Mindfulness meditation training during adolescence Dr. Iroise - PDF document

29/07/2016 Mindfulness meditation training during adolescence Dr. Iroise Dumontheil Department of Psychological Sciences Birkbeck, University of London 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) 1

29/07/2016 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 Rules Goals Value Cognitive control Sensation Emotional Emotion reactivity Zelazo & Lyons, 2012 2

29/07/2016 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) 3

29/07/2016 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 4

29/07/2016 The adolescent brain Brain structure development Volume(cm 3 ) Lebel & Beaulieu, J of Neuroscience ( 2011) 5

29/07/2016 Changes in activation during cognitive control Lateral Medial Crone & Dahl Nature Neuroscience 2012 Changes in activation in response to emotions Hare et al. Biological Psychiatry 2008 6

29/07/2016 Adolescence and mental health Impulse-control disorders Substance-use disorders Anxiety disorders Mood disorders Schizophrenia 0 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)) • Leading causes of death in adolescence are: 1) accidents, 2) violence and 3) suicide (Patton et al., The Lancet (2009)) 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 7

29/07/2016 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 8

29/07/2016 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) T1 14 adolescents, 14 adolescents, 14 adolescents, 14 adolescents, 12 adults 12 adults 11 adults 11 adults 8 weeks 8 weeks Mindfulness Relaxation training training 13 adolescents, 13 adolescents, 13 adolescents, 13 adolescents, 8 adults 8 adults 9 adults 9 adults T2 9

29/07/2016 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 10

29/07/2016 Workbooks 11

29/07/2016 Test Battery • Functional MRI • Self-report questionnaires – Development/Puberty (Petersen et al., – Flanker Task/Attention Network 1988) test (Fan et al., 2002; Konrad et al., 2005) – Child & Adolescent Mindfulness – Emotional N-back Task (Ladouceur Measure (Greco et al., 2011) / Mindful et al., 2009) Awareness and Attention Scale (Brown • Structural MRI & Ryan, 2003) – Positive and Negative Affect Scale • Behavioural tasks (Watson, Clark & Tellegen, 1988) – Perceived Stress Scale (Cohen & – Standard verbal working Williamson, 1988) memory test (Backwards digit) – State-Trait Anxiety Inventory (Spielberger et al., 1983) – Perceptual load and mindwandering task (Forster & Lavie, • Verbal IQ test (WASI, Wechsler, 1999) 2009; Levinson, Smallwood &Davidson, 2012) – T2 only to confirm similarity of groups across training conditions Attendance data • Attendance rates were higher for adolescents (7.4/8 classes) than adults (5.6/8) but did not differ between relaxation and mindfulness groups 12

29/07/2016 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. 13

29/07/2016 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 14

29/07/2016 Modified Flanker task 400ms 150ms Cue 20% invalid + * + 400ms Target, 50% incongruent * 1300ms + + Varied ITI 50-450ms + Konrad et al., Neuroimage 2005 Effects on reorienting behaviour Time x Cue x Training group (p=0.008) *** 700 650 Reaction time (ms) 600 550 500 450 Valid cue Invalid cue Valid cue Invalid cue Valid cue Invalid cue Valid cue Invalid cue T1 T2 T1 T2 Mindfulness Relaxation Dumontheil, Blakemore, Zelazo, Lyons, in preparation 15

29/07/2016 Effects on reorienting brain activation p=0.032 p=0.078 p=0.071 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) 16

29/07/2016 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 . 17

29/07/2016 MYRIAD Team UCL Research Team Sarah-Jayne Russell Viner Lucy Foulkes, Ashok Blakemore (PI) Co-Investigator Across the project Sakhardande Oxford Research Team Catherine Crane Mark Williams Willem Kuyken Daniel Brett, Liz Lord, Elizabeth Nuthall, Lucy Scientific Project Manager (PI) (PI) Palmer, Anna Sonley, Laura Taylor, Stephanie Wilde Cambridge Research Team Sue Gathercole Tim Dalgleish (PI) Darren Dunning, Kirsty Griffiths Co-Investigator Obi Ukoumunne Tamsin Ford Mark Greenberg Sarah Byford Co-Investigator Co-Investigator Co-Investigator Co-Investigator Collaborators Consultants Philip Zelazo Duncan Astle, Fergus Crow, Iroise Dumontheil, Richard Burnett, Chris Cullen, Christopher Fairburn, Ian Goodyer, Felicia Co-Investigator Katherine Weare Huppert, Patrick Smith, Marteen Speekenbrink, Alan Stein 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 Theme 2A Teacher training routes for personal mindfulness training and curriculum Theme 1 training. Investigating effectiveness Investigating the impact of and cost-effectiveness. 1 2 mindfulness training on cognitive Theme 2B and neural mechanisms during adolescence Investigating the challenges to successful implementation of mindfulness training in secondary schools 3 4 Theme 3 Theme 4 A randomised controlled trial to explore the impact of A cohort study following the mindfulness training on participants of theme 3. depression, wellbeing and behavior in adolescence. Reproduced with permission from The MYRIAD Team – Oxford University. 18