Tag Archives: Mindfulness-Based Stress Reduction for Urban Youth – Journal of Alternative & Complementary Medicine

The *Journal of Alternative and Complementary Medicine* has scheduled an article for publication in a future issue: “Mindfulness-Based Stress Reduction for Urban Youth.”

The authors are Erica M.S. Sibinga, Deanna Kerrigan, Miriam Stewart, Kelly Johnson, Trish Magyari, & Jonathan M. Ellen.

Here’s how the article begins:

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Many urban youth in the United States experience inevitable and unremitting stresses, including poverty, failing educational systems, and exposure to community and interpersonal violence. In light of negative physical and psychologic effects of prolonged exposure to stress, such as hypertension, obesity, anxiety, aggression, and depression,1-6 we are interested in identifying effective approaches to reduce stress and/or ameliorate the effects of stress for urban youth.

Studies of mindfulness-based stress reduction (MBSR) programs in adult populations have shown decreased stress, as well as improvements in psychologic and physical outcomes.7,8 MBSR is a structured 8-week program of instruction, designed to enhance participants’ mindfulness, or present-focused awareness. Research in adult patients with chronic pain,9 cancer,10-13 anxiety and depression,14 and in heterogeneous clinical populations15-19 have shown benefit in health-related quality of life, alleviation of physical symptoms, and decreased psychologic distress. Roth’s research describes benefits of MBSR for low-income urban populations, with improvements in medical and psychologic outcomes, as well as decreased health care utilization.18-20 Additionally, MBSR programs for healthy adults have shown enhanced immune response and decreased mood disturbance.21,22

Despite decades of research in adults, the literature of MBSR for children and youth is now beginning to emerge. A few small and multimodal studies in children and youth describe benefits of mindfulness instruction, including increased well-being, decreased anxiety and worry, and decreased reactivity.23-29 Work by Bogels30 in schools and Biegel31 with psychiatric outpatients have also shown acceptability and suggest improvements in mental health, somatization, and general well-being. We have previously published results of a pilot study in which we demonstrated the acceptability of MBSR for human immunodeficiency virus (HIV)-infected urban youth, defined as session attendance, perceived positive impact, and enthusiasm for participation in the group. Five (5) of 7 (71%) session attendees completed the MBSR program and reported benefits related to improved attitude, decreased reactivity, improved behavior, importance of self-care, and importance of involvement in the MBSR group.32 The goal of the study reported here was to investigate further the potential domains of effect of the existing MBSR program,33 for underserved urban youth, using both qualitative and quantitative measures to enrich our understanding of the program’s effect in this population.

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Here’s how the Discussion section begins:

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Our mixed-method exploration of the MBSR program for urban youth allowed us to identify specific domains that might have been affected by MBSR participation. The quantitative survey data show significant reductions from baseline in hostility, general discomfort, and emotional discomfort. The qualitative data show perceived improvements in interpersonal relationships (including less engagement in conflict), school achievement, physical health, and reduced stress. We believe these different types of data are both consistent and complementary, as the reductions in psychologic symptoms and improved well-being could both contribute to and result from the improvements articulated in the qualitative data.

The reduction in hostility seen in our MBSR participants is consistent with reports of decreased anger in a small number of adult studies.12,18 We did not find statistically significant decreases in other psychologic domains often described with MBSR for adults, such as depression. This may be related to the adolescent-specific expression of anger and hostility as a predominant feature of depressive symptomatology, as opposed to melancholic symptoms commonly associated with adult depression.42 Additionally, our data suggest that MBSR may have beneficial effects on health-related behaviors, with participants describing a variety of healthier behaviors, such as increased physical activity, healthier eating, improved sleep hygiene, and improved HIV medication adherence.

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Here’s how the article ends: “These data suggest that MBSR may be beneficial for urban youth in a number of salient domains, including hostility, general and emotional discomfort, as well as interpersonal relationships, school achievement, and physical health. Future randomized controlled studies of MBSR to test its efficacy should explore outcomes related to these domains.”

The author note provides the following contact information:

Erica M.S. Sibinga, MD, MHS Center for Child and Community Health Research Suite 4200, Mason F Lord Building, Center Tower 5200 Eastern Avenue Baltimore, MD 21224 E-mail: esibinga@jhmi.edu

Courtesy of Ken Pope