysis from randomized trials. JAMA Psychiatry, 73(6), 565–574. doi: 10.1001/jamapsychiatry.2016.0076.PubMedCrossRefGoogle Scholar
- Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales (2nd ed.). Sidney: Psychology Foundation.Google Scholar
- Mueller, S., Rohde, P., Gau, J. M., & Stice, E. (2015). Moderators of the effects of indicated group and bibliotherapy cognitive behavioral depression prevention programs on adolescents’ depressive symptoms and depressive disorder onset. Behaviour Research and Therapy, 75, 1–10. doi: 10.1016/j.brat2015.10.002.CrossRefGoogle Scholar
- Pearson, M. R., Lawless, A. K., Brown, D. B., & Bravo, A. J. (2015). Mindfulness and emotional outcomes: identifying subgroups of college students using latent profile analysis. Personality and Individual Differences, 76, 33–38. doi: 10.1016/j.paid.2014.11.009.PubMedPubMedCentralCrossRefGoogle Scholar
- Poessel, P., Martin, N. C., Garber, J., & Hautzinger, M. (2013). A randomized controlled trial of a cognitive-behavioral program for the prevention of depression in adolescents compared with nonspecific and no-intervention control conditions. Journal of Counseling Psychology, 60(3), 432–438. doi: 10.1037/a0032308.CrossRefGoogle Scholar
- Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: Guilford Press.Google Scholar
- Stice, E., Shaw, H., Bohon, C., Marti, C. N., & Rohde, P. (2009). A meta-analytic review of depression prevention programs for children and adolescents: factors that predict magnitude of intervention effects. Journal of Consulting and Clinical Psychology, 77(3), 486–503.PubMedPubMedCentralCrossRefGoogle Scholar
- Stockings, E. A., Degenhardt, L., Dobbins, T., Lee, Y. Y., Erskine, H. E., Whiteford, H. A., et al. (2016). Preventing depression and anxiety in young people: a review of the joint efficacy of universal, selective and indicated prevention. Psychological Medicine, 46(1), 11–26. doi: 10.1017/s0033291715001725.PubMedCrossRefGoogle Scholar
- Team, R. D. C (2007). R: A Language and Environment for Statistical Computing Vienna: R Foundation for Statistical Computing.Google Scholar
- van den Hurk, P. A., Janssen, B. H., Giommi, F., Barendregt, H. P., & Gielen, S. C. (2010). Mindfulness meditation associated with alterations in bottom-up processing: psychophysiological evidence for reduced reactivity. International Journal of Psychophysiology, 78(2), 151–157.PubMedCrossRefGoogle Scholar
- Willemsen, J., Markey, S., Declercq, F., & Vanheule, S. (2011). Negative emotionality in a large community sample of adolescents: the factor structure and measurement invariance of the short version of the depression anxiety stress scales (DASS-21). Stress and Health, 27(3), E120–E128. doi: 10.1002/smi.1342.CrossRefGoogle Scholar