Mindfulness-Based Interventions for University Students: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

6-Week student wellness program improves psychological wellbeing of students

Objective: Employing a waitlist control design, the current study examined the effectiveness of a shortened version of a newly developed wellness program. Participants/Methods: Twenty-four students were randomly assigned to an experimental wellness (EW) group or a waitlist control (WLC) group. The 6-week wellness program focused on specific wellness topics (i.e., relaxation and mindfulness, yoga, gratitude and self-compassion, emotion regulation, goal setting and time management, and nutrition and movement). Both mental health and wellbeing outcomes were examined pre-post group. Results/Conclusions: Findings revealed that the EW group reported significantly improved overall psychological wellbeing, optimism, self-compassion, and satisfaction with life following the program relative to baseline, but the WLC group did not.

Effects of a mindfulness-based program on the occupational balance and mental health of university students. Protocol for a randomized controlled trial

OBJECTIVE

The aim is to examine whether the addition of Virtual Reality (VR) meditation training to a standard 8-week Mindfulness-Based Health Care Program (MBHC-VR) results in a significantly increased improvement in occupational, mental health, and psychological functioning versus MBHC-only in university students.

MATERIALS AND METHODS

A randomized controlled clinical trial with three arms (MBHC, MBHC-VR, Control Group), four assessment time points (pre-intervention, inter-session, post-intervention, and 3-month follow-up), and mixed methodology will be proposed. University students (undergraduate, master, or doctoral) interested in participating and who meet the inclusion/exclusion criteria will be included over two years. Data will be collected from different ad hoc questionnaires, several standardized tests, and an Ecological Momentary Assessment. We will use R software to carry out descriptive analyses (univariate and bivariate), multilevel modeling, and structural equation models to respond to the proposed objective. The qualitative analysis will be carried out using the MAXQDA program and the technique of focus groups.

DISCUSSION

It is expected that with the proposed intervention university students will learn to relate in a healthier way with their mental processes, so as to improve their occupational balance (OB) and their psychological well-being.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier NCT05929430.

Adverse Effects of Meditation: Autonomic Nervous System Activation and Individual Nauseous Responses During Samadhi Meditation in the Czech Republic

Buddhist meditation practices, including Samadhi meditation, which forms the basis for mindfulness practice, are broadly promoted as pathways to wellbeing, but evidence of their adverse effects is emerging. In a single-group observational study with assessments of autonomic system before, during, and after Samadhi meditation, we explore the relationship between post-meditation nausea symptoms and the degree of change in autonomic system activity during meditation as compared to before and after in 57 university students (42 women; mean age = 22.6) without any previous experience in meditation or yoga practices. We hypothesize that nauseous feelings in meditation are connected to a rapid increase of activity in the sympathetic nervous system, as indicated by decreased heart-rate variability (HRV). We additionally explore links between meditation-induced nausea and two markers of parasympathetic activity: increased HRV and vasovagal syncope. Engaging in meditation and increased nausea during meditation were both associated with increased markers of HRV parasympathetic activity, but 12 individuals with markedly higher nausea demonstrated increased HRV markers of sympathetic activity during meditation. Vasovagal syncope was observed but found to be unrelated to nausea levels. Drivers of adverse effects of meditation in some individuals require further investigation.

The efficacy of a virtual and in-person mindfulness-based intervention course on university students' during COVID-19 pandemic

Objective: The purpose of this research was to evaluate the impact of a mindfulness-based intervention (MBI) on university students during the COVID-19 pandemic. Methods and participants: There were 53 participants who voluntarily enrolled in a mindfulness course at a regional state university (24 virtual and 29 in-person) and 56 in the control group. Participants completed surveys at the beginning and end of the course on mindfulness, life satisfaction, and resilience. Results: Results revealed that the in-person group showed significantly higher mindfulness, life satisfaction, and resilience over the course of the semester. The virtual group showed increases across all three variables as well, but only significantly improved on resilience. Conclusion: Results indicate that the inclusion of MBIs in university courses may be a cost-effective and proactive means to support the mental health and well-being of college students, and that in-person delivery may be a more effective modality.

The Role of Mental Health Stigma in University Students' Satisfaction With Web-Based Stress Management Resources: Intervention Study

BACKGROUND

University students frequently report elevated levels of stress and mental health difficulties. Thus, the need to build coping capacity on university campuses has been highlighted as critical to mitigating the negative effects of prolonged stress and distress among students. Since the COVID-19 pandemic, web-based stress management resources such as infographics and web-based workshops have been central to supporting university students' mental health and well-being. However, there is a lack of research on students' satisfaction with and uptake of these approaches. Furthermore, mental health stigma has been suggested to have not only fueled the emergence of these web-based approaches to stress management but may also influence students' help-seeking behaviors and their satisfaction with and uptake of these resources.

OBJECTIVE

This study explored potential differences in students' satisfaction and strategy use in response to an interactive infographic (an emerging resource delivery modality) presenting stress management strategies and a web-based workshop (a more common modality) presenting identical strategies. This study also examined the relative contribution of students' strategy use and family-based mental health stigma in predicting their sustained satisfaction with the 2 web-based stress management approaches.

METHODS

University students (N=113; mean age 20.93, SD 1.53 years; 100/113, 88.5% women) completed our web-based self-report measure of family-based mental health stigma at baseline and were randomly assigned to either independently review an interactive infographic (n=60) or attend a synchronous web-based workshop (n=53). All participants reported their satisfaction with their assigned modality at postintervention (T1) and follow-up (T2) and their strategy use at T2.

RESULTS

Interestingly, a 2-way mixed ANOVA revealed no significant group × time interaction or main effect of group on satisfaction. However, there was a significant decrease in satisfaction from T1 to T2, despite relatively high levels of satisfaction being reported at both time points. In addition, a 1-way ANOVA revealed no significant difference in strategy use between groups. Results from a hierarchical multiple regression revealed that students' strategy use positively predicted T2 satisfaction in both groups. However, only in the web-based workshop group did family-based mental health stigma predict T2 satisfaction over and above strategy use.

CONCLUSIONS

While both approaches were highly satisfactory over time, findings highlight the potential utility of interactive infographics since they are less resource-intensive than web-based workshops and students' satisfaction with them is not impacted by family-based mental health stigma. Moreover, although numerous intervention studies measure satisfaction at a single time point, this study highlights the need for tracking satisfaction over time following intervention delivery. These findings have implications for student service units in the higher education context, emphasizing the need to consider student perceptions of family-based mental health stigma and preferences regarding delivery format when designing programming aimed at bolstering students' coping capacity.

Effects of a mindfulness course on vital signs and five facet mindfulness questionnaire scores of college students

Objective: This study examined the effects of a college mindfulness course on vital-signs and Five Facet Mindfulness Questionnaire (FFMQ) scores. Participants: Two independent groups of 20 students were enrolled in the mindfulness course during the Fall 2018 (Trial 1) and Spring 2019 (Trial 2) semesters. Methods: Blood pressure, heart rate, and respiration rate were recorded before and after in-class mindfulness meditations several times throughout each semester. FFMQ scores were recorded at the beginning and conclusion of each semester. Results: Statistical analyses indicated that 20 minutes of mindfulness meditation significantly decreased respiration rate (both trials) and heart rate (Trial 2) for female students. There were significant changes in the FFMQ mean scores for "non-react," "observe," "act aware," and "non-judge." Conclusions: These results suggest that mindfulness meditation may be beneficial for students to enhance their well-being. Recommendations are provided to further examine the implications of consistent mindfulness practices for college students.

Long-term effects of combined mindfulness intervention and app intervention compared to single interventions during the COVID-19 pandemic: a randomized controlled trial

Objectives

The study examines the short-, middle-, and long-term effects of a combined intervention (face-to-face mindfulness intervention plus the mindfulness app 7Mind), compared to single interventions (face-to-face mindfulness intervention alone and an intervention via app 7Mind alone). The subgroups were compared with an active control group on mindfulness, mindful characteristics, mental health, emotion regulation, and attentional abilities during the COVID-19 pandemic. Additionally, the study explores whether students' engagement with the app and their formal mindfulness practice at home improves intervention outcomes.

Methods

The study employs a randomized controlled trial approach involving three intervention groups and an active control group, with two follow-ups conducted over 12 months. The study included 177 university students who were randomly assigned to a mindfulness group (n = 42), a mindfulness app group (7Mind app, n = 44), a mindfulness + app group (n = 45), and an active control group (n = 46). The duration of the interventions was 4 weeks. The outcome variables were assessed at pre- and post-intervention, at 4 and 12 months post-intervention.

Results

At post-intervention and during both follow-ups, students in the combined mindfulness intervention did not demonstrate better outcomes compared to students in the single interventions or the active control group across all measures. Additionally, no statistically significant difference was observed between all interventions and the active control groups on any of the measures. However, it is noteworthy that all intervention groups and the active control group exhibited improvement in mindfulness, body awareness, emotion regulation, stress, and attentional abilities over the short, medium, and long term. Moreover, higher app usage in the app groups was significantly associated with increased body awareness. However, greater app use was also correlated with higher stress.

Conclusion

The results suggest that the mindfulness intervention and the mindfulness app were similar to the active control condition (communication training) on the investigated variables in the short, medium, and long term. Furthermore, an increased use of a mindfulness app can negatively affect stress.

Low-intensity mindfulness and cognitive-behavioral therapy for social anxiety: a pilot randomized controlled trial

BACKGROUND

Cognitive-behavioral therapy (CBT) effectively improves the clinical symptoms of social anxiety disorder. However, there are non-responders who cannot decrease their cost/probability bias significantly; hence, their social anxiety symptoms remain unaddressed. Mindfulness training and cognitive-behavioral approaches promote a reduction in cost/probability bias and social anxiety symptoms. This study examines the effectiveness of a four-session program of mindfulness and CBT (M-CBT) in a non-clinical sample of individuals with high social anxiety.

METHODS

Participants were 50 Japanese undergraduate students (37 women and 13 men) randomly allocated to an intervention group (n = 27) and a control group (n = 23). The intervention group underwent a four-session M-CBT program, while the control group did not receive any treatment.

RESULTS

A group × time analysis of covariances showed significant interactions in the negative cognition generated when paying attention to others in probability bias, fear of negative evaluation by others, dispositional mindfulness, depressive symptoms, and subjective happiness. M-CBT also produced significant pre-post improvements in the above outcomes with moderate to high effect sizes (ds = .51-1.55). Conversely, there were no interactions in social anxiety symptoms and self-focused attention.

CONCLUSIONS

These results indicate that M-CBT was effective for the negative cognition generated when paying attention to others in probability bias, fear of negative evaluation by others, dispositional mindfulness, depressive symptoms, and subjective happiness. The combination of mindfulness training with cognitive restructuring is proposed as potentially helpful for individuals with probability bias, leading to negative cognition from paying attention to others.

TRIAL REGISTRATION

University Hospital Medical Information Network (UMIN CTR) UMIN000036763. Registered May 16, 2019.

Work Engagement and Well-being Study (SWELL): a randomised controlled feasibility trial evaluating the effects of mindfulness versus light physical exercise at work

BACKGROUND

Mindfulness-based programmes (MBPs) are increasingly offered at work, often in online self-guided format. However, the evidence on MBPs' effect on work performance (WP) is inconsistent.

OBJECTIVE

This pragmatic randomised controlled feasibility trial assessed procedural uncertainties, intervention acceptability and preliminary effect sizes of an MBP on WP, relative to an alternative intervention.

METHODS

241 employees from eight employers were randomised (1:1) to complete a 4-week, self-guided, online MBP or a light physical exercise programme (LE)(active control). Feasibility and acceptability measures were of primary interest. WP at postintervention (PostInt) was the primary outcome for preliminary assessment of effect sizes. Secondary outcomes assessed mental health (MH) and cognitive processes hypothesised to be targeted by the MBP. Outcomes were collected at baseline, PostInt and 12-week follow-up (12wFUP). Prospective trial protocol: NCT04631302.

FINDINGS

87% of randomised participants started the course. Courses had high acceptability. Retention rates were typical for online trials (64% PostInt; 30% 12wFUP). MBP, compared with the LE control, offered negligible benefits for WP (PostInt (d=0.06, 95% CI -0.19 to 0.32); 12wFUP (d=0.02, 95% CI -0.30 to 0.26)). Both interventions improved MH outcomes (ds=-0.40 to 0.58, 95% CI -0.32 to 0.18); between-group differences were small (ds=-0.09 to 0.04, 95% CI -0.15 to 0.17).

CONCLUSION

The trial is feasible; interventions are acceptable. Results provide little support for a later phase trial comparing an MBP to a light exercise control. To inform future trials, we summarise procedural challenges.

CLINICAL IMPLICATIONS

Results suggest MBPs are unlikely to improve WP relative to light physical exercise. Although the MBP improved MH, other active interventions may be just as efficacious.

TRIAL REGISTRATION NUMBER

NCT04631302.

Effectiveness of Mindfulness-Based Stress Reduction on Mental Health and Psychological Quality of Life among University Students: A GRADE-Assessed Systematic Review

Background

Psychological distress is a progressive health problem that has been linked to decreased quality of life among university students. This meta-analysis reviews existing randomized controlled trials (RCTs) that have examined the effects of mindfulness-based stress reduction (MBSR) on the relief of psychosomatic stress-related outcomes and quality of life among university students.

Methods

The PubMed, EMBASE, Web of Science, PsycINFO (formerly PsychLit), Ovid MEDLINE, ERIC, Scopus, Google Scholar, ProQuest, and Cochrane Library databases were searched in November 2023 to identify the RCTs for analysis. Data on pathology (anxiety, depression, and perceived stress), physical capacity (sleep quality and physical health), and well-being (mindfulness, self-kindness, social function, and subjective well-being) were analyzed.

Results

Of the 276 articles retrieved, 29 met the inclusion criteria. Compared with control therapies, the pooled results suggested that MBSR had significant effects, reducing anxiety (SMD = -0.29; 95% CI: -0.49 to -0.09), depression (SMD = -0.32; 95% CI: -0.62 to -0.02), and perceived stress (SMD = -0.41; 95% CI: -0.60 to -0.29) and improving mindfulness (SMD = 0.34; 95% CI: 0.08 to 0.59), self-kindness (SMD = 0.57; 95% CI: 0.30 to 1.12), and physical health (SMD = -0.59; 95% CI: -1.14 to -0.04). No significant differences were observed in sleep quality (SMD = -0.20; 95% CI: -0.06 to 0.20), social function (SMD = -0.71; 95% CI: -2.40 to 0.97), or subjective well-being (SMD = 0.07; 95% CI: -0.18 to 0.32). The quality of the evidence regarding sleep quality and physical health outcomes was low.

Conclusions

MBSR therapy appears to be potentially useful in relieving functional emotional disorders. However, additional evidence-based large-sample trials are required to definitively determine the forms of mindfulness-based therapy that may be effective in this context and ensure that the benefits obtained are ongoing. Future studies should investigate more personalized approaches involving interventions that are tailored to various barriers and students' clinical characteristics. To optimize the effects of such interventions, they should be developed and evaluated using various designs such as the multiphase optimization strategy, which allows for the identification and tailoring of the most valuable intervention components.

Effects of mindfulness-based interventions on cardiovascular risk factors: An umbrella review of systematic reviews and meta-analyses

OBJECTIVE

Reviews have shown that mindfulness-based interventions (MBIs) were effective in improving cardiovascular risk factors (CVRFs), but the results were contradictory. This umbrella review aimed to summarize and grade the existing reviews on CVRFs associated with MBIs.

METHODS

The protocol of this umbrella review had been registered in PROSPERO (CRD42022356812). PubMed, Web of science, Embase, The Cochrane Library, Scopus, Medline, PsycINFO and CINAHL were searched from database inception to 20 July 2022. The quality of evidence was assessed through GRADE.

RESULTS

Twenty-seven reviews with 14,923 participants were included. Overall, 45% of reviews had low heterogeneity (I2 < 25%). For the quality of evidence, 31% were rated very low, 42% were rated low, 17% were rated moderate and 10% were rated high. MBIs significantly improved systolic blood pressure [SMD -5.53 mmHg (95% CI -7.81, -3.25)], diastolic blood pressure [SMD -2.13 mmHg (95% CI -2.97, -1.30)], smoking [Cohen's d 0.42 (95% CI 0.20, 0.64)], glycosylated hemoglobin [MD 0.01 (95% CI -0.43, -0.07)], binge eating behavior [SMD -6.49 (95% CI -10.80, -2.18)], depression [SMD -0.72 (95% CI -1.23, -0.21)] and stress [SMD -0.67 (95% CI -1.00, -0.34)].

CONCLUSIONS

In conclusion, this umbrella review provided evidence for the role of MBIs in the improvement of CVRFs.

Self-efficacy, mindfulness, and perceived social support as resources to maintain the mental health of students in Switzerland's universities of applied sciences: a cross-sectional study

BACKGROUND

Switzerland's student population is at a particularly high risk of developing mental health disorders, creating a major challenge for Switzerland's higher education establishments. Research to date has primarily sought to identify the risk factors affecting students' mental health; however, their exposure to these factors is often unavoidable. Thus, the present study adopted a salutogenic approach focussing on the determinants of health. We examined the mental health resources available to students reported in the literature as being susceptible to helping them maintain good mental health despite their exposure to risk factors.

METHODS

In February 2020, 2,415 first- and second-year bachelor's degree students in applied sciences in French-speaking Switzerland completed an online questionnaire. The variables measured were self-evaluated mental health, perceived stress and three potential health resources: students' feelings of self-efficacy, their capacity for mindfulness and their social support. The results were analysed using hierarchical linear regression models.

RESULTS

When all the variables were included in the model without interaction effect, our results revealed that students' self-evaluated mental health was negatively associated with perceived stress (β = -0.43, p < 0.001) and positively associated with the three potential health resources (self-efficacy: β = 0.26, p < 0.001; mindfulness: β = 0.10, p < 0.001; social support: β = 0.17, p < 0.001). An analysis of the interaction effects also revealed that a high level of self-efficacy was associated with perceived stress being less strongly linked to mental health (β = 0.29, p < 0.001).

CONCLUSIONS

These findings suggest that self-efficacy, mindfulness, and perceived social support are valuable resources for protecting students' mental health. Thus, implementing interventions aimed at reinforcing them, could support students in applied sciences all along their academic pathway, in their classes and during their professional work experience placements.

Broadening the Perspective on the Dynamics of Men's Suicide: Thought Suppression as a Mediator between Men's Self-Reliance and Suicidality

OBJECTIVE

In most countries, men are at higher risk than women for suicide death. Research focused on masculinity and men's mental health increasingly demonstrates that relationships between gender and various health outcomes, including suicidality, is complex as these relationships can be further explained by certain psychological processes or health behaviors. The objective of this study was to extend this area of research in a national sample of US men (n = 785) by investigating if their adherence to certain hegemonic masculine gender role norms (toughness and self-reliance through mechanical skills) is associated with the suppression of distressing thoughts and if thought suppression then increases their risk for suicidal thoughts and behaviors.

METHODS

Men in the US who have recently experienced a stressful life event completed an anonymous online survey. Structural Equational Modeling (SEM) was used to test for direct and indirect effects (i.e., mediation) between variables.

RESULTS

Men's engagement in thought suppression mediated the relationship between self-reliance and suicidality. The norm of toughness was both directly related to suicidality and mediated by thought suppression.

CONCLUSIONS

Thought suppression appears to be a process that provides some explanation for the relationships between hegemonic masculine norms and suicidality in men, though this study indicated it may play only a small role. Research continues to build that certain masculine norms, such as self-reliance and toughness, are particularly concerning for men's health.HIGHLIGHTSMen's thought suppression mediates the relationship between self-reliance and suicidalityMen's toughness impacts suicidality both directly and via engagement in thought suppressionThese findings have implications for interventions that help men manage distressing thoughts.

Multi-year investigation of a relaxation course with a mindfulness meditation component on college students' stress, resilience, coping and mindfulness

Examine the effects of a relaxation course with a mindfulness meditation component in a two-group pre-test and post-test non-randomized study design.

Participants included 219 undergraduate students (experimental group: n = 103; control group: n = 116), 18-43 years old.

Completion of measures of stress, resilience, coping and mindfulness at the beginning and end of the intervention.

The independent sample t-test analysis revealed a statistically significant decrease in stress and maladaptive coping, and an increase in resilience in the experimental group compared to the control group.

Benefits were observed following the intervention by positively impacting factors associated with increased functioning in life. Classroom-based interventions could be considered beneficial for students.

The efficacy of mindfulness-based interventions on mental health among university students: a systematic review and meta-analysis

Introduction

We aimed to estimate the effect of mindfulness therapy on mental health.

Methods

Two researchers searched 12 databases to identify relevant trials that were published from 1 January 2018 to 1 May 2023. We performed a meta-analysis to determine the effect of mindfulness therapy on depression, which was measured by the Beck Depression Inventory (BDI), Patient Health Questionnaire-9 (PHQ-9), Quick Inventory of Depressive Symptomatology (QIDS), Hamilton Depression Rating Scale (HDRS), Patient-Reported Outcomes Measurement Information System (PROMIS), Hospital Anxiety and Depression Scale (HADS), and Depression Anxiety Stress Scales (DASS); anxiety, which was measured by the Beck Anxiety Inventory (BAI), PROMIS, and DASS, Generalized Anxiety Disorder-7 (GAD-7); stress, which was measured by the Perceived Stress Scale (PSS), DASS, and GAD-7; mindfulness, which was measured by the GAD-7, Five Facet Mindfulness Questionnaire (FFMQ), Mindful Attention Awareness Scale (MAAS), Short Form-12 Mental Component Score (SF-12 MCS) and Short Form-12 Physical Component Score (SF-12 PCS); and sleep quality, which was measured by the Pittsburgh Sleep Quality Index (PSQI). After screening studies based on the inclusion and exclusion criteria, 11 randomized controlled trials (RCTs) involving 1,824 participants were ultimately included.

Results

All these studies demonstrated positive effects of mindfulness therapy on depression (SMD = -0.33, 95% CI: [-0.44, -0.22], p < 0.00001, I2 = 29%), anxiety (SMD = -0.35, 95% CI: [-0.46, -0.25], p < 0.00001, I2 = 40%), stress (SMD = -0.39, 95% CI: [-0.48, -0.29], p < 0.00001, I2 = 69%) and sleep quality scores (SMD = -0.81, 95% CI: [-1.54, -0.09], p = 0.03, I2 = 0%). However, there was no significant difference in mindfulness (SMD = -0.12, 95% CI: [-0.36, -0.12], p = 0.34, I2 = 34%) between the mindfulness therapy group and the control group.

Discussion

In future studies, it is necessary to consider the investigation on whether the strategies of improving the mindfulness therapy in adherence and fidelity can work on the improvement of the outcomes in mental health.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/, https://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42023469301].

Mindfulness, coping, and disruptions as predictors of college student distress at the beginning of the COVID-19 pandemic

Objective: This research examined how stressors experienced by college students within the first month of the COVID-19 pandemic were associated with their reports of psychological distress, mindfulness, and coping strategies. Participants: Students attending 11 universities in the U.S. (N = 464, M age = 20.72, SD = 3.90, 91% female, 61% White, and 77% non-Hispanic) in early childhood education, child development, and family science classes participated.Methods: Students completed an online survey about pandemic-related disruptions, depressive symptoms, mindfulness, coping, and demographics.Results: Students whose families had more financial difficulties reported more disruptions. Depression and avoidant coping were positively correlated with distress, while mindfulness was inversely correlated with distress and depression. Disruptions, family financial status, depressive symptoms, mindfulness, and avoidant coping significantly predicted distress, controlling for university site and student sex, age, race, and ethnicity in multiple regression analyses. Avoidant coping significantly moderated (amplified) the effect of disruptions on distress. Conclusions: College student well-being can be supported through Campus programming that includes mindfulness practices and alternatives to avoidant strategies for coping with stress.

Cost-effectiveness of providing university students with a mindfulness-based intervention to reduce psychological distress: economic evaluation of a pragmatic randomised controlled trial

OBJECTIVE

Increasing numbers of young people attending university has raised concerns about the capacity of student mental health services to support them. We conducted a randomised controlled trial (RCT) to explore whether provision of an 8 week mindfulness course adapted for university students (Mindfulness Skills for Students-MSS), compared with university mental health support as usual (SAU), reduced psychological distress during the examination period. Here, we conduct an economic evaluation of MSS+SAU compared with SAU.

DESIGN AND SETTING

Economic evaluation conducted alongside a pragmatic, parallel, single-blinded RCT comparing provision of MSS+SAU to SAU.

PARTICIPANTS

616 university students randomised.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary economic evaluation assessed the cost per quality-adjusted life year (QALY) gained from the perspective of the university counselling service. Costs relate to staff time required to deliver counselling service offerings. QALYs were derived from the Clinical Outcomes in Routine Evaluation Dimension 6 Dimension (CORE-6D) preference based tool, which uses responses to six items of the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM; primary clinical outcome measure). Primary follow-up duration was 5 and 7 months for the two recruitment cohorts.

RESULTS

It was estimated to cost £1584 (2022 prices) to deliver an MSS course to 30 students, £52.82 per student. Both costs (adjusted mean difference: £48, 95% CI £40-£56) and QALYs (adjusted mean difference: 0.014, 95% CI 0.008 to 0.021) were significantly higher in the MSS arm compared with SAU. The incremental cost-effectiveness ratio (ICER) was £3355, with a very high (99.99%) probability of being cost-effective at a willingness-to-pay threshold of £20 000 per QALY.

CONCLUSIONS

MSS leads to significantly improved outcomes at a moderate additional cost. The ICER of £3355 per QALY suggests that MSS is cost-effective when compared with the UK's National Institute for Health and Care Excellence thresholds of £20 000 per QALY.

TRIAL REGISTRATION NUMBER

Australian and New Zealand Clinical Trials Registry, ACTRN12615001160527.

Wellbeing Convene during COVID-19: A pilot intervention for improving wellbeing and social connectedness for staff, students, residents, and faculty

Background

Canada is facing its worst crisis among healthcare workers in recent healthcare history. Anxiety, depression, suicidal ideation, and severe burnout are higher than before the COVID-19 pandemic. University Faculties of Medicine (FoMs) are vital to healthcare systems. Not only are they responsible for training personnel, but clinicians and staff from FoMs often work directly within healthcare systems. FoMs include students, staff, residents, faculty members, residents, researchers, and others, many experiencing higher stress levels due to pandemic tensions. Most FoMs emphasize cognitive and psychomotor learning needs. On the other hand, affective learning needs are not as well addressed within most FoMs. Finding innovative means to ameliorate mental and emotional health status, particularly at this critical juncture, will improve health and wellness, productivity, and retention. This article discusses a pilot program, Wellbeing Convene during COVID-19, in a Canadian FoM, which aimed to (1) provide staff, faculty, residents, and students with a toolkit for greater wellbeing and (2) build a sense of community during isolating times.

Results

Participants found the program beneficial in both regards. We recommend that these kinds of programs be permanently available to all members in FoMs, at no cost. Wellness programs alone, however, will not solve the root causes of mental and emotional stress, often based on concerns related to finances, hierarchical workplace structures, and nature of the work itself, among other factors.

Conclusion

Addressing the mental and emotional health of people in FoMs is vital to improving productivity and reducing stress of FoMs, healthcare professionals, and, ultimately, patients.

Combination of EEG-Guided Adaptive Neurostimulation with Resonance Scanning in Correction of Stress-Induced States and Cognitive Rehabilitation of University Students

The correction of stress-induced states and cognitive rehabilitation were carried out during the examination session in three university student groups comparable in the number, sex, and age. In the experimental group, a combination of EEG-guided adaptive neurostimulation with preliminary resonance scanning was used. In control group 1, only EEG-guided adaptive neurostimulation was used. In control group 2, musical-acoustic stimuli were presented without feedback from the subject's EEG. Experiments with preliminary resonance scanning revealed the maximum positive effects compared to the two control types of stimulation. A significant increase in the power of EEG rhythms, especially in the alpha range, was accompanied by a significant increase in subjective indicators of the functional state and cognitive activity. These results can be explained from the standpoint of the progressive involvement of the resonant, integrative, and neuroplasticity mechanisms of the brain into the processes of normalization the functional state of the body under the influence of combined stimulation procedures.

A mixed-methods investigation of COVID-19 pandemic-specific stress in college students

OBJECTIVE

To identify pandemic-specific stressors among college students and compare patterns of stressors in samples obtained during early and chronic phases of the pandemic.

METHOD

Different undergraduate student samples from a Southeastern university completed an online survey in Spring 2020 (early pandemic; N = 673) and Fall 2020 (chronic pandemic; N = 439). This repeated cross-sectional survey study used a mixed methods triangulation design to validate and expand on quantitative findings using qualitative data.

RESULTS

Quantitative and qualitative analyses revealed 13 pandemic stressor domains, with academics and lifestyle adjustment among the most stressful in both samples, and more stressful in the chronic pandemic sample. Non-freshmen, female, and first-generation college students were at greater risk for pandemic stress.

CONCLUSIONS

As college students continue to experience stressors related to COVID-19 and encounter future crises, colleges and universities must adapt to meet their unique needs specific to the context.

Mental and Physical Health Impacts of Mindfulness Training for College Undergraduates: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background

Universities increasingly offer mindfulness-based programs (MBPs) to improve student health and reduce their impact on overburdened psychological services. It is critical for evidence-based policy to determine for what health outcomes mindfulness programs are effective and under what conditions. Objectives were to: (a) perform a comprehensive analysis of the effects of mindfulness interventions on physical, mental, and behavioral health outcomes in college undergraduate students, and (b) examine moderators of intervention effects to identify factors that may help improve existing university mindfulness programs and guide the design of new programs.

Method

Systematic searches of five databases identified MBP randomized controlled trials for undergraduate students, measuring any health outcome. Analyses using robust variance estimation focused on standardized mean differences for outcomes between groups and modeled through coded study features.

Results

The 58 studies in the review primarily focused on mental health with fewer assessments of physical health or health behaviors. Overall, mindfulness interventions significantly outperformed both active and inactive controls (ps<.05), with the most marked effects on anxiety symptoms, depressive symptoms, and mindfulness; greater success appeared for clinical populations. Online programs performed equivalent to in-person, and non-MBP programs were equivalent to MBP programs after controlling for other factors. Publication bias and other quality issues also emerged.

Conclusions

Mindfulness programs improve well-being in college students, with the strongest evidence for reducing anxiety and depressive symptoms. More studies utilizing stronger methods are needed to evaluate mindfulness programs' effects on additional health outcomes and online interventions in clinical populations.

Promotive and preventive interventions for mental health and well-being in adult populations: a systematic umbrella review

Introduction

Mental health disorders are increasing worldwide, leading to significant personal, economic, and social consequences. Mental health promotion and prevention have been the subject of many systematic reviews. Thus, decision makers likely face the problem of going through literature to find and utilize the best available evidence. Therefore, this systematic umbrella review aims to evaluate the effectiveness of interventions for promoting mental health and mental well-being, as well as for the primary prevention of mental health disorders.

Methods

Literature searches were performed in APA PsycInfo, Medline, and Proquest Social Science databases from January 2000 to December 2021. The search results were screened for eligibility using pre-defined criteria. The methodological quality of the included reviews was evaluated using the AMSTAR 2 tool. The key findings of the included reviews were narratively synthesized and reported with an emphasis on reviews achieving higher methodological quality.

Results

Out of the 240 articles found, 16 systematic reviews and four systematic umbrella reviews were included. The methodological quality of included reviews was low or critically low.

Discussion

This review suggests that interventions using cognitive-behavioral therapy and those developing resilience, mindfulness, or healthy lifestyles can be effective in the promotion of mental health and well-being in adult populations. Motivational interviewing may reduce alcohol consumption in young adults. Indicated or selective prevention is likely to be cost-effective compared to universal prevention. Parenting interventions and workplace interventions may be cost-effective in terms of promoting mental health. Due to the low methodological quality of the included reviews and substantial heterogeneity among the reported results, the findings from the reviews we summarized should be interpreted with caution. There is a need for further rigorous, high-quality systematic reviews.

Effects of Web-Based Mindfulness-Based Interventions on Anxiety, Depression, and Stress Among Frontline Health Care Workers During the COVID-19 Pandemic: Systematic Review and Meta-Analysis

BACKGROUND

Since 2019, the COVID-19 outbreak has spread around the world, and health care workers, as frontline workers, have faced tremendous psychological stress.

OBJECTIVE

The purpose of this study is to explore whether web-based mindfulness-based interventions continue to have a positive impact on anxiety, depression, and stress among health care workers during the COVID-19 pandemic.

METHODS

The inclusion criteria were as follows: (1) participants were frontline health care workers during the COVID-19 pandemic; (2) the experimental group was a web-based mindfulness-based intervention; (3) the control group used either general psychological intervention or no intervention; (4) outcome indicators included scales to assess anxiety, depression, and stress; and (5) the study type was a randomized controlled study. Studies that did not meet the above requirements were excluded. We searched 9 databases, including Web of Science, Embase, PubMed, Cochrane Library, Scopus, ScienceDirect, SinoMed, China National Knowledge Infrastructure (CNKI), and Wanfang Database, for randomized controlled studies on the effects of web-based mindfulness-based interventions on common mental disorder symptoms among health care workers from January 1, 2020, to October 20, 2022. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database scale. The Cochrane risk of bias tool was used to assess the risk of bias. Subgroup analysis was used to look for sources of heterogeneity and to explore whether the results were the same for subgroups under different conditions. Sensitivity analysis was used to verify the stability of the pooled results.

RESULTS

A total of 10 randomized controlled studies with 1311 participants were included. The results showed that web-based mindfulness-based interventions were effective in reducing the symptoms of anxiety (standard mean difference [SMD]=-0.63, 95% CI -0.96 to -0.31, P<.001, I2=87%), depression (SMD=-0.52, 95% CI -0.77 to -0.26, P<.001, I2=75%), and stress (SMD=-0.20, 95% CI -0.35 to -0.05, P=.01, I2=58%) among health care workers during the COVID-19 pandemic, but with wide CIs and high heterogeneity.

CONCLUSIONS

Web-based mindfulness-based interventions may be effective in reducing the symptoms of anxiety, depression, and stress among frontline health care workers during the COVID-19 pandemic. However, this effect is relatively mild and needs to be further explored by better studies in the future.

TRIAL REGISTRATION

PROSPERO CRD42022343727; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=343727.

Effectiveness of attachment-based compassion therapy to reduce psychological distress in university students: a randomised controlled trial protocol

Introduction

Higher education, particularly university, is a challenge for many students that can lead to their mental health being seriously affected. The stress to which they are subject throughout their time at university can lead to anxiety and depression. "Third wave" psychotherapies, including compassion-based therapy, have been used to improve psychological outcomes, such as stress, anxiety, emotional distress and well-being. There are some signs that third wave psychotherapies reduce psychological distress in university students, but more and higher-quality studies are needed. In this randomised controlled trial (RCT), we hypothesise that the provision of attachment-based compassion therapy (ABCT) will be more effective than an active control group based on relaxation therapy for improving psychological distress in university students.

Methods and analysis

A two-arm RCT will be conducted involving 140 university undergraduate and postgraduate students from the University of Zaragoza and the National University of Distance Education (UNED) who reside in the autonomous community of Aragon, Spain. Interventions with either ABCT or relaxation therapy will be implemented, with an allocation ratio of 1:1 between groups. Both interventions will last six weeks and consist of six weekly group sessions lasting 1.5 h each. Data will be collected before and after the intervention, and there will be a follow-up at six months. The primary outcome will be psychological distress at post-intervention. Secondary outcomes will be depression, anxiety, stress and burnout symptoms, affectivity and emotional regulation. Attachment style, experiential avoidance, compassion (for others/oneself) and mindfulness skills will be measured as potential mechanistic variables. Intention-to-treat analysis will be performed using linear mixed regression models. The clinical significance of improvements will be calculated. Potential side effects will be monitored by an independent clinical psychologist.

Ethics and dissemination

This study was approved by the Clinical Research Ethics Committee of Aragón. Participant data will remain anonymous, and results will be submitted to peer-reviewed open-access journals and disseminated via conferences.

Clinical Trial Registration

ClinicalTrials.gov, identifier NCT05197595.

A Digital Music-Based Mindfulness Intervention for Black Americans With Elevated Race-Based Anxiety: A Multiple-Baseline Pilot Study

BACKGROUND

Race-based anxiety is a substantial health issue for the Black community. Although mindfulness interventions have demonstrated efficacy for alleviating anxiety, three central barriers prevent Black Americans from accessing existing mindfulness treatments: high costs, excessive time commitments, and limited cultural relevance. There is a need for novel mindfulness interventions for the Black community that can overcome these barriers.

OBJECTIVE

The goal of this web-based study was to examine the preliminary efficacy, feasibility, and acceptability of a novel digital music-based mindfulness intervention for middle-to-low-income Black Americans with elevated race-based anxiety.

METHODS

This study used a nonconcurrent multiple-baseline design (n=5). The intervention featured contributions from Lama Rod Owens (a world-renowned meditation teacher and LA Times best-selling author) and Terry Edmonds (the former chief speechwriter for President Bill Clinton). We examined the effect of the intervention on state anxiety and assessed its feasibility and acceptability using quantitative and qualitative measures.

RESULTS

Results revealed that administration of the intervention led to significant decreases in state anxiety (Tau-U range -0.75 to -0.38; P values<.001). Virtually all feasibility and acceptability metrics were high (ie, the average likelihood of recommending the intervention was 98 out of 100).

CONCLUSIONS

This study offers preliminary evidence that a digital music-based mindfulness intervention can decrease race-based anxiety in Black Americans. Future research is needed to replicate these results, test whether the intervention can elicit lasting changes in anxiety, assess mechanisms of change, and explore the efficacy of the intervention in real-world contexts.

Effects and mechanisms of an online short-term audio-based mindfulness program on positive affect: A randomized controlled trial including exploratory moderator analyses

This study investigated the effects and mechanisms of an online short-term audio-based mindfulness (SAM) intervention program on positive affect and explored how well-being and negative affect influenced these effects and mechanisms. Participants (N = 100) were randomized into an intervention group (n = 50) and a control group (n = 50). Those in the mindfulness group underwent 3 weeks of an online SAM program and completed the online measures four times, while those in the control group completed the measures twice. Participants completed measures including the World Health Organization Well-Being Index, the Freiburg Mindfulness Inventory, and the Positive and Negative Affect Schedule. The effects of measures in both groups were compared. Parallel process latent growth curve modeling analysis was used to explore the longitudinal moderated mediation effects. The results showed that SAM was effective at improving positive affect, mindfulness, well-being, and reducing negative affect. Mindfulness growth speed during the intervention period mediated the relationship between SAM and positive affect improvement speed. The moderation effects of baseline well-being and negative effect on mediation effects were found to be significant. The SAM program was effective for the general public and was more beneficial for those with medium/high well-being and low/medium negative affect.

Psychological distance intervention reminders reduce alcohol consumption frequency in daily life

Modifying behaviors, such as alcohol consumption, is difficult. Creating psychological distance between unhealthy triggers and one's present experience can encourage change. Using two multisite, randomized experiments, we examine whether theory-driven strategies to create psychological distance-mindfulness and perspective-taking-can change drinking behaviors among young adults without alcohol dependence via a 28-day smartphone intervention (Study 1, N = 108 participants, 5492 observations; Study 2, N = 218 participants, 9994 observations). Study 2 presents a close replication with a fully remote delivery during the COVID-19 pandemic. During weeks when they received twice-a-day intervention reminders, individuals in the distancing interventions reported drinking less frequently than on control weeks-directionally in Study 1, and significantly in Study 2. Intervention reminders reduced drinking frequency but did not impact amount. We find that smartphone-based mindfulness and perspective-taking interventions, aimed to create psychological distance, can change behavior. This approach requires repeated reminders, which can be delivered via smartphones.

Psychophysiological stress response after a 6-week Mindful Self-Compassion training in psychiatric rehabilitation inpatients: a randomized post-test only study

Objectives

Mindfulness-based interventions (including self-compassion interventions) are effective in improving stress management at psychological and physical levels. Mindful Self-Compassion (MSC) is a newly developed program particularly aimed at increasing self-compassion. The main objective of this study was to determine whether the psychophysiological stress response during a social-evaluative speaking task differs in inpatients participating in the MSC or the Progressive Muscle Relaxation (PMR) program at the end of their 6-week psychiatric rehabilitation stay (i.e., post-test only design).

Method

Data from 50 inpatients (25 MSC, 25 PMR, 35 female) aged 19 to 76 years (M = 47.22, SD = 12.44) were analyzed in terms of psychophysiological stress response. For this purpose, heart rate variability, heart rate, and blood pressure were assessed together with several psychometric variables: positive and negative affect (PANAS), subjective stress perception (Visual Analog Scale), self-compassion (Self-Compassion Scale), cognitive reappraisal and suppression (Emotion Regulation Questionnaire), psychological distress (Brief Symptom Inventory-18), and appraisal and rumination (selected items).

Results

After correction for alpha inflation no differences in the psychophysiological stress response and psychometric parameters between the MSC and PMR group were found.

Discussion

In general, our results indicate that MSC is not superior to PMR training. However, more research with clinical randomized controlled trials investigating larger samples are needed to further affirm these initial findings.

Individual participant data systematic review and meta-analysis of randomised controlled trials assessing adult mindfulness-based programmes for mental health promotion in non-clinical settings

Introduction

Mindfulness-based programmes (MBPs) are widely used to prevent mental ill-health that is becoming the leading global cause of morbidity. Evidence suggests beneficial average effects but wide variability. We aimed to confirm the effect of MBPs on psychological distress, and to understand whether and how baseline distress, gender, age, education, and dispositional mindfulness modify the effect of MBPs on distress among adults in non-clinical settings.

Methods

We conducted a pre-registered systematic review and individual participant data (IPD) meta-analysis (PROSPERO CRD42020200117). Thirteen databases were searched in December 2020 for randomised controlled trials satisfying a quality threshold and comparing in-person, expert-defined MBPs in non-clinical settings with passive control groups. Two researchers independently selected, extracted, and appraised trials using the revised Cochrane Risk-of-Bias Tool (RoB2). Anonymised IPD of eligible trials were sought from collaborating authors. The primary outcome was psychological distress (unpleasant mental or emotional experiences including anxiety and depression) at 1 to 6 months after programme completion. Data were checked and imputed if missing. Pairwise, random-effects, two-stage IPD meta-analyses were conducted. Effect modification analyses followed a within-studies approach. Public and professional stakeholders were involved in the planning, conduct and dissemination of this study.

Results

Fifteen trials were eligible, 13 trialists shared IPD (2,371 participants representing 8 countries, median age 34 years-old, 71% women, moderately distressed on average, 20% missing outcome data). In comparison with passive control groups, MBPs reduced average distress between one- and six-months post-intervention with a small to moderate effect size (standardised mean difference (SMD) -0.32; 95% confidence interval (CI) -0.41 to -0.24; p-value < 0.001; 95% prediction interval (PI) -0.41 to -0.24 (no heterogeneity)). Results were robust to sensitivity analyses, and similar for the other psychological distress time point ranges. Confidence in the primary outcome result is high. We found no clear indication that this effect is modified by baseline psychological distress, gender, age, education level, or dispositional mindfulness.

Conclusions

Group-based teacher-led MBPs generally reduce psychological distress among community adults who volunteer to receive this type of intervention. More research is needed to identify sources of variability in outcomes at an individual level.

Moderators and mediators of change of an internet-based mindfulness intervention for college students: secondary analysis from a randomized controlled trial

Background

Existing evidence suggests internet- and mobile-based interventions (IMIs) improve depressive symptoms in college students effectively. However, there is far less knowledge about the potential mechanisms of change of mindfulness-based IMIs, which could contribute to optimizing target groups and interventions. Hence, within this secondary analysis of data from a randomized controlled trial (RCT), potential moderators and mediators of the effectiveness of the IMI StudiCare Mindfulness were investigated.

Methods

Moderation and mediation analyses were based on secondary data from a RCT that examined the effectiveness of the 7-module IMI StudiCare Mindfulness in a sample of college students (intervention group: n = 217; waitlist control group: n = 127). Assessments were collected before (t0; baseline), 4 weeks after (t1; during intervention), and 8 weeks after (t2; post-intervention) randomization. Longitudinal mediation analyses using structural equation modeling were employed, with depressive symptom severity as the dependent variable. For moderation analyses, bilinear interaction models were calculated with depressive symptom severity and mindfulness at t2 as dependent variables. All data-analyses were performed on an intention-to-treat basis.

Results

Mediation analyses showed a significant, full mediation of the intervention effect on depressive symptom severity through mindfulness (indirect effect, a*b = 0.153, p < 0.01). Only the number of semesters (interaction: β = 0.24, p = 0.035) was found to moderate the intervention's effectiveness on depressive symptom severity at t2, and only baseline mindfulness (interaction: β = -0.20, p = 0.047) and baseline self-efficacy (interaction: β = -0.27, p = 0.012) were found to be significant moderators of the intervention effect on mindfulness at t2.

Conclusion

Our results suggest a mediating role of mindfulness. Moderation analyses demonstrated that the intervention improved depressive symptom severity and mindfulness independent of most examined baseline characteristics. Future confirmatory trials will need to support these findings.

Clinical Trial Registration

The trial was registered a priori at the WHO International Clinical Trials Registry Platform via the German Clinical Studies Trial Register (TRN: DRKS00014774; registration date: 18 May 2018).

Student wellness: Interest and program ideas & pilot of a student wellness program

Objective: To increase our knowledge related to student wellness programs, the current studies examined interest in wellness and wellness programs among university students and piloted a newly developed wellness program targeting students in higher education. Participants/Methods: In Study 1, 93 undergraduate students answered questions related to their wellness and mental health (e.g. psychological wellbeing, satisfaction with life, optimism, and stress) and to wellness programs (e.g. interest, barriers, duration, and topics). In Study 2, 13 undergraduate and graduate students participated in a 9-week pilot wellness program focused on specific wellness topics (e.g. relaxation, yoga, gratitude and self-compassion, and emotion regulation). Results/Conclusions: Study 1 results support a strong interest in wellness and wellness programs among undergraduate students. Study 2 results suggest that students who participated in an on-campus wellness program reported higher levels of overall psychological wellbeing and optimism and lower levels of mental health issues relative to baseline.

A multicenter feasibility study on implementing a brief mindful breathing exercise into regular university courses

Practicing mindfulness is associated with stress reduction and with positive effects in the context of learning and teaching. Although effects on student populations have been studied extensively, there are few studies implementing mindfulness exercises in university courses directly. For this reason, we aimed to investigate whether the use of a brief mindfulness exercise in regular university courses, guided by the lecturers, is feasible and has immediate effects on the students' mental states. We conducted a preregistered multicenter study with one observational arm, following an ABAB design. In total, N = 325 students from 19 different university courses were included at baseline and n = 101 students at post measurement. Students were recruited by N = 14 lecturers located in six different universities in Germany. Lecturers started their courses either by guiding a brief mindfulness exercise (intervention condition) or as they regularly would, with no such exercise (control condition). In both conditions, the mental states of students and lecturers were assessed. Over the semester, n = 1193 weekly observations from students and n = 160 observations from lecturers were collected. Intervention effects were analyzed with linear mixed-effects models. The brief mindfulness exercise, compared to no such exercise, was associated with lower stress composite scores, higher presence composite scores, higher motivation for the courses, as well as better mood in students. Effects persisted throughout a respective course session. Lecturers also reported positive effects of instructing mindfulness. Implementing a brief mindfulness exercise in regular university teaching sessions is feasible and has positive effects on both students and lecturers.

Effectiveness of a Brief Online Mindfulness-Based Intervention for University Students

Objectives

The COVID-19 pandemic resulted in a dramatic increase in Web-based education, lacking face-to-face student-teacher and student-student interaction, and consequently impairing students' sense of belonging to a community, interoceptive awareness, and academic self-efficacy. This study examined how a brief mindfulness-based intervention in an online university course can be effective in enhancing attention resources, developing a stronger sense of academic self-efficacy, and improving the sense of belonging to a community, which represent critical factors affecting students' participation in online and blended courses.

Method

Four-hundred and eighty-six participants (Mage 22.88) completed a battery of measures at pre- and post-treatment. One class (experimental group) participated in a brief online mindfulness-based intervention (42%), whereas the other one (control group) did not take part in the intervention (58%). The intervention included breathing meditation at the beginning of class, sharing of experiences, mini-lectures on mindfulness, and daily practice, and lasted for 28 consecutive days.

Results

Participants in the experimental group when compared to controls showed a significant increase in the feeling of influencing the course activities (F = 9.628; p < 0.005), in the self-regulation of attention (F = 19.133; p < 0.001), in academic self-efficacy (F = 9.220; p < 0.005), and, particularly, in their self-efficacy in regulating learning (F = 12.942; p < 0.001). The students' adherence to the assigned practice could partially explain the effectiveness of the intervention.

Conclusions

This study offers useful clues about the effectiveness of mindfulness interventions in the classroom in enhancing sense of belonging to a community, attention grounded in bodily sensations, and academic self-efficacy.

Preregistration

This study is not preregistered.

Feasibility and Acceptability of an Online Mindfulness-Based Intervention for Stress Reduction and Psychological Wellbeing of University Students in Pakistan: A Pilot Randomized Controlled Trial

The rise in mental health concerns of university students is causing a serious hinderance to their wellbeing, impeding their functioning. The socio-economic and political friction in low- and middle-income countries adds to their vulnerability and calls for a cost-effective indigenous intervention. Consequently, this study aimed to inform a large definitive trial by assessing the feasibility and acceptability of a randomized controlled trial (RCT) design evaluating a culturally adapted online Mindfulness Training Course (MTC) used to improve stress and wellbeing among Pakistani university students. A two-arm pilot randomized controlled trial was conducted. University students (n = 156) were randomly assigned to either the MTC group (n = 80) or Wait-list (WL) control group (n = 76) and completed baseline and post-intervention self-report measures for mindfulness, stress and psychological wellbeing. Additionally, semi-structured interviews were conducted with consenting MTC group participants (n = 18) to explore their views about MTC, employing reflexive thematic analysis. Of 80 participants randomized to the MTC group, 32 completed the course, whereas, from the 156 randomized participants, 102 completed assessment surveys. Feasibility and acceptability indicators showed high recruitment, compliance, and adherence to MTC, with practical steps for randomization and online data collection. Further results showed higher levels of mindfulness and psychological wellbeing and lowered stress levels in the MTC group compared to the control group. The attrition and dropout rates were high; however, the feedback from participants who completed the MTC was highly positive and encouraging. In conclusion, if the trial proceeds with increased outreach in a large-scale RCT, the recruitment might be revised to reduce attrition rates. Further recommendations are discussed.

Advancing the Study of Mindfulness-Based Interventions in Relation to Psychological Health

Since 2006, there has been exponential growth in the number of publications on mindfulness [...].

Social jetlag and quality of life among nursing students during the COVID-19 pandemic: a cross-sectional study

BACKGROUND

Amid drastic changes in the educational environment and continued substitution of in-person learning with online learning owing to the COVID-19 pandemic, it is important to analyze the predictors of quality of life among nursing students to devise strategies to enhance their quality of life. This study aimed to identify the predictors of nursing students' quality of life during the COVID-19 pandemic, focusing on social jetlag.

METHODS

In this cross-sectional study, data were collected from 198 Korean nursing students in 2021, using an online survey. Chronotype, social jetlag, depression symptoms, and quality of life were assessed using the Korean version of the Morningness-Eveningness Questionnaire, Munich Chronotype Questionnaire, Center for Epidemiological Studies Depression Scale, and World Health Organization Quality of Life Scale abbreviated version, respectively. Multiple regression analyses were performed to identify the predictors of quality of life.

RESULTS

Factors affecting participants' quality of life were age (β = - 0.19, p = .003), subjective health status (β = 0.21, p = .001), social jetlag (β = - 0.17, p = .013), and depression symptoms (β = - 0.33, p < .001). These variables accounted for 27.8% of the variance in quality of life.

CONCLUSION

As the COVID-19 pandemic continues, the social jetlag of nursing students has decreased compared to before the pandemic. Nevertheless, the results showed that mental health issues such as depression affect their quality of life. Therefore, it is necessary to devise strategies to support students' ability to adapt to the rapidly changing educational environment and promote their mental and physical health.

The effectiveness and acceptability of formal versus informal mindfulness among university students with and without recent nonsuicidal self-injury: Protocol for an online, parallel-group, randomized controlled trial

BACKGROUND

Mindfulness-based programming comprising both formal (FM) and informal (IM) mindfulness practice is increasingly offered to university students. However, difficulties with emotion regulation, self-criticism, and a potentially complex relationship with their body may undermine the benefits of FM for students with a history of nonsuicidal self-injury (NSSI), given its requirement of sustained attention on thoughts, emotions, and bodily sensations. IM may be better tolerated by these students. This protocol describes a randomized controlled trial comparing a brief FM practice, a brief IM practice, and an active control task in university students with and without recent NSSI.

METHODS

Recruitment began in November 2022. An online, parallel-group, single-blind, randomized controlled trial will compare a 10-min, single-session FM practice, a 10-min, single session IM practice, and a 10-min, single session active control task in university students with and without recent NSSI. Outcomes will be assessed immediately pre-intervention and within five minutes post-intervention. The primary outcome will be state mindfulness. Secondary outcomes will be state stress, state well-being, and acceptability. Students with a history of NSSI are expected to report (i) greater improvements in state mindfulness, stress, and well-being, and (ii) greater acceptability in the IM condition, relative to the FM and control conditions. This distinction is not expected to occur in the no-NSSI comparison group.

CONCLUSION

This trial is the first to parse out the impacts of FM versus IM practice among university students with and without a history of self-injury. Findings will be relevant to academic and clinical audiences within university settings.

Effectiveness of four deconstructive meditative practices on well-being and self-deconstruction: study protocol for an exploratory randomized controlled trial

INTRODUCTION

The efficacy of interventions based on mindfulness and compassion has been demonstrated in both clinical and general population, and in different social contexts. These interventions include so-called attentional and constructive meditation practices, respectively. However, there is a third group, known as deconstructive meditation practices, which has not been scientifically studied. Deconstructive practices aim to undo maladaptive cognitive patterns and generate knowledge about internal models of oneself, others and the world. Although there are theoretical and philosophical studies on the origin of addiction to the self or on the mechanisms of action associated with the deconstruction of the self, there are no randomized controlled trials evaluating these techniques in either a healthy population or clinical samples. This study aims to evaluate the effect of three deconstructive techniques by comparing them to mindfulness in the general population.

METHODS AND ANALYSIS

A randomized controlled clinical trial will be conducted with about 240 participants allocated to four groups: (a) mindful breathing, (b) prostrations, according to Tibetan Buddhist tradition; (c) the Koan Mu, according to Zen Buddhist tradition; and (d) the mirror exercise, according to Toltec tradition. The primary outcome will be the qualities of the non-dual experience and spiritual awakening, measured by the Nondual Embodiment Thematic Inventory, assessed at pre- and post-treatment and at 3- and 6-month follow-ups. Other outcomes will be mindfulness, happiness, compassion, affectivity and altered state of consciousness. Quantitative data will be compared using mixed-effects linear regression models, and qualitative data will be analysed through thematic analysis and using the constant comparative method from grounded theory.

ETHICS AND DISSEMINATION

Approval was obtained from the Research Ethics Committee of Aragon, Spain. The results will be submitted to peer-reviewed specialized journals, and brief reports will be sent to participants on request.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05317754. Registered on August 2,2022.

A Three-Armed Randomized Controlled Trial to Evaluate the Effectiveness, Acceptance, and Negative Effects of StudiCare Mindfulness, an Internet- and Mobile-Based Intervention for College Students with No and "On Demand" Guidance

The college years can be accompanied by mental distress. Internet- and mobile-based interventions (IMIs) have the potential to improve mental health but adherence is problematic. Psychological guidance might promote adherence but is resource intensive. In this three-armed randomized controlled trial, "guidance on demand" (GoD) and unguided (UG) adherence-promoting versions of the seven-module IMI StudiCare Mindfulness were compared with a waitlist control group and each other. The GoD participants could ask for guidance as needed. A total of 387 students with moderate/low mindfulness were recruited. Follow-up assessments took place after 1 (t1), 2 (t2), and 6 (t3) months. Post-intervention (t2), both versions significantly improved the primary outcome of mindfulness (d = 0.91-1.06, 95% CI 0.66-1.32) and most other mental health outcomes (d = 0.25-0.69, 95% CI 0.00-0.94) compared with WL, with effects generally persisting after 6 months. Exploratory comparisons between UG and GoD were mostly non-significant. Adherence was low but significantly higher in GoD (39%) vs. UG (28%) at the 6-month follow-up. Across versions, 15% of participants experienced negative effects, which were mostly mild. Both versions effectively promoted mental health in college students. Overall, GoD was not associated with substantial gains in effectiveness or adherence compared with UG. Future studies should investigate persuasive design to improve adherence.

Effects of online mindfulness-based interventions on the mental health of university students: A systematic review and meta-analysis

Objectives

Mental health problems among university students are a cause of widespread concern. Mindfulness-based interventions (MBIs) delivered online have considerable potential to help university students manage mental health challenges. However, there is no consensus regarding the efficacy of online MBIs. This meta-analysis aims to determine whether MBIs are feasible and effective for improving university students' mental health.

Methods

Randomised controlled trials (RCTs) in Web of Science, PubMed, Cochrane Library, Embase and the US National Library of Medicine (Clinical Trial Registry) published through August 31, 2022, were searched. Two reviewers selected the trials, conducted a critical appraisal, and extracted the data. Nine RCTs met our inclusion criteria.

Results

This analysis showed that online MBIs were effective in improving depression (standardised mean difference [SMD] = -0.27; 95% confidence interval [CI], -0.48 to -0.07; P = 0.008), anxiety (SMD = -0.47; 95% CI, -080 to -0.14; P = 0.006), stress (SMD = -0.58; 95% CI, -0.79 to -0.37; P < 0.00001), and mindfulness (SMD = 0.71; 95% CI, 0.17 to 1.25; p = 0.009) in university students. No significant effect was found on wellbeing (SMD = 0.30; 95% CI, -0.00 to 0.60; P = 0.05).

Conclusion

The findings indicated that online MBIs could effectively improve the mental health of university students. Nevertheless, additional rigorously designed RCTs are required.

Systematic review registration

https://inplasy.com/inplasy-2022-9-0099/, identifier INPLASY202290099.

The effectiveness of mindfulness-based interventions for ruminative thinking: A systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

To systematically evaluate the effectiveness of mindfulness-based interventions for ruminative thinking.

METHODS

Cochrane Library, Web of Science, Embase, EBSCO, PubMed and Science Direct databases were searched to include randomized controlled trials of mindfulness-based interventions for rumination that met the criteria. The Rumination scale was used as the primary outcome indicator, and the secondary outcome indicator included the Mindfulness scale. An evaluation of bias risk was conducted to identify possible sources of bias based on methodological and clinical factors. Stata 16.0 software was used to perform meta-analysis, subgroup analysis, sensitivity analysis, meta-regression analysis and publication bias detection of the extracted data.

RESULTS

A total of 61 studies with 4229 patients were included. Meta-analysis results revealed a significant intervention effect on ruminative thinking (SMD = -0.534, 95 % CI = [-0.675, -0.394], z = -7.449, P < 0.001). However, there was no significant difference between mindfulness-based interventions and CBT (SMD = 0.009, 95%CI = [-0.239, 0.258], z = 0.073, P = 0.941). Meta-analysis showed that mindfulness-based interventions significantly enhanced the level of mindfulness (SMD = 0.495, 95 % CI = [0.343, 0.647], z = 6.388, P < 0.001), while it was not significant compared to CBT (SMD = 0.158, 95%CI = [-0.087, 0.403], z = 1.266, P = 0.205). The two subgroups with >65 % (SMD = -0.534, 95%CI = [-0.681, -0.386], z = -7.081, P < 0.001) and 80 % (SMD = -0.462, 95%CI = [-0.590, -0.334], z = -7.071, P < 0.001) of females showed significant improvement in ruminative thinking. There were significant intervention effects for depression, students, cancer, healthy adults, and clinical patients. Significant intervention effects were demonstrated for various participant ages and intervention periods.

CONCLUSION

This study confirmed the feasibility of mindfulness-based interventions in improving ruminative thinking and enhancing the level of mindfulness. However, the effectiveness of mindfulness-based interventions was not significant compared to CBT. The two subgroups with a higher proportion of females showed a more significant improvement in ruminative thinking, whereas there were no significant differences in participant characteristics, age, and the duration of intervention.

Web-based training for post-secondary student well-being during the pandemic: a randomized trial

Background: The COVID-19 pandemic has been a highly stressful period where post-secondary education moved to online formats. Coping skills like decentering and reappraisal appear to promote stress resilience, but limited research exists on cultivating these skills in online learning contexts.Methods: In a three-arm randomized trial design, we evaluated three-week, web-based interventions to gauge how to best cultivate mindfulness and stress-reappraisal skills and whether the proposed interventions led to improved mental health. Undergraduate participants (N = 183) were randomly assigned to stress mindset, mindfulness meditation, or mindfulness with choice conditions.Results: At the study level (baseline vs. post-intervention), decentering improved across all conditions. Mindfulness with choice significantly decreased negative affect and rumination compared to stress mindset, while stress mindset significantly enhanced stress mindset skills compared to both mindfulness groups. At the daily level (three sessions per week), stress mindset significantly increased positive affect compared to mindfulness meditation.Conclusions: Results suggest that student mental health can be remotely supported through brief web-based interventions. Mindfulness practices seem to be effective in improving students' negative mood and coping strategies, while stress mindset training can help students to adopt a stress-is-enhancing mindset. Additional work on refining and better matching students to appropriate interventions is needed.

Students experiences of an 8-week mindfulness-based intervention at a college of opportunity: a qualitative investigation of the mindfulness-based college program

BACKGROUND

Mindfulness-based programs have the potential to improve the well-being of undergraduate students by reducing anxiety, depression, and isolation in the wake of the COVID-19 pandemic. The aim of this qualitative study was to explore lived experiences of undergraduates in a mindfulness-based program at a "college of opportunity" that has high proportions of first-generation college students. Specifically, we sought to: (1) explore the application of mindfulness practices in students' daily lives; (2) explore how participants believe mindfulness training affected their health and well-being; (3) learn participants' recommendations and suggested changes for mindfulness-based interventions in future iterations.

METHODS

Students were recruited from XXX and consented to participate in semi-structured digitally conducting interviews after the completion of the 8-week intervention in the Fall/Spring 2020 academic year. Data were analyzed using Applied Thematic Analysis and a codebook was constructed using a consensus-driven process using both a priori and emergent coding. All transcripts were double-coded, and concordance was achieved for all interviews.

RESULTS

Qualitative results indicated that the most applied practices were those that could be easily incorporated into a daily routine. Furthermore, students reported an increased ability to cope with a variety of stressors, decreased reactivity, and enhanced resilience specifically concerning mental health challenges. Additionally, engaging in mindfulness training improved students' ability to navigate social distancing measures, other COVID-19-specific stress, and enhanced motivation for self-care practices to sustain well-being. Concerning preferred intervention delivery modality, participants stated that due to multiple, growing responsibilities (e.g., pressures of commuting to class) they preferred in-person delivery, shorter sessions over a longer period, with classes in the morning or early afternoon.

CONCLUSIONS

Findings provide pragmatic and psychosocial insights into students' application of mindfulness training across personal, professional, and academic domains enhancing their well-being. This work builds on qualitative work concerning students' perceptions and applications of mindfulness while offering insights into the future of mindfulness programs among undergraduates.

TRIAL REGISTRATION

Clinicaltrials.gov NCT03124446.

A systematic review of the effect of university positive psychology courses on student psychological wellbeing

Educational courses that teach positive psychology interventions as part of university degree programs are becoming increasingly popular, and could potentially form part of university-wide strategies to respond to the student mental health crisis. To determine whether such courses are effective in promoting student wellbeing, we conducted a systematic review of studies across the globe investigating the effects of positive psychology courses taught within university degree programs on quantitative measures of psychological wellbeing. We searched Embase, PsychInfo, PubMed, and Web of Science electronic databases from 1998 to 2021, identifying 27 relevant studies. Most studies (85%) reported positive effects on measures of psychological wellbeing, including increased life satisfaction and happiness. However, risk of bias, assessed using the ROBINS-I tool, was moderate or serious for all studies. We tentatively suggest that university positive psychology courses could be a promising avenue for promoting student wellbeing. However, further research implementing rigorous research practices is necessary to validate reported benefits, and confirm whether such courses should form part of an evidence-based response to student wellbeing.

Systematic review registration

[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=224202], identifier [CRD42020224202].

App-based mindfulness meditation reduces perceived stress and improves self-regulation in working university students: A randomised controlled trial

We investigated whether a brief mindfulness meditation programme delivered via a smartphone app improves perceived stress, self-regulation and life satisfaction in part-time working university students. Mindfulness and cognitive reappraisal were analysed as potential mediators. A total of 64 university students working at least 20 h per week during the semester were randomised to either a mindfulness-based mobile intervention or a wait-list control condition. Participants in the intervention group were asked to complete one training session of 10-15 min per day using the app. Psychological measures were assessed via a self-report questionnaire at baseline and after 8 weeks. The online mindfulness programme was found to significantly decrease perceived stress (η_p ²  = .180, a large effect). It also increased self-regulation (η_p ²  = .195, a large effect), mindfulness (η_p ²  = .174; a large effect) and cognitive reappraisal (η_p ²  = .136, a medium effect). Increments in life satisfaction were not significant. Changes in self-regulation were mediated by increased mindfulness. Overall, the mobile application was effective in improving mental well-being and coping abilities in a non-clinical sample, encouraging further development of digital health treatments.

The efficacy of online mindfulness-based interventions in a university student sample: Videoconference- or podcast-delivered intervention

The increasing mental health issues among university students during the COVID-19 pandemic and the challenges of delivering face-to-face interventions during lockdowns have increased the demand for online interventions. The report presents results from a randomized controlled trial investigating the benefits of online mindfulness interventions delivered by videoconference or podcast during the early phase of the pandemic in Germany. Fifty university students were randomized to a mindfulness intervention conducted by videoconference (n = 25) or to an unguided training provided by podcasts (n = 25). All students participated in a 7-week mindfulness intervention. Outcome measures included mindfulness, depression, anxiety, and life satisfaction preintervention and postintervention. The study showed a larger reduction in depression in the videoconferencing group than in the podcast group across per protocol (PP) and intention-to-treat (ITT) analyses. There was a significant increase in mindfulness (PP and ITT samples) and life satisfaction (ITT sample) in both groups. The frequency of home practice was related to positive changes in outcomes but only for the videoconferencing group. The results suggest that mindfulness training delivered via videoconferencing can be a viable option to address depressive symptoms among students. However, both interventions were effective in increasing mindfulness and life satisfaction.

Effects of the Interculturality and Mindfulness Program (PIM) on University Students: A Quasi-Experimental Study

Rates of mental health issues have been increasing among university students. This study investigates the effects of the Interculturality and Mindfulness Program (PIM) on academic students on mindfulness, emotional regulation, depression, anxiety, stress, life satisfaction, optimism, positive solitude, and loneliness. A quasi-experimental research was conducted, with pre- and post-test comparative measurements in three groups: in-person (IG), synchronous online (OG), and passive control (CG). A diverse group of students (n = 150; mean age = 25.4 ± 8.31) participated from two universities in Portugal. When compared to the CG, both active groups (IG and OG) demonstrated a beneficial interaction effect in acceptance, positive solitude, optimism, and mindfulness. The IG demonstrated a positive interaction effect in awareness and satisfaction with life, whereas the OG indicated a favorable interaction effect in impulse. When analyzing the intra-group effects, both active groups presented a significant improvement in stress, emotion regulation, mindfulness, positive solitude, and optimism. The OG demonstrated an improvement in awareness and loneliness. The main limitations of this research are that students were not randomly assigned, and groups were heterogeneous in nationality, education level, and sex. Nonetheless, PIM has indicated beneficial results in both IG and OG, and is a promising intervention for the prevention of mental health issues (e.g., stress, difficulties in emotional regulation, and loneliness), as well as for the promotion of well-being (e.g., positive solitude, mindfulness, life satisfaction, and optimism).