Effectiveness of a school-based mindfulness program for transdiagnostic prevention in young adolescents

• We investigated mindfulness as a prevention program for anxiety, depression and eating disorders in early secondary school.
• In a moderately large RCT design, we did not replicate the improvements in mental health of earlier studies.
• Further research is required to optimise key ingredients, dose and delivery formats of mindfulness interventions in schools.

Anxiety, depression and eating disorders show peak emergence during adolescence and share common risk factors. School-based prevention programs provide a unique opportunity to access a broad spectrum of the population during a key developmental window, but to date, no program targets all three conditions concurrently. Mindfulness has shown promising early results across each of these psychopathologies in a small number of controlled trials in schools, and therefore this study investigated its use in a randomised controlled design targeting anxiety, depression and eating disorder risk factors together for the first time. Students (M age 13.63; SD = .43) from a broad band of socioeconomic demographics received the eight lesson, once weekly.b (“Dot be”) mindfulness in schools curriculum (N = 132) or normal lessons (N = 176). Anxiety, depression, weight/shape concerns and wellbeing were the primary outcome factors. Although acceptability measures were high, no significant improvements were found on any outcome at post-intervention or 3-month follow-up. Adjusted mean differences between groups at post-intervention were .03 (95% CI: −.06 to −.11) for depression, .01 (−.07 to −.09) for anxiety, .02 (−.05 to −.08) for weight/shape concerns, and .06 (−.08 to −.21) for wellbeing. Anxiety was higher in the mindfulness than the control group at follow-up for males, and those of both genders with low baseline levels of weight/shape concerns or depression. Factors that may be important to address for effective dissemination of mindfulness-based interventions in schools are discussed. Further research is required to identify active ingredients and optimal dose in mindfulness-based interventions in school settings.