The Effects of Mindfulness-Based Interventions on Cognition and Mental Health in Children and Adolescents: A Meta-Analysis of Randomised Controlled Trials

Background: Mindfulness based interventions (MBIs) are an increasingly popular way of attempting to improve the behavioural, cognitive and mental health outcomes of children and adolescents, though there is a suggestion that enthusiasm has moved ahead of the evidence base. Most evaluations of MBIs are either uncontrolled or nonrandomized trials. This meta-analysis aims to establish the efficacy of MBIs for children and adolescents in studies that have adopted a randomized, controlled trial (RCT) design. Methods: A systematic literature search of RCTs of MBIs was conducted up to October 2017. Thirty-three independent studies including 3,666 children and adolescents were included in random effects meta-analyses with outcome measures categorized into cognitive, behavioural and emotional factors. Separate random effects meta-analyses were completed for the seventeen studies (n = 1,762) that used an RCT design with an active control condition. Results: Across all RCTs we found significant positive effects of MBIs, relative to controls, for the outcome categories of Mindfulness, Executive Functioning, Attention, Depression, Anxiety/Stress and Negative Behaviours, with small effect sizes (Cohen’s d), ranging from .16 to .30. However, when considering only those RCTs with active control groups, significant benefits of an MBI were restricted to the outcomes of Mindfulness (d = .42), Depression (d = .47) and Anxiety/Stress (d = .18) only.Conclusions: This meta-analysis reinforces the efficacy of using MBIs for improving the mental health and wellbeing of youth as assessed using the gold standard RCT methodology. Future RCT evaluations should incorporate scaledup definitive trial designs to further evaluate the robustness of MBIs in youth, with an embedded focus on mechanisms of action. Keywords: Mindfulness; meta-analysis; intervention; adolescence; attention.

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Prenatal Maternal Anxiety as a Risk Factor for Preterm Birth and the Effects of Heterogeneity on This Relationship: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2016/8312158 ◽

2016 ◽

Vol 2016 ◽

pp. 1-18 ◽

Cited By ~ 21

Author(s):

M. Sarah Rose ◽

Gianella Pana ◽

Shahirose Premji

Keyword(s):

Mental Health ◽

Preterm Birth ◽

Controlled Trial ◽

Meta Analysis ◽

Maternal Anxiety ◽

Published Evidence ◽

Causal Nature ◽

Randomised Controlled ◽

Meta Analyses ◽

The Relationship

Background.Systematic reviews (SR) and meta-analyses (MA) that previously explored the relationship between prenatal maternal anxiety (PMA) and preterm birth (PTB) have not been comprehensive in study inclusion, failing to account for effects of heterogeneity and disagree in their conclusions.Objectives.This SRMA provides a summary of the published evidence of the relationship between PMA and PTB while examining methodological and statistical sources of heterogeneity.Methods.Published studies from MEDLINE, CINAHL, PsycINFO, and EMBASE, until June 2015, were extracted and reviewed.Results.Of the 37 eligible studies, 31 were used in this MA; six more were subsequently excluded due to statistical issues, substantially reducing the heterogeneity. The odds ratio for PMA was 1.70 (95% CI 1.33, 2.18) for PTB and 1.67 (95% CI 1.35, 2.07) for spontaneous PTB comparing higher levels of anxiety to lower levels.Conclusions.Consistent findings indicate a significant association between PMA and PTB. Due to the statistical problem of including collinear variables in a single regression model, it is hard to distinguish the effect of the various types of psychosocial distress on PTB. However, a prenatal program aimed at addressing mental health issues could be designed and evaluated using a randomised controlled trial to assess the causal nature of different aspects of mental health on PTB.

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The Effect of Mindfulness-Based Interventions on Stress, Depression and Anxiety During the Perinatal Period in Women Without Pre-existing Stress, Depressive or Anxiety Disorders: a Systematic Review and Meta-analysis of Controlled Trials

Mindfulness ◽

10.1007/s12671-021-01697-3 ◽

2021 ◽

Author(s):

Linda Corbally ◽

Mick Wilkinson

Keyword(s):

Mental Health ◽

Systematic Review ◽

Controlled Trial ◽

Meta Analysis ◽

Perinatal Period ◽

Health Issues ◽

Symptoms Of Depression ◽

Mental Health Issues ◽

Meta Analyses ◽

Trial Evidence

Abstract Objectives The objective of this systematic review and meta-analysis was to examine controlled trial evidence for the effectiveness of mindfulness-based interventions on stress, anxiety and depression in the perinatal period in women without pre-existing mental health issues. Methods Six databases were searched for studies exploring the effects of mindfulness-based interventions on mental health outcomes of women during the perinatal period. Quality of both controlled trial meeting inclusion criteria were assessed using a tool specifically designed for meta-analyses of mindfulness-based interventions. Effect sizes were extracted for measures of mindfulness, depression, stress and anxiety outcomes. Effects were pooled in separate meta-analyses for all outcomes except anxiety which lacked sufficient studies. Results Twelve studies were analysed. Pooled effects suggest that mindfulness-based interventions cause small but clear increases in mindfulness and reductions in depression in women without pre-existing disorders. Effects of mindfulness-based interventions on other outcomes were unclear and confounded by heterogeneity. Conclusions Available controlled trial evidence suggests that mindfulness-based interventions improve mindfulness and decrease symptoms of depression during pregnancy in women without pre-existing mental health issues and might be a useful approach to prevent or attenuate the development of depression in the perinatal period.

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Family Talk versus usual services in improving child and family psychosocial functioning in families with parental mental illness (PRIMERA—Promoting Research and Innovation in Mental hEalth seRvices for fAmilies and children): study protocol for a randomised controlled trial

Trials ◽

10.1186/s13063-021-05199-4 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Mairead Furlong ◽

Sinead McGilloway ◽

Christine Mulligan ◽

Colm McGuinness ◽

Nuala Whelan

Keyword(s):

Mental Health ◽

Mental Illness ◽

Randomised Controlled Trial ◽

Psychosocial Functioning ◽

Controlled Trial ◽

Evidence Base ◽

Parental Mental Illness ◽

Research And Innovation ◽

Mental Health Settings ◽

Randomised Controlled

Abstract Background Parental mental illness is common and can lead to dependent children incurring a high risk of developing mental disorders, physical illness, and impaired educational and occupational outcomes. Family Talk is one of the better known interventions designed to prevent the intergenerational transmission of mental illness. However, its evidence base is small, with few robust independent randomised controlled trials, and no associated process or cost evaluations. The PRIMERA (Promoting Research and Innovation in Mental hEalth seRvices for fAmilies and children) research programme involves a mixed method evaluation of Family Talk which is being delivered in mental health settings in Ireland to improve child and family psychosocial functioning in families with parental mental illness. Methods The study comprises a multi-centre, randomised controlled trial (RCT), with nested economic and process evaluations, to assess the clinical and cost-effectiveness and implementation mechanisms of Family Talk compared to usual services. The study is being conducted in 15 adult and child mental health settings in Ireland. Families with a parent with mental illness, and children aged 5–18 years (n = 144 families) will be randomised to either the 7-session Family Talk programme (n = 96) or to standard care (n = 48) using a 2:1 allocation ratio. The primary outcomes are child psychosocial functioning and family functioning. Secondary outcomes are as follows: understanding and experience of parental mental illness, parental mental health, child and parental resilience, partner wellbeing and service utilisation. Blind assessments will take place at pre-intervention and at 6- and 12-month follow-up. Discussion Given the prevalence and burden of intergenerational mental illness, it is imperative that prevention through evidence-based interventions becomes a public health priority. The current study will provide an important contribution to the international evidence base for Family Talk whilst also helping to identify key implementation lessons in the scaling up of Family Talk, and other similar interventions, within routine mental health settings. Trial registration ISRCTN Registry, ISRCTN13365858. Registered 5th February 2019.

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New Evidence in the Booming Field of Online Mindfulness: An Updated Meta-Analysis of Randomised Controlled Trials (Preprint)

10.2196/preprints.28168 ◽

2021 ◽

Author(s):

Marion Sommers-Spijkerman ◽

Judith Austin ◽

Ernst Bohlmeijer ◽

Wendy Pots

Keyword(s):

Mental Health ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Well Being ◽

Evidence Base ◽

Effect Sizes ◽

Controlled Trials ◽

Long Term Follow Up ◽

Randomised Controlled

BACKGROUND There is a need for regularly updating the evidence base on the effectiveness of online mindfulness-based interventions (MBIs), especially considering how fast this field is growing and developing. OBJECTIVE The current study presents an updated meta-analysis of randomised controlled trials assessing the effects of online MBIs on mental health, as well as the potential moderators of those effects. METHODS A systematic literature search was conducted in PsycINFO, PubMed and Web of Science up to July 19th, 2019. Seventy trials totalling 91 comparisons were included. Pre-to-post and pre-to-follow-up between-group effect sizes (Hedges’ g) were calculated for depression, anxiety, stress, well-being and mindfulness, using a random effects model. RESULTS The findings revealed statistically significant moderate pre-to-post effects on stress (g=0.41) and mindfulness (g=0.43) and small effects on depression (g=0.31) and anxiety (g=0.23). For well-being, a significant effect was found only when omitting low quality studies (g=0.34). Significant but small follow-up effects were found for depression (g=0.25), anxiety (g=0.17) and stress (g=-0.11). Subgroup analyses revealed that online MBIs resulted in higher effect sizes for stress when offered with guidance. For stress and mindfulness, studies that used an inactive control condition yielded larger effects. CONCLUSIONS Our findings do not only demonstrate that the field of online MBIs is booming, but also corroborate previous evidence that online MBIs are beneficial for improving mental health outcomes in a broad range of samples. To advance the field of online MBIs, future trials should pay specific attention to methodological quality, adherence and long-term follow-up measurements.

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Comparison of splint and conventional cast for treating wrist torus fractures in children (systematic review)

Advanced Emergency Medicine ◽

10.18686/aem.v6.107 ◽

2017 ◽

Vol 6 (4) ◽

Author(s):

Abdulrahman Alsawadi ◽

Mustafa Abbas

Keyword(s):

Systematic Review ◽

Controlled Trial ◽

Meta Analysis ◽

Cost Effective ◽

Easy Access ◽

Fractures In Children ◽

Cost Effective Treatment ◽

Electronic Database Search ◽

Randomised Controlled ◽

Meta Analyses

<span>Wrist torus fractures in children are common. Although it might be simple and straightforward, the management of these injuries remains controversial and depends on the personal experience and preference of the treating physician. The consensus agreement, however, is that these fractures are inherently stable. Some authors argue that splints should replace the traditional method of cast immobilisation. The splints are viewed as easier to use, more convenient and do not require follow up clinics for removal. It has also been argued that splints are more cost-effective than casts. The aim of this systematic review is to examine the effectiveness and cost-effectiveness of removable splints versus casts in the treatment of torus wrist fractures of children in the current literature. This review followed the Systematic reviews and Meta-Analyses (PRISMA) statement for reporting. Comprehensive electronic database search and handsearch were conducted. Studies were considered for review if they were randomised or quasi-randomised controlled trial and compared removable splints and casts for treating torus fractures of distal radius and/or ulna in children. Four papers identified by two reviewers as potentially eligible for inclusion were appraised and two identified for inclusion were further assessed for any risk of bias. Data were narratively presented and discussed as meta-analysis would not have been possible for the identified studies. The limited available data favours the use of splint as a clinically effective and more cost-effective method of immobilisation. However, the findings of the systematic review are limited by the quality of the identified studies. It has been viewed that explanation to patients and parents and involving them in the decision, plus implementation of safety protocol to avoid under-treatment of misdiagnosed fractures and allow easy access of patients to the clinic, is an alternative way to provide safe, convenient and cost-effective treatment. </span>

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A randomised controlled trial of clinical supervision: selected findings from a novel Australian attempt to establish the evidence base for causal relationships with quality of care and patient outcomes, as an informed contribution to mental health nursing practice development

Journal of Research in Nursing ◽

10.1177/1744987109357816 ◽

2010 ◽

Vol 15 (2) ◽

pp. 151-167 ◽

Cited By ~ 74

Author(s):

Edward White ◽

Julie Winstanley

Keyword(s):

Mental Health ◽

Clinical Practice ◽

Randomised Controlled Trial ◽

Clinical Supervision ◽

Controlled Trial ◽

Evidence Base ◽

Mental Health Nursing ◽

Health Nursing ◽

Randomised Controlled ◽

Practice Development

This paper reports on selected findings from a novel randomised controlled trial (RCT) conducted in mental health settings in Queensland, Australia. Several national and state reports recently revealed the sub-optimal state of Australian mental health service provision which have direct implications for mental health nursing, including the privately experienced cost of working and coping in these settings. Clinical supervision (CS), a structured staff support arrangement, has shown promise as a positive contribution to the clinical practice development agenda and is now found reflected in health policy themes elsewhere in the world. However, CS is underdeveloped in Australia and the empirical evidence base for the informed implementation of CS, per se, has remained elusive. Within the overall context of a RCT design, therefore, and supplemented by other data collection methods, this large and generously funded study attempted to make an incremental contribution to better understanding this demanding substantive domain. Whilst the substantive insights and theoretical propositions reported here were derived from, and may be limited by, a sub-specialty of nursing and a single geographic location, they were earthed in the personal self-reported experience of those directly involved with a clinical practice innovation. They may resonate with counterparts beyond mental health nursing and Queensland, Australia, respectively, therefore, and may assist in both conceptualising and operationalising CS research, education, management, policy and clinical practice development decision making in the future.

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Twenty years of telemedicine in chronic disease management – an evidence synthesis

Journal of Telemedicine and Telecare ◽

10.1258/jtt.2012.120219 ◽

2012 ◽

Vol 18 (4) ◽

pp. 211-220 ◽

Cited By ~ 284

Author(s):

Richard Wootton

Keyword(s):

Chronic Disease ◽

Chronic Diseases ◽

Evidence Synthesis ◽

Meta Analysis ◽

Evidence Base ◽

Negative Effects ◽

Short Term ◽

Positive Effects ◽

Randomised Controlled ◽

High Level

A literature review was conducted to obtain a high-level view of the value of telemedicine in the management of five common chronic diseases (asthma, COPD, diabetes, heart failure, hypertension). A total of 141 randomised controlled trials (RCTs) was identified, in which 148 telemedicine interventions of various kinds had been tested in a total of 37,695 patients. The value of each intervention was categorised in terms of the outcomes specified by the investigators in that trial, i.e. no attempt was made to extract a common outcome from all studies, as would be required for a conventional meta-analysis. Summarizing the value of these interventions shows, first, that most studies have reported positive effects ( n = 108), and almost none have reported negative effects ( n = 2). This suggests publication bias. Second, there were no significant differences between the chronic diseases, i.e. telemedicine seems equally effective (or ineffective) in the diseases studied. Third, most studies have been relatively short-term (median duration 6 months). It seems unlikely that in a chronic disease, any intervention can have much effect unless applied for a long period. Finally, there have been very few studies of cost-effectiveness. Thus the evidence base for the value of telemedicine in managing chronic diseases is on the whole weak and contradictory.

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Olive oil consumption and risk of CHD and/or stroke: a meta-analysis of case–control, cohort and intervention studies

British Journal Of Nutrition ◽

10.1017/s0007114514000713 ◽

2014 ◽

Vol 112 (2) ◽

pp. 248-259 ◽

Cited By ~ 58

Author(s):

Miguel A. Martínez-González ◽

Ligia J. Dominguez ◽

Miguel Delgado-Rodríguez

Keyword(s):

Randomised Controlled Trial ◽

Cohort Studies ◽

Olive Oil ◽

Random Effects ◽

Controlled Trial ◽

Meta Analysis ◽

Case Control ◽

Random Effects Model ◽

Oil Consumption ◽

Randomised Controlled

Increasing evidence suggests that the Mediterranean diet can reduce the risk of CVD. Olive oil is the hallmark of this dietary pattern. We conducted a meta-analysis of case–control, prospective cohort studies and a randomised controlled trial investigating the specific association between olive oil consumption and the risk of CHD (101 460 participants) or stroke (38 673 participants). The results of all observational studies were adjusted for total energy intake. The random-effects model assessing CHD as an outcome showed a relative risk (RR) of 0·73 (95 % CI 0·44, 1·21) in case–control studies and 0·96 (95 % CI 0·78, 1·18) in cohort studies for a 25 g increase in olive oil consumption. In cohort studies, the random-effects model assessing stroke showed a RR of 0·74 (95 % CI 0·60, 0·92). The random-effects model combining all cardiovascular events (CHD and stroke) showed a RR of 0·82 (95 % CI 0·70, 0·96). Evidence of heterogeneity was apparent for CHD, but not for stroke. Both the Egger test (P= 0·06) and the funnel plot suggested small-study effects. Available studies support an inverse association of olive oil consumption with stroke (and with stroke and CHD combined), but no significant association with CHD. This finding is in agreement with the recent successful results of the PREDIMED randomised controlled trial.

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Speech Intervention Effects for Childhood Apraxia of Speech: Quality Appraisal of Systematic Reviews

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-19-00019 ◽

2020 ◽

Vol 5 (3) ◽

pp. 646-653

Author(s):

Alisha P. Springle ◽

Amber Breeden ◽

Anastasia M. Raymer

Keyword(s):

Systematic Reviews ◽

Controlled Trial ◽

Evidence Base ◽

Motor Programming ◽

Measurement Tool ◽

Apraxia Of Speech ◽

Childhood Apraxia Of Speech ◽

Positive Effects ◽

Treatment Research ◽

Meta Analyses

Purpose A number of justification have examined the effects of speech interventions on outcomes in childhood apraxia of speech (CAS). The findings have been summarized in the form of systematic reviews (SRs) and meta-analyses, which are used to support evidence-based clinical practice decisions. Yet without acceptable rigor, SRs/meta-analyses may be biased in their recommendations. We appraised the quality of existing SRs for CAS treatment using a tool developed within epidemiology, the AMSTAR-2 (A MeaSurement Tool to Assess Systematic Reviews). Method A search of five databases to identify published SRs that coalesced treatment research for CAS revealed six systematic reviews that met inclusion criteria. Two examiners coded each article with the AMSTAR-2 to rate the methodologic rigor of the SRs and extracted summary data. Results One rigorous systematic review included only one randomized controlled trial. A second moderately rigorous review examined multiple single participant research designs. The weight of high-quality evidence supported the positive effects of motor programming treatments for children with CAS. Conclusions Findings of six systematic reviews, two of which were conducted with relative rigor, suggest that motor programming treatments have the best evidence base for treatment decisions pertaining to CAS. Clinicians are referred to online resources to implement these treatments according to published protocols.

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Start as you mean to carry on: The emerging evidence base for the treatment of conflict-related mental health difficulties in children and adolescents

The British Journal of Psychiatry ◽

10.1192/bjp.bp.116.194654 ◽

2017 ◽

Vol 210 (4) ◽

pp. 243-244

Author(s):

Richard Meiser-Stedman ◽

Leila R. Allen

Keyword(s):

Traumatic Stress ◽

Controlled Trial ◽

Meta Analysis ◽

Evidence Base ◽

Post Traumatic Stress ◽

Psychological Therapies ◽

Mental Health Difficulties ◽

Post Traumatic ◽

Randomised Controlled ◽

Trial Evidence

SummaryIn this editorial, we discuss Morina and colleagues' meta-analysis of psychological therapies for youth with post-traumatic stress disorder (PTSD) and depression following conflict. Recent years have seen significantly more randomised controlled trial evidence addressing the needs of this population. More work is needed to understand post-traumatic depression, dissemination, timing of intervention and whether trauma-focused interventions are essential.

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