Improve Anxiety Disorders in Children and Adolescents with Mindfulness
By John M. de Castro, Ph.D.
“The more present you are in life, the more you realize you make better decisions, manage your emotions, and are fully engaged in life.” – Stephanie Gutzmer
A characterizing feature of anxiety disorders is recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety often co-occurs with depression or is a precursor to bipolar disorder. Anxiety disorders and depression have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. In addition, drugs can be problematic for the developing brain. So, there is a need to develop alternative treatments particularly for children and adolescents. Mindfulness practices have been shown to be quite effective in relieving anxiety.
Mindfulness-Based Cognitive Therapy (MBCT) involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy That is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to reduce anxiety. It has been proposed that intervening early may tend to mitigate or prevent future disorders So, it makes sense to examine the ability of MBCT to treat anxiety disorders in children and adolescents.
In today’s Research News article “Mindfulness-based cognitive therapy for children and adolescents with anxiety disorders at-risk for bipolar disorder: A psychoeducation waitlist controlled pilot trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307795/ ) Cotton and colleagues recruited youths aged 9-18 years diagnosed with anxiety disorder and who had at least one parent diagnosed with bipolar disorder. They were assigned in an age balanced way to either a wait-list control condition or to receive 12 weekly, 75-minute Mindfulness-Based Cognitive Therapy for Children (MBCT-C) group sessions. They were measured before and after training and weekly for anxiety, clinician-rated anxiety and anxiety-related functional impairment, emotion regulation, mindfulness, and clinician-rated illness severity.
They found that in comparison to baseline and the wait-list control group after Mindfulness-Based Cognitive Therapy for Children (MBCT-C) there was a significant reduction in clinician-rated illness severity. They also found that during the 12 weeks of treatment, the MBCT-C group had significant reductions in anxiety. In addition, the greater the increase in mindfulness the greater the reduction in anxiety and the greater the increase in emotion regulation.
These are interesting results that suggest that Mindfulness-Based Cognitive Therapy (MBCT) may be effective in reducing anxiety and illness severity in children and adolescents with anxiety disorders at-risk for bipolar disorder. In some ways these results are not surprising in that MBCT has been shown to reduce anxiety in adults and mindfulness has been found to be associated with reduced anxiety and improved emotion regulation. But MBCT might be considered as too sophisticated for children and adolescents. So, it is significant that it can be successfully applied to children and adolescents. It can relieve their anxiety and decrease the intensity of their disorder.
So, improve anxiety disorders in children and adolescents with mindfulness.
“Being mindful means paying attention to the present moment, exactly as it is. It is really hard to be anxious if you are completely focused on the present moment – what you are sensing and doing RIGHT NOW … and NOW … and NOW.” – Anxiety Canada
CMCS – Center for Mindfulness and Contemplative Studies
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Cotton, S., Kraemer, K. M., Sears, R. W., Strawn, J. R., Wasson, R. S., McCune, N., Welge, J., Blom, T. J., Durling, M., & Delbello, M. P. (2020). Mindfulness-based cognitive therapy for children and adolescents with anxiety disorders at-risk for bipolar disorder: A psychoeducation waitlist controlled pilot trial. Early intervention in psychiatry, 14(2), 211–219. https://doi.org/10.1111/eip.12848
Previous studies suggest that Mindfulness-Based Cognitive Therapy for Children (MBCT-C) is feasible and may improve anxiety and emotion regulation in youth with anxiety disorders at-risk for bipolar disorder. However, controlled studies are warranted to replicate and extend these findings.
In the current study, 24 youth with anxiety disorders who have at least one parent with bipolar disorder participated in a MBCT-C treatment period (n = 24; Mage = 13.6, 75% girls, 79% White) with a subset also participating in a prior psychoeducation waitlist control period (n = 19 Mage = 13.8, 68% girls, 84% White). Participants in both the waitlist and MBCT-C periods completed independently-rated symptom scales at each time point. Participants in the waitlist period received educational materials 12 weeks prior to the beginning of MBCT-C.
There were significantly greater improvements in overall clinical severity in the MBCT-C period compared to the waitlist period, but not in clinician- and child-rated anxiety, emotion regulation or mindfulness. However, increases in mindfulness were associated with improvements in anxiety and emotion regulation in the MBCT-C period, but not the waitlist period.
Findings suggest that MBCT-C may be effective for improving overall clinical severity in youth with anxiety disorders who are at-risk for bipolar disorder. However, waitlist controlled designs may inflate effect sizes so interpret with caution. Larger studies utilizing prospective randomized controlled designs are warranted.