Tymofiyeva Olga, Hu Melody Y, Sipes Benjamin S, Jakary Angela, Glidden David V, Jariwala Namasvi, Bhandari Sarina, Parks Kendall C, Nguyen Ca, Henje Eva, Yang Tony T
Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States.
Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Langley Porter Psychiatric Institute, University of California, San Francisco, San Francisco, CA, United States.
Front Psychiatry. 2022 May 12;13:838694. doi: 10.3389/fpsyt.2022.838694. eCollection 2022.
Social distancing, home confinement, economic challenges, and COVID-19-related illness and deaths during the COVID-19 pandemic can significantly affect mental health in youth. One promising approach to reduce anxiety and depression in adolescents is the neuroscience-based mindfulness intervention Training for Awareness, Resilience, and Action (TARA). The objective of this individually randomized waitlist-controlled trial (RCT) was (1) to test the feasibility of TARA, delivered partially over Zoom, and (2) to assess changes in the emotional wellbeing in healthy adolescents between the ages of 14-18 years old during the COVID-19 pandemic.
Twenty-one healthy adolescents were randomized to the TARA intervention or to the waitlist control group in February 2020, just before the start of the pandemic. The TARA group intervention was delivered in person for the first five sessions and remotely over Zoom for the remaining seven sessions due to the pandemic. The participants' acceptability of TARA was assessed weekly using the Child Session Rating Scale (CSRS). The primary outcome was the emotional wellbeing measured using emotional symptoms subscale of the Strengths and Difficulties Questionnaire (SDQ) pre/post-TARA. We also explored weekly changes in TARA participants' wellbeing using the Child Outcome Rating Scale (CORS).
The overall session rating in TARA participants improved after the switch to Zoom (Cohen's d = 1.2, = 0.008). The results of the two-way ANOVA showed no statistically significant difference in the change of the SDQ emotional symptoms during the 12 weeks between the TARA group and waitlist-control group (timepoint × group interaction: = 0.77, = 0.38). The exploratory analysis using the CORS in the TARA participants showed a significant improvement in their functioning over the weeks of training.
Our results support the feasibility of TARA delivered over Zoom. While our primary outcome did not provide support for the improvement of the emotional wellbeing with TARA compared to a passive control group, our exploratory analysis in the intervention group indicated an improved functioning over the weeks of TARA training. The important general positive impact of this study lies in the possibility of offering a neuroscience-based mindfulness intervention remotely to youth living in remote areas and for all youth during pandemic times.
在新冠疫情期间,社交距离、居家隔离、经济挑战以及与新冠病毒相关的疾病和死亡,会对青少年的心理健康产生重大影响。一种有望减轻青少年焦虑和抑郁情绪的方法是基于神经科学的正念干预——意识、复原力和行动训练(TARA)。这项个体随机等待列表对照试验(RCT)的目的是:(1)测试部分通过Zoom进行的TARA干预的可行性;(2)评估在新冠疫情期间,14至18岁健康青少年的情绪健康变化。
2020年2月,在疫情开始前,21名健康青少年被随机分为TARA干预组或等待列表对照组。由于疫情,TARA组的前五次干预是面对面进行的,其余七次则通过Zoom远程进行。每周使用儿童课程评定量表(CSRS)评估参与者对TARA的接受程度。主要结果是在TARA前后,使用优势与困难问卷(SDQ)的情绪症状子量表测量的情绪健康状况。我们还使用儿童结果评定量表(CORS)探索了TARA参与者每周的健康变化。
在改为通过Zoom进行干预后,TARA参与者的总体课程评定有所改善(科恩d值 = 1.2,P = 0.008)。双向方差分析的结果显示,在12周内,TARA组和等待列表对照组之间,SDQ情绪症状的变化没有统计学上的显著差异(时间点×组间交互作用:F = 0.77,P = 0.38)。在TARA参与者中,使用CORS进行的探索性分析表明,在数周的训练过程中,他们的功能有显著改善。
我们的结果支持通过Zoom进行TARA干预的可行性。虽然我们的主要结果没有表明与被动对照组相比,TARA能改善情绪健康,但我们在干预组中的探索性分析表明,在数周的TARA训练过程中,功能有所改善。这项研究的重要总体积极影响在于,有可能在疫情期间,为偏远地区的青少年以及所有青少年远程提供基于神经科学的正念干预。