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Mind-Body Skills Groups for Adolescents With Depression in Primary Care: A Pilot Study

      Highlights

      • Adolescent depression is growing concern that can lead to negative health outcomes.
      • Primary care settings are an ideal setting for receiving depression treatment.
      • Mind-Body Skills Groups are a feasible treatment in primary care settings.
      • Preliminary effectiveness for Mind-Body Skills Groups are evident in this study.

      Abstract

      Introduction

      The objective of this study was to determine the acceptability and preliminary effectiveness of Mind-Body Skills Groups (MBSGs) as a treatment for depressed adolescents in primary care.

      Method

      A single-arm clinical trial was conducted. A 10-week MBSG program was implemented in primary care. Participants completed self-report measures at baseline, postintervention, and 3 months following the MBSGs. Measures included the Children's Depression Inventory-2, Suicidal Ideation Questionnaire, Mindful Attention Awareness Scale, Self-Efficacy for Depressed Adolescents, rumination subscale of the Children's Response Style Questionnaire, and a short acceptability questionnaire.

      Results

      Participants included 43 adolescents. The total depression scores significantly improved following the MBSG intervention and continued to improve significantly from posttreatment to follow-up. Mindfulness, self-efficacy, rumination, and suicidal ideation all had significant improvement following the intervention. Acceptability of the program was strong, and attendance was excellent.

      Discussion

      Preliminary evidence suggests that MBSGs are an acceptable treatment for primary care settings and lead to improved depression symptoms in adolescents.

      KEY WORDS

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      References

        • Abela J.R.Z.
        • Aydin C.M.
        • Auerbach R.P.
        Responses to depression in children: Reconceptualizing the relation among response styles.
        Journal of Abnormal Child Psychology. 2007; 35: 913-927
        • Anderson L.E.
        • Chen M.L.
        • Perrin J.M.
        • Van Cleave J.
        Outpatient visits and medication prescribing for US children with mental health conditions.
        Pediatrics. 2015; 136: e1178-e1185
        • Asarnow J.R.
        • Rozenman M.
        • Wiblin J.
        • Zeltzer L.
        Integrated medical-behavioral care compared with usual primary care for child and adolescent behavioral health: A meta-analysis.
        Journal of the American Medical Association Pediatrics. 2015; 169: 929-937
        • Avenevoli S.
        • Swendsen J.
        • He J.P.
        • Burstein M.
        • Merikangas K.R.
        Major depression in the national comorbidity survey–adolescent supplement: Prevalence, correlates, and treatment.
        Journal of the American Academy of Child and Adolescent Psychiatry. 2015; 54 (.e2): 37-44
        • Biegel G.M.
        • Brown K.W.
        • Shapiro S.L.
        • Schubert C.M.
        Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: A randomized clinical trial.
        Journal of Consulting and Clinical Psychology. 2009; 77: 855-866
        • Brown K.W.
        • West A.M.
        • Loverich T.M.
        • Biegel G.M.
        Assessing adolescent mindfulness: Validation of an adapted mindful attention awareness scale in adolescent normative and psychiatric populations.
        Psychological Assessment. 2011; 23: 1023-1033
        • Carrellas N.W.
        • Biederman J.
        • Uchida M.
        How prevalent and morbid are subthreshold manifestations of major depression in adolescents? A literature review.
        Journal of Affective Disorders. 2017; 210: 166-173
        • Center for Behavioral Health Statistics and Quality
        Key substance use and mental health indicators in the United States: Results from the 2015 national survey on drug use and health.
        2016 (Retrieved from)
        • Centers for Disease Control and Prevention
        YRBSS results.
        2017 (Retrieved from)
        • Cha C.B.
        • Franz P.J.
        • M Guzmán E.
        • Glenn C.R.
        • Kleiman E.M.
        • Nock M.K.
        Annual research review: Suicide among youth – epidemiology, (potential) etiology, and treatment.
        Journal of Child Psychology and Psychiatry, and Allied Disciplines. 2018; 59: 460-482
        • Cheung A.H.
        • Zuckerbrot R.A.
        • Jensen P.S.
        • Ghalib K.
        • Laraque D.
        • Stein R.E.K.
        • GLAD-PC Steering Group
        Guidelines for adolescent depression in primary care (GLAD-PC): II. Treatment and ongoing management.
        Pediatrics. 2007; 120: e1313-e1326
        • Cheung A.H.
        • Zuckerbrot R.A.
        • Jensen P.S.
        • Laraque D.
        • Stein R.E.K.
        • GLAD-PC STEERING GROUP.
        Guidelines for adolescent depression in primary care (GLAD-PC): Part II. Treatment and ongoing management.
        Pediatrics. 2018; 141e20174082
        • Collins C.
        • Hewson D.L.
        • Munger R.
        • Wade T.
        Evolving models of behavioral health integration in primary care.
        The Milbank Memorial Fund, New York, NY2010
        • Crowley R.A.
        • Kirschner N.
        • Health and Public Policy Committee of the American College of Physicians
        The integration of care for mental health, substance abuse, and other behavioral health conditions into primary care: Executive summary of an American College of Physicians position paper.
        Annals of Internal Medicine. 2015; 163: 298-299
        • Duncan L.
        • Georgiades K.
        • Wang L.
        • Van Lieshout R.J.
        • MacMillan H.L.
        • Ferro M.A.
        • Boyle M.H.
        Psychometric evaluation of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID).
        Psychological Assessment. 2018; 30: 916-928
        • Fletcher J.M.
        Adolescent depression and educational attainment: Results using sibling fixed effects.
        Health Economics. 2010; 19: 855-871
        • Fontanella C.A.
        • Bridge J.A.
        • Marcus S.C.
        • Campo J.V.
        Factors associated with antidepressant adherence for Medicaid-enrolled children and adolescents.
        Annals of Pharmacotherapy. 2011; 45: 898-909
        • Gariépy G.
        • Honkaniemi H.
        • Quesnel-Vallée A.
        Social support and protection from depression: Systematic review of current findings in Western countries.
        British Journal of Psychiatry. 2016; 209: 284-293
        • Gordon J.S.
        • Fisher T.
        • Lord S.
        • Buckley R.
        • Kimmel J.
        • Shinal A.
        The advanced training manual.
        The Center for Mind-Body Medicine, Washington, DC2000
        • Gordon J.S.
        • Staples J.K.
        • Blyta A.
        • Bytyqi M.
        • Wilson A.T.
        Treatment of posttraumatic stress disorder in postwar Kosovar adolescents using mind-body skills groups: A randomized controlled trial.
        Journal of Clinical Psychiatry. 2008; 69: 1469-1476
        • Gordon M.S.
        • Tonge B.
        • Melvin G.A.
        Outcome of adolescent depression: 6 months after treatment.
        Australian and New Zealand Journal of Psychiatry. 2011; 45: 232-239
        • Gordon M.S.
        • Tonge B.
        • Melvin G.A.
        The Self-Efficacy Questionnaire for Depressed Adolescents: A measure to predict the course of depression in depressed youth.
        Australian and New Zealand Journal of Psychiatry. 2012; 46: 47-54
        • Kearns N.P.
        • Shawyer F.
        • Brooker J.E.
        • Graham A.L.
        • Enticott J.C.
        • Martin P.R.
        • Meadows G.N.
        Does rumination mediate the relationship between mindfulness and depressive relapse.
        Psychology and Psychotherapy. 2016; 89: 33-49
        • Kodish I.
        • Richardson L.
        • Schlesinger A.
        Collaborative and integrated care for adolescent depression.
        Child and Adolescent Psychiatric Clinics of North America. 2019; 28: 315-325
        • Kovács M.
        Children's Depression Inventory: Technical manual update.
        Multi-Health Systems, Toronto, ON, Canada2003
        • Merikangas K.R.
        • He J.P.
        • Burstein M.
        • Swanson S.A.
        • Avenevoli S.
        • Cui L.
        • Swendsen J.
        Lifetime prevalence of mental disorders in U.S. adolescents: Results from the national comorbidity survey replication—adolescent supplement (NCS-A).
        Journal of the American Academy of Child and Adolescent Psychiatry. 2010; 49: 980-989
        • Merikangas K.R.
        • He J.P.
        • Burstein M.
        • Swendsen J.
        • Avenevoli S.
        • Case B.
        • Olfson M.
        Service utilization for lifetime mental disorders in U.S. adolescents: Results of the national comorbidity survey-adolescent supplement (NCS-A).
        Journal of the American Academy of Child and Adolescent Psychiatry. 2011; 50: 32-45
        • Michalak J.
        • Hölz A.
        • Teismann T.
        Rumination as a predictor of relapse in mindfulness-based cognitive therapy for depression.
        Psychology and Psychotherapy. 2011; 84: 230-236
        • Mojtabai R.
        • Olfson M.
        • Han B.
        National trends in the prevalence and treatment of depression in adolescents and young adults.
        Pediatrics. 2016; 138e20161878
        • Naicker K.
        • Galambos N.L.
        • Zeng Y.
        • Senthilselvan A.
        • Colman I.
        Social, demographic, and health outcomes in the 10 years following adolescent depression.
        Journal of Adolescent Health. 2013; 52: 533-538
        • National Center for Complementary and Integrative Health
        Complementary, alternative, or integrative health: what's in a name?.
        2018 (Retrieved from)
        • O'Connor B.C.
        • Lewandowski R.E.
        • Rodriguez S.
        • Tinoco A.
        • Gardner W.
        • Hoagwood K.
        • Scholle S.H.
        Usual care for adolescent depression from symptom identification through treatment initiation.
        Journal of the American Medical Association Pediatrics. 2016; 170: 373-380
        • Olfson M.
        • Blanco C.
        • Wang S.
        • Laje G.
        • Correll C.U.
        National trends in the mental health care of children, adolescents, and adults by office-based physicians.
        Journal of the American Medical Association Psychiatry. 2014; 71: 81-90
        • Reynolds W.M.
        • Mazza J.J.
        Suicidal Ideation Questionnaire: professional manual.
        Psychological Assessment Resources, Odessa, FL1988
        • Richardson L.P.
        • Ludman E.
        • McCauley E.
        • Lindenbaum J.
        • Larison C.
        • Zhou C.
        • Katon W.
        Collaborative care for adolescents with depression in primary care: A randomized clinical trial.
        Journal of the American Medical Association. 2014; 312: 809-816
        • Rohde P.
        • Lewinsohn P.M.
        • Klein D.N.
        • Seeley J.R.
        • Gau J.M.
        Key characteristics of major depressive disorder occurring in childhood, adolescence, emerging adulthood, adulthood.
        Clinical Psychological Science. 2013; 1: 41-53
        • Shomaker L.B.
        • Pivarunas B.
        • Annameier S.K.
        • Gulley L.
        • Quaglia J.
        • Brown K.W.
        • Bell C.
        One-year follow-up of a randomized controlled trial piloting a mindfulness-based group intervention for adolescent insulin resistance.
        Frontiers in Psychology. 2019; 10: 1040
        • Staples J.K.
        • Abdel Atti J.A.
        • Gordon J.S.
        Mind-body skills groups for posttraumatic stress disorder and depression symptoms in Palestinian children and adolescents in Gaza.
        International Journal of Stress Management. 2011; 18: 246-262
        • Substance Abuse and Mental Health Services Administration
        Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health.
        2018 (Retrieved from)
        • Thapar A.
        • Collishaw S.
        • Pine D.S.
        • Thapar A.K.
        Depression in adolescence.
        Lancet. 2012; 379: 1056-1067
        • Twenge J.M.
        • Joiner T.E.
        • Rogers M.L.
        • Martin G.N.
        Increases in depressive symptoms, suicide-related outcomes, and suicide rates among U.S. Adolescents after 2010 and links to increased new media screen time.
        Clinical Psychological Science. 2018; 6: 3-17

      Biography

      Matthew C. Aalsma, Professor, Department of Pediatrics, Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN.

      Biography

      Lindsey D. Jones, Clinical Research Assistant, Department of Psychology, Indiana University–Purdue University Indianapolis, Indianapolis, IN.

      Biography

      Julie K. Staples, Research Director, The Center for Mind-Body Medicine, Washington, DC.

      Biography

      Jennifer M. Garabrant, Program Manager, Department of Psychology, Indiana University–Purdue University Indianapolis, Indianapolis, IN.

      Biography

      James S. Gordon, Founder and Executive Director, The Center for Mind-Body Medicine, Washington, DC.

      Biography

      Lynda Richtsmeier Cyr, Associate Clinical Director,The Center for Mind-Body Medicine, Washington, DC.

      Biography

      Eduardo Salgado, Doctoral Student, Department of Psychology, Indiana University–Purdue University Indianapolis, Indianapolis, IN.

      Biography

      Michelle P. Salyers, Professor, Department of Psychology, Indiana University–Purdue University Indianapolis, Indianapolis, IN.