The aim of the study is to explore the feasibility and initial outcomes of a mindfulness-based group intervention (MBI) for adolescents with inflammatory bowel disease (IBD). A mixed-methods uncontrolled study using an adapted 8-week group MBI for adolescents with IBD was conducted at a pediatric tertiary hospital. Primary outcomes focused on feasibility. Secondary outcomes focused on preliminary efficacy via quality of life, mindfulness, and symptoms of anxiety and depression. Of a total of 44 adolescents invited to participate, 16 adolescents completed the study. Group attendance and home meditation practice was satisfactory. There were significant differences in emotional functioning relative to IBD following MBI-A participation. Qualitative analysis rendered two themes: (1) personal interpretation and application of mindfulness and (2) the benefits of IBD-specific peer support. Several key adaptations are needed to increase feasibility of group MBIs prior to randomized controlled trials. Findings can be generalized to inform group-based therapies for adolescents with IBD.
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Ahola Kohut, S., Stinson, J., Davies-Chalmers, C., Ruskin, D., & van Wyk, M. (2017). Mindfulness-based interventions in clinical samples of adolescents with chronic ilness: A systematic review. Journal of Alternative and Complementary Medicine,23(8), 581–589. https://doi.org/10.1089/acm.2016.0316.
Ahola Kohut, S., Walker, K., Ruskin, D., Walters, T. D., Church, P. C., & Pignatiello, T. (2018). Feasibility, acceptability, and initial outcomes of iACT: An online group intervention for adolescents with Inflammatory Bowel disease. Toronto: Hospital for Sick Children.
Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice,10(2), 125–143.
Berrill, J. W., Sadlier, M., Hood, K., & Green, J. T. (2014). Mindfulness-based therapy for inflammatory bowel disease patients with functional abdominal symptoms or high perceived stress levels. Journal of Crohn’s and Colitis,8(9), 945–955. https://doi.org/10.1016/j.crohns.2014.01.018.
Biegel, G. M., Brown, K. W., Shapiro, S. L., & Schubert, C. M. (2009). Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: A randomized clinical trial. Journal of Consulting and Clinical Psychology,77(5), 855–866. https://doi.org/10.1037/a0016241.
Bursch, B., Tsao, J. C. I., Meldrum, M., & Zeltzer, L. K. (2006). Preliminary validation of a self-efficacy scale for child functioning despite chronic pain (child and parent versions). Pain,125(1–2), 35–42. https://doi.org/10.1016/j.pain.2006.04.026.
Chadi, N., Kaufman, M., Weisbaum, E., Malboeuf-Hurtubise, C., Kohut, S. A., Viner, C., & Vo, D. X. (2017). In-Person versus eHealth mindfulness-based intervention for adolescents with chronic illness: Protocol for a randomized controlled trial. JMIR Research Protocols,6(11), e241. https://doi.org/10.2196/resprot.7700.
Chadi, N., McMahon, A., Vadnais, M., Malboeuf-Hurtubise, C., Djemli, A., Dobkin, P. L., & Haley, N. (2016). Mindfulness-based intervention for female adolescents with chronic pain: A pilot randomized trial. Journal of the Canadian Academy of Child and Adolescent Psychiatry,25(3), 159–168.
Cotton, S., Humenay Roberts, Y., Tsevat, J., Britto, M. T., Succop, P., McGrady, M. E., & Yi, M. S. (2010). Mind-body complementary alternative medicine use and quality of life in adolescents with Inflammatory Bowel disease. Inflammatory Bowel Diseases,16(3), 501–506. https://doi.org/10.1002/ibd.21045.
Cotton, S., Luberto, C. M., Sears, R. W., Strawn, J. R., Stahl, L., Wasson, R. S.,… Delbello, M. P. (2016). Mindfulness-based cognitive therapy for youth with anxiety disorders at risk for bipolar disorder: A pilot trial. Early Interv Psychiatry, 10(5), 426–434. https://doi.org/10.1111/eip.12216.
Dewalt, D. A., Thissen, D., Stucky, B. D., Langer, M. M., Morgan Dewitt, E., Irwin, D. E.,… Varni, J. W. (2013). PROMIS Pediatric peer relationships scale: Development of a peer relationships item bank as part of social health measurement. Health Psychology, 32(10), 1093–1103. https://doi.org/10.1037/a0032670.
Dinya, E., Csorba, J., Sorfozo, Z., Steiner, P., Ficsor, B., & Horvath, A. (2009). Profiles of suicidality and clusters of Hungarian adolescent outpatients suffering from suicidal behaviour. Psychopathology,42(5), 299–310.
Gordon, J. S., Staples, J. K., Blyta, A., Bytyqi, M., & Wilson, A. T. (2008). Treatment of posttraumatic stress disorder in postwar Kosovar adolescents using mind-body skills groups: A randomized controlled trial. Journal of Clinical Psychiatry,69(9), 1469–1476.
Greco, L. A., Baer, R. A., & Smith, G. T. (2011). Assessing mindfulness in children and adolescents: Development and validation of the child and adolescent mindfulness measure (CAMM). Psychological Assessment,23(3), 606–614. https://doi.org/10.1037/a0022819.
Greenley, R. N., Hommel, K. A., Nebel, J., Raboin, T., Li, S. H., Simpson, P., & Mackner, L. (2010). A meta-analytic review of the psychosocial adjustment of youth with inflammatory Bowel disease. Journal of Pediatric Psychology,35(8), 857–869. https://doi.org/10.1093/jpepsy/jsp120.
Hoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Morris, L. K., Robinaugh, D. J.,… Simon, N. M. (2013). Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: Effects on anxiety and stress reactivity. Journal of Clinical Psychiatry, 74(8), 786–792. https://doi.org/10.4088/jcp.12m08083.
Jastrowski Mano, K. E., Salamon, K. S., Hainsworth, K. R., Anderson Khan, K. J., Ladwig, R. J., Davies, W. H., & Weisman, S. J. (2013). A randomized, controlled pilot study of mindfulness-based stress reduction for pediatric chronic pain. Alternative Therapies in Health and Medicine,19(6), 8–14.
Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. New York: Hyperion.
Levenstein, S. (2004). Embracing complexity: What determines quality of life in Inflammatory Bowel Disease? European Journal of Gastroenterology and Hepatology,16(12), 1253–1255.
Levenstein, S., Prantera, C., Varvo, V., Scribano, M. L., Andreoli, A., Luzi, C.,… Marcheggiano, A. (2000). Stress and exacerbation in ulcerative colitis: A prospective study of patients enrolled in remission. The American Journal of Gastroenterology, 95(5), 1213–1220. https://doi.org/10.1111/j.1572-0241.2000.02012.x.
Malboeuf-Hurtubise, C., Achille, M., Muise, L., Beauregard-Lacroix, R., Vadnais, M., & Lacourse, É. (2016). A mindfulness-based meditation pilot study: Lessons learned on acceptability and feasibility in adolescents with cancer. Journal of Child and Family Studies,25(4), 1168–1177.
March, J. S., Parker, J. D. A., Sullivan, K., Stallings, P., & Conners, C. K. (1997). The multidimensional anxiety scale for children (MASC): Factor structure, reliability, and validity. Journal of the American Academy of Child and Adolescent Psychiatry,36(4), 554–565. https://doi.org/10.1097/00004583-199704000-00019.
Neilson, K., Ftanou, M., Monshat, K., Salzberg, M., Bell, S., Kamm, M. A.,… Castle, D. (2016). A controlled study of a group mindfulness intervention for individuals living with inflammatory bowel disease. Inflammatory Bowel Diseases, 22(3), 694–701. https://doi.org/10.1097/mib.0000000000000629.
Otley, A., Smith, C., Nicholas, D., Munk, M., Avolio, J., Sherman, P. M., & Griffiths, A. M. (2002). The IMPACT questionnaire: A valid measure of health-related quality of life in pediatric inflammatory bowel disease. Journal of Pediatric Gastroenterology and Nutrition,35(4), 557–563.
Palermo, T. M., Eccleston, C., Lewandowski, A. S., Williams, A. C. D. C., & Morley, S. (2010). Randomized controlled trials of psychological therapies for management of chronic pain in children and adolescents: An updated meta-analytic review. Pain,148(3), 387–397. https://doi.org/10.1016/j.pain.2009.10.004.
Rausch, J., Hametz, P., Zuckerbrot, R., Rausch, W., & Soren, K. (2012). Screening for depression in Urban Latino adolescents. Clinical Pediatrics,51(10), 964–971.
Ruskin, D., Campbell, L., Stinson, J., & Ahola Kohut, S. (2018). Changes in parent psychological flexibility after a one-time mindfulness-based intervention for parents of adolescents with persistent pain conditions. Manuscript in preparation.
Ruskin, D. A., Gagnon, M. M., Kohut, S. A., Stinson, J. N., & Walker, K. S. (2017). A Mindfulness program adapted for adolescents with chronic pain: Feasibility, acceptability, and initial outcomes. Clinical Journal of Pain,33(11), 1019–1029. https://doi.org/10.1097/ajp.0000000000000490.
Ruskin, D., Kohut, S. A., & Stinson, J. (2014). The development of a mindfulness-based stress reduction group for adolescents with chronic pain. Journal of Pain Management,7(4), 301.
Sandelowski, M. (2000). Whatever happened to qualitative description? Research in Nursing and Health,23(4), 334–340.
Schoultz, M., Atherton, I., & Watson, A. (2015). Mindfulness-based cognitive therapy for inflammatory bowel disease patients: Findings from an exploratory pilot randomised controlled trial. Trials,16, 379. https://doi.org/10.1186/s13063-015-0909-5.
Serpico, M. R., Boyle, B. M., Kemper, K. J., & Kim, S. C. (2016). Complementary and alternatice medicine use in children with inflammatory bowel diseases: A single-centrer survey. Journal of Pediatric Gastroenterology and Nutrition,63(6), 651–657. https://doi.org/10.1097/mpg.0000000000001187.
Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M. K., & Schwab-Stone, M. E. (2000). NIMH diagnostic interview schedule for children version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry,39(1), 28–38. https://doi.org/10.1097/00004583-200001000-00014.
Simren, M., Axelsson, J., Gillberg, R., Abrahamsson, H., Svedlund, J., & Bjornsson, E. S. (2002). Quality of life inflammatory bowel disease in remission: The impact of IBS-like symptoms and associated psychological factors. American Journal of Gastroenterology,97(2), 389–396. https://doi.org/10.1111/j.1572-0241.2002.05475.x.
Tan, L., & Martin, G. (2015). Taming the adolescent mind: A randomised controlled trial examining clinical efficacy of an adolescent mindfulness-based group programme. Child and Adolescent Mental Health,20(1), 49–55.
Turner, D., Griffiths, A. M., Walters, T. D., Seah, T., Markowitz, J., Pfefferkorn, M., & Levine, A. (2010). Appraisal of the pediatric Crohn’s disease activity index on four prospectively collected datasets: Recommended cutoff values and clinimetric properties. American Journal of Gastroenterology,105(9), 2085–2092. https://doi.org/10.1038/ajg.2010.143.
Turner, D., Otley, A. R., Mack, D., Hyams, J., de Bruijne, J., Uusoue, K., & Griffiths, A. M. (2007). Development, validation, and evaluation of a pediatric ulcerative colitis activity index: A prospective multicenter study. Gastroenterology,133(2), 423–432. https://doi.org/10.1053/j.gastro.2007.05.029.
Waelde, L. C., Feinstein, A. B., Bhandari, R., Griffin, A., Yoon, I. A., & Golianu, B. (2017). A pilot study on mindfulness meditation for pediatric chronic pain. Children,4(5), 32. https://doi.org/10.3390/children4050032.
Wicksell, R. K., Lekander, M., Sorjonen, K., & Olsson, G. L. (2010). The psychological inflexibility in pain scale (PIPS)—statistical properties and model fit of an instrument to assess change processes in pain related disability. European Journal of Pain,14(7), 771.e771. https://doi.org/10.1016/j.ejpain.2009.11.015.
Zenner, C., Herrnleben-Kurz, S., & Walach, H. (2014). Mindfulness-based interventions in schools—a systematic review and meta-analysis. Frontiers in Psychology,5, 603. https://doi.org/10.3389/fpsyg.2014.00603.
Zoogman, S., Goldberg, S. B., Hoyt, W. T., & Miller, L. (2015). Mindfulness interventions with youth: A meta-analysis. Mindfulness,6(2), 290–302.
Dr. Ahola Kohut was supported by the Medical Psychiatry Alliance, a collaborative health partnership of the University of Toronto, the Centre for Addiction and Mental Health, the Hospital for Sick Children, Trillium Health Partners, the Ontario Ministry of Health and Long-Term Care, and an anonymous donor. The authors would also like to thank Natalie Weiser for qualitative analysis support.
This research was generously supported by funds from the Robbie’s Rainbow Accelerator Grant (PI: Ruskin).
Conflict of interest
Sara Ahola Kohut, Jennifer Stinson, Ahlexxi Jelen, and Danielle Ruskin declare that they have no conflict of interest.
All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.
Informed consent was obtained from all adolescents included in the study.
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Ahola Kohut, S., Stinson, J., Jelen, A. et al. Feasibility and Acceptability of a Mindfulness-Based Group Intervention for Adolescents with Inflammatory Bowel Disease. J Clin Psychol Med Settings 27, 68–78 (2020). https://doi.org/10.1007/s10880-019-09622-6
- Ulcerative colitis
- Crohn’s disease