The effects of mindfulness-based interventions in medical students: a systematic review.

The number of studies on the effects of mindfulness on healthcare professionals is increasing. The main aim of this study was to collate the quantitative results of original studies analyzing the effects of mindfulness-based interventions on a variety of outcomes in medical students. We also analyzed how the study design and characteristics of the intervention affect the results, and identified qualitative effects of mindfulness interventions. A literature search was performed in different databases in June 2020. Original articles meeting the following criteria were included: (1) at least 50% of the participants were medical students, (2) included a mindfulness intervention, (3) analyzed any outcome relating to mindfulness intervention, (4) peer-reviewed (5) written in English. Eventually, 31 articles including 24 different samples were included. Over half of the studies were RCTs. In over half of the studies, the intervention was 4- to 10-week original Mindfulness-Based Stress Reduction or Mindfulness-Based Cognitive Therapy or a modification of these. In general, satisfaction with the interventions was good. Based on a meta-analysis, after the intervention, the intervention group had statistically significantly fewer symptoms of stress and distress and had higher mindfulness than the controls. The beneficial effects persisted in follow-ups over months or years. Both long and shorter courses and courses with and without face-to-face sessions were effective. Both controlled and uncontrolled studies had statistically significant results. Qualitative results revealed potential factors behind the quantitative effects. The number of studies on mindfulness interventions in medical students has increased drastically. Mindfulness-based interventions seem to offer a good possibility to enhance medical students' well-being.

School-based mindfulness intervention for depressive symptoms in adolescence: For whom is it most effective?

INTRODUCTION: There is accumulating evidence for the effectiveness of mindfulness-based interventions in alleviating depressive symptoms. A crucial question is, however, whether mindfulness interventions are more effective for some individuals than others, depending on individual characteristics before a mindfulness intervention. We exploratorily investigated whether the effectiveness of school-based mindfulness intervention against depressive symptoms is modified by executive functions, rumination, and emotion regulation among adolescents. METHODS: The longitudinal data included adolescents with at least mild depressive symptoms at the baseline (n = 369, at the 6th-8th grade, 68.4% female) who were randomized into a 9-week school-based mindfulness intervention group, into an active control group receiving relaxation program, or into an inactive control group. Adolescents' executive functions, rumination, and emotion regulation (i.e., acceptance, catastrophizing, and positive reappraisal) were assessed at the baseline; and depressive symptoms at three time points (at the baseline and at 9-week and 6-month follow-ups). RESULTS AND CONCLUSIONS: In adolescents with at least mild depressive symptoms at the baseline, high catastrophizing, high acceptance, and low executive functions were found to increase the effectiveness of mindfulness-based intervention against depressive symptoms. There seemed to be some sex differences. Thus, when aiming to alleviate depressive symptoms, mindfulness-based intervention may possibly be more effective for adolescents with high catastrophizing, high acceptance, and low executive functioning (than for adolescents with the opposite dispositions). However, as this study was exploratory by nature and corrections for multiple testing were not used, the findings must be regarded as preliminary and need confirmation in further studies.

Effects of school-based mindfulness intervention on health-related quality of life: moderating effect of gender, grade, and independent practice in cluster randomized controlled trial.

OBJECT: We investigated the impact of a school-based 9-week mindfulness program vs. active control program (relaxation) and inactive control group on children's self-reported Health-Related Quality of Life (HRQoL) moderated by gender, grade, and independent practice. METHOD: In total 3519 (50/50% boys/girls) Finnish students aged 12-15 years from 56 schools were randomized into mindfulness intervention, active, and inactive control groups. HRQoL was measured at baseline, at 9 weeks, and at 26 weeks and analyzed with multilevel linear modeling. RESULTS: Significant improvement on HRQoL was found (ß = mean difference) (ß = 1.587, 95% CI 0.672-2.502, p < 0.001) after 9 weeks and at 26 weeks of follow-up among students in the mindfulness group as compared to the active control group. Moderating effects on HRQoL were found for gender, grade, and independent practice: girls, 7th and 8th grade students, and students with regular independent mindfulness practice benefited most. CONCLUSIONS: Gender and developmental stage may moderate the effects of mindfulness interventions on HRQoL and offer guidance in designing effective promotive interventions for children and adolescents. TRIAL REGISTRATION INFORMATION: Healthy Learning Mind-a school-based mindfulness and relaxation program: a study protocol for a cluster randomized controlled trial (RCT) ISRCTN18642659 retrospectively registered on 13 October 2015. The full trial protocol can be accessed at http://rdcu.be/t57S .

The Effects of School-based Mindfulness Intervention on Executive Functioning in a Cluster Randomized Controlled Trial.

Executive functions (EFs) are essential for student's learning and classroom functioning. The current cluster randomized controlled trial examines the effects of mindfulness intervention vs. active control program (i.e., relaxation) focusing on the main EFs (i.e., working memory, response inhibition, cognitive processing, cognitive flexibility and verbal fluency). A total of 131 students from 6th grade and 8th grade (median age 12 and 15) from four comprehensive schools participated. The schools were to equal shares randomized to intervention and active control groups, i.e., groups who underwent a 9-week mindfulness practice or relaxation program, respectively. Participants completed a cognitive test-package at baseline/pre-intervention, post-intervention at 9 weeks and follow-up at 6 months. Both intervention and active relaxation-based control groups improved on a majority of EF measures at both 9 weeks and 6 months. There was no significant difference between the mindfulness intervention group and the active control program in EFs. The current study suggests that mindfulness intervention and active control program do not differ in their effects to EFs, although both may have positive outcomes. Further research with both active and inactive control groups is needed to map the potential benefits of similar programs for cognitive functioning.

Healthy Learning Mind - a school-based mindfulness and relaxation program: a study protocol for a cluster randomized controlled trial.

BACKGROUND: Mindfulness has shown positive effects on mental health, mental capacity and well-being among adult population. Among children and adolescents, previous research on the effectiveness of mindfulness interventions on health and well-being has shown promising results, but studies with methodologically sound designs have been called for. Few intervention studies in this population have compared the effectiveness of mindfulness programs to alternative intervention programs with adequate sample sizes. METHODS/DESIGN: Our primary aim is to explore the effectiveness of a school-based mindfulness intervention program compared to a standard relaxation program among a non-clinical children and adolescent sample, and a non-treatment control group in school context. In this study, we systematically examine the effects of mindfulness intervention on mental well-being (primary outcomes being resilience; existence/absence of depressive symptoms; experienced psychological strengths and difficulties), cognitive functions, psychophysiological responses, academic achievements, and motivational determinants of practicing mindfulness. The design is a cluster randomized controlled trial with three arms (mindfulness intervention group, active control group, non-treatment group) and the sample includes 59 Finnish schools and approx. 3 000 students aged 12-15 years. Intervention consists of nine mindfulness based lessons, 45 mins per week, for 9 weeks, the dose being identical in active control group receiving standard relaxation program called Relax. The programs are delivered by 14 educated facilitators. Students, their teachers and parents will fill-in the research questionnaires before and after the intervention, and they will all be followed up 6 months after baseline. Additionally, students will be followed 12 months after baseline. For longer follow-up, consent to linking the data to the main health registers has been asked from students and their parents. DISCUSSION: The present study examines systematically the effectiveness of a school-based mindfulness program compared to a standard relaxation program, and a non-treatment control group. A strength of the current study lies in its methodologically rigorous, randomized controlled study design, which allows novel evidence on the effectiveness of mindfulness over and above a standard relaxation program. TRIAL REGISTRATION: ISRCTN18642659 . Retrospectively registered 13 October 2015.