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

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Abstract

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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References

  1. Hoffman JI, Kaplan S (2002) The incidence of congenital heart disease. JACC 39:1890–1900

    Article  PubMed  Google Scholar 

  2. Marelli AJ, Mackie AS, Ionescu-Ittu R (2007) Congenital heart disease in the general population. Circulation 115:163–172

    Article  PubMed  Google Scholar 

  3. Kovacs AH, Saidi AS, Kuhl EA et al (2009) Depression and anxiety in adult congenital heart disease: predictors and prevalence. Int J Cardiol 137:158–164

    Article  PubMed  Google Scholar 

  4. Wang Q, Hay M, Clarke D et al (2012) The prevalence and predictors of anxiety and depression in adolescents with heart disease. J Pediatr 161:943–946

    Article  PubMed  Google Scholar 

  5. Awaad MI, Darahim KE (2015) Depression and anxiety in adolescents with congenital heart disease. Middle East Curr Psychiatry 22:2–8

    Article  Google Scholar 

  6. Latal B, Helfricht S, Fischer JE et al (2009) Psychological adjustment and quality of life in children and adolescents following open-heart surgery for congenital heart disease: a systematic review. BMC Pediatr 9:6

    Article  PubMed  PubMed Central  Google Scholar 

  7. Webster G, Panek KA, Labella M et al (2014) Psychiatric functioning and quality of life in young patients with cardiac rhythm devices. Pediatrics 133:e964–e972

    Article  PubMed  PubMed Central  Google Scholar 

  8. Raj V, Haman KL, Raj SR et al (2009) Psychiatric profile and attention deficits in postural tachycardia syndrome. J Neurol Neurosurg Psychiatry 80:339–344

    Article  CAS  PubMed  Google Scholar 

  9. Biegel GM, Brown KW, Shapiro SL et al (2009) Mindfulness Based Stress Reduction for the treatment of adolescent psychiatric outpatients: a randomized clinical trial. J Consult Clin Psychol 77:855

    Article  PubMed  Google Scholar 

  10. DeMaso DR, Neto LB, Hirshberg J (2009) Psychological and quality-of-life issues in the young patient with an implantable cardioverter-defibrillator. Heart Rhythm 6:130–132

    Article  PubMed  Google Scholar 

  11. Dunbar S, Dougherty C, Sears S et al (2012) Educational and psychological interventions to improve outcomes for recipients of implantable cardioverter defibrillators and their families: a scientific statement from the American Heart Association. Circulation 126:2146–2172

    Article  PubMed  Google Scholar 

  12. Karsdorp P, Everaerd W, Kindt M (2007) Psychological and cognitive functioning in children and adolescents with congenital heart disease: a meta-analysis. J Pediatr Psychol 32:527–541

    Article  PubMed  Google Scholar 

  13. Kabat-Zinn J, Hanh TN (2009) Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. Delta, London

    Google Scholar 

  14. Perry-Parrish CK, Sibinga EM (2014) Mindfulness meditation for children. In: Functional symptoms in pediatric disease. Springer, New York, pp 343–352

    Chapter  Google Scholar 

  15. Grossman P, Niemann L, Schmidt S et al (2004) Mindfulness Based Stress Reduction and health benefits: a meta-analysis. J Psychosom Res 57:35–43

    Article  PubMed  Google Scholar 

  16. Irving JA, Dobkin PL, Park J (2009) Cultivating mindfulness in health care professionals: a review of empirical studies of Mindfulness Based Stress Reduction (MBSR). Complement Ther Clin Pract 15:61–66

    Article  PubMed  Google Scholar 

  17. Schneider RH, Alexander CN, Staggers F et al (2005) Long-term effects of stress reduction on mortality in persons > or =55 years of age with systemic hypertension. Am J Cardiol 95:1060–1064

    Article  PubMed  PubMed Central  Google Scholar 

  18. Curtis B, O’Keefe J (2002) Autonomic tone as a cardiovascular risk factor: the dangers of chronic fight or flight. Mayo Clin Proc 77:45–54

    Article  PubMed  Google Scholar 

  19. Schneider RH, Grim CE, Rainforth MV et al (2013) Stress reduction in the secondary prevention of cardiovascular disease: randomized, controlled trial of transcendental meditation and health education in Blacks. Circ Cardiovasc Qual Outcomes 5:750–758

    Article  Google Scholar 

  20. Sibinga EM, Kerrigan D, Stewart M et al (2011) Mindfulness Based Stress Reduction for urban youth. J Altern Complement Med 17:213–218

    Article  PubMed  PubMed Central  Google Scholar 

  21. Burke CA (2010) Mindfulness-based approaches with children and adolescents: a preliminary review of current research in an emergent field. J Child Fam Stud 19:133–144

    Article  Google Scholar 

  22. Kanitz JL, Camus ME, Seifert G (2013) Keeping the balance—an overview of mind–body therapies in pediatric oncology. Complement Ther Med 21:S20–S25

    Article  PubMed  Google Scholar 

  23. Freedenberg VA, Thomas SA, Friedmann E (2015) A pilot study of a mindfulness based stress reduction program in adolescents with implantable cardioverter defibrillators or pacemakers. Pediatr Cardiol 36:786–795

    Article  PubMed  Google Scholar 

  24. Zigmond AS, Snaith RP (1983) The Hospital Anxiety and Depression. Acta Psychiatr Scand 67:361–370

    Article  CAS  PubMed  Google Scholar 

  25. White D, Leach C, Sims R et al (1999) Validation of the Hospital Anxiety and Depression for use with adolescents. Br J Psychiatry 175:452–454

    Article  CAS  PubMed  Google Scholar 

  26. Connor-Smith JK, Compas BE, Wadsworth ME (2000) Responses to stress in adolescence: measurement of coping and involuntary stress responses. J Consult Clin Psychol 68:976–992

    Article  CAS  PubMed  Google Scholar 

  27. Jaser SS, White LE (2011) Coping and resilience in adolescents with type I diabetes. Child Care Health Dev 37:335–342

    Article  CAS  PubMed  Google Scholar 

  28. Compas BE, Connor-Smith JK, Saltzman H et al (2001) Coping with stress during childhood and adolescence: problems, progress, and potential in theory and research. Psychol Bull 127:87

    Article  CAS  PubMed  Google Scholar 

  29. Connor-Smith JK, Calvete E (2004) Cross-cultural equivalence of coping and involuntary responses to stress in Spain and the United States. Anxiety Stress Coping 17:163–185

    Article  Google Scholar 

  30. Connor-Smith JK, Compas BE, Wadsworth ME et al (2000) Responses to stress in adolescence: measurement of coping and involuntary stress responses. J Consult Clin Psychol 68:976

    Article  CAS  PubMed  Google Scholar 

  31. Krippendorff K (2012) Content analysis: an introduction to its methodology. Sage, Thousand Oaks

    Google Scholar 

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Acknowledgements

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.

Funding

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

Authors

Contributions

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.

Corresponding author

Correspondence to Vicki A. Freedenberg.

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All authors have declared that they have no conflicts 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. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

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). https://doi.org/10.1007/s00246-017-1679-5

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  • DOI: https://doi.org/10.1007/s00246-017-1679-5

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