Effects Of Modified Mindfulness-Based Stress Reduction (MBSR) On The Psychological Health Of Adolescents With Subthreshold Depression: A Randomized Controlled Trial

Figures & data

Figure 1 Study flow diagram: enrollment to analysis.

Table 1 The MBSR Intervention Group Session Details

Week-Time	Themes	Contents	Homework	Main Problems	Solutions
1-1	Approaching mindfulness and MBSR	1. Introduce each other and become familiar with each other. 2. Step into and cultivate mindfulness. 3. Introduce MBSR and the formal techniques.	Practice mindfulness breathing every day.	Absent-minded	Never mind the distractions at the beginning of the practice. Let it be.
2-2	Eye mindfulness	1. Explain the core of observing mindfulness and teach the skills to be mindfulness. 2. Teach how to focus on one’s mind on the moment and without judgement	Pick one picture to observe with mindfulness and record your feelings.	Interrupted	No judgement and no anxiety. Do your best.
3-3	Ear mindfulness	1. Explain the meaning of sound mindfulness. 2. Lead the team for hearing training, feeling around sound through the waves lapping, distinguishing sound and so on to get physical and mental relaxation. 3. At the same time, learn how to experience the changes with the sounds.	Choose a gentle song to listen with mindfulness and record your feelings.	Sneak off	Trying to focus your mind on the present moment; if you cannot, let it be.
4-4	Nose mindfulness	1. Illustrate the basis of smell mindfulness and lead team members to train them how to use their nose to feel and comprehend the world. 2. Guide team members to communicate and discuss smell training.	Choose one kind of fruit and smell with mindfulness and record your feelings.	Giving up	Practice makes perfect. Believe in your heart.
5-5	Tongue mindfulness	1. Teach members how to apply mindfulness to drinking and eating. 2. Taste mineral water and an apple with 7 steps: hold, look, touch, smell, release, swallow and feel.	Mindfulness eating training with raisins. Imagine the food source and the process when eating and record your feelings.	Emotional instability	Do not rush. Stop when in a bad state. Take a break and bring breath to this moment and keep a peaceful mind.
6-6	Body mindfulness	1. Introduce body scan, which enriches the content of practice through the establishment of physical and psychological responses to stress 2. Teach appropriate yoga-based stretches, which include lying and standing postures.	1. Do body scan from head to toe. 2. According to one’s own ability do mindfulness yoga.	Disturbed by trifles	Choose a set time to practice before sleep.
7-7	Positive thinking	1. Introduce sitting meditation and under the researchers’ instruction, team members how to practice sitting meditation. 2. Put forward specific events and ask members how to think and handle the events. 3. Find out the problems and teach them how to handle things in a mindful way.	1. Do 2 hr sitting meditation 2. Try to think about one thing in your life with mindfulness and record your feelings in detail.	1. Tired 2. Cannot detect emotions during practice	Moderate principle to practice yoga as much as you can. Focus on the process, not on the outcome
8-8	Start a new mindfulness life	1. Do a summary of all the mindfulness skills and solve existing problems. 2. Meditation is a means to possess wellness were emphasize mindfulness. 3. Provide related resources to facilitate participants for further practice.	Encourage all participants to keep practising MBSR and mindfulness in their life and in the future.	How to cultivate mindfulness in daily life	Keep the cores of mindfulness in your heart; that is, focusing on the present moment without judgement.

Table 2 Comparison Of Demographic And Clinical Characteristics Of Two Groups (n=56)

	MBSR group (n=28)	Control group (n=28)	t or χ2	P
Age(mean+SD)	19.14±1.27	18.68±1.30	1.369^a	0.182
Grade			2.311^b	0.315
Freshman	16	20
Sophomore	10	5
Junior	2	3
Residence			0.350^b	0.554
Country	21	19
Rural	7	9
Gender			0.292^b	0.589
Female	17	15
Male	11	13
Only-Child or not			1.191^b	0.275
Yes	22	25
No	6	3

Notes: ^aPresent t-test; ^bPresent χ² test.

Table 3 Comparison Of Two Groups On BDI, MASS And RRS

Measure	MBSR (n=28)			Control Group (n=28)			F	P	Effect Size(η2)
	Pre Post 3 Months Mean(SD)			Pre Post 3 Months Mean(SD)
BDI	17.00 (2.26)	14.75 (2.14)	13.43 (2.38)	16.75 (2.29)	15.93 (2.42)	16.11 (2.22)
Time effect							44.396	0.00	0.774
Time and group effect							17.721	0.00	0.577
Group effect							5.764	0.024	0.176
MASS	51.00 (6.04)	54.53 (4.70)	56.96 (5.04)	47.18 (6.72)	47.21 (6.45)	48.96 (5.81)
Time effect							39.080	0.00	0.75
Time and group effect							13.489	0.00	0.509
Group effect							15.006	0.01	0.357
RRS total score	49.89 (8.23)	44.14 (7.66)	41.35 (7.01)	49.11 (7.31)	48.96 (6.47)	50.04 (6.35)
Time effect							28.277	0.00	0.685
Time and group effect							81.566	0.00	0.863
Group effect							4.585	0.041	0.145