Health Education and Health Promotion

Effectiveness of School-Based Mindfulness Training as a Program to Prevent Stress, Anxiety, and Depression in High School Students

Document Type : Original Research

Authors

P. Mostafazadeh 1
Z. Ebadi 2
S. Mousavi 2
N. Nouroozi 3

1 Clinical Psychology Department, Psychology Faculty, Tehran Medical Branch, Islamic Azad University, Tehran, Iran

2 Psychology Department, Psychology Faculty, Payame Noor University, Tehran, Iran

3 General Psychology Department, Literature Faculty, Izeh Branch, Islamic Azad University, Izeh, Iran

https://doi.org/10.29252/HEHP.7.3.111
Abstract
Aims: The aim of this study was to investigate the effectiveness of the implementation of mindfulness training on depression, anxiety, and stress in high school students in Ahvaz in the academic year of 2017-2018.

Materials & Methods: This is a quasi-experimental study with pre-test post-test design with control group. The statistical population included all of high school female students in the academic year of 2017-2018. The sample size consisted of 40 students, who were selected by multi-stage cluster sampling and randomly divided into experimental (n=20) and control (n=20) groups. For the experimental group, 8 sessions (each session 90 minutes) of the mindfulness program were performed, but no experimental test was performed for the control group and the Depression Anxiety Stress Scales (DASS) was used for collecting data. To test the hypotheses, covariance analysis and multivariate analysis of variance was performed, using SPSS 21 software. In addition, Levin test was used to test the equivalency of variances. After completion of educational programs, post-test was performed on both groups.

Findings: The results of data analysis indicated that the effect of mindfulness training on decreasing depression, anxiety, and stress has been shown and there was a significant relationship between mindfulness education and anxiety reduction, depression, and stress (p<0.01).

Conclusion: Based on the results of this study, it is worthwhile for educators to teach students how to train their mind-learning skills to be able to manage their self-control coping processes and reduce the amount of anxiety disorder in psychological conditions.

Keywords

Mindfulness
Training
Anxiety
stress
Depression
Subjects
  1. References


    1. Kabat-Zinn J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: Theoretical considerations and preliminary results. General Hospital Psychiatry. 1982;4:33–47.
    2. Kabat-Zin, J. Full Catastrophe Living: Usingthe Wisdom of Your Body and Mind to Face Stress, Pain and Illness. New York: Dell Publishing.1990.

    3. Dundan LGJ, Coatsworth, JD, Greenberg M T. A Model of Mindful Parenting: Implications for Parent–Child Relationships and Prevention Research. Clin Child FamPsychol Rev, 2009;12, 255–270.
    4. Keng SL, Smoski MJ, Robins CJ. Effects of mindfulness on psychological health: A review of
    empirical studies. Clin Psychol Rev. 2011;31(6):1041-56.http://doi.org/10.1016/j.cpr.2011.04.006
    5.Eberth J, Sedlmeier P. The effects of mindfulness meditation: a meta-analysis. Mindfulness, 2012; 3: 174–189. doi:10.1007/ s12671-012-0101-x.
    6. Somers JM, Goldner EM, Waraich P, Hsu L. Prevalence and incidence studies of anxiety disorders: a systematic review of the literature. Canadian Journal of Psychiatry, 2006; 51:100–113. Retrieved from http://publications.cpa-apc.org/browse/sections /0
    7. Rohi A. Exceptional education. Theoretical and Applied Approaches in Children's Anxiety Disorders. 2014; 14(3): 12
    8. Abolqasemi A, Jafari I, Ahmadi M. Comparison of perfectionism, aggression and coping style of patients with tension and migraine headaches with common people. Journal of Kerman University of Medical Sciences, 21st Century,2013; 2:173-162.
    9. Bassaknezhad S, Shapurabadi F, Davoudi A. The Effectiveness of Anxiety Management Training for Preterm Premature Mothers, Zahedan Journal of Research in Medical Sciences, 2011;13-9
    10. Dehestani M. The Effectiveness of Mindfulness-Based Stress Management on Depression, Anxiety and Depression in Female Students. Thought and Behavior in Clinical Psychology, 2015; 10 (37): 47-56.
    11. Kaviani H, Javaheri F, Bahiray H. Efficacy of Mindfulness-Based Cognitive Therapy in Reducing Automatic Thoughts, Dysfunctional Attitude, Depression And Anxiety: A Sixty Day Follow-Up. Advances in Cognitive Science. 2005; 7 (1) :49-59.URL: http://icssjournal.ir/article-1-117-fa.html
    12. Ghavai D. Efficacy of Mindfulness technics on Mental Health of girl students od Arak. Clinical psychology and counseling research, 2017; 7 (1): 76-67.
    13. Khoury B , Sharma M , Rush SE , Fournier C Mindfulness-based stress reduction for healthy individuals: A meta-analysis. J Psychosom Res. 2015; 78(6):519-28. doi: 10.1016/j.jpsychores.2015.03.009. Epub 2015 Mar 20.
    14. Song, Y., and Lindquist, R. Effects of mindfulness-based stress reduction on depression, anxiety, stress and mindfulness in Korean nursing students. Nurs. Educ. 2015; 35, 86–90. doi: 10.1016/j.nedt.2014.06.010

    15. Hogwarts P. The Effect of Cognitive-Based Knowledge-Based Therapy on Prevention of Relapses in Major Depressive Disorders: a systematic and analytical review. University of Aarhus, Department of Psychology, Aarhus, Denmark.2011.
    16. Beirami M, Abdi R. The Effect of Teaching Based on Mindfulness Knowledge on Reducing Test Anxiety in Students. Journal of Psychology and Educational Sciences,2009; 6, 54-35

    17. Afsharinia K, Kakaberiya K, Amiri H. A Comparative Study of the Effectiveness of Mentally Conscious Learning and Cognitive Recovery Method in Reducing Students' Anxiety Test. Two Chapters of Cognitive Learning Strategies in Learning, Number One.2013.
    18. Sabah B. Efficacy of Mindfulness-Based Cognitive Therapy in Reducing the anxiety of divorced women. Master's Degree, Shahid Chamran University, Ahvaz.2013.
    19.Yousefian, F., Asgharipour, N. Comparative effectiveness of group mindfulness-based cognitive therapy and group cognitive-behavioral therapy on self-esteem of girl students. Journal of Fundamentals of Mental Health, 2013; 15(59): 205-215. doi: 10.22038/jfmh.2013.1836
    20.Praissman, S. Mindfulness-based stress reduction: A literature review and clinician’s guide. Journal of the American Academy of Nurse Practitioners, 2008; 20: 212–216.
    21. Ortiz, R and M Sibinga, E The Role of Mindfulness in Reducing the Adverse Effects of Childhood Stress and Trauma. Children 2017, 4(3), 16; doi:10.3390/children4030016
    22. Hofmann SG, Sawyer AT, Witt AA, Oh D. The Effect of Mindfulness-Based Therapy on Anxiety and Depression: A Meta-Analytic Review. Journal of Consulting and Clinical Psychology, 2010; 78(2): 169–183. http://doi.org/10.1037/a0018555
    23. Farb NAS, Anderson AK, Mayberg H, Bean J, McKeon D, Segal ZV. Minding one’s emotions: Mindfulness training alters the neural expression of sadness. Emotion, 2010; 10: 25–33. doi:10.1037/ a0017151.supp
    24. Williams JMG. Mindfulness and psychological process. Emotion, 2010; 10: 1–7. doi:10.1037/a0018360

    25. Ames CS, Richardson J, Payne S, Smith P, Leigh E. Mindfulness-based cognitive therapy for depression in adolescents. Child and Adolescent Mental Health 2014; 19 ( 1): 74–78
    26. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol, 2000;1: 68-78.
    27. Mace C. Long-term impacts of mindfulness practice on wellbeing: new findings from qualitative research. In Delle Fave A. Dimensions of Well-being. Research and Intervention. Milano: FrancoAngeli, p. 2006; 455–69.
    28. Kabat-Zinn J. Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice. 2003;10:144–156.
    29.Napoli M, Krech PR, Holley LC. Mindfulness Training for Elementary School Students: The Attention Academy. Journal of Applied School Psychology. 2005;21:99–125.
    30. Biegel, G. M., Brown, K. W., Shapiro, S. L., and Schubert, C. M. Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: a randomized clinical trial. J. Consult. Clin. Psychol. 2009;77, 855–866. doi: 10.1037/a0016241.
    31. Saltzman A, Goldin P. Mindfulness based stress reduction for school-age children. In: Hayes SC, Greco LA, editors. Acceptance and mindfulness interventions for children adolescents and families.Context Press/New Harbinger; Oakland, CA: 2008. pp. 139–161.
    32. Behar E, DiMarco ID, Hekler EB, Mohlman J, Staples AM. Current theoretical models of generalized anxiety disorder (GAD): conceptual review and treatment implications. Journal of Anxiety Disorders, 2009; 23: 1011–1023. doi:10.1016/j. janxdis.2009.07.006.
    33. Narimani M, Ariapouran S, Abolghasemi A, Ahadi B. compared the effectiveness of mindful-ness and emotion regulation training on mental health chemical veterans. Journal of Clinical Psychology. 2011; 2(1): 93-110.
    34. Lovibond SM, Lovibond P FM. Manual for the Depression Anxiety Stress Scale. 2nd ed. Australia, Sydney: Psychology Formulation, 1995
    35. Asghari Moghadam MA. Asghari Moghaddam MAS .Chronic pain control: application of psychological methods. Proceedings of the Third Congress of the Psychological Association.2010.
    36. Segal, Z.V., Williams, J.M.G.,and Teasdale, J.D. Mindfulness- based cognitive therapy for depression: A New approach to preventing relapse. New York: Guilford press.2002

    37. Emanuel AS, Updegraff J A, Kalmbach D A, Ciesla J.A. The role of mindfulness facets in affective forecasting. Personality and Individual Differences. 2011; 49(7): 815-818

    38. Alidina S. 9 Ways Mindfulness Reduces Stress. How mindful practices give you the space to respond differently under pressure—plus, a meditation for lowering stress levels.2016.
  2. Kabat-Zinn J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. Gen Hosp Psychiatry. 1982;4(1):33-47. [Link] [DOI:10.1016/0163-8343(82)90026-3]
  3. Kabat-Zin, J. Full Catastrophe Living: Usingthe Wisdom of Your Body and Mind to Face Stress, Pain and Illness. New York: Random House Publishing Group; 1990. [Link]
  4. Duncan LG, Coatsworth JD, Greenberg MT. A model of mindful parenting: implications for parent-child relationships and prevention research. Clin Child Fam Psychol Rev. 2009;12(3):255-70. [Link] [DOI:10.1007/s10567-009-0046-3]
  5. Keng SL, Smoski MJ, Robins CJ. Effects of mindfulness on psychological health: A review of empirical studies. Clin Psychol Rev. 2011;31(6):1041-56. [Link] [DOI:10.1016/j.cpr.2011.04.006]
  6. Eberth J, Sedlmeier P. The effects of mindfulness meditation: a meta-analysis. Mindfulness. 2012; 3(3): 174-89. [Link] [DOI:10.1007/s12671-012-0101-x]
  7. Somers JM, Goldner EM, Waraich P, Hsu L Prevalence and incidence studies of anxiety disorders: a systematic review of the literature. Can J Psychiatry. 2006;51(2):100-13. [Link] [DOI:10.1177/070674370605100206]
  8. Nahravanian P, Askari P, Dortaj F, Naderi F, Bakhtiarpoor S. The effect of cognitive training on the executive function and divided attention of anxious children. J Psychol Achiev. 2017;24(2):43-64. [Persian] [Link]
  9. Darchini-Maragheh E, Salehi M, Payandeh A, Behdani F, Ghasemzadeh Kolagar H. Evaluation of the correlations between depression, anxiety, and stress as DASS-21 subscales and high-risk behaviors in the adolescents in Torghabeh and Shandiz Towns, Iran. Patient Saf Qual Improv. 2017; 5(3):584-90. [Link]
  10. Chi X, Bo A, Liu T, Zhang P, Chi I. Effects of Mindfulness-Based Stress Reduction on Depression in Adolescents and Young Adults: A Systematic Review and Meta-Analysis. Front Psychol. 2018;9:1034. [Link] [DOI:10.3389/fpsyg.2018.01034]
  11. Shahidi S, Akbari H, Zargar F. Effectiveness of mindfulness-based stress reduction on emotion regulation and test anxiety in female high school students. J Educ Health Promot. 2017;6:87. [Link] [DOI:10.4103/jehp.jehp_98_16]
  12. Abolqasemi A, Jafari I, Ahmadi M. Comparison of perfectionism, aggression and coping styles in patients with migraine and tension type headaches and healthy individuals. J Kerman Univ Med Sci. 2014;21(2):162-73. [Persian] [Link]
  13. Bassaknezhad S, Shapurabadi F, Davoudi A. Efficacy of family anxiety management training with mothers of anxious preschool children. Zahedan J Res Med Sci. 2014;16(5):45-9. [Link]
  14. Dehestani M. The effectiveness of mindfulness-based stress reduction program on depression, anxiety and depression of female students. Thought Behav Clin Psychol. 2015;10(37):47-56. [Persian] [Link]
  15. Kaviani H, Javaheri F, Bahiray H. Efficacy of mindfulness-based cognitive therapy in reducing automatic thoughts, dysfunctional attitude, depression and anxiety: a sixty day follow-up. J Adv Cognit Sci. 2005;7(1) :49-59. [Persian] [Link]
  16. Taghvaei D. Effectiveness of teaching mindfulness techniques on general health in female secondary school students of Arak. Clin Psychol Counsel Res. 201;7(1):67-76. [Persian] [Link]
  17. Khoury B, Sharma M, Rush SE, Fournier C. Mindfulness-based stress reduction for healthy individuals: a meta-analysis. J Psychosom Res. 2015;78(6):519-28. [Link] [DOI:10.1016/j.jpsychores.2015.03.009]
  18. Song Y, Lindquist R. Effects of mindfulness-based stress reduction on depression, anxiety, stress, and mindfulness in Korean nursing students. Nurse Educ Today. 2015;35(1):86-90. [Link] [DOI:10.1016/j.nedt.2014.06.010]
  19. Beirami M, Abdi R. The effect of mindfulness-based techniques in reduction of students test anxiety. J Psychol Educ Sci. 2010;6(2);35-54. [Persian] [Link]
  20. Rasouli R, Mohamad Alipour Z, Taghi Pour E. Effectiveness of cognitive learning strategies on test anxiety and school performance of students. Int J Educ Psychol Res. 2018;4(1):20-5. [Link] [DOI:10.4103/jepr.jepr_84_16]
  21. Gouda S, Luong MT, Schmidt S, Bauer J. Students and teachers benefit from mindfulness-based stress reduction in a school-embedded pilot study. Front Psychol. 2016;7:590. [Link] [DOI:10.3389/fpsyg.2016.00590]
  22. Yousefian F, Asgharipour N. Comparative effectiveness of group mindfulness-based cognitive therapy and group cognitive-behavioral therapy on self-esteem of girl students. J Fundam Ment Health. 2013;15(59):205-15. [Persian] [Link]
  23. Praissman S. Mindfulness-based stress reduction: a literature review and clinician's guide. J Am Acad Nurse Pract. 2008;20(4):212-6. [Link] [DOI:10.1111/j.1745-7599.2008.00306.x]
  24. Ortiz R, M Sibinga E. The role of mindfulness in reducing the adverse effects of childhood stress and trauma. Children (Basel). 2017;4(3). [Link] [DOI:10.3390/children4030016]
  25. Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consult Clin Psychol. 2010;78(2):169-83. [Link] [DOI:10.1037/a0018555]
  26. Farb NA, Anderson AK, Mayberg H, Bean J, McKeon D, Segal ZV. Minding one's emotions: mindfulness training alters the neural expression of sadness. Emotion. 2010;10(1):25-33. [Link] [DOI:10.1037/a0017151]
  27. Johnston JM, RoakeI C, Sheikh F, Mole A, Nigg JT, Oken B. School-based mindfulness intervention for stress reduction in adolescents: Design and methodology of an open-label, parallel group, randomized controlled trial. Contemp ClinTrial Commun. 2016; 4(15):99-104. [Link] [DOI:10.1016/j.conctc.2016.07.001]
  28. Ames CS, Richardson J, Payne S, Smith P, Leigh E. Mindfulness‐based cognitive therapy for depression in adolescents. Child Adolesc Ment Health. 2013;19(1):74-8. [Link] [DOI:10.1111/camh.12034]
  29. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1):68-78. [Link] [DOI:10.1037/0003-066X.55.1.68]
  30. Mace C. Dimensions of well-being: research and intervention. Milano: FrancoAngeli; 2006. [Link]
  31. Perry-Parrish C, Copeland-Linder N, Webb L, Shields AH1, Sibinga EM. Improving self-regulation in adolescents: current evidence for the role of mindfulness-based cognitive therapy. Adolesc Health Med Ther. 2016;7:101-108. [Link] [DOI:10.2147/AHMT.S65820]
  32. Lindsay EK, Chin B, Greco CM, Young S, Brown KW, Wright AGC, et al. How mindfulness training promotes positive emotions: Dismantling acceptance skills training in two randomized controlled trials. J Pers Soc Psychol. 2018;115(6):944-973. [Link] [DOI:10.1037/pspa0000134]
  33. Lindsay EK, Young S, Smyth JM, Brown KW, Creswell JD. Acceptance lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial. Psychoneuroendocrinology. 2018;87:63-73. [Link] [DOI:10.1016/j.psyneuen.2017.09.015]
  34. Saltzman A, Goldin P. Mindfulness based stress reduction for school-age children. In: Hayes SC, Greco LA, editors. Acceptance and mindfulness interventions for children adolescents and families. A practitioner's guide (pp. 139-161). Oakland: New Harbinger Publications; 2008. [Link]
  35. Yadav P, Chauhan VS, Bhat PS, Agarwal N, Yadav C, Bhatia S. Cross-sectional study of anxiety symptoms in students in preexamination period. Ind Psychiatry J. 2017;26(1):56-63. [Link] [DOI:10.4103/ipj.ipj_40_17]
  36. Narimani M, Ariapouran S, Abolghasemi A, Ahadi B. The comparison of the effectiveness of mindfulness and emotion regulation training on mental health in chemical weapon victims. J Clin Psychol. 2011;2(4):93-110. [Persian] [Link]
  37. Lovibond SM, Lovibond P FM. Manual for the depression anxiety stress scale. 2nd Ed. Sydney: Psychology Foundation of Australia; 1996. [Link] [DOI:10.1037/t39835-000]
  38. Asghari A, Saed F, Parvin Dibajnia P. Psychometric properties of the Depression Anxiety Stress Scales-21 (DASS-21) in a non-clinical Iranian sample. Inter J Psychol. 2008;2(2):82-102 . [Persian] [Link]
  39. Biegel GM, Brown KW, Shapiro SL, Schubert CM. Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: A randomized clinical trial. J Consult Clin Psychol. 2009;77(5):855-66. [Link] [DOI:10.1037/a0016241]
  40. Emanuel AS, Updegraff J A, Kalmbach D A, Ciesla J.A. The role of mindfulness facets in affective forecasting. Personal Individ Differ. 2011;49(7): 815-8. [Link] [DOI:10.1016/j.paid.2010.06.012]
Health Education and Health Promotion
Volume 7, Issue 3
Summer 2019
Pages 111-117