The effect of a mindfulness-based intervention on executive, behavioural and socio-emotional competencies in very preterm young adolescents

Vanessa Siffredi, Maria Chiara Liverani, Petra Susan Hüppi, Lorena G A Freitas, Jiske De Albuquerque, Fanny Gimbert, Arnaud Merglen, Djalel Eddine Meskaldji, Cristina Borradori Tolsa, Russia Hà-Vinh Leuchter, Vanessa Siffredi, Maria Chiara Liverani, Petra Susan Hüppi, Lorena G A Freitas, Jiske De Albuquerque, Fanny Gimbert, Arnaud Merglen, Djalel Eddine Meskaldji, Cristina Borradori Tolsa, Russia Hà-Vinh Leuchter

Abstract

Very preterm (VPT) children and adolescents show executive, behavioural and socio-emotional difficulties that persists into adulthood. This study aims to assess the effectiveness of a mindfulness-based intervention (MBI) in improving these competencies in VPT young adolescents using a randomised controlled trial design. 56 young adolescents aged 10-14 years, born before 32 gestational weeks, were randomly assigned to an "intervention" or a "waiting" group and completed an 8-week MBI in a cross-over design. Executive, behavioural and socio-emotional competencies were assessed at three different time points via parent and self-reported questionnaires, neuropsychological testing and computerised tasks. The data were analysed using an intention-to-treat approach with linear regression modelling. Our findings show a beneficial effect of MBI on executive, behavioural and socio-emotional competencies in VPT young adolescents measured by parent questionnaires. Increased executive competencies were also observed on computerised task with enhanced speed of processing after MBI. Two subgroups of participants were created based on measures of prematurity, which revealed increased long-term benefits in the moderate-risk that were not observed in the high-risk subgroups of VPT young adolescents. MBI seems a valuable tool for reducing detrimental consequences of prematurity in young adolescents, especially regarding executive, behavioural and socio-emotional difficulties.Clinical Trial Registration ClinicalTrials, NCT04638101. Registered 20 November 2020-Retrospectively registered, https://ichgcp.net/clinical-trials-registry/NCT04638101 .

Conflict of interest statement

The authors declare no competing interests.

© 2021. The Author(s).

Figures

Figure 1
Figure 1
Plots showing the distribution of the delta scores (Δ) of the “Treatment as usual”, “MBI” and “Long-term” groups of the significant planned contrasts only. Lines in the violin plots represent the means for each group.
Figure 2
Figure 2
Distribution of the delta scores (Δ) of the “Treatment as usual”, “MBI” and “Long-term” groups for the significant planned contrasts for the two subgroups of VPT: moderate-risk and high-risk. Lines in the violin plots represent the means for each group.
Figure 3
Figure 3
CONSORT flow diagram of the present cross-over RCT design.
Figure 4
Figure 4
Illustration of the RCT study design. Participants enrolled in the RCT design were randomised in two groups: the intervention group (IG) in blue and the waiting group (WG) in orange.

References

    1. Nosarti C, et al. Impaired executive functioning in young adults born very preterm. J. Int. Neuropsychol. Soc. JINS. 2007;13:571–581. doi: 10.1017/s1355617707070725.
    1. Rushe TM, et al. Neuropsychological outcome at adolescence of very preterm birth and its relation to brain structure. Dev. Med. Child Neurol. 2001;43:226–233. doi: 10.1017/s0012162201000433.
    1. Foulder-Hughes LA, Cooke RW. Motor, cognitive, and behavioural disorders in children born very preterm. Dev. Med. Child Neurol. 2003;45:97–103. doi: 10.1111/j.1469-8749.2003.tb00912.x.
    1. Bayless S, Stevenson J. Executive functions in school-age children born very prematurely. Early Hum. Dev. 2007;83:247–254. doi: 10.1016/j.earlhumdev.2006.05.021.
    1. Anderson PJ, Howard K, Doyle LW. In: Neurodevelopmental Outcomes of Preterm Birth: From Childhood to Adult Life, Ch. 5. Nosarti C, Murray RM, Hack M, editors. University Press; 2010. pp. 195–208.
    1. Aarnoudse-Moens CS, Weisglas-Kuperus N, van Goudoever JB, Oosterlaan J. Meta-analysis of neurobehavioral outcomes in very preterm and/or very low birth weight children. Pediatrics. 2009;124:717–728. doi: 10.1542/peds.2008-2816.
    1. Mulder H, Pitchford NJ, Hagger MS, Marlow N. Development of executive function and attention in preterm children: A systematic review. Dev. Neuropsychol. 2009;34:393–421. doi: 10.1080/87565640902964524.
    1. Reveillon M, Huppi PS, Barisnikov K. Inhibition difficulties in preterm children: Developmental delay or persistent deficit? Child Neuropsychol. 2018;24:734–762. doi: 10.1080/09297049.2017.1294665.
    1. Lynn LN, Cuskelly M, O’Callaghan MJ, Gray PH. Self-regulation: A new perspective on learning problems experienced by children born extremely preterm. Aust. J. Educ. Dev. Psychol. 2011;11:1–10.
    1. Brydges CR, et al. Cognitive outcomes in children and adolescents born very preterm: A meta-analysis. Dev. Med. Child Neurol. 2018;60:452–468. doi: 10.1111/dmcn.13685.
    1. Burnett AC, et al. Trends in executive functioning in extremely preterm children across 3 birth eras. Pediatrics. 2018 doi: 10.1542/peds.2017-1958.
    1. Jones KM, Champion PR, Woodward LJ. Social competence of preschool children born very preterm. Early Hum. Dev. 2013;89:795–802. doi: 10.1016/j.earlhumdev.2013.06.008.
    1. Clark CA, Woodward LJ, Horwood LJ, Moor S. Development of emotional and behavioral regulation in children born extremely preterm and very preterm: Biological and social influences. Child Dev. 2008;79:1444–1462. doi: 10.1111/j.1467-8624.2008.01198.x.
    1. Anderson P. Assessment and development of executive function (EF) during childhood. Child Neuropsychol. 2002;8:71–82. doi: 10.1076/chin.8.2.71.8724.
    1. Mikolajczak M, Quoidbach J, Kotsou I, Nelis D. Les Compétences Émotionnelles. Dunod; 2009.
    1. Best JR, Miller PH, Naglieri JA. Relations between executive function and academic achievement from ages 5 to 17 in a large, representative national sample. Learn. Individ. Differ. 2011;21:327–336. doi: 10.1016/j.lindif.2011.01.007.
    1. Vaughan L, Giovanello K. Executive function in daily life: Age-related influences of executive processes on instrumental activities of daily living. Psychol. Aging. 2010;25:343–355. doi: 10.1037/a0017729.
    1. Izard CE. Forms and functions of emotions: Matters of emotion–cognition interactions. Emot. Rev. 2011;3:371–378. doi: 10.1177/1754073911410737.
    1. Carter AS, Briggs-Gowan MJ, Davis NO. Assessment of young children's social-emotional development and psychopathology: Recent advances and recommendations for practice. J. Child Psychol. Psychiatry Allied Discip. 2004;45:109–134. doi: 10.1046/j.0021-9630.2003.00316.x.
    1. Kabat-Zinn J. Mindfulness-based interventions in context: Past, present and future. Clin. Psychol. Sci. Pract. 2003;10:144–156. doi: 10.1093/clipsy.bpg016.
    1. Flook L, et al. Effects of mindful awareness practices on executive functions in elementary school children. J. Appl. Sch. Psychol. 2010;26:70–95. doi: 10.1080/15377900903379125.
    1. Geronimi EMC, Arellano B, Woodruff-Borden J. Relating mindfulness and executive function in children. Clin. Child Psychol. Psychiatry. 2019 doi: 10.1177/1359104519833737.
    1. van der Oord S, Bogels SM, Peijnenburg D. The effectiveness of mindfulness training for children with ADHD and mindful parenting for their parents. J. Child Fam. Stud. 2012;21:139–147. doi: 10.1007/s10826-011-9457-0.
    1. Semple RJ, Lee J, Rosa D, Miller L. A randomized trial of mindfulness-based cognitive therapy for children: Promoting mindful attention to enhance social-emotional resiliency in children. J. Child Fam. Stud. 2009;19:218–229. doi: 10.1007/s10826-009-9301-y.
    1. Napoli M, Krech PR, Holley LC. Mindfulness training for elementary school students: The attention academy. J. Appl. Sch. Psychol. 2004;21:99–123. doi: 10.1300/J370v21n01_05.
    1. Felver JC, Tipsord JM, Morris MJ, Racer KH, Dishion TJ. The effects of mindfulness-based intervention on children’s attention regulation. J. Atten. Disord. 2017;21:872–881. doi: 10.1177/1087054714548032.
    1. Zylowska L, et al. Mindfulness meditation training in adults and adolescents with ADHD: A feasibility study. J. Atten. Disord. 2008;11:737–746. doi: 10.1177/1087054707308502.
    1. Haffner J, Roos J, Goldstein N, Parzer P, Resch F. The effectiveness of body-oriented methods of therapy in the treatment of attention-deficit hyperactivity disorder (ADHD): Results of a controlled pilot study. Z. Kinder Jugendpsychiatrie Psychother. 2006;34:37–47. doi: 10.1024/1422-4917.34.1.37.
    1. Flook L, Goldberg SB, Pinger L, Davidson RJ. Promoting prosocial behavior and self-regulatory skills in preschool children through a mindfulness-based kindness curriculum. Dev. Psychol. 2015;51:44–51. doi: 10.1037/a0038256.
    1. Mak C, Whittingham K, Cunnington R, Boyd RN. Efficacy of mindfulness-based interventions for attention and executive function in children and adolescents—A systematic review. Mindfulness. 2018 doi: 10.1007/s12671-017-0770-6.
    1. Schonert-Reichl KA, et al. Enhancing cognitive and social-emotional development through a simple-to-administer mindfulness-based school program for elementary school children: A randomized controlled trial. Dev. Psychol. 2015;51:52–66. doi: 10.1037/a0038454.
    1. Schonert-Reichl K, Lawlor MS. The effects of a mindfulness-based education program on pre- and early adolescents’ well-being and social and emotional competence. Mindfulness. 2010;1:137–151. doi: 10.1007/s12671-010-0011-8.
    1. Barnes VA, Bauza LB, Treiber FA. Impact of stress reduction on negative school behavior in adolescents. Health Qual. Life Outcomes. 2003;1:10. doi: 10.1186/1477-7525-1-10.
    1. Lee J, Semple RJ, Rosa D, Miller L. Mindfulness-based cognitive therapy for children: Results of a pilot study. J. Cognit. Psychother. 2008;22:15–28. doi: 10.1891/0889.8391.22.1.15.
    1. Beauchemin J, Hutchins TL, Patterson F. Mindfulness meditation may lessen anxiety, promote social skills, and improve academic performance among adolescents with learning disabilities. Complement. Health Pract. Rev. 2008;13:34–45. doi: 10.1177/1533210107311624.
    1. Biegel GM, Brown KW, Shapiro SL, Schubert CM. Mindfulness-based stress reduction for the treatment of adolescent psychiatric outpatients: A randomized clinical trial. J. Consult. Clin. Psychol. 2009;77:855–866. doi: 10.1037/a0016241.
    1. Broderick PC, Metz S. Learning to BREATHE: A pilot trial of a mindfulness curriculum for adolescents. Adv. Sch. Ment. Health Promot. 2009;2:35–46. doi: 10.1080/1754730X.2009.9715696.
    1. Black DS, Milam J, Sussman S. Sitting-meditation interventions among youth: A review of treatment efficacy. Pediatrics. 2009;124:e532–541. doi: 10.1542/peds.2008-3434.
    1. Singh NN, et al. Mindfulness training for parents and their children with ADHD increases the children’s compliance. J. Child Fam. Stud. 2010;19:157–166. doi: 10.1007/s10826-009-9272-z.
    1. Zhang D, et al. Mindfulness-based intervention for Chinese children with ADHD and their parents: A pilot mixed-method study. Mindfulness. 2017;8:859–872. doi: 10.1007/s12671-016-0660-3.
    1. van de Weijer-Bergsma E, Formsma AR, de Bruin EI, Bogels SM. The effectiveness of mindfulness training on behavioral problems and attentional functioning in adolescents with ADHD. J. Child Fam. Stud. 2012;21:775–787. doi: 10.1007/s10826-011-9531-7.
    1. Haydicky J, Shecter C, Wiener J, Ducharme JM. Evaluation of MBCT for adolescents with ADHD and their parents: Impact on individual and family functioning. J. Child Fam. Stud. 2015;24:76–94. doi: 10.1007/s10826-013-9815-1.
    1. Zhang J, Díaz-Román A, Cortese S. Meditation-based therapies for attention-deficit/hyperactivity disorder in children, adolescents and adults: A systematic review and meta-analysis. Evid. Based Ment. Health. 2018;21:87–94. doi: 10.1136/ebmental-2018-300015.
    1. Kiani B, Hadianfard H, Mitchell JT. The impact of mindfulness meditation training on executive functions and emotion dysregulation in an Iranian sample of female adolescents with elevated attention-deficit/hyperactivity disorder symptoms. Aust. J. Psychol. 2017;69:273–282. doi: 10.1111/ajpy.12148.
    1. Jensen PS, Kenny DT. The effects of yoga on the attention and behavior of boys with attention-deficit/hyperactivity disorder (ADHD) J. Atten. Disord. 2004;7:205–216. doi: 10.1177/108705470400700403.
    1. Semple RJ, Reid EF, Miller L. Treating anxiety with mindfulness: An open trial of mindfulness training for anxious children. J. Cognit. Psychother. 2005;19:379–392. doi: 10.1891/jcop.2005.19.4.379.
    1. Bogels S, Hoogstad B, van Dun L, de Schutter S, Restifo K. Mindfulness training for adolescents with externalizing disorders and their parents. Behav. Cognit. Psychother. 2008;36:193. doi: 10.1017/S1352465808004190.
    1. Bootzin RR, Stevens SJ. Adolescents, substance abuse, and the treatment of insomnia and daytime sleepiness. Clin. Psychol. Rev. 2005;25:629–644. doi: 10.1016/j.cpr.2005.04.007.
    1. Tang Y-Y, Hölzel BK, Posner MI. The neuroscience of mindfulness meditation. Nat. Rev. Neurosci. 2015;16:213–225. doi: 10.1038/nrn3916.
    1. Kuyken W, et al. Effectiveness of the Mindfulness in schools programme: Non-randomised controlled feasibility study. Br. J. Psychiatry J. Ment. Sci. 2013;203:126–131. doi: 10.1192/bjp.bp.113.126649.
    1. Gioia G, Isquith P, Guy S, Kenworthy L. BRIEF—Behavior Rating Inventory of Executive Function. Professional Manual. Psychological Assessment Resources Inc; 2000.
    1. Goodman R. The strengths and difficulties questionnaire: A research note. J. Child Psychol. Psychiatry Allied Discip. 1997;38:581–586. doi: 10.1111/j.1469-7610.1997.tb01545.x.
    1. Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J. Am. Acad. Child Adolesc. Psychiatry. 2001;40:1337–1345. doi: 10.1097/00004583-200111000-00015.
    1. Huguet A, Ruiz DM, Haro JM, Alda JA. A pilot study of the efficacy of a mindfulness program for children newly diagnosed with attention-deficit hyperactivity disorder: Impact on core symptoms and executive functions. Int. J. Psychol. Psychol. Ther. 2017;17:305–316.
    1. Johansson B, Bjuhr H, Ronnback L. Mindfulness-based stress reduction (MBSR) improves long-term mental fatigue after stroke or traumatic brain injury. Brain Inj. 2012;26:1621–1628. doi: 10.3109/02699052.2012.700082.
    1. Moore A, Malinowski P. Meditation, mindfulness and cognitive flexibility. Conscious Cognit. 2009;18:176–186. doi: 10.1016/j.concog.2008.12.008.
    1. Geronimi EM, Arellano B, Woodruff-Borden J. Relating mindfulness and executive function in children. Clin. Child Psychol. Psychiatry. 2020;25:435–445. doi: 10.1177/1359104519833737.
    1. Janz P, Dawe S, Wyllie M. Mindfulness-based program embedded within the existing curriculum improves executive functioning and behavior in young children: A waitlist controlled trial. Front. Psychol. 2019;10:2052. doi: 10.3389/fpsyg.2019.02052.
    1. Riggs NR, Black DS, Ritt-Olson A. Associations between dispositional mindfulness and executive function in early adolescence. J. Child Fam. Stud. 2015;24:2745–2751. doi: 10.1007/s10826-014-0077-3.
    1. Coholic DA, Eys M. Benefits of an arts-based mindfulness group intervention for vulnerable children. Child Adolesc. Soc. Work J. 2016;33:1–13. doi: 10.1007/s10560-015-0431-3.
    1. Schonert-Reichl K, Lawlor MS. The effects of a mindfulness-based education program on pre-and early adolescents’ well-being and social and emotional competence. Mindfulness. 2010;1:137–151. doi: 10.1007/s12671-010-0011-8.
    1. Razavi N, Ahadi H, Forooshani GS. Comparison between cognitive behavioral therapy and mindfulness in reducing weight and improvement of health in obese and over weighted children. Int. J. Humanit. Cult. Stud. 2016;1:1972–1986.
    1. Moreira H, Canavarro MC. Is body shame a significant mediator of the relationship between mindfulness skills and the quality of life of treatment-seeking children and adolescents with overweight and obesity? Body Image. 2017;20:49–57. doi: 10.1016/j.bodyim.2016.11.004.
    1. Vilaverde RF, Correia AI, Lima CF. Higher trait mindfulness is associated with empathy but not with emotion recognition abilities. R. Soc. Open Sci. 2020;7:192077. doi: 10.1098/rsos.192077.
    1. Diamond A, Lee K. Interventions shown to aid executive function development in children 4 to 12 years old. Science. 2011;333:959–964. doi: 10.1126/science.1204529.
    1. Mercer J. Martial arts research: Weak evidence. Science. 2011;334:310–311. doi: 10.1126/science.334.6054.310-c.
    1. MacCoon DG, et al. The validation of an active control intervention for mindfulness based stress reduction (MBSR) Behav. Res. Ther. 2012;50:3–12. doi: 10.1016/j.brat.2011.10.011.
    1. Gough B, Madill A. Subjectivity in psychological science: From problem to prospect. Psychol. Methods. 2012;17:374–384. doi: 10.1037/a0029313.
    1. de Nijs PF, et al. Attention-deficit/hyperactivity disorder (ADHD): Parents' judgment about school, teachers' judgment about home. Eur. Child Adolesc. Psychiatry. 2004;13:315–320. doi: 10.1007/s00787-004-0405-z.
    1. Weber B, et al. Mindfulness-based cognitive therapy for bipolar disorder: A feasibility trial. Eur. Psychiatry. 2010;25:334–337. doi: 10.1016/j.eurpsy.2010.03.007.
    1. Van Dam NT, Earleywine M, Borders A. Measuring mindfulness? An item response theory analysis of the mindful attention awareness scale. Personal. Individ. Differ. 2010;49:805–810. doi: 10.1016/j.paid.2010.07.020.
    1. Jaeggi SM, Buschkuehl M, Shah P, Jonides J. The role of individual differences in cognitive training and transfer. Mem. Cognit. 2014;42:464–480. doi: 10.3758/s13421-013-0364-z.
    1. Shah P, Buschkuehl M, Jaeggi S, Jonides J. Cognitive training for ADHD: The importance of individual differences. J. Appl. Res. Mem. Cognit. 2012;1:204–205. doi: 10.1016/j.jarmac.2012.07.001.
    1. Siffredi V, et al. Improving executive, behavioural and socio-emotional competences in very preterm young adolescents through a mindfulness-based intervention: Study protocol and feasibility. Early Human Development. 2021;161:105435. doi: 10.1016/j.earlhumdev.2021.105435.
    1. Lawlor MS, Schonert-Reichl KA, Gadermann AM, Zumbo BD. A validation study of the mindful attention awareness scale adapted for children. Mindfulness. 2013;5:730–741. doi: 10.1007/s12671-013-0228-4.
    1. Wechsler D. Manual for the Wechsler Intelligence Scale for Children-IV. Psychological Corporation; 2003.
    1. Largo RH, et al. Significance of prenatal, perinatal and postnatal factors in the development of AGA preterm infants at five to seven years. Dev. Med. Child Neurol. 1989;31:440–456. doi: 10.1111/j.1469-8749.1989.tb04022.x.
    1. Christ SE, Kester LE, Bodner KE, Miles JH. Evidence for selective inhibitory impairment in individuals with autism spectrum disorder. Neuropsychology. 2011;25:690–701. doi: 10.1037/a0024256.
    1. Liverani MC, et al. Children's sense of reality: The development of orbitofrontal reality filtering. Child Neuropsychol. J. Norm. Abnorm. Dev. Childh. Adolesc. 2017;23:408–421. doi: 10.1080/09297049.2015.1120861.
    1. Liverani MC, et al. Get real: Orbitofrontal cortex mediates the ability to sense reality in early adolescents. Brain Behav. 2020 doi: 10.1002/brb3.1552.
    1. Visu-Petra L, Cheie L, Benga O, Miclea M. Cognitive control goes to school: The impact of executive functions on academic performance. Soc. Behav. Sci. 2011;11:240–244. doi: 10.1016/j.sbspro.2011.01.069.
    1. Holmes J, Adams JW. Working memory and children’s mathematical skills: Implications for mathematical development and mathematics curricula. Educ. Psychol. 2006 doi: 10.1080/01443410500341056.
    1. De Vos T. Tempo Test Rekenen [Tempo Test Arithmetic]. Handleiding Tempo-Test-Rekenen. 2. Swets Test Publishers; 1994.
    1. Robitail S, et al. Testing the structural and cross-cultural validity of the KIDSCREEN-27 quality of life questionnaire. Qual. Life Res. 2007;16:1335–1345. doi: 10.1007/s11136-007-9241-1.
    1. Wentzel KR. Relations of social goal pursuit to social acceptance, classroom behavior, and perceived social support. J. Educ. Psychol. 1994;86:173–182. doi: 10.1037/0022-0663.86.2.173.
    1. Raes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the self-compassion scale. Clin. Psychol. Psychother. 2011;18:250–255. doi: 10.1002/cpp.702.
    1. Korkman M, Kirk U, Kemp S. A Developmental Neuropsychological Assessment: NEPSY-II. 2. Pearson; 2007.
    1. Benjamini Y, Hochberg Y. Controlling the false discovery rate: A practical and powerful approach to multiple testing. J. R. Stat. Soc. 1995;57:289–300.
    1. Team, R. (ed Inc. RStudio) (Boston, MA, 2020).
    1. Team, R. C. (ed R Foundation for Statistical Computing) (Vienna, Austria, 2019).
    1. Wang R, Lagakos SW, Ware JH, Hunter DJ, Drazen JM. Statistics in medicine—Reporting of subgroup analyses in clinical trials. N. Engl. J. Med. 2007;357:2189–2194. doi: 10.1056/NEJMsr077003.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir