Vohra Sunita, Punja Salima, Sibinga Erica, Baydala Lola, Wikman Erik, Singhal Anthony, Dolcos Florin, Van Vliet K Jessica
Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Child Adolesc Ment Health. 2019 Feb;24(1):29-35. doi: 10.1111/camh.12302. Epub 2018 Oct 15.
Mental illness is among the most common causes of morbidity, mortality, and disability in childhood. Mindfulness-based stress reduction (MBSR) has shown significant benefit in mental health; however, evidence of its effectiveness in youth is limited. The objective of this study was to compare the efficacy of MBSR plus usual care versus usual care alone for reducing mental health symptoms in youth.
A two-arm, mixed methods, randomized cluster-controlled trial of 12-18 year olds who were residents of CASA House, a voluntary residential treatment program for adolescents, between January 2011 and March 2013 (clinicaltrials.gov, NCT01307943).
Treatment terms were randomized to usual care, or MBSR plus usual care, which included eight MBSR sessions of 2 hr/week.
The primary outcome was impact on emotions and behavior at the end of the program, using the Behavior Assessment System for Children, Second Edition (BASC-2). Secondary outcomes included perceived stress levels, mindfulness, and emotional regulation.
A total of 85 participants were randomized to either the MBSR arm (n = 45) or control arm (n = 40). Significant differences in favor of MBSR were found on Teacher ratings of the Internalizing Problems (p = .038) and Adaptive Skills subscales (p = .022) on the BASC-2. No significant differences were found on other outcomes. A post hoc analysis found that the MBSR arm had a significantly shorter time to discharge (p = .02).
The results of this study indicate that MBSR is effective for improved coping with internalizing problems and adaptive emotional skills in our sample. Future studies should focus on larger, longer-term studies in youth.
精神疾病是儿童发病、死亡和残疾的最常见原因之一。基于正念的减压疗法（MBSR）已显示出对心理健康有显著益处；然而，其在青少年中的有效性证据有限。本研究的目的是比较MBSR加常规护理与单纯常规护理在减轻青少年心理健康症状方面的疗效。
一项双臂、混合方法、随机整群对照试验，研究对象为2011年1月至2013年3月期间居住在CASA之家的12 - 18岁青少年，CASA之家是一个针对青少年的自愿住院治疗项目（clinicaltrials.gov，NCT01307943）。
治疗组被随机分配接受常规护理，或MBSR加常规护理，后者包括每周2小时共8次的MBSR课程。
使用儿童行为评估系统第二版（BASC - 2），主要结局是该项目结束时对情绪和行为的影响。次要结局包括感知压力水平、正念和情绪调节。
共有85名参与者被随机分配到MBSR组（n = 45）或对照组（n = 40）。在BASC - 2的内化问题教师评分（p = 0. 038）和适应技能分量表（p = 0. 02）上发现MBSR组有显著优势。在其他结局上未发现显著差异。事后分析发现MBSR组的出院时间显著更短（p = 0. 02）。
本研究结果表明，MBSR对改善我们样本中青少年应对内化问题和适应性情绪技能有效。未来研究应聚焦于针对青少年的更大规模、更长期的研究。
