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School-based mindfulness training in early adolescence: what works, for whom and how in the MYRIAD trial?, 2022, Montero-Marin et al

Discussion in 'Other psychosomatic news and research' started by John Mac, Jul 13, 2022.

  1. John Mac

    John Mac Senior Member (Voting Rights)

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    Abstract here
    Links to related MYRIAD papers here


    https://www.bbc.co.uk/news/health-62126567
     
    Last edited by a moderator: Jul 15, 2022
    rainy, Hutan, Simbindi and 13 others like this.
  2. Andy

    Andy Committee Member

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    "Other interventions that might help, like tackling deprivation and giving more targeted mental health support, should be explored, they recommend."

    So, trying to resolve the negative situations that pupils might be in, rather than trying to get them to think positively about them, might be more useful? Unfortunately that will cost more, so probably won't happen.
     
  3. chrisb

    chrisb Senior Member (Voting Rights)

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    The BBC headline seems to lack particularity. It is surely a highly beneficial way of spending time-for those delivering the courses. For the rest it would be useful to consider the "opportunity cost".
     
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  4. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

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    Amazing, research that looks at a psychological/behavioural intervention, presumably with subjective outcome measures, that does not come out in favour of the intervention. Who’d’ve thought it possible?
     
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  5. MSEsperanza

    MSEsperanza Senior Member (Voting Rights)

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    Last edited: Jul 13, 2022
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  6. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

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    I think @MSEsperanza you might have mixed up the links in your post. The first is to an unrelated study, and I assume you intended to include instead the link to the actual comments, see https://www.sciencemediacentre.org/...ulness-training-in-adolescents-aged-11-to-14/
     
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  7. MSEsperanza

    MSEsperanza Senior Member (Voting Rights)

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  8. CRG

    CRG Senior Member (Voting Rights)

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    A most telling quote: "This is disappointing as there had been some hope for an easy solution" * I think that quote is revealing of the enthusiasm for this kind of intervention at the political level. Easy = cheap, and that is a defining attitude to children and young people in the UK.

    *Professor Dame Til Wykes
     
  9. NelliePledge

    NelliePledge Moderator Staff Member

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  10. rvallee

    rvallee Senior Member (Voting Rights)

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    What's amazing about all of this is that psychology and psychiatry went through a decades-long phase working with militaries and other awful agencies to brainwash people for nefarious ends, like trying to train people to be super soldiers incapable of remorse (although that alarmed wise people in militaries who understand that a remorseless killer doesn't make for a good soldier). And found out that it's not possible, doesn't work.

    And since then they turned into the idea of doing the same for positive ends. And it's working just as well. Why would any of this nonsense work in the first place? There is literally no basis other than a generic "it would be interesting/awesome/terrifying if we could do this".

    This childish nonsense can't come to a sudden a brutal end soon enough. It will take at least a full generation to repair the reputational harm done to medicine with this, but until then we'll go through an even stupider phase where this stuff is prescribed just because, along with power poses and museum visits and a bunch of other dumb things.

    There's a solid chance that almost all behavioral sciences are a bunch of nonsense all the way through. They are stuck at magical thinking, that never goes well, never produces anything useful.
     
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  11. Sean

    Sean Moderator Staff Member

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    'worry'

    And that is how you spin normal, healthy, ongoing and necessary integration of the past, present, and future, into simplistic pathology.

    The past matters, the present matters, the future matters, concurrently, all the time.
     
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  12. Hutan

    Hutan Moderator Staff Member

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    I thought Dr Galante's quote was worth posting in full, from the SMC material linked by MSEspe. I liked the recognition of the importance of follow-up outcomes.

    Professor Dame Wykes, (she of the ' easy solution' comment) said:
    Techniques beneficial personally for the teachers - well I guess the course of mindfulness techniques provided during school time meant that the teachers had a break from teaching, and could go have a cup of tea in the staff room or go home early. So, not surprising that the teachers liked it.

    'Childish' doesn't seem the right adjective, because the 11 to 14 year olds seem to have had no problem identifying this course as a waste of time and letting people know that's what they thought. The nonsense is a near opposite of childish - maybe 'patronising', 'manipulative' ....

    I rather liked museum visits.
     
  13. Art Vandelay

    Art Vandelay Senior Member (Voting Rights)

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    It's not surprising that it was a child who first pointed out the Emperor was wearing no clothes.
     
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  14. Andy

    Andy Committee Member

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    Here is the actual study.

    School-based mindfulness training in early adolescence: what works, for whom and how in the MYRIAD trial?, 2022,Montero-Marin et al

    Abstract

    Background Preventing mental health problems in early adolescence is a priority. School-based mindfulness training (SBMT) is an approach with mixed evidence.

    Objectives To explore for whom SBMT does/does not work and what influences outcomes.

    Methods The My Resilience in Adolescence was a parallel-group, cluster randomised controlled trial (K=84 secondary schools; n=8376 students, age: 11–13) recruiting schools that provided standard social–emotional learning. Schools were randomised 1:1 to continue this provision (control/teaching as usual (TAU)), and/or to offer SBMT (‘.b’ (intervention)). Risk of depression, social–emotional–behavioural functioning and well-being were measured at baseline, preintervention, post intervention and 1 year follow-up. Hypothesised moderators, implementation factors and mediators were analysed using mixed effects linear regressions, instrumental variable methods and path analysis.

    Findings SBMT versus TAU resulted in worse scores on risk of depression and well-being in students at risk of mental health problems both at post intervention and 1-year follow-up, but differences were small and not clinically relevant. Higher dose and reach were associated with worse social–emotional–behavioural functioning at postintervention. No implementation factors were associated with outcomes at 1-year follow-up. Pregains−postgains in mindfulness skills and executive function predicted better outcomes at 1-year follow-up, but the SBMT was unsuccessful to teach these skills with clinical relevance.

    SBMT as delivered in this trial is not indicated as a universal intervention. Moreover, it may be contraindicated for students with existing/emerging mental health symptoms.

    Clinical implications Universal SBMT is not recommended in this format in early adolescence. Future research should explore social−emotional learning programmes adapted to the unique needs of young people.

    https://ebmh.bmj.com/content/early/2022/07/07/ebmental-2022-300439
     
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  15. Trish

    Trish Moderator Staff Member

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    So not only was it unsuccessful in reducing mental health problems, it actually made things worse for those with existing mental health problems. That's pretty damning. I suspect mindfulness training can also make situations worse for adults with mental health problems.
     
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  16. MSEsperanza

    MSEsperanza Senior Member (Voting Rights)

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    From the SMC's covering:


    A series of 7 papers, including 2 perspective pieces are being published as a special edition of Evidence-Based Mental Health:

    ‘Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial’ by Willem Kukyen et al.
    DOI: 10.1136/ebmental-2021-300396

    ‘Effectiveness of universal school-based mindfulness training compared with normal school provision on teacher mental health and school climate: results of the MYRIAD cluster randomised controlled trial’ by Willem Kukyen et al.
    DOI: 10.1136/ebmental-2022-300424

    ‘School-based mindfulness training in early adolescence: what works, for whom and how in the MYRIAD trial?’ by Jesus Montero-Marin et al.
    DOI: 10.1136/ebmental-2022-300439

    ‘The impact of mindfulness training in early adolescence on affective executive control, and on later mental health during the COVID-19 pandemic: a randomised controlled trial’ by Daren Dunning et al.
    DOI: 10.1136/ebmental-2022-300460

    ‘Do mindfulness-based programmes improve the cognitive skills, behaviour and mental health of children and adolescents? An updated meta-analysis of randomised controlled trials’ by Daren Dunning et al.
    DOI: 10.1136/ebmental-2022-300464

    (Perspective) ‘Universal prevention of depression at schools: dead end or challenging crossroad?’ By Pim Cuijpers
    DOI: 10.1136/ebmental-2022-300469

    ‘How can we optimise learning from trials in child and adolescent mental health?’
    (Perspective) by Nick Axford et al.
    DOI: 10.1136/ebmental-2022-300500

    Edit: See also https://myriadproject.org/publications/ for clickable URLs (directing to PDFs)
     
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  17. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

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    This is interesting, people cherry pick from eastern religions, with yoga, meditation and mindfulness being prime examples but ignore much of the original context including things like contraindications.

    Though mindfulness is primarily lifted from Buddhism, it is not unconnected to meditation techniques that developed as part of classical yoga, where mental health issues were seen as a clear contra indicator for meditation. I am aware of a number of anecdotes of mental breakdowns triggered by mindfulness meditation techniques and I believe it should only be taught by someone who understands what can go wrong and how to deal with such outcomes. However in the commoditising of mindfulness it is seen something that can be taught by a technician and something that is a go to for people with mental health issues without any real understanding of how the two may interact.
     
  18. rvallee

    rvallee Senior Member (Voting Rights)

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    Honestly the most surprising thing about this is that they accepted the results. Not that those results are reliable, there is no reliable way to assess mental health or the impact of such an intervention, either way, but they're deviating from the script here, although the "benefits the teachers by giving them free time off" is kind of the same as pointing at secondary measures that can be spun as positive.

    I wonder why they accept failure here. They usually simply pretend that whatever benefit they want is still there. Probably over budgets, someone actually wanted to know whether it's worth the expenses before committing them. Those budgets would come out of educational budgets, not healthcare, and they aren't as reckless over this stuff.

    But it says a lot, that an accepted definition of mental health is basically: don't worry, be happy. As if it's normal for people to be gullible idiots always chasing a high somewhere, walking across the street without ever stressing over whether there are cars on the way. That's actually awful and basically goes against human nature.
     
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  19. Amw66

    Amw66 Senior Member (Voting Rights)

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    For many with anxiety and other mental health issues distraction is a coping mechanism.
    Focusing on the moment , or on something in particular can make things worse.( Similar to if you are in pain )

    some types of yoga are not recommended for those with some forms of depression.
    Some with autism can find these therapies harmful too.

    CBT can also be disastrous for some mental health conditions.

    Harms are rarely acknowledged - it's good to see it reported here.
     
  20. Sean

    Sean Moderator Staff Member

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    :facepalm:
     

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