Skip to main content
SpringerLink
Log in

Potential Moderators of the Effects of a School-Based Mindfulness Program on Symptoms of Depression in Adolescents

  • ORIGINAL PAPER
  • Published:
Mindfulness Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Ahlen, J., Lenhard, F., & Ghaderi, A. (2015). Universal prevention for anxiety and depressive symptoms in children: a meta-analysis of randomized and cluster-randomized trials. Journal of Primary Prevention, 36(6), 387–403. doi:10.1007/s10935-015-0405-4.

    Article  PubMed  Google Scholar 

  • Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the depression anxiety stress scales in clinical groups and a community sample. Psychological Assessment, 10(2), 176–181.

    Article  Google Scholar 

  • Bates, D., Maechler, M., Bolker, B., & Walker, S. (2015). Fitting linear mixed-effects models using lme4. Journal of Statistical Software, 67(1), 1–48. doi:10.18637/jss.v067.i01.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google 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 

  • Bluth, K., Campo, R. A., Pruteanu-Malinici, S., Reams, A., Mullarkey, M., & Broderick, P. C. (2016). A school-based mindfulness pilot study for ethnically diverse at-risk adolescents. Mindfulness, 7(1), 90–104. doi:10.1007/s12671-014-0376-1.

    Article  PubMed  Google Scholar 

  • Brière, F. N., Rohde, P., Shaw, H., & Stice, E. (2014). Moderators of two indicated cognitive-behavioral depression prevention approaches for adolescents in a school-based effectiveness trial. Behaviour Research and Therapy, 53, 55–62. doi:10.1016/j.brat.2013.12.005.

    Article  PubMed  Google Scholar 

  • Castelao, C. F., & Kroener-Herwig, B. (2013). Different trajectories of depressive symptoms in children and adolescents: predictors and differences in girls and boys. Journal of Youth and Adolescence, 42(8), 1169–1182. doi:10.1007/s10964-012-9858-4.

    Article  Google Scholar 

  • Chambers, R., Gullone, E., Hassed, C., Knight, W., Garvin, T., & Allen, N. (2015). Mindful emotion regulation predicts recovery in depressed youth. Mindfulness, 6(3), 523–534. doi:10.1007/s12671-014-0284-4.

    Article  Google Scholar 

  • Chiesa, A., Serretti, A., & Jakobsen, J. C. (2013). Mindfulness: top-down or bottom-up emotion regulation strategy? Clinical Psychology Review, 33(1), 82–96. doi:10.1016/j.cpr.2012.10.006.

    Article  PubMed  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.

    Article  Google 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.

    Article  PubMed  Google Scholar 

  • Gould, L. F., Dariotis, J. K., Mendelson, T., & Greenberg, M. T. (2012). A school-based mindfulness intervention for urban youth: exploring moderators of intervention effects. Journal of Community Psychology, 40(8), 968–982. doi:10.1002/jcop.21505.

    Article  Google 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.

    Article  PubMed  Google Scholar 

  • Henry, J. D., & Crawford, J. R. (2005). The short-form version of the depression anxiety stress scales (DASS-21): construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44(2), 227–239.

    Article  PubMed  Google Scholar 

  • Horowitz, J. L., & Garber, J. (2006). The prevention of depressive symptoms in children and adolescents: a meta-analytic review. Journal of Consulting and Clinical Psychology, 74(3), 401–415.

    Article  PubMed  Google 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.

    Article  PubMed  Google Scholar 

  • Johnson, C., Burke, C., Brinkman, S., & Wade, T. (2016). Effectiveness of a school-based mindfulness program for transdiagnostic prevention in young adolescents. Behaviour Research and Therapy, 81, 1–11.

    Article  PubMed  Google Scholar 

  • Kabat-Zinn, J. (1990). Full catastrophe living: how to cope with stress, pain and illness using mindfulness meditation. New York: Delacorte.

    Google Scholar 

  • Kallapiran, K., Koo, S., Kirubakaran, R., & Hancock, K. (2015). Effectiveness of mindfulness in improving mental health symptoms of children and adolescents: a meta-analysis. Child and Adolescent Mental Health, 20(4), 182–194.

    Article  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.

    PubMed  PubMed Central  Google Scholar 

  • Kraemer, H. C., Wilson, G. T., Fairburn, C. G., & Agras, W. S. (2002). Mediators and moderators of treatment effects in randomized clinical trials. Archives of General Psychiatry, 59(10), 877–883.

    Article  PubMed  Google 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.

    Article  PubMed  Google Scholar 

  • Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales (2nd ed.). Sidney: Psychology Foundation.

    Google Scholar 

  • McCart, M. R., Priester, P. E., Davies, W. H., & Azen, R. (2006). Differential effectiveness of behavioral parent-training and cognitive-behavioral therapy for antisocial youth: a meta-analysis. Journal of Abnormal Child Psychology, 34(4), 525–541.

    Article  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.

    Article  Google Scholar 

  • Murakami, H., Katsunuma, R., Oba, K., Terasawa, Y., Motomura, Y., Mishima, K., et al. (2015). Neural networks for mindfulness and emotion suppression. PloS One, 10(6), e0128005. doi:10.1371/journal.pone.0128005.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nehmy, T. J. (2010). School-based prevention of depression and anxiety in Australia: current state and future directions. Clinical Psychologist, 14(3), 74–83. doi:10.1080/13284207.2010.524884.

    Article  Google Scholar 

  • Nehmy, T. J., & Wade, T. D. (2015). Reducing the onset of negative affect in adolescents: evaluation of a perfectionism program in a universal prevention setting. Behaviour Research and Therapy, 67, 55–63. doi:10.1016/j.brat.2015.02.007.

    Article  PubMed  Google Scholar 

  • Patton, G. C., Coffey, C., Romaniuk, H., Mackinnon, A., Carlin, J. B., Degenhardt, L., et al. (2014). The prognosis of common mental disorders in adolescents: a 14-year prospective cohort study. Lancet, 383(9926), 1404–1411. doi:10.1016/s0140-6736(13)62116-9.

    Article  PubMed  Google 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.

    Article  PubMed  PubMed Central  Google 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.

    Article  Google Scholar 

  • Raes, F., Griffith, J. W., Van der Gucht, K., & Williams, J. M. G. (2014). School-based prevention and reduction of depression in adolescents: a cluster-randomized controlled trial of a mindfulness group program. Mindfulness, 5(5), 477–486. doi:10.1007/s12671-013-0202-1.

    Article  Google Scholar 

  • Sanger, K. L., & Dorjee, D. (2015). Mindfulness training for adolescents: a neurodevelopmental perspective on investigating modifications in attention and emotion regulation using event-related brain potentials. Cognitive, Affective, & Behavioral Neuroscience, 15(3), 696–711.

    Article  Google 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.

    Article  PubMed  PubMed Central  Google 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.

    Article  PubMed  Google Scholar 

  • Tang, Y.-Y., Hoelzel, B. K., & Posner, M. I. (2015). The neuroscience of mindfulness meditation. Nature Reviews Neuroscience, 16(4), 213–U280. doi:10.1038/nrn3916.

    Article  PubMed  Google Scholar 

  • Team, R. D. C (2007). R: A Language and Environment for Statistical Computing Vienna: R Foundation for Statistical Computing.

  • 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.

    Article  PubMed  Google Scholar 

  • Westbrook, C., Creswell, J. D., Tabibnia, G., Julson, E., Kober, H., & Tindle, H. A. (2013). Mindful attention reduces neural and self-reported cue-induced craving in smokers. Social Cognitive and Affective Neuroscience, 8(1), 73–84.

    Article  PubMed  Google Scholar 

  • Wetherill, R., & Tapert, S. F. (2013). Adolescent brain development, substance use, and psychotherapeutic change. Psychology of Addictive Behaviors, 27(2), 393–402. doi:10.1037/a0029111.

    Article  PubMed  Google 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.

    Article  Google Scholar 

  • Zenner, C., Herrnleben-Kurz, S., & Walach, H. (2014). Mindfulness-based interventions in schools—a systematic review and meta-analysis. Frontiers in Psychology, 5, 603. doi:10.3389/fpsyg.2014.00603.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zoogman, S., Goldberg, S. B., Hoyt, W. T., & Miller, L. (2015). Mindfulness interventions with youth: a meta-analysis. Mindfulness, 6(2), 290–302. doi:10.1007/s12671-013-0260-4.

    Article  Google Scholar 

Download references

Acknowledgements

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.

Author information

Authors and Affiliations

  1. Faculty of Psychology and Educational Sciences, University of Leuven, Tiensestraat 102, 3000, Leuven, Belgium

    Katleen Van der Gucht, Keisuke Takano, Peter Kuppens & Filip Raes

Authors
  1. Katleen Van der Gucht
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Keisuke Takano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peter Kuppens
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Filip Raes
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Katleen Van der Gucht.

Ethics declarations

Funding

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.

Ethical Approval

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

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

der Gucht, K.V., Takano, K., Kuppens, P. et al. Potential Moderators of the Effects of a School-Based Mindfulness Program on Symptoms of Depression in Adolescents. Mindfulness 8, 797–806 (2017). https://doi.org/10.1007/s12671-016-0658-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12671-016-0658-x

Keywords

Search

Navigation