Mindfulness meditation training during adolescence Dr. Iroise - - PDF document

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• Dr. Iroise Dumontheil

Department of Psychological Sciences Birkbeck, University of London

Mindfulness meditation training during adolescence

Self-regulation

• Voluntary control of thought, emotion, and action
• “Systematic efforts to direct thoughts, feelings and

actions, toward the attainment of one’s goals”

(Zimmerman, 2000)

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Self-regulation

• Frees individuals from reactive responding
• Predicts academic achievement, social competence,

adult health and wealth (Bull et al., 2008; Carlson & Wang, 2007;

Mischel et al., 2010; Moffitt et al., 2011)

Self-regulation in the brain

Zelazo & Lyons, 2012

Sensation Emotion Value Goals

Rules Cognitive control Emotional reactivity

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Mindfulness

A type of awareness that involves attending to moment- to-moment experiences in a nonjudgmental and nonreactive way (Kabat-Zinn, 2003; Lutz et al., 2007)

Mindfulness training effects in adults

• Improved cognitive control

– Working memory (Jha et al., 2010; Zeidan et al., 2010) – Selective attention (Jha et al., 2007; Tang et al., 2007)

• Improved emotion regulation (Farb et al., 2010; Ortner et

al., 2007; Robins et al., 2012)

• Reduced anxiety/depression, enhanced immune

function, increases in self-reported well-being

(Grossman et al., 2004 meta-analysis)

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What are the effects of mindfulness training on the brain?

• Different types of studies

Trait mindfulness is associated with greater prefrontal cortex and reduced amygdala activation during affect labelling

Creswell et al. Psychosomatic Medicine 2007

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The adolescent brain

Lebel & Beaulieu, J of Neuroscience (2011)

Brain structure development

Volume(cm3)

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Crone & Dahl Nature Neuroscience 2012

Lateral Medial

Changes in activation during cognitive control Changes in activation in response to emotions

Hare et al. Biological Psychiatry 2008

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Adolescence and mental health

• Leading causes of death in adolescence are: 1) accidents, 2)

violence and 3) suicide (Patton et al., The Lancet (2009))

Impulse-control disorders Substance-use disorders Anxiety disorders Mood disorders Schizophrenia 5 10 15 20 25 30 35 40 Age of onset (years)

• 75% of adult mental disorder has its onset before 24 years of

age; mostly during adolescence (Kessler et al, Arch Gen Psych (2005))

How effective might training be for adolescents?

• Possibly more effective because neural networks

supporting cognitive control and emotion regulation are still developing

• Possibly less effective because adolescents may lack

cognitive control skills needed to practice mindfulness meditations

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Why try mindfulness training during adolescence?

• Fostering self-regulation, i.e. non-reactivity and emotion

regulation may be particularly important during adolescence,

• When emotional regulation is particularly challenging and

cognitive control skills still maturing,

• And failures to regulate emotions have important

consequences, e.g. mood disorders, risk taking, but also broadly affect learning and educational outcomes

Project: The effect of mindfulness training on adolescent self-regulation

Institute of Cognitive Neuroscience Sarah-Jayne Blakemore Institute of Child Development Philip Zelazo Kristen Lyons

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Ongoing research

• Experiment 1: Behavioural study in Minneapolis

– Adolescents vs. Adults – Mindfulness Training vs. Relaxation Training vs. Passive Control Group – Battery of measures of cognitive control and emotion regulation

• Experiment 2: Neuroimaging study in London

– Adolescents vs. Adults (females only) – Mindfulness Training vs. Relaxation Training – Focal set of tasks (attention, emotional regulation)

Design

51 Participants (adolescents aged 12-14, adults aged 23-33) 14 adolescents, 11 adults 14 adolescents, 11 adults 14 adolescents, 12 adults 14 adolescents, 12 adults 13 adolescents, 8 adults 13 adolescents, 8 adults 13 adolescents, 9 adults 13 adolescents, 9 adults 8 weeks Mindfulness training 8 weeks Relaxation training

T1 T2

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Relaxation training

• Muscle relaxation
• Time management
• Mental imagery
• Tension releasers

Mindfulness and relaxation training

Teacher: Dr Tamara A Russell Clinical Psychologist & Mindfulness Trainer and Therapist

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Workbooks

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Test Battery

• Functional MRI

– Flanker Task/Attention Network test (Fan et al., 2002; Konrad et al., 2005) – Emotional N-back Task (Ladouceur

et al., 2009)

• Structural MRI
• Behavioural tasks

– Standard verbal working memory test (Backwards digit) – Perceptual load and mindwandering task (Forster & Lavie,

2009; Levinson, Smallwood &Davidson, 2012)

• Self-report questionnaires

– Development/Puberty (Petersen et al.,

1988)

– Child & Adolescent Mindfulness Measure (Greco et al., 2011)/ Mindful Awareness and Attention Scale (Brown

& Ryan, 2003)

– Positive and Negative Affect Scale

(Watson, Clark & Tellegen, 1988)

– Perceived Stress Scale (Cohen &

Williamson, 1988)

– State-Trait Anxiety Inventory

(Spielberger et al., 1983)

• Verbal IQ test (WASI, Wechsler, 1999)

– T2 only to confirm similarity of groups across training conditions

• Attendance rates were higher for adolescents (7.4/8 classes)

than adults (5.6/8) but did not differ between relaxation and mindfulness groups

Attendance data

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Practice data

Adolescents: 12 Mindfulness, 13 Relaxation Adults: 5 Mindfulness, 8 Relaxation

* *

Practice data

Adolescents: 12 Mindfulness, 13 Relaxation Adults: 5 Mindfulness, 8 Relaxation Adolescents practiced more often in the relaxation training condition than in the mindfulness condition, and more than adults.

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Questionnaire data

After either mindfulness/relaxation training:

• Mindfulness scores worsened in adolescents
• State and trait anxiety improved in adults, only state anxiety in

adolescents

• Positive affect increased and perceived stress decreased in

adults, not in adolescents, but the groups do not differ significantly

Reorienting

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400ms

+

150ms Cue 20% invalid

+

400ms

+

Target, 50% incongruent

1300ms

+

Varied ITI 50-450ms

Konrad et al., Neuroimage 2005

* *

Modified Flanker task

450 500 550 600 650 700 Valid cue Invalid cue Valid cue Invalid cue Valid cue Invalid cue Valid cue Invalid cue T1 T2 T1 T2 Mindfulness Relaxation Reaction time (ms)

Time x Cue x Training group (p=0.008)

Effects on reorienting behaviour

*** Dumontheil, Blakemore, Zelazo, Lyons, in preparation

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p=0.032 p=0.071 p=0.078

Effects on reorienting brain activation

Dumontheil, Blakemore, Zelazo, Lyons, in preparation

Conclusions: Neuroimaging study

• Mindfulness training feasible in adolescence, age groups

reported practicing to a similar extent

• But adolescents practiced more often the relaxation exercises
• Mindfulness training seems to have similar effects on

attentional control in adolescents and adults

– increased speed of reorienting attention – parallel changes in brain activation in part of the attention network

Preliminary evidence of attentional control improvements across age groups on both behavioural and neural measures

Lyons, Zelazo, Sommerfeldt, Blakemore, Dumontheil (in preparation)

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Mindfulness in schools

Mindfulness meditation training

Wellcome Trust Strategic award A £6.4 million research programme over seven years investigating the underlying cognitive mechanisms, teacher training routes, school-based implementation and effectiveness of mindfulness training in UK secondary schools.

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Sarah-Jayne Blakemore (PI) Oxford Research Team Daniel Brett, Liz Lord, Elizabeth Nuthall, Lucy Palmer, Anna Sonley, Laura Taylor, Stephanie Wilde Russell Viner

Co-Investigator

Willem Kuyken

(PI)

Mark Williams

(PI)

Catherine Crane

Scientific Project Manager

Tamsin Ford

Co-Investigator

Obi Ukoumunne

Co-Investigator

Sarah Byford

Co-Investigator

Mark Greenberg

Co-Investigator

Philip Zelazo

Co-Investigator

Collaborators Duncan Astle, Fergus Crow, Iroise Dumontheil, Christopher Fairburn, Ian Goodyer, Felicia Huppert, Patrick Smith, Marteen Speekenbrink, Alan Stein Consultants Richard Burnett, Chris Cullen, Katherine Weare UCL Research Team Lucy Foulkes, Ashok Sakhardande Tim Dalgleish (PI) Sue Gathercole

Co-Investigator

Cambridge Research Team Darren Dunning, Kirsty Griffiths

MYRIAD Team

Across the project Declaration of interests WK is Director of the University of Oxford Mindfulness Centre. MW is co-author of Mindfulness- based Cognitive Therapy and Mindfulness, Finding Peace in a Frantic World and receives royalties from their sales.

MYRIAD OUTLINE

The four themes

1

2

3 4

Theme 1

Investigating the impact of mindfulness training on cognitive and neural mechanisms during adolescence

Theme 2A

Teacher training routes for personal mindfulness training and curriculum

• training. Investigating effectiveness

and cost-effectiveness.

Theme 2B

Investigating the challenges to successful implementation of mindfulness training in secondary schools

Theme 3

A randomised controlled trial to explore the impact of mindfulness training on depression, wellbeing and behavior in adolescence.

Theme 4

A cohort study following the participants of theme 3.

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• Individual diff., cross-sectional, training studies
• Blinding of training conditions
• Randomisation of participants to conditions
• Control condition
• Number of participants
• Cost
• Measures
• Practice
• Different types of training/practice
• Implementation in schools

Issues in the field Overall conclusions

• Mindfulness meditation practice is associated with a range
• f changes in adults, from working memory to stress, via

emotional regulation

• Mindfulness training may reinforce self-regulation by

targeting top-down regulation of behaviour while lessening bottom-up influences (such as anxiety, stress, curiosity)

• Neuroimaging studies are starting to show the neural basis

for these changes

• Mindfulness training appears feasible in adolescence
• Observed effects are not general but specific to certain

aspects of cognitive control/self-regulation, possibly involving resistance to distraction and/or reorientation of attention

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Thank You

Institute of Cognitive Neuroscience Sarah-Jayne Blakemore Institute of Child Development Philip Zelazo Kristen Lyons Department of Psychological Sciences Jo Bevan Ben Francis Sherine Lovegrove Gizelle Anzures