School-Based Prevention and Reduction of Depression in Adolescents: a Cluster-Randomized Controlled Trial of a Mindfulness Group Program
Our objective was to conduct the first randomized controlled trial of the efficacy of a group mindfulness program aimed at reducing and preventing depression in an adolescent school-based population. For each of 12 pairs of parallel classes with students (age range 13–20) from five schools (N = 408), one class was randomly assigned to the mindfulness condition and one class to the control condition. Students in the mindfulness group completed depression assessments (the Depression Anxiety Stress Scales) prior to and immediately following the intervention and 6 months after the intervention. Control students completed the questionnaire at the same times as those in the mindfulness group. Hierarchical linear modeling showed that the mindfulness intervention showed significantly greater reductions (and greater clinically significant change) in depression compared with the control group at the 6-month follow-up. Cohen's d was medium sized (>.30) for both the pre-to-post and pre-to-follow-up effect for depressive symptoms in the mindfulness condition. The findings suggest that school-based mindfulness programs can help to reduce and prevent depression in adolescents.
KeywordsMindfulness-based cognitive therapy Mindfulness-based stress reduction Randomized controlled trial Depression Adolescents
- Beurs, E., de 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 [The DASS: a questionnaire for the measurement of depression, anxiety, and stress]. Gedragstherapie, 34, 35–53.Google Scholar
- 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, 855–866. doi:10.1037/a0016241.PubMedCrossRefGoogle Scholar
- Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: Lawrence Erlbaum.Google Scholar
- Dewulf, D. (2009). Mindfulness voor jongeren. Tielt, Belgium: Lannoo.Google Scholar
- Dewulf, D. (2013). Mindfulnesstraining voor jongeren: Stappenplan voor hulpverleners. Houten, the Netherlands: Lannoo Campus.Google Scholar
- Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy. New York: Guilford.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
- Kabat-Zinn, J. (1994). Wherever you go there you are: mindfulness meditation in everyday life. New York: Hyperion.Google Scholar
- Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford.Google Scholar
- Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety stress scales (2nd ed.). Sydney: Psychology Foundation.Google Scholar
- Mendelson, T., Greenberg, M. T., Dariotis, J. K., Feagans Gould, L., Rhoades, B. L., & Leaf, P. J. (2010). Feasibility and preliminary outcomes of a school-based mindfulness intervention for urban youth. Journal of Abnormal Child Psychology, 38, 985–994. doi:10.1007/s10802-010-9418-x.PubMedCrossRefGoogle Scholar
- Raes, F., Dewulf, D., Van Heeringen, C., & Williams, J. M. G. (2009). Mindfulness and reduced cognitive reactivity to sad mood: evidence from a correlational study and a non-randomized waiting list controlled study. Behaviour Research and Therapy, 47, 623–627. doi:10.1016/j.brat.2009.03.007.PubMedCrossRefGoogle Scholar
- Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models: applications and data analysis methods (2nd ed.). London: Sage.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.Google Scholar
- Stice, E., Shaw, H., Bohon, C., Marti Nathan, C., & 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, 486–503. doi:10.1037/a0015168.PubMedCrossRefPubMedCentralGoogle Scholar
- Van der Does, A. J. W., Barnhofer, T., & Williams, J. M. G. (2003). The major depression questionnaire (MDQ). www.dousa.nl/publications. Accessed 11 Sept 2008.
- Van de Weijer-Bergsma, E., Formsma, A. R., de Bruin, E. I., & Bögels, S. (2012). The effectiveness of mindfulness training on behavioral problems and attentional functioning in adolescents with ADHD. Journal of Child and Family Studies, 21, 775–787. doi:10.1007/s10826-011-9531-7.PubMedCrossRefPubMedCentralGoogle Scholar
- Van de Weijer-Bergsma, E., Langenberg, G., Brandsma, R., Oort, F. J., & Bögels, S. M. (2013). The effectiveness of a school-based mindfulness training as a program to prevent stress in elementary school children. Mindfulness. doi: 10.1007/s12671-012-0171-9.
- 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, 120–128. doi:10.1002/smi.1342.CrossRefGoogle Scholar