What is Mindfulness: Benefits, How to Practice, and More - Healthline
It often involves focusing on sensations to root yourself in your body in the here and now. It can be practiced during formal meditation or ...
2020 review
A <anchor>2020 review</anchor> found that MBSR was better than controls at treating young people with anxiety symptoms, but that treatment duration was an important factor.
Effects of mindfulness-based stress reduction on anxiety symptoms in young people: A systematic review and meta-analysis - ScienceDirect
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## Article preview

- [Abstract](#preview-section-abstract)
- [Introduction](#preview-section-introduction)
- [Section snippets](#preview-section-snippets)
- [References (67)](#preview-section-references)
- [Cited by (39)](#preview-section-cited-by)

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## [Psychiatry Research](/journal/psychiatry-research "Go to Psychiatry Research on ScienceDirect")

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# Review article  Effects of mindfulness-based stress reduction on anxiety symptoms in young people: A systematic review and meta-analysis

Author links open overlay panelXiangZhoua, JieyuGuoa, GuangliLub, ChaoranChena, ZhenxingXiec, JiangminLiud, ChuningZhanga

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## Highlights

- •
[MBSR](/topics/medicine-and-dentistry/mindfulness-based-stress-reduction "Learn more about MBSR from ScienceDirect's AI-generated Topic Pages") significantly reduced anxiety symptoms at post treatment.

- •
The effect of [MBSR](/topics/biochemistry-genetics-and-molecular-biology/mindfulness "Learn more about MBSR from ScienceDirect's AI-generated Topic Pages") on anxiety symptoms in young people may be affected by intervention duration.

- •
The effects of long-term intervention and follow-up in young people need further investigation.


## Abstract

In this study, we evaluated the efficacy of mindfulness-based stress reduction (MBSR) for young people with anxiety symptoms. We used many databases, including PubMed, PsycINFO, Web of Science, EMBASE, CINAHL and Cochrane Library (from inception to May 2019). We included randomized controlled trials (RCTs) comparing [MBSR](/topics/neuroscience/mindfulness "Learn more about MBSR from ScienceDirect's AI-generated Topic Pages") with various control conditions, including didactic lecture course, health education, treatment as usual, didactic seminar and cognitive behavioral program in young people with anxiety symptoms. Finally, we selected fourteen studies comprising 1489 participants comparing with control conditions. The meta-analysis suggested that [MBSR](/topics/psychology/mindfulness "Learn more about MBSR from ScienceDirect's AI-generated Topic Pages") significantly reduced anxiety symptoms compared to control conditions at post-treatment (Standardized Mean Difference, SMD = –0.14, 95% CI –0.24 to –0.04). However, the effect of MBSR on anxiety symptoms in young people may be affected by different intervention duration, especially the significance in a short-term intervention (less than 8 weeks). In addition, the meta-analysis indicated publication bias for anxiety symptoms. Using the trim-and-fill method, we found the adjusted standardized mean difference, which indicated that MBSR was still significantly superior to the other control conditions. The sensitivity analysis showed that the result was reliable. Current evidence indicates MBSR has superior efficacy compared with control conditions in treating young people with anxiety symptoms. Based on this, we suggest there is a significant effect of MBSR on young people with anxiety symptoms, especially the effects of long-term intervention for future studies.

## Introduction

Anxiety is one of the most prevalent and nationwide diagnosed psychiatric conditions in youth (Bear et al., 2019). According to the World Health Organization (WHO), the prevalence of anxiety disorders in adolescents is 10 to 19 percent (Bandelow and Michaelis, 2015). Left untreated, anxiety disorders tend to develop into a chronic that often continues into adulthood (Hill et al., 2016). Anxiety symptoms are associated with a range of physical and mental problems and other negative outcomes. Physical discomfort such as palpitations, dizziness, chest tightness, sleep disorders, and joint muscle tension (Rouillon, 1999; Woodward and Fergusson, 2001) is often prone to occur, while there is also an increased risk of illicit drug dependence seeking to relieve anxiety and stress (Woodward and Fergusson, 2001). In term of mental damage, anxiety is associated with low self-esteem, reduced well-being and other mental illnesses, especially depression (Woodward and Fergusson, 2001);anxiety disorder not only causes a huge economic burden and reduces the quality of life, but also becomes one of the main reasons of suicide among youths (Hoffman et al., 2008; Kim-Cohen et al., 2003; Windfuhr et al., 2008). A study has shown that anxiety disorder leads to lower educational attainment and adolescents with anxiety disorders have a higher risk of education failure than those without anxiety disorders (Woodward and David, 2001). However, less than 50% of young people with mental disorders receive specialized treatment services (Ye et al., 2014). Moreover, anxiety is hard to identify among young people as adolescents may not be as clear as adults (Hill et al., 2016). Therefore, timely identification and evidence-based treatment is urgently needed to ensure optimal outcomes.

The anxiety problem of adolescents has attracted the attention of practitioners and scholars. A growing empirical literature has studied the short-term efficacy and feasibility of both psychosocial (James et al., 2013) and psychopharmacological (Dieleman and Ferdinand, 2008) interventions for the treatment of anxiety disorders in youth. In terms of pharmacotherapy, the overall response rate of generalized anxiety symptoms (GAD) to current mainstream drugs is 44-81% (Borwin et al., 2013), mainly including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), second-line drug buspirone, benzodiazepines, and tricyclic antidepressants, etc. (Borwin et al., 2013). However, due to many side effects of these drugs, long-term use of these drugs is likely to lead to the increase of total cholesterol, dyslipidemia, sexual dysfunction, and even high incidence of drug dependence (Baldwin and Polkinghorn, 2005; Beyazyuz et al., 2013; Lader, 2012; Mahe and Balogh, 2000). Therefore, the current strategy of drug treatment only is not satisfactory for the high incidence of anxiety disorder in young people. In the non-drug treatment situation, psychotherapy has been recommended as the main method for the treatment of anxiety by many countries' guidelines and clinical studies (Cuijpers et al., 2016; Hopkins et al., 2015; Malhi et al., 2015). Studies have shown that cognitive-behavioral therapy (CBT) (James et al., 2015; Zhou et al., 2015), reading therapy (Rapee et al., 2006), music therapy (Goldbeck and Ellerkamp, 2012), and mindfulness-based stress reduction (MBSR) (Hjeltnes et al., 2017; Shauna et al., 1998) have been widely used in relieving anxiety symptoms of teenagers. Cognitive-behavioral therapy (CBT) (James et al., 2015; Zhou et al., 2015) serves as beneficial interventions for the relief of adolescent anxiety symptoms, and is recommended as a first-line psychotherapy for anxiety disorders in the treatment guidelines (Health and Welfare, 2016). Although CBT has achieved positive results in previous RCTs, the response rate of it is not demonstrative, as about 40-50% of young people receiving treatment still have symptoms at the end of acute treatment (Silverman et al., 2008). A Child/Adolescent Anxiety Multimodal Study (CAMS) (Compton et al., 2010) found that the combination (COMB) of CBT, sertraline, and placebo) was superior to both CBT (59.7%) and sertraline (SRT) alone (54.9%), as well as pill placebo (23.7%). Therefore, for the anxiety symptoms of young people, we need to find new and effective psychological intervention methods, such as MBSR.

In the late 1970s, Dr. Kabat-zinn introduced mindfulness-based stress reduction into psychotherapy, helping patients cope with stress, relieve pain, improve mood and improve life comfort (Holzel et al., 2011; Kabat-Zinn, 1982). The original MBSR was designed only for individuals with illnesses, but currently MBSR has widely been used to relieve stress, anxiety, and depression in the general population (Virgili, 2015). Standard MBSR training consists of an 8-week course (Williams and Penman, 2011), including many parts such as body scans (a progressive movement of attention through the body from toes to head observing any sensations in the different regions of the body), sitting and breathing (involving awareness of body sensations, thoughts, and emotions while focusing on the breath), "Hatha Yoga" (which consists of stretches and postures designed to enhance greater awareness and to balance and strengthen the musculoskeletal system), walking meditation (observing the abdominal undulating movement caused by breathing, such as emotional observations). Mindfulness therapy helps individuals stop "action mode" (referring to the individual's automatic, unconscious, inner feelings, thoughts, and bodily sensations, and habitual reaction mode) in the presence of negative emotions (anxiety, depression, stress, fear, etc.) and stressful life events. Instead, it was replaced by the "existence mode" of thinking (that is, learning to accept and recognize all the objective experiences of the present, without reacting to such negative experiences) (Didonna, 2009). In the state of existence mode, individuals think out of the box, eliminates unnecessary worries, finding themselves in the real world (Didonna, 2009), thus changing their self-esteem, psychological resilience and life satisfaction (Bajaj et al., 2016; Zainal et al., 2013). In addition, MBSR has been shown to improve emotional disorders in people with a variety of diseases, such as pain, diabetes, asthma, and malignant tumors, etc. It has been used in the treatment of various physical and mental diseases (Hoffman et al., 2012; Pbert et al., 2012; van Son et al., 2013).

The impact of mindfulness-based stress reduction on young people's mood regulation has been widely accepted in treatment. It draws increasing attention. MBSR interventions for medical students and preschool students can effectively reduce self-reported status and trait anxiety and improve mental experience score assessed at the end of the intervention (Shapiro et al., 1998). In addition, MBSR has a significant effect on reducing symptoms such as depression, anxiety, paranoia, and sensory stress in adolescent outpatients (Diaz-Gonzalez et al., 2018). In addition to these clinical effects of coping with negative emotions, MBSR is highly recommended for non-clinical overweight or obese adolescents. The research found that it can decrease depressive symptoms more efficiently than cognitive and behavioral adolescents 6 months of treatment (Shomaker et al., 2017).

Previous meta-analyses (Bamber and Morpeth, 2019; Borquist-Conlon et al., 2019; Dunning et al., 2019; Halladay et al., 2019; Kallapiran et al., 2015a; Zoogman et al., 2015) have shown the effect of mindfulness training on anxiety and other psychological outcomes in children, adolescents and college students. First of all, some meta-analyses have included non-randomized controlled studies, such as Borquist (2017) and Zoogman (2015)’s study involving QED (quasi-experimental design) (Borquist-Conlon et al., 2019), Tx only (treatment only design), OCT (open-controlled trial (no randomization)) (Zoogman et al., 2015), and research on the pretest/posttest analysis of MBI (Bamber and Morpeth, 2019); second, some meta-analyses involve children and adolescents (under 18 years old) (Borquist-Conlon et al., 2019; Dunning et al., 2019; Kallapiran et al., 2015a; Zoogman et al., 2015), or college students and graduate (Bamber and Morpeth, 2019; Halladay et al., 2019) in the sample population; in the meanwhile, varied types of mindfulness practices (including MBCT, MBSR, ACT, Meditation, mindfulness martial arts and others) were blended by the studies (Bamber and Morpeth, 2019; Borquist-Conlon et al., 2019; Dunning et al., 2019; Halladay et al., 2019; Kallapiran et al., 2015; Zoogman et al., 2015), which masked the evidence of the specific treatment effect of MBSR on anxiety symptoms. It is necessary to explore the effects of single MBSR on young people's emotional symptoms in randomized controlled trials. Recently, a systematic review has demonstrated the role of single MBSR in improving related psychological symptoms, such as reducing depression symptoms in adolescents (Chi et al., 2018). Therefore, it is urgent to assess the impact of MBSR on adolescent anxiety symptoms. Moreover, more young adult data has been collected in the recent publications. So a well-designed new meta-analysis is urgently needed to resolve the limitations of the previous meta-analysis and update the findings with more recent studies. We aimed to explore the effect of MBSR on anxiety symptoms among adolescents and young adults by conducting a systematic review and meta-analysis of relevant RCTs.

## Section snippets

## Selection of studies

Literature was systematically and independently obtained by two authors (XZ and JYG) through PubMed, PsycINFO, Web of Science, EMBASE, The Cumulative Index to Nursing & Allied Health Literature (CINAHL), and the Cochrane Library (from inception to May 2019). The selection was using the following keywords: (mindfulness-based stress reduction OR MBSR) AND (anxiety OR anxiety symptom) AND (adolescent OR teen OR teenager OR student OR youth OR young people OR young adult). In order to extend the

## Literature search and screening

A total of 237 records were obtained for the online database search, and two additional studies were generated by manually searching for published comments or meta-analysis. After the removal of duplicates, 107 studies remained, as 65 of them were excluded at the title and abstract screening stages. The remain 42 studies were then included in the full-text screening process. Finally 14 studies were remained after this process and put into the meta-analysis. Fourteen studies (RCTs) (Bergen-Cico

## Summary of main findings

In this study, we attempt to assess the effect of MBSR on anxiety symptoms of young people by a meta-analysis of randomized controlled trials. A total of 14 articles involving 1489 participants were obtained through literature retrieval and screening. The meta-analysis found that MBSR was significantly superior to other control conditions in reducing anxiety symptoms in young people. The results of our study showed that MBSR can effectively reduce young people's anxiety symptoms compared with

## Conclusion

To our knowledge, it is the first time that meta-analysis has been used to examine the efficacy of MBSR on anxiety symptoms of young people. Overall, the findings of this systematic review and meta-analysis suggest that mindfulness-based stress reduction (MBSR) may be helpful in alleviating anxiety symptoms in young people. MBSR, as a promising method, can be widely used in the treatment of anxiety symptoms. At the same time, MBSR in the youth population showed the outstanding effect of the

## Funding

The study was supported by the Henan University Graduate Education Innovation and Quality Improvement Program Project(SYL18060142) and Henan Provincial Social Science Planning Decision Consulting Project(2018JC38).

## Declaration of Competing Interest

The authors declare no conflict of interest. Authors of this article have approved the submission of the manuscript to the journal and the data presented in the article is novel and has not yet been presented elsewhere.

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Anxiety is among the most prevalent mental disorders present in the general population. Benzodiazepines are the most commonly prescribed drugs for the treatment of anxiety. Using zebrafish as a model organism, we investigated the anxiolytic activity of JM-20, a novel hybrid molecule with a 1,5-benzodiazepine ring fused to a dihydropyridine moiety. Firstly, we carried out some assays to analyze the possible toxicity mediated by JM-20. For this, zebrafish were exposed to different JM-20 concentrations (0-5 μM) for 96 h. Then, using the novel tank test, we evaluated both locomotor and anxiety-like behavior of the animals. Furthermore, brain, liver and plasma were removed to assess toxicity parameters. JM-20 exposure did not cause changes on novel tank, and also did not alter brain viability, hepatic LDH and plasma ALT levels. Afterward, we investigated whether a pre-exposure to JM-20 would prevent the anxiogenic effect evoked by caffeine. In the novel tank test, caffeine significantly decreased the time spent at the top, as well as the number of transitions to the top area. Moreover, caffeine decreased both the total and average time spent in the lit area, as well as increased the number of risk episodes evaluated by the light-dark test. Whole-body cortisol levels were also increased by caffeine exposure. Interestingly, pre-treatment with JM-20 abolished all alterations induced by caffeine. The anxiolytic effect profile of JM-20 was similar to those found for diazepam (positive control). Our findings show, for the first time, the anxiolytic effect of JM-20 in zebrafish, and its relationship with cortisol regulation.

- ### [A call for mindfulness-based interventions for cannabis-use disorders](/science/article/pii/S0013700623001185)



2024, Encephale



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Cannabis use is being increasingly liberalized worldwide, and an increasing prevalence of cannabis-use disorder (CUD) is observed. The few current therapeutic options for CUD are only modestly effective. Mindfulness-based interventions offer promising prospects for the management of substance-use disorders. However, despite proliferating literature on mindfulness and substance use, few studies have explored mindfulness in terms of cannabis use and CUD. There are many possibilities for the implementation of mindfulness-based interventions for cannabis use reduction, especially for younger users, who are more vulnerable to cannabis-related harms. Accordingly, large controlled trials are needed to reliably assess the potential of such interventions.



La consommation de cannabis est de plus en plus libéralisée dans le monde, et on observe une prévalence croissante des troubles liés à l’usage de cannabis (TUC). Les quelques options thérapeutiques actuellement disponibles pour les TUC ne sont que modestement efficaces. Les interventions basées sur la pleine conscience offrent des perspectives prometteuses pour la gestion des troubles liés à l’usage de substances. Cependant, malgré la prolifération de la littérature scientifique sur la pleine conscience et l’usage de substances, peu d’études ont exploré le potentiel de la pleine conscience dans le cadre spécifique de l’usage de cannabis et des TUC. Il existe de nombreuses possibilités de mise en œuvre d’interventions basées sur la pleine conscience pour la réduction de l’usage de cannabis, particulièrement pertinentes pour les jeunes consommateurs, plus vulnérables aux méfaits du cannabis. Par conséquent, des essais contrôlés à grande échelle sont nécessaires pour évaluer de manière fiable le potentiel de telles interventions.

- ### [Mindfulness-based interventions for anxiety and depression](/science/article/pii/S2666869623000015)



2023, Clinics in Integrated Care



Show abstract







Mindfulness-based interventions (MBIs) have a growing body of support in the literature and are increasingly popular for treating a variety of mental health disorders. The two most investigated MBIs include Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT).



We provide a comprehensive up-to-date review of MBIs for reducing anxiety and depression in a broad range of clinical populations.



MBIs outperformed passive controls for treating anxiety and depression. However, the effect sizes are mixed when compared to active controls.


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