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Mindfulness-Based Stress Reduction and Group Support Decrease Stress in Adolescents with Cardiac Diagnoses: A Randomized Two-Group Study


Adolescents with cardiac diagnoses face unique challenges that can cause psychosocial distress. This study compares a Mindfulness-Based Stress Reduction (MBSR) program to a video online support group for adolescents with cardiac diagnoses. MBSR is a structured psycho-educational program which includes yoga, meditation, cognitive restructuring, and group support. A published feasibility study by our group showed significant reduction in anxiety following this intervention. Participants were randomized to MBSR or video online support group, and completed measures of anxiety, depression, illness-related stress, and coping pre- and post-6-session interventions. Qualitative data were obtained from post-intervention interviews. A total of 46 teens participated (mean 14.8 years; 63% female). Participants had congenital heart disease and/or cardiac device (52%), or postural orthostatic tachycardia syndrome (48%). Illness-related stress significantly decreased in both groups. Greater use of coping skills predicted lower levels of depression in both groups post-study completion. Higher baseline anxiety/depression scores predicted improved anxiety/depression scores in both groups. Each group reported the benefits of social support. The MBSR group further expressed benefits of learning specific techniques, strategies, and skills that they applied in real-life situations to relieve distress. Both the MBSR intervention and video support group were effective in reducing distress in this sample. Qualitative data elucidated the added benefits of using MBSR techniques to manage stress and symptoms. The video group format is useful for teens that cannot meet in person but can benefit from group support. Psychosocial interventions with stress management techniques and/or group support can reduce distress in adolescents with cardiac diagnoses.

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The authors would like to thank Robin Fabian, RN, BSN for her contributions and enthusiastic support in participant recruitment and delivery of the interventions. The authors would also like to thank Lauren Dome, RN, CPNP for her innovative ideas and support during the interventions.


This work was supported by the William and Joanne Conway Research Chair at Children’s National Health System in Washington, DC.

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Authors and Affiliations



Vicki A. Freedenberg: concept/design, data collection, data analysis/interpretation, drafting article; Pamela S. Hinds: Critical revision of article, concept/design, qualitative data analysis/interpretation; Funding secured by. Erika Friedmann: statistics, quantitative data analysis/interpretation.

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Correspondence to Vicki A. Freedenberg.

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All authors have declared that they have no conflicts of interest.

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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. This article does not contain any studies with animals performed by any of the authors.

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

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Freedenberg, V.A., Hinds, P.S. & Friedmann, E. Mindfulness-Based Stress Reduction and Group Support Decrease Stress in Adolescents with Cardiac Diagnoses: A Randomized Two-Group Study. Pediatr Cardiol 38, 1415–1425 (2017).

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  • Adolescent
  • Cardiac
  • Psychosocial
  • Intervention
  • Mindfulness