Abstract
Background
Adolescents’ psychological stress has become an important problem. Mindfulness-based interventions (MBIs) are proven to be effective in school settings in the Western world, and so expanding MBIs further is a particularly important consideration.
Objective
This study addresses the effectiveness of MBI in reducing psychological stress in Chinese school settings and the mediating role of resilience between trait mindfulness and psychological stress.
Methods
This study conducts a cluster randomized controlled trial. Ninety-two middle school students in the experimental group received 10 weeks of MBI, with 10 sessions of a mindfulness course, while 97 students in the control group followed their regular school program without intervention.
Results
Psychological stress, trait mindfulness, and psychological resilience were measured by the Psycho-Somatic-Tension-Relaxation Inventory (PSTRI), Five Facet Mindfulness Questionnaire (FFMQ), and Resilience Scale for Chinese Adolescents (RSCA). The results showed that (1) compared with the pretest scores of the experimental group, and the pre- and post-test scores of the control group, the post-test scores of trait mindfulness and psychological resilience in the experimental group were significantly increased, while psychological stress was significantly decreased. (2) Trait mindfulness was positively associated with psychological resilience. Trait mindfulness and psychological resilience were negatively associated with psychological stress. (3) The mediating effect of psychological resilience accounted for 43.58% of the overall effect of trait mindfulness on psychological stress.
Conclusions
These findings provide encouraging evidence for MBI’s effectiveness in reducing adolescents’ psychological stress and the possible mediating role of psychological resilience; thus, MBI is worthy of expanding to Chinese school settings.
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10566-022-09690-0/MediaObjects/10566_2022_9690_Fig1_HTML.png)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10566-022-09690-0/MediaObjects/10566_2022_9690_Fig2_HTML.png)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs10566-022-09690-0/MediaObjects/10566_2022_9690_Fig3_HTML.png)
Similar content being viewed by others
Data Availability
The data that support the findings of the current study are available from the corresponding author on reasonable request.
References
Aleccia, J. (2014). “Teens more stressed-out than adults,” NBC News, http://www.nbcnews.com/health/kids-health/teens-more-stressed-outadults-survey-shows-n26921.
Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45. https://doi.org/10.1177/1073191105283504
Bernstein, A., Tanay, G., & Vujanovic, A. A. (2011). Concurrent relations between mindful attention and awareness and psychopathology among trauma-exposed adults: Preliminary evidence of transdiagnostic resilience. Journal of Cognitive Psychotherapy, 25, 99–113. https://doi.org/10.1891/0889-8391.25.2.99
Bethell, C., Gombojav, N., Solloway, M., & Wissow, L. (2016). Adverse childhood experiences, resilience and mindfulness-based approaches: Common denominator issues for children with emotional, mental, or behavioral problems. Child and Adolescent Psychiatric Clinics, 25(2), 139–156. https://doi.org/10.1016/j.chc.2015.12.001
Birchinall, L., Spendlove, D., & Buck, R. (2019). In the moment: Does mindfulness hold the key to improving the resilience and wellbeing of pre-service teachers? Teaching and Teacher Education, 86, 102919. https://doi.org/10.1016/j.tate.2019.102919
Bluth, K., Campo, R. A., Pruteanu-Malinici, S., Reams, A., Mullarkey, M., & Broderick, P. C. (2016). A school-based mindfulness pilot study for ethnically diverse at-risk adolescents. Mindfulness, 7(1), 90–104. https://doi.org/10.1007/s12671-014-0376-1
Bränström, R., Duncan, L. G., & Moskowitz, J. T. (2011). The association between dispositional mindfulness, psychological well-being, and perceived health in a Swedish population-based sample. British Journal of Health Psychology, 16(2), 300–316. https://doi.org/10.1348/135910710X501683
Burke, C. A. (2010). Mindfulness-based approaches with children and adolescents: A preliminary review of current research in an emergent field. Journal of Child and Family Studies, 19, 133–144. https://doi.org/10.1007/s10826-009-9282-x
Carsley, D., Khoury, B., & Heath, N. L. (2018). Effectiveness of mindfulness interventions for mental health in schools: A comprehensive meta-analysis. Mindfulness, 9(3), 693–707. https://doi.org/10.1007/s12671-017-0839-2
Chapman, M., Hare, D., Caton, S., Donalds, D., McInnes, E., & Mitchell, D. (2013). The use of mindfulness with people with intellectual disabilities: A systematic review and narrative analysis. Mindfulness, 4(2), 179–189. https://doi.org/10.1177/0145445513476085
Che, W., Zhang, L., Huang, D., & Zhang, X. (2003). Research on the characteristics of psychological stress for college students. Chinese Journal of Applied Psychology, 9(3), 3–9.
Cheung, S., **e, X., & Huang, C. (2020). Mind Over Matter: Mindfulness, Income, Resilience, and Life Quality of Vocational High School Students in China. International Journal of Environmental Research and Public Health, 17(16), 5701. https://doi.org/10.3390/ijerph17165701
Coster, S., Gould, R. L., Coulson, M., & Norman, I. J. (2020). An online mindfulness intervention to enhance compassion in nursing practice: A feasibility and acceptability study with nursing students. International Journal of Nursing Studies Advances, 2, 100004. https://doi.org/10.1016/j.ijnsa.2020.100004
Creswell, J. D. (2017). Mindfulness interventions. Annual Review of Psychology, 68, 491–516. https://doi.org/10.1146/annurev-psych-042716-051139
Deng, Y. Q., Liu, X. H., Rodriguez, M. A., & **a, C. Y. (2011). The five facet mindfulness questionnaire: Psychometric properties of the Chinese version. Mindfulness, 2(2), 123–128. https://doi.org/10.1007/s12671-011-0050-9
Desbordes, G., Gard, T., Hoge, E. A., Hölzel, B. K., Kerr, C., Lazar, S. W., Olendzki, A., & Vago, D. R. (2015). Moving beyond mindfulness: defining equanimity as an outcome measure in meditation and contemplative research. Mindfulness, 6(2), 356–372. https://doi.org/10.1007/s12671-013-0269-8
Dunning, D. L., Griffiths, K., Kuyken, W., Crane, C., Foulkes, L., Parker, J., & Dalgleish, T. (2019). Research review: The effects of mindfulness-based interventions on cognition and mental health in children and adolescents–a meta-analysis of randomized controlled trials. Journal of Child Psychology and Psychiatry, 60(3), 244–258. https://doi.org/10.1111/jcpp.12980
Eisenlohr-Moul, T. A., Peters, J. R., Pond, R. S., & DeWall, C. N. (2016). Both trait and state mindfulness predict lower aggressiveness via anger rumination: A multilevel mediation analysis. Mindfulness, 7(3), 713–726. https://doi.org/10.1007/s12671-016-0508-x
Faul, F., Erdfelder, E., Buchner, A., & Lang, A. G. (2009). Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149–1160. https://doi.org/10.3758/BRM.41.4.1149
Felver, J. C., Celis-de Hoyos, C., Tezanos, K., & Singh, N. (2016). A systematic review of mindfulness-based interventions for youth in school settings. Mindfulness, 7(1), 34–45. https://doi.org/10.1007/s12671-015-0389-4
Fergus, S., & Zimmerman, M. A. (2005). Adolescent resilience: A framework for understanding healthy development in the face of risk. Annual Review of Public Health, 26, 399–419. https://doi.org/10.1146/annurev.publhealth.26.021304.144357
Finkelstein, D. M., Kubzansky, L. D., Capitman, J., & Goodman, E. (2007). Socioeconomic differences in adolescent stress: The role of psychological resources. Journal of Adolescent Health, 40(2), 127–134. https://doi.org/10.1016/j.jadohealth.2006.10.006
Fletcher, D., & Sarkar, M. (2013). Psychological resilience: A review and critique of definitions, concepts, and theory. European Psychologist, 18(1), 12–23. https://doi.org/10.1027/1016-9040/a000124
Foody, M., & Samara, M. (2018). Considering mindfulness techniques in school-based anti-bullying programmes. Journal of New Approaches in Educational Research (NAER Journal), 7(1), 3–9. https://doi.org/10.7821/naer.2018.1.253
Galante, J., Dufour, G., Vainre, M., Wagner, A. P., Stochl, J., Benton, A., Lathia, N., Howarth, E., & Jones, P. B. (2018). A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): A pragmatic randomised controlled trial. The Lancet Public Health, 3(2), e72–e81. https://doi.org/10.1016/S2468-2667(17)30231-1
Golubickis, M., Tan, L. B., Falben, J. K., & Macrae, C. N. (2016). The observing self: Diminishing egocentrism through brief mindfulness meditation. European Journal of Social Psychology, 46(4), 521–527. https://doi.org/10.1002/ejsp.2186
Good, D. J., Lyddy, C. J., Glomb, T. M., Bono, J. E., Brown, K. W., Duffy, M. K., Baer, R. A., Brewer, J. A., & Lazar, S. W. (2016). Contemplating mindfulness at work: An integrative review. Journal of Management, 42(1), 114–142. https://doi.org/10.1177/0149206315617003
Goodman, E., McEwen, B. S., Dolan, L. M., Schafer-Kalkhoff, T., & Adler, N. E. (2005). Social disadvantage and adolescent stress. Journal of Adolescent Health, 37, 484–492. https://doi.org/10.1016/j.jadohealth.2004.11.126
Greinacher, A., Nikendei, A., Kottke, R., Wiesbeck, J., Herzog, W., & Nikendei, C. (2019). Secondary traumatization, psychological stress, and resilience in psychosocial emergency care personnel. International Journal of Environmental Research and Public Health, 16(17), 3213. https://doi.org/10.3390/ijerph16173213
Hu, Y., & Gan, Y. (2008). Development and Psychometric Validity of the Resilience Scale for Chinese Adolescents. Acta Psychologica Sinica, 40(8), 902–912.
Huang, C. C., Chen, Y., Greene, L., Cheung, S., & Wei, Y. (2019). Resilience and emotional and behavioral problems of adolescents in China: Effects of a short-term and intensive mindfulness and life skills training. Children and Youth Services Review, 100, 291–297. https://doi.org/10.1016/j.childyouth.2019.03.015
Huang, C. C., Chen, Y., **, H., Stringham, M., Liu, C., & Oliver, C. (2020). Mindfulness, life skills, resilience, and emotional and behavioral problems for gifted low-income adolescents in China. Frontiers in Psychology, 11, 594. https://doi.org/10.3389/fpsyg.2020.00594
Irarrázaval, M. (2019). Recommendations for mindfulness interventions in the educational context. In: Steinebach, C., Langer, Á. (eds) Enhancing resilience in youth (pp. 117–137). Springer.
Isbel, B., & Summers, M. J. (2017). Distinguishing the cognitive processes of mindfulness: Develo** a standardised mindfulness technique for use in longitudinal randomised control trials. Consciousness and Cognition, 52, 75–92. https://doi.org/10.1016/j.concog.2017.04.019
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156. https://doi.org/10.1093/clipsy.bpg016
Kaplan, J. B., Bergman, A. L., Christopher, M., Bowen, S., & Hunsinger, M. (2017). Role of resilience in mindfulness training for first responders. Mindfulness, 8(5), 1373–1380. https://doi.org/10.1007/s12671-017-0713-2
Kelifa, M. O., Yang, Y., Herbert, C., He, Q., & Wang, P. (2020). Psychological resilience and current stressful events as potential mediators between adverse childhood experiences and depression among college students in Eritrea. Child Abuse & Neglect, 106, 104480. https://doi.org/10.1016/j.chiabu.2020.104480
Kiken, L. G., Garland, E. L., Bluth, K., Palsson, O. S., & Gaylord, S. A. (2015). From a state to a trait: Trajectories of state mindfulness in meditation during intervention predict changes in trait mindfulness. Personality and Individual Differences, 81, 41–46. https://doi.org/10.1016/j.paid.2014.12.044
Kroon, B., Menting, C., & Woerkom, M. (2015). Why mindfulness sustains performance: The role of personal and job resources. Industrial and Organizational Psychology: Perspectives on Science and Practice, 8(4), 638–642. https://doi.org/10.1017/iop.2015.92
Kuyken, W., Weare, K., Ukoumunne, O. C., Vicary, R., Motton, N., Burnett, R., Cullen, C., Hennelly, S., & Huppert, F. (2013). Effectiveness of the mindfulness in schools programme: Non-randomised controlled feasibility study. The British Journal of Psychiatry, 203(2), 126–131. https://doi.org/10.1192/bjp.bp.113.126649
LaRue, D. E., & Herrman, J. W. (2008). Adolescent stress through the eyes of high-risk teens. Pediatric Nursing, 34(5), 375–380.
Li, Q., Xue, Y., Zhao, L., Jia, J., & Feng, L. (2016). Analyzing and identifying teens’ stressful periods and stressor events from a microblog. IEEE Journal of Biomedical and Health Informatics, 21(5), 1434–1448. https://doi.org/10.1109/JBHI.2016.2586519
Liu, J. J., Reed, M., & Girard, T. A. (2017). Advancing resilience: An integrative, multi-system model of resilience. Personality and Individual Differences, 111, 111–118. https://doi.org/10.1016/j.paid.2017.02.007
Loh, J., & Klug, J. (2012). Voices of migrant women: The mediating role of resilience on the relationship between acculturation and psychological distress. The Australian Community Psychologist, 24(2), 59–78.
Lu, J., Potts, C. A., & Allen, R. S. (2020). Homeless people’s trait mindfulness and their resilience-a mediation test on the role of inner peace and hope. Journal of Social Distress and Homelessness. https://doi.org/10.1080/10530789.2020.1774847
Ma, W., Sang, B., & Hong, L. (2008). A review of researches on psychological resilience and its mechanism. Journal of East China Normal University (educational Sciences), 26(1), 89–96. https://doi.org/10.16382/j.cnki.1000-5560.2008.01.003
MacKinnon, D. P., Warsi, G., & Dwyer, J. H. (1995). A simulation study of mediated effect measures. Multivariate Behavioral Research, 30(1), 41–62. https://doi.org/10.1207/s15327906mbr3001_3
Matsuyama, Y. (2010). A comparison of the results of intent-to-treat, per-protocol, and g-estimation in the presence of non-random treatment changes in a time-to-event non-inferiority trial. Statistics in Medicine, 29(20), 2107–2116. https://doi.org/10.1002/sim.3987
McCluskey, D. L., Haliwa, I., Wilson, J. M., Keeley, J. W., & Shook, N. J. (2020). Experiential avoidance mediates the relation between mindfulness and anxiety. Current Psychology. https://doi.org/10.1007/s12144-020-00929-4
McCoy, C. E. (2017). Understanding the intention-to-treat principle in randomized controlled trials. Western Journal of Emergency Medicine, 18(6), 1075. https://doi.org/10.5811/westjem.2017.8.35985
McKeering, P., & Hwang, Y. S. (2019). A systematic review of mindfulness-based school interventions with early adolescents. Mindfulness, 10(4), 593–610. https://doi.org/10.1007/s12671-018-0998-9
Meiklejohn, J., Philips, C., Freedman, M. L., Griffin, M. L., Biegel, G., Roach, A., Frank, J., Burke, C., **er, L., Soloway, G., Isberg, R., Sibinga, E., & Grossman, l., & Saltzman, A. (2012). Integrating mindfulness training into K-12 education: Fostering the resilience of teachers and students. Mindfulness, 3(4), 291–307. https://doi.org/10.1007/s12671-012-0094-5
Mesmer-Magnus, J., Manapragada, A., Viswesvaran, C., & Allen, J. W. (2017). Trait mindfulness at work: A meta-analysis of the personal and professional correlates of trait mindfulness. Human Performance, 30(2–3), 79–98. https://doi.org/10.1080/08959285.2017.1307842
Papies, E. K., Pronk, T. M., Keesman, M., & Barsalou, L. W. (2015). The benefits of simply observing: Mindful attention modulates the link between motivation and behavior. Journal of Personality and Social Psychology, 108(1), 148. https://doi.org/10.1037/a0038032
Rawana, J. S., Diplock, B. D., & Chan, S. (2018). Mindfulness-based programs in school settings: current state of the research. In Handbook of school-based mental health promotion (pp. 323–355). Springer. https://doi.org/10.1007/978-3-319-89842-1_18.
Schafer, J. L., & Graham, J. W. (2002). Missing data: Our view of the state of the art. Psychological Methods, 7(2), 147–177. https://doi.org/10.1037/1082-989X.7.2.147
Sibinga, E. M., Perry-Parrish, C., & Chung, S. E. (2013). School-based mindfulness instruction for urban male youth: A small randomized controlled trial. Preventive Medicine, 57(6), 799–801. https://doi.org/10.1016/j.ypmed.2013.08.027
Wagnild, G. M., & Young, H. M. (1993). Development and psychometric evaluation of the Resilience Scale. Journal of Nursing Measurement, 1(2), 165–178.
Wallace, J. M. (1980). Behavioral Health Change through Tension Control Learning in Adult Education Classes. In Stress and Tension Control (pp.243–261). Springer.
Waugh, C. E., & Koster, E. H. W. (2015). A resilience framework for promoting stable remission from depression. Clinical Psychology Review, 41, 49–60. https://doi.org/10.1016/j.cpr.2014.05.004
Weinstein, N., Brown, K. W., & Ryan, R. M. (2009). A multi-method examination of the effects of mindfulness on stress attribution, co**, and emotional well-being. Journal of Research in Personality, 43(3), 374–385. https://doi.org/10.1016/j.jrp.2008.12.008
Wilson, D.B. (2018). Practical meta-analysis effect size calculator. https:// www.campbellcollaboration.org/escalc/html/ EffectSizeCalculator-Home.php
Wilson, D., Bennett, E. V., & Mosewich, A. D. (2019). The zipper effect, Exploring the interrelationship of mental toughness and self-compassion among Canadian elite women athletes. Psychology of Sport and Exercise, 40(9), 61–70. https://doi.org/10.1016/j.psychsport.2018.09.006
Zenner, C., Herrnleben-Kurz, S., & Walach, H. (2014). Mindfulness-based interventions in schools–a systematic review and meta-analysis. Frontiers in Psychology, 5, 603. https://doi.org/10.3389/fpsyg.2014.00603
Zhang, H., Cao, L., Feng, L., & Yang, M. (2020). Multi-modal interactive fusion method for detecting teenagers’ psychological stress. Journal of Biomedical Informatics, 106, 103427. https://doi.org/10.1016/j.jbi.2020.103427
Zhao, L., & Yuan, L. (2006). A survey of middle school students' learning pressure. Journal of Tian** Academy of Educational Science, (2), 18–21+67.
Zhao, D. (2008). Study on liaoning normal graduates’ employment pressure and profession relecting. China Journal of Health Psychology, 16(4), 375–377. https://doi.org/10.13342/j.cnki.cjhp.2008.04.050
Zhou, Y., Liu, F., **e, A., & Wang, L. (2004). Investigation and Countermeasures of middle school students’ psychological stress. Education Exploration, 4, 84–86.
Acknowledgements
The current study was supported by Hunan Provincial Postgraduate Quality Curriculum Project of China (Grant No. [2019] 370: 319).
Funding
The current study was supported by Hunan Provincial Postgraduate Quality Curriculum Project of China (Grant No. [2019] 370: 319).
Author information
Authors and Affiliations
Contributions
XL carried out the study and had the main responsibility for writing the manuscript. WT undertook statistical analysis and participated in the writing. RX and WZ was responsible for the translation of English version and involved in revising the draft in several stages. HH, RL, CT and XT were responsible for data collection and preliminary arrangement. All authors read the final manuscript, and all have given final approval of the version submitted for publication.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical Approval
All procedures were in accordance with the ethical standards of the local institutional research ethics committee and with the 1964 Helsinki Declaration and its later amendments. Human subject approval was granted by the Human Studies Program/IRB of the university.
Informed Consent
Informed consent was obtained from all participants for being included in the study, their parents/guardians and the school authority. All the participants voluntarily participated in the current study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Liu, X., Tang, W., **ao, R. et al. Reducing Psychological Stress of Chinese Adolescents by Mindfulness-Based Intervention: The Mediating Role of Resilience. Child Youth Care Forum 52, 351–370 (2023). https://doi.org/10.1007/s10566-022-09690-0
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10566-022-09690-0