In this research, we tried to explore how short-term mindfulness (STM) intervention affects adolescents’ anxiety, depression, and negative and positive emotion during the COVID-19 pandemic.
10 classes were divided into experiment groups (5 classes;
Paired-sample
(1) With the intervention of STM, there was a significant decrease in negative emotions and an increase in positive emotions in the experimental group, whereas there were non-significant differences in the control group. (2) To explore the heterogeneity trajectories of dependent variables, we built a GMM and found there were two latent growth classes in the trajectories. (3) The results of the models showed their trajectories were downward, which meant that the levels of anxiety, depression, and negative emotions of participants decreased during the STM training period. Nonetheless, the score of positive affect showed upward in three loops of intervention, which indicated that the level of the participants’ positive affect increased through the STM intervention. (4) This research indicated that STM should be given increasing consideration to enhance mental health during the worldwide outbreak of COVID-19.
The COVID-19 pandemic expanded from Wuhan and spread to more than 200 countries, with millions of people becoming infected and even losing their lives to the disease, thus causing large mental health problems (e.g., depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms) [
Anxiety and depressive disorders are two of the largest negative emotional issues evident during the COVID-19 pandemic [
First, the emotion of anxiety is defined as an uncertain threat that triggers emotional, cognitive, and behavioral reactions, which provoke an individual’s attention and prompt them to prepare responses to uncertain threats [
Second, the emotion of depression combined with the internalization of a negative cognitive model affects the enhanced acquisition of negative information over time [
Mindfulness can be defined as embodied nonjudgmental attention and lucid awareness of oneself, others, and the environment [
Not only does the mindfulness emotion regulation model confirm the internal mechanism relationship between mindfulness and emotion, but neurophysiological research on mindfulness and emotion has provided a more objective scientific basis to explain this effect. Mindfulness regulates emotions by changing the balance of the cerebral hemispheres [
In summary, overall statements seem to explain the vital role that mindfulness plays in increasing positive and decreasing negative emotions. Nonetheless, knowledge and empirical research on the dynamic process by which mindfulness decreases negative emotion and enhances positive emotion is still scant, especially during the global COVID-19 pandemic. Thus, this study aimed to explore the dynamic emotional changes associated with mindfulness interventions during the COVID-19 pandemic.
After obtaining approval from the Ethical Committee of Northwest Normal University (Grant Number: 202003016), we contacted the headmaster of middle school X to discuss our research project. Permission for our intervention program was granted, and informed consent was obtained from the selected students and their guardians. G*Power was used to estimate the sample size for a repeated-measures analysis of variance (ANOVA) with experimental and control groups, and four time-points indicated that a total of 73 participants were needed to detect a medium-to-large effect size (f = 0.40) data changes with a type I error rate (alpha) of 0.05, a power of 0.80, and a 0.50 correlation between repeated measures (Heinrich Heine University Düsseldorf). We selected all students in Grade 8 from a total of 10 classes. All selected students and their guardians agreed to participate in this intervention program. We administered the Chinese versions of the Hospital Anxiety and Depression Scale (HADS) and Positive and Negative Affect Schedule (PANAS) to all students using paper in class on March 16th (T1). Then, we randomly divided the 10 classes in each grade into two groups; the experimental group comprised five classes (
This intervention study was conducted during the COVID-19 pandemic in China. This study started on March 15, when all students started school after a long period of confinement and a winter holiday. Before March 15th, the area where the sample school was located did not have a case for two weeks. Confinement restrictions were lifted from the area in early March. In addition, this study was conducted on November 27. During the research period, all students studied at school every day. During school, they still faced strict pandemic prevention and control requirements, such as taking body temperature measurements before entering school, not being allowed to gather, wearing masks in class, and so on.
Most research on mindfulness training programs usually lasts 45 min per course [
The mindfulness voice media used in this research was from the Daily Mindfulness Course in the Himalayan APP. The daily mindfulness course was developed by respected mindfulness instructors Jack Kornfield and Tara Brach. Two senior Chinese mindfulness instructors, HuiQi Tong and HaiFeng Guo, completed the course’s Chinese version (
Lesson | Short-term mindfulness | Lesson | Short-term mindfulness |
---|---|---|---|
1 | Arriving in presence | 21 | Beyond thoughts |
2 | Conscious relaxing | 22 | The core practice |
3 | Coming back to your senses | 23 | Self-judgment and self-compassion |
4 | Attitude of friendliness | 24 | Resilience, healing and inner freedom |
5 | Mindfulness of breath | 25 | Emotion and inner resources |
6 | Calming and steadying with the breath | 26 | Emotion and accepting |
7 | Counting the breath | 27 | Spacious awareness |
8 | Deepening the focus | 28 | Equanimity |
9 | Mindfulness of the body | 29 | Mindfulness of awareness |
10 | Feeling from the inside out | 30 | Empathy and compassion |
11 | Body scan | 31 | Forgiveness |
12 | Naming sensations | 32 | Seeing goodness |
13 | Working with intense sensations | 33 | Intention |
14 | Mindfulness and emotions | 34 | Conflict |
15 | Naming emotions | 35 | Listening |
16 | Working with difficult emotions | 36 | Speaking |
17 | Fostering positive emotion | 37 | Trusting and inhabiting your being |
18 | Recognizing thinking | 38 | Generosity and service |
19 | Wise relationship to thoughts | 39 | Nourishing a grateful heart |
20 | Life under thoughts | 40 | Aspiration and vision |
We conducted short-term mindfulness practice interventions in the experimental group every morning in the first class. Specifically, the researcher sent a daily audio file of short-term mindfulness to head teachers. We trained the head teachers and class monitors in the experimental classes to play the audio. In addition, we put a mindfulness course voice on the DingTalk App so that participants in the experiment could practice mindfulness at home independently. However, no intervention was performed in the control group. In the experimental group, three assessments were performed: after (1) the first loop of the course (8 weeks in May (T2)); (2) the second loop of course (16 weeks in September (T3)); and (3) the third loop of course (24 weeks in November (T4)). No intervention was conducted during the summer holiday between late June and July. In the control group, the assessments were performed only in November (T4).
We conducted short-term mindfulness practice interventions in the class of experiment group every morning in their first class. Specifically, researcher send the daily audio file of short-term mindfulness to the head teachers. And we trained the head teachers and class monitors in experiment classes to play the audio. Also, we put mindfulness course voice on DingTalk App, so participants in experiment can practice mindfulness at home by themselves. Nonetheless, no intervention were conducted in control group. In group of experiment, 3 assessments were performed: (1), after the first loop of course (8 weeks, in May (T2)); (2), the second loop of course (16 weeks, September (T3)); (3), the third loop of course (24 weeks in November (T4)). No intervention were conducted in the summer holiday, which between late June and July. In the control group, we only performed assessments in November (T4).
First, we used IBM SPSS 26.0 for data management, descriptive analysis, paired-sample t-tests, and repeated ANOVA. Paired-sample t-tests were used to compare whether there was a significant difference between each time point of the experiment (T1, T2, T3, T4) and control (T1, T4) groups. Repeated ANOVA was used to analyze the tendencies of positive and negative emotions, anxiety, and depression in the experimental group. Then, we use Mplus 8.3 (Muthén & Muthén, 1998–2019) to build a growth mixture model (GMM) in the experimental group.
Firstly, we conducted paired sample t-test to make comparison of how dependent variable change by the intervention of short-term mindfulness in every assessment. In Experiment group, anxiety depression, positive and negative emotion have significant difference at 0.01 levels, while there were no significant difference in control group.
Specifically, short-term mindfulness training increased positive emotion from T1 to T2 (
Variable | T1 (M ± SD) | T2 (M ± SD) | T3 (M ± SD) | T4 (t =M ± SD) | Time | Difference |
||
---|---|---|---|---|---|---|---|---|
Experiment |
Positive | 15.95 |
23.95 |
29.85 |
37.05 |
T1-T2 | −8.00 ± 2.86 | −43.14** |
T2-T3 | −5.90 ± 1.86 | −48.88** | ||||||
T3-T4 | −7.20 ± 3.65 | −30.39** | ||||||
Negative | 27.83 |
21.79 |
18.35 |
12.57 |
T1-T2 | 6.04 ± 3.73 | 25.01** | |
T2-T3 | 3.44 ± 2.53 | 21.01** | ||||||
T3-T4 | 5.78 ± 2.78 | 32.04** | ||||||
Anxiety | 17.73 |
15.02 |
13.26 |
10.14 |
T1-T2 | 2.71 ± 1.51 | 27.67** | |
T2-T3 | 1.76 ± 1.20 | 22.58** | ||||||
T3-T4 | 3.12 ± 1.62 | 29.73** | ||||||
Depression | 15.46 ± 2.13 | 12.20 ± 1.48 | 10.38 ± 1.36 | 8.17 ± 1.85 | T1-T2 | 3.27 ± 2.01 | 25.08** | |
T2-T3 | 1.82 ± 1.78 | 15.79** | ||||||
T3-T4 | 2.21 ± 2.06 | 16.55** | ||||||
Control |
Positive | 15.78 |
15.68 |
T1-T4 | 0.18 ± 2.67 | 1.08 | ||
Negative | 27.62 |
27.89 |
T1-T4 | −0.27 ± 2.31 | −1.84 | |||
Anxiety | 17.83 |
17.91 |
T1-T4 | −0.08 ± 0.90 | −1.46 | |||
Depression | 15.62 |
15.73 |
T1-T4 | −0.11 ± 1.85 | −0.92 |
Note: *
We conducted 2 (Time: T1, T4) × 2 (Group: Experiment, Control) ANOVA on the process dependent shifts. For positive emotion, the main effect of time is significant (F (1, 237) = 1364.71,
For the experimental group, it is essential to choose the most appropriate analytic strategies needed to identify adolescent subgroups following qualitatively distinct joint trajectories. We conducted growth mixture modeling (GMM) of anxiety, depression, and positive and negative emotions to explore the potential categories to examine the heterogeneity of the trajectory under the intervention among adolescents [
Entropy is a standardized index of model-based classification accuracy, with higher values indicating a more precise assignment of individuals to latent profiles [
Model | K | Log(L) | AIC | BIC | aBIC | Entropy | LMR | BLRT | Class | Probability |
---|---|---|---|---|---|---|---|---|---|---|
Positive | 12 | −2153.416 | 4330.833 | 4372.500 | 4334.464 | 1.000 | 0.317 | 0.021 | 0.979 | |
Negative | 12 | −2139.404 | 4302.809 | 4344.476 | 4306.44 | 1.000 | 0.640 | 0.025 | 0.975 | |
Anxiety | 12 | −1523.746 | 3071.492 | 3113.159 | 3075.123 | 0.999 | 0.124 | 0.029 | 0.971 | |
Depression | 12 | −1742.66 | 3509.318 | 3550.985 | 3512.949 | 0.990 | 0.030 | 0.052 | 0.948 |
Growth Mixture Modeling of Positive Trajectories: Two latent-class GMM trajectories of positive emotion are demonstrated in
Growth Mixture Modeling of Negative Trajectories: Two latent-class GMM trajectories of negative emotion are demonstrated in
Growth Mixture Modeling of Anxiety Trajectories: Two latent-class GMM trajectories of anxiety are demonstrated in
Growth Mixture Modeling of Depression Trajectories: Two latent-class GMM trajectories of depression are demonstrated in
The purpose of the present research was to explore whether the intervention of mindfulness training is a constructive method that can reduce negative emotions (e.g., anxiety and depression) and increasing positive emotions long-term. Thus, we first performed a randomized controlled trial to evaluate the changes in anxiety, depression, negative and positive emotions in the experimental group and control group. As expected, after mindfulness training, there was a significant decrease in negative emotions and an increase in positive emotions in the experimental group, whereas there was no significant difference in the control group. This result is in line with previous research [
As expected, this study indicated that after short term mindfulness training, the anxiety, depression and negative affect scores decreased, whereas there were no changes in the control group. With the continuous intervention of short term mindfulness training in the experimental group, the trajectory of anxiety, depression and negative affect was reduced, and the trajectory of positive affect was enhanced. This result is consistent with the results of several studies showing that mindfulness training is beneficial for regulating positive and negative emotions [
In addition, neurophysiological research on mindfulness and emotion has indicated that by mindfulness, the activation of an individual’s left prefrontal brain area is enhanced; pertinently, the left prefrontal brain area can provoke positive emotion [
The results of this study are also consistent with some brain imaging studies on depression and anxiety patients [
In the condition of mindfulness, the thickness of an individual’s right insula, right hippocampus and left inferior temporal gyrus cortex increased; all of these regions are related to inner and physical perception. Notably, the hippocampus regulates the activity of the amygdala, which is involved in the process of attention and emotion [
Currently, the magnitude and rapid spread of the COVID-19 viral disease during the pandemic has led to the proliferation of anxiety, depression, and other negative emotions in a range of different factions of society, in addition to the contagion. In this circumstance, learning to face negative emotions without repression and to enhance positive emotions is particularly vital. In view of this situation and considering the results of this study, the intervention of short-term mindfulness practice offers an efficient strategy to help reduce negative emotions.
In addition, there are a few limitations that may guide future research. All subjects in this research had undergone other positive incidents, such as transitioning from being quarantined to being free, and transitioning from taking classes online to attending school. These incidents may have also improved positive emotions and decreased negative emotions in adolescents. Further research can extend tracking time and comprehensively consider life changes, personality characteristics, and other factors.
As predicted, our results showed that short-term mindfulness is a practical intervention to increase positive emotions and decrease anxiety, depression, and negative emotions. To thoroughly check the trajectory and heterogeneity in the experimental group, we conducted GMM analyses. The GMM analyses distinguished two classes of participants that differed in the change trajectory of anxiety, depression, negative emotions, and positive emotions in the three loops of intervention.
This research was funded by
The authors confirm contribution to the paper as follows: study conception and design: Yue Yuan, Aibao Zhou; data collection: Yue Yuan, Tinghao Tang; analysis and interpretation of results: Yue Yuan, Manying Kang, Tinghao Tang; draft manuscript preparation: Aibao Zhou, Yue Yuan, Tinghao Tang, Zhi Wang. All authors reviewed the results and approved the final version of the manuscript.
We declare that they have no conflicts of interest to report regarding the present study.