Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/118183
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dc.contributor.advisorRoberts, Rachel-
dc.contributor.advisorProeve, Michael-
dc.contributor.authorWright, Kathleen Mary-
dc.date.issued2018-
dc.identifier.urihttp://hdl.handle.net/2440/118183-
dc.description.abstractAnxiety and depression are common mental disorders, with onset of symptoms typically during childhood. Prevention and early intervention programs for children are available, but little is known about efficacy compared to active controls, or duration of effects. Mindfulness-based interventions (MBIs) are a relatively recent addition to this field. It is theorised that focusing on the present moment ameliorates the worry and rumination associated with anxiety and depression, and attention has been proposed as a mechanism of change. However, the literature for children is in need of validation studies of MBIs. The overall aim of this study was to conduct a randomised controlled trial (RCT) of Mindfulness-Based Cognitive Therapy for Children (MBCT-C), for children aged 9-12 years, as a preventive mental health program. Responding to critiques of MBIs in the literature, the research includes: multi-respondent data (children, their parents and teachers); both self-report and objective measures; exploration of attention as a mechanism of change; and follow-up data from 3- and 6-months post-intervention. A pilot study was conducted with children (n=26) in primary schools (n=2). In a mixed methods evaluation, qualitative analysis (participant interviews/feedback) was triangulated with quantitative pre- to post-participation measures. Results demonstrated feasibility and acceptability of MBCT-C for (n=22) children with internalizing difficulties. The qualitative data provides a rich picture of the experience of participating in MBCT-C, and changes observed within the children. An RCT was then implemented with children experiencing internalizing difficulties (n=89), from primary schools (n=3). A Cognitive behaviour therapy (CBT) program was selected as the control condition, providing comparable active components and known effect sizes. Children were randomised to program group within schools, and multi-level mixed models provided between- and within-group effects. Contrary to the hypotheses, only limited differences were found between programs. Pre- to post-intervention effects were similar for both programs, and were mostly small to moderate, for measures including anxiety, depression, attention, and quality of life. Preliminary mediation analyses did not support the hypothesis that attention was a unique mediator of change for MBCT-C compared to CBT. Follow-up data showed that where change had occurred, effects continued to strengthen. Compared to baseline, 6-month post-intervention effects were similar for each program, and were large for anxiety and depression, attention control, and shifting attention. This study provides the first RCT of MBCT-C compared to an active control condition. It demonstrates feasibility and acceptability in a new culture and setting (Australian primary schools) and provides a robust test of MBCT-C in “real life” setting. Overall it shows that MBCT-C may be used as a clinically-oriented preventive program in schools to reduce children’s internalizing symptoms. The finding that MBCT-C was equally effective to a well-established CBT program is considered a positive for MBCT-C, given the extensive evidence-base available for the CBT program selected. The results also challenge the theory that attention is a unique component of change for MBCT-C. Future studies could continue to explore: possible mechanisms of change; specific factors that might predict whether a child is more likely to respond to MBCT-C or CBT; and effectiveness of MBCT-C for children with diagnosed anxiety or depression.en
dc.language.isoenen
dc.subjectMindfulnessen
dc.subjectMindfulness-Based Cognitive Therapy for Children (MBCT-C)en
dc.subjectchildrenen
dc.subjectattentionen
dc.subjectanxietyen
dc.titleMindfulness-Based Cognitive Therapy for Children: Is it feasible, acceptable, and effective, for prevention of internalizing difficulties in Australian primary school children?en
dc.typeThesisen
dc.contributor.schoolSchool of Psychologyen
dc.provenanceThis electronic version is made publicly available by the University of Adelaide in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. This thesis may incorporate third party material which has been used by the author pursuant to Fair Dealing exceptions. If you are the owner of any included third party copyright material you wish to be removed from this electronic version, please complete the take down form located at: http://www.adelaide.edu.au/legalsen
dc.description.dissertationThesis (Combined MPsych (Clin) & Ph.D.) -- University of Adelaide, School of Psychology, 2018en
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