Promoting Resilience in Youth Through Mindfulness mEditation
NCT ID: NCT05916651
Last Updated: 2024-12-13
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
RECRUITING
NA
155 participants
INTERVENTIONAL
2023-07-07
2026-07-01
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
Participants will be randomly assigned to one of two groups: 1) mindfulness + care-as-usual (CAU) or 2) CAU-only. The mindfulness program was developed specifically for youth with internalizing problems. The 8-week training program consists of weekly 2-hour sessions, with mindfulness, yoga, and mindful active movement in each session. In addition, participants are invited to practice at home in between sessions for around 20 minutes per day.
Data will be collected at baseline (T0), end-of-treatment (T1) (or 2-3 months after baseline for the CAU-only group), and at 2 months follow-up (T2) and 6 months follow-up (T3).
Measurements will include:
* Self-report questionnaires (T0, T1, T2, T3)
* Psychiatric diagnostic interview (T0, T3)
* MRI scans (T0, T1)
* Cognitive tasks (T0, T1)
The primary outcome parameter is the total number of internalizing problems measured with the Adult Self Report (ASR) at end-of-treatment. The effect of mindfulness training (mindfulness + CAU vs. CAU-only) on internalizing problems at T1 will be assessed using a linear-mixed effects model.
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
Background The majority of mental illnesses (75%) emerge before the age of 25 and many have a life-long impact on health and functioning. Early intervention may be more effective than treatment required in later stages. The early stage of mental illness is typically characterized by mild, non-specific complaints such as anxiety, worrying, and low mood. These "internalizing problems" are increasingly common in youth and associated with various adverse outcomes including mental illness development and therefore represent an important target for early intervention.
Internalizing problems are observed in the early stages of various mental disorders. Help-seeking youth with internalizing problems may thus reflect an early stage of mental illness development. Mindfulness training is effective in the treatment of a range of mental disorders including major depression and may promote resilience by acting on underlying mechanisms. In mindfulness training, participants learn to focus and sustain attention on present-moment experiences in a non-judgmental manner. This process fosters awareness of automatic patterns of behavior and improves cognitive flexibility and emotion regulation.
Research shows that a network of brain regions involved in the processing of self-related information (i.e., Default Mode Network; DMN) is hyperactive in people with serious mental illness. Individuals who are at risk for depression are prone to interpret experiences in a negative, self-critical manner. MRI studies have shown that mindfulness reduces activity of the DMN during processing of self-relevant information. Mindfulness training may thus normalize abnormalities in self-referential processing and thereby reduce risk of mental illness development.
Study design This study is a Randomized Controlled Trial. Participants are randomly assigned to one of two groups: 1) the intervention group, who receives mindfulness training in addition to care-as-usual (CAU) and 2) the control group, who receives CAU-only. Research team members who perform clinical follow-up assessments are blind to group-allocation. Data is collected at 4 time points: baseline (T0), end-of-treatment (T1) (within 1 month after completing the mindfulness training intervention group, and approximately 3 months after the baseline measurement for the control group), 2-months follow-up (T2), and 6-months follow-up (T3). Assessments include clinical interviews, self-report questionnaires, and cognitive tasks and MRI scans (at baseline and end-of-treatment only). The main outcome is the total number of internalizing problems at T1 as measured with the Adult Self Report (ASR). Secondary data include self-report questionnaires on comorbid symptoms, rumination, self-esteem, experiential avoidance, mindfulness skills, self-compassion, social and emotional well-being and resilience.
MRI and experimental task data are acquired to assess (changes in) underlying neurocognitive mechanisms and neural correlates. MRI scans are acquired at baseline and T1 and include an anatomical scan, diffusion-MRI scan, and resting-state fMRI scan. In addition, the Self-Referent Encoding Task (SRET), which measures biases for positive and negative self-related information, is acquired in the scanner. Furthermore, participants perform an aversive go/no-go task to measure escape/avoidance behavior in the context of aversive cues. In addition, participants are invited to perform a Pavlovian-to-Instrumental Transfer (PIT) task and Control Belief Updating (CBU) task online. The PIT task measures how Pavlovian biases influence instrumental approach and withdrawal behavior. The CBU measures the extent to which one can flexibly update beliefs about the controllability of their environment.
Study population Help-seeking youth (16-25 years of age) will be recruited from primary (mental) health care providers, including student psychologists, general practitioners (GPs), and mental health nurse practitioners. As both internalizing problems and interest in mindfulness training are more common in women, an imbalance in sex (more women than men) is accepted. Sample size calculations to ensure adequate power to detect small to medium-sized group-differences in internalizing problems from baseline to T1, resulted in a required sample size of N = 155.
Interventional treatment The mindfulness program used in the study is the Learning to Offset Stress (LOS; in Dutch: Leren Omgaan met Stress) program. This 8-week mindfulness training program was designed specifically for youth with internalizing problems. The program consists of weekly 2-hour sessions, with mindfulness exercises, yoga and mindful physical activity in each session, and daily at-home practice (\~20 min).
Care-as-usual Care-as-usual comprises all care from primary mental health care providers or secondary mental health services following referral. Primary mental health care typically involves supportive counseling and/or behavioral activation.
Nature and extent of the burden and risks associated with participation The risks and discomfort associated with participation in this study are estimated as low. The main burden consists of repeated non-invasive assessments and MRI scanning, which may be uncomfortable for some participants.
Hypothesis The main hypothesis is that mindfulness training + CAU relative to CAU-only will reduce internalizing problems at T1 as measured with the ASR.
Hypotheses on cognitive and MRI data will be described in detail elsewhere (aspredicted.com). Briefly, it is hypothesized that higher internalizing problems at baseline will be associated with higher negativity bias in endorsement and recall of self-related information on the SRET, exaggerated escape and avoidance responses on the aversive go/no-go task, increased aversive Pavlovian influence over instrumental behavior on the PIT, and a bias towards reduced controllability on the CBU task and that these effects will be attenuated following mindfulness training (+CAU) as compared to CAU-only.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Keywords
Explore important study keywords that can help with search, categorization, and topic discovery.
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
Intervention (LOS training) + care as usual (intervention group)
Intervention group: mindfulness (LOS) training + CAU
Learning to Offset Stress (LOS) (in Dutch: Leren Omgaan met Stress) training
The investigational treatment is the LOS training, which is an adaptation of two previously validated mindfulness-based programs: Mindfulness-Based Cognitive Therapy (MBCT) developed by Segal, Williams, and Teasdale (2002) and the Mindful2Work (M2W) program developed by de Bruin, Formsma, and Bögels (2018). The M2W program combines mindful physical activity, yoga, and mindfulness meditation to target stress symptoms and burn-out in adults. The LOS training was adapted from these programs to meet the needs of youth with internalizing problems. The training consists of 8 weekly 2-hour sessions that each comprise three elements: mindful physical activity (15-20 minutes), yoga (15-20 minutes), and mindfulness meditation exercises (80-90 minutes). In addition to attending group sessions, participants are invited to practice at home on a daily basis. Home practice consists of daily mindfulness practices comprising mindfulness exercises, yoga and mindful physical activity.
Care as usual
Youth who seek help for internalizing problems from a primary mental health practitioner, including student psychologists or mental health nurse practioners, but do not (yet) meet criteria for (major) mental illness are typically offered supportive counselling, aimed primarily at helping people feel understood and supported. Supportive counselling may also include instructions on behavioral activation, particularly when individuals report reduced activity and behavioral avoidance including social withdrawal. In addition, mental health practitioners commonly employ a "watchful waiting" policy for people with symptoms in the milder range, where they check-in with clients on a regular basis and refer for more intensive treatment if and when symptoms worsen.
Care-as-usual (CAU)-only (control group)
Control group: CAU-only
Care as usual
Youth who seek help for internalizing problems from a primary mental health practitioner, including student psychologists or mental health nurse practioners, but do not (yet) meet criteria for (major) mental illness are typically offered supportive counselling, aimed primarily at helping people feel understood and supported. Supportive counselling may also include instructions on behavioral activation, particularly when individuals report reduced activity and behavioral avoidance including social withdrawal. In addition, mental health practitioners commonly employ a "watchful waiting" policy for people with symptoms in the milder range, where they check-in with clients on a regular basis and refer for more intensive treatment if and when symptoms worsen.
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
Learning to Offset Stress (LOS) (in Dutch: Leren Omgaan met Stress) training
The investigational treatment is the LOS training, which is an adaptation of two previously validated mindfulness-based programs: Mindfulness-Based Cognitive Therapy (MBCT) developed by Segal, Williams, and Teasdale (2002) and the Mindful2Work (M2W) program developed by de Bruin, Formsma, and Bögels (2018). The M2W program combines mindful physical activity, yoga, and mindfulness meditation to target stress symptoms and burn-out in adults. The LOS training was adapted from these programs to meet the needs of youth with internalizing problems. The training consists of 8 weekly 2-hour sessions that each comprise three elements: mindful physical activity (15-20 minutes), yoga (15-20 minutes), and mindfulness meditation exercises (80-90 minutes). In addition to attending group sessions, participants are invited to practice at home on a daily basis. Home practice consists of daily mindfulness practices comprising mindfulness exercises, yoga and mindful physical activity.
Care as usual
Youth who seek help for internalizing problems from a primary mental health practitioner, including student psychologists or mental health nurse practioners, but do not (yet) meet criteria for (major) mental illness are typically offered supportive counselling, aimed primarily at helping people feel understood and supported. Supportive counselling may also include instructions on behavioral activation, particularly when individuals report reduced activity and behavioral avoidance including social withdrawal. In addition, mental health practitioners commonly employ a "watchful waiting" policy for people with symptoms in the milder range, where they check-in with clients on a regular basis and refer for more intensive treatment if and when symptoms worsen.
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
2. Provide written informed consent
3. Adequate mastery of Dutch language
Exclusion Criteria
2. History of major medical illness or neurological illness
3. Participation in a mindfulness programme in the past year
4. Current participation in another intervention study
5. Moderate to severe substance use disorders (i.e., we will allow for mild substance use)
6. Current active suicidality, current psychotic symptoms above clinical cut-off for psychosis, or current trauma-related complaints above clinical cut-off for PTSD.
7. Diagnosed or suspected (mild) intellectual disability (estimated IQ \< 75)
16 Years
25 Years
ALL
No
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
Donders Centre for Cognitive Neuroimaging
OTHER
ZonMw: The Netherlands Organisation for Health Research and Development
OTHER
Brain & Behavior Research Foundation
OTHER
Radboud University Medical Center
OTHER
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
Radboud university medical center (Radboudumc)
Nijmegen, Gelderland, Netherlands
Donders Centre for Cognitive Neuroimaging (DCCN)
Nijmegen, Gelderland, Netherlands
Countries
Review the countries where the study has at least one active or historical site.
Central Contacts
Reach out to these primary contacts for questions about participation or study logistics.
Facility Contacts
Find local site contact details for specific facilities participating in the trial.
Guusje Collin, MD, PhD
Role: primary
Paul Lagerweij, MSc
Role: backup
References
Explore related publications, articles, or registry entries linked to this study.
Schepers M, Lagerweij P, Geurts D, Krause F, Ouden HD, Cools R, Speckens A, Collin G. Promoting Resilience in Youth through Mindfulness mEditation (PRYME): Study protocol for a randomized controlled trial investigating the effects of mindfulness training as add-on to care-as-usual on internalizing problems, mental illness development, and associated brain and cognitive processes in help-seeking youth. BMC Psychiatry. 2025 Feb 14;25(1):126. doi: 10.1186/s12888-024-06430-7.
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
60-63600-98-1054
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
29875
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
NL82568.091.22
Identifier Type: -
Identifier Source: org_study_id