Elsevier

Behavior Therapy

Volume 52, Issue 6, November 2021, Pages 1339-1350
Behavior Therapy

Acceptability and Preliminary Effects of a Mindfulness Mobile Application for Ruminative Adolescents☆,☆☆

https://doi.org/10.1016/j.beth.2021.03.004Get rights and content

Highlights

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    Ruminative adolescents found a mindfulness mobile app to be an acceptable intervention.

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    In the context of a within-subjects design, using a mindfulness mobile app reduced negative repetitive thinking in ruminative adolescents.

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    In the context of a within-subjects design, using a mindfulness mobile app reduced internalizing symptoms in ruminative adolescents.

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    Effects for rumination, anxiety and parent-reported symptoms lasted throughout the 12-week follow-up period.

Abstract

Rumination is a transdiagnostic risk factor that appears to be reduced through mindfulness interventions. However, mindfulness mobile apps have not been tested for their effects on rumination, especially among adolescents. Thus, we aimed to test the acceptability and effects of a mindfulness mobile intervention among ruminative adolescents using a within-subjects pretest/posttest design. Participants were 80 adolescents ages 12-15, selected for moderate-to-high rumination (M age = 14.01, SD = .99; 46.2% girls; 86.25% White; 3.75% Hispanic). We asked adolescents to use our mindfulness app 3 times per day for 3 weeks. Participants and parents completed questionnaires at baseline, post-intervention, and 6 and 12 weeks later. Acceptability was assessed by tracking app use and asking adolescents and parents to report on their experiences post-intervention. We assessed repetitive negative thinking (i.e., rumination and worry) and internalizing symptoms via self- and parent-report. The intervention demonstrated acceptability, and there were significant reductions in rumination, worry, anxiety and parent-reported internalizing symptoms post-intervention. Effects on rumination, anxiety and internalizing symptoms persisted throughout the 12-week follow-up with large effect sizes using an intention-to-treat approach. Thus, a brief mindfulness mobile app intervention appeared to be both engaging and helpful in reducing negative repetitive thinking and internalizing symptoms among ruminative adolescents. It will be important to test this intervention in a randomized controlled trial to control for effects of time and attention.

Section snippets

The Present Study

In order to address the question of whether a mindfulness mobile app can be helpful for adolescents and reduce both repetitive negative thinking and internalizing symptoms, we designed an app to deliver mindfulness exercises and asked ruminative adolescents to use it for 3 weeks. We aimed to determine both the acceptability and initial effects of this brief intervention. Acceptability is defined as how “reasonable” or “palatable” an intervention is for the consumer (i.e., adolescent and parent;

Participants

Participants were 80 adolescents ages 12–15 (M age = 14.01 years, SD = .99) recruited in 2018 through word of mouth and letters sent in the mail to parents of children enrolled in the local public-school district for a study investigating the effects of a mindfulness mobile app intervention. All participants reported at least moderate levels of trait rumination, which were assessed via phone screen to determine eligibility. Participants were eligible if their average score, based on two

Results

We first removed outliers (i.e., z-score >3 or <−3 on outcome measures; n = 7) in order to bring all values for skewness and kurtosis within acceptable ranges to meet assumptions of repeated-measures ANOVA.2 Adolescents received an average of 29.18 mindfulness exercises during the 3-week intervention period (SD = 10.42; range = 6–47). During the follow-up period, when app use was optional, adolescents received an average of 10.36

Discussion

Trait rumination is a transdiagnostic risk factor for the onset and maintenance of psychopathology, which tends to first emerge during adolescence. Thus, targeting rumination is important for both the prevention and treatment of psychopathology among adolescents. The present study sought to explore whether a brief app-based mindfulness intervention may be an engaging and effective way to help adolescents who ruminate regularly. Our findings provide preliminary evidence that a 3-week

Conclusions

In sum, this study addresses the important need for transdiagnostic preventive interventions. Risk for developing psychopathology increases during adolescence, and successful preventive measures can reduce the lifetime burden of psychopathology. For example, preventing a first episode of depression is of great importance, given the findings that a first episode results in scars that make future episodes more likely (Kendler et al., 2000, Rohde et al., 1994). Furthermore, as mood disorders are

Conflict of Interest Statement

The authors declare that there are no conflicts of interest.

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    ☆

    This project was supported by a grant from the American Psychological Foundation to LMH.

    ☆☆

    We thank families who participated in this research as well as Kieran Laursen for help with data collection.

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