Classroom-Based Mindfulness Training Reduces Anxiety in Adolescents: Acceptability and Effectiveness of a Cluster-Randomized Pilot Study

Author: Jeanette M Johnstone1,2,3, Amanda Ribbers2, David Jenkins2, Rachel Atchley3, Hanna Gustafsson2, Joel T Nigg2,4, Helané Wahbeh3, Barry Oken3,4,5
Affiliation: <sup>1</sup> National University of Natural Medicine, Helfgott Research Institute, 2220 SW 1st Ave, Portland, OR, 97201, USA. <sup>2</sup> Department of Psychiatry, Oregon Health &amp; Science University (OHSU), 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA. <sup>3</sup> Department of Neurology, Oregon Health &amp; Science University (OHSU), 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA. <sup>4</sup> Department of Behavioral Neuroscience, Oregon Health &amp; Science University (OHSU), 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA. <sup>5</sup> Department of Biomedical Engineering, Oregon Health &amp; Science University (OHSU), 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.
Conference/Journal: J Restor Med
Date published: 2020 Dec 29
Other: Volume ID: 10 , Issue ID: 1 , Special Notes: doi: 10.14200/jrm.2020.0101. , Word Count: 278


Objective:
Many high school students experience a high degree of anxiety and perceived stress. This study examined whether a classroom-based mindfulness program or a wellness program were acceptable and effective as anxiety and stress reduction interventions based on students' self-reports.

Design setting and participants:
Thirteen health education classes (n=285 students, aged 14-16 years) were randomized by classroom to one of three conditions: mindfulness, wellness, or usual health class only (passive control/ waitlist), for 8 weeks.

Outcomes:
Pre- and post-intervention scores compared self-reported measures of depression, anxiety and stress.

Results:
Complete data were available from nine classes (n=202 students). Post-intervention anxiety scores were reduced in students who received the mindfulness intervention compared to those who received only their usual health class (β=-0.07, SE=0.03, P≤0.001; 95% CI=-0.12, -0.02). No significant between group differences were found for depression or stress (P>0.4). Students' satisfaction with the mindfulness intervention they received withstood baseline credibility and expectancy effects: r=0.21, n=67, P=0.17 for credibility; r=-0.001, n=67, P=0.99 for expectancy. However, students' satisfaction with the wellness intervention they received was positively correlated with their pre-intervention expectations, r=0.42, n=47, P>0.001. Fifty-two percent of the 68 students assigned to mindfulness (n=35) used the iPad app for mindfulness home practice at least once; of those, 10% used it 10 or more times.

Conclusion:
Eight weeks of classroom-based mindfulness, with limited home practice, reduced self-reported anxiety compared to usual health class, and withstood baseline expectancy effects in this group of high school students, a majority who come from high income families.

Clinical implications:
School- or community-based mindfulness may be an appropriate recommendation for adolescents who experience anxiety.

Keywords: Adolescents; Anxiety; High school; Mindfulness; Stress reduction; Wellness.

PMID: 33365203 PMCID: PMC7755132 DOI: 10.14200/jrm.2020.0101