Effects of A Parenting-Focused Mindfulness Intervention on Adolescent Substance Use and Psychopathology: A Randomized Controlled Trial

Abstract

Substance use and psychopathology symptoms increase in adolescence. One key risk factor for these is high parent stress. Mindfulness interventions reduce stress in adults and may be useful to reduce parent stress and prevent substance use (SU) and psychopathology in adolescents. This study tested the feasibility and effects of a mindfulness intervention for parents on adolescent SU and psychopathology symptoms. Ninety-six mothers of 11-17 year olds were randomly assigned to a mindfulness intervention for parents (the Parenting Mindfully [PM] intervention) or a brief parent education [PE] control group. At pre-intervention, post-intervention, 6-month follow-up, and 1-year follow-up, adolescents reported on SU and mothers and adolescents reported on adolescent externalizing and internalizing symptoms. Primary intent to treat analyses found that the PM intervention prevented increases in adolescent SU over time, relative to the PE control group. The PM intervention also prevented increases in mother-reported externalizing symptoms over time relative to the PE control group. However, PM did not have a significant effect on internalizing symptoms. PM had an indirect effect on adolescent-reported externalizing symptoms through greater mother mindfulness levels at post-intervention, suggesting mother mindfulness as a potential intervention mechanism. Notably, while mothers reported high satisfaction with PM, intervention attendance was low (31% of mothers attended zero sessions). Secondary analyses with mothers who attended > = 50% of the interventions (n = 48) found significant PM effects on externalizing symptoms, but not SU. Overall, findings support mindfulness training for parents as a promising intervention and future studies should work to promote accessibility for stressed parents.Clinical Trials Identifier: NCT02038231; Date of Registration: January 13, 2014.

Keywords: Adolescence; Externalizing behavior problems; Intervention; Mindfulness; Parenting; Substance use.

Conflict of interest statement

Conflicts of Interest

The authors have no conflicts of interest to declare.

Figures

Figure 1. CONSORT diagram of PM Study

Figure 2. Mean Adolescent Substance Use through 1-Year Follow-Up for Parenting Mindfully (PM) and Parent Education (PE) Groups, Controlling Pre-Intervention Scores

Note. Figure shows estimated marginal means from analysis of covariance (ANCOVA) tests at each time-point, using transformed scores (square root [substance use score +1]). ᵻ indicates difference between the two groups at p < . 10

Figure 3. Mean Adolescent Externalizing Symptoms through 1-Year Follow-Up for Parenting Mindfidly (PM) and Parent Education (PE) Groups, Controlling Pre-Intervention Scores

Note. Figure shows estimated marginal means from analysis of covariance (ANCOVA) tests at each time-point, using mother-reported externalizing symptoms composite scores (z scores of three externalizing symptom scales, summed). ᵻ indicates difference between the two groups at p < . 10 * indicates significant difference p < .05) between two groups