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App-Based Mindfulness Training for Adolescent Rumination: Predictors of Immediate and Cumulative Benefit

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Abstract

Objectives

Rumination is a transdiagnostic risk factor for depression and anxiety, which surge during the adolescent years. Mindfulness training—with its emphasis on metacognitive awareness and present-moment attention—may be effective at reducing rumination. Mindfulness apps offer a convenient, engaging, and cost-effective means for accessing mindfulness training for teens. Despite their increasing popularity among adolescents, no study to date has investigated which teens are well-suited to app-based mindfulness training.

Methods

Eighty adolescents (M age = 14.01 years, 45% girls) with elevated rumination were enrolled in a 3-week trial of app-based mindfulness training. Repeated daily ecological momentary assessment (EMA) surveys assessed problem-focused and emotion-focused rumination immediately prior to and following each mindfulness exercise. Elastic net regularization (ENR) models tested baseline predictors of “immediate” (post-mindfulness exercise) and “cumulative” (post-3-week intervention) benefit from app-based mindfulness training.

Results

Ninety percent (72/80) of adolescents completed the 3-week trial, and the mean number of mindfulness exercises completed was 28.7. Baseline adolescent characteristics accounted for 14–25% of the variance in outcomes (i.e., reduction in problem-focused or emotion-focused rumination). Higher baseline rumination, and lower emotional suppression, predicted better immediate and cumulative outcomes. In contrast, female gender and older age predicted better immediate, but not cumulative, outcomes. Differences in results across outcome timeframes (immediate vs. cumulative) are discussed.

Conclusions

Findings from this study highlight the potential of data-driven approaches to inform which adolescent characteristics may predict benefit from engaging with an app-based mindfulness training program. Additional research is needed to test these predictive models against a comparison (non-mindfulness) condition.

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Data Availability

Data are available upon request from Dr. Hilt and with a Data Use Agreement (DUA).

This study was approved by Lawrence University IRB and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Funding

This project was supported by a grant from the American Psychological Foundation to LMH. The first author (CAW) was partially supported by R01 MH116969, the Tommy Fuss Fund, and a NARSAD Young Investigator Grant from the Brain & Behavior Research Foundation. The opinions and assertions contained in this article should not be construed as reflecting the views of the sponsors.

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Authors and Affiliations

  1. Harvard Medical School & McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA

    Christian A. Webb & Laura Murray

  2. Lawrence University, Appleton, WI, USA

    Caroline M. Swords & Lori M. Hilt

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  1. Christian A. Webb
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  2. Caroline M. Swords
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  4. Lori M. Hilt
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Contributions

CW developed the study concept, conceptualized, performed, and interpreted the data analyses, and drafted the manuscript. CMS coordinated data collection, wrote the methods, prepared Table 1, and assisted with editing of the final manuscript. LM contributed to the literature review and drafting of the introduction and methods, and edited the final manuscript. LMH designed the trial, managed data collection, and assisted with writing and editing the manuscript. All authors approved the final version of the paper for submission.

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Correspondence to Christian A. Webb.

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Webb, C.A., Swords, C.M., Murray, L. et al. App-Based Mindfulness Training for Adolescent Rumination: Predictors of Immediate and Cumulative Benefit. Mindfulness 12, 2498–2509 (2021). https://doi.org/10.1007/s12671-021-01719-0

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