Mindfulness-Based Interventions for Youth with Anxiety: A Systematic Review and Meta-Analysis

Background and Purpose: The use of mindfulness-based interventions (MBIs) has increased dramatically over the past 30 years. A growing amount of research has found positive effects of MBIs with adults on various outcomes and problems. MBIs are now being adapted and used widely for youth with anxiety and other behavioral health problems; however, the efficacy of MBIs for youth is not well established. This study examined the effects of MBIs with youth with anxiety disorder—the most common mental health diagnosis among youth between the ages of 13 and 18—to bridge this gap in the literature. The primary research questions were: 1) What are the population samples, research designs, and treatment characteristics in current studies of MBIs for youth with anxiety disorders? 2) What are the immediate effects of MBIs with this population? 3) What are the long-term effects of MBIs with this population?

Methods: The present study used systematic review and meta-analytic procedures to synthesize experimental and quasi-experimental studies of MBIs for youth (ages 5-18) with anxiety disorders. A comprehensive and systematic search, comprised of searching 11 databases, research registers, reference lists, contacts with researchers and search of gray literature, was undertaken to locate studies conducted between 1980 and 2015 that met a priori criteria. Two coders independently extracted data from all studies. Descriptive analysis was conducted to describe characteristics of included studies. Effect sizes were calculated using the standard mean difference effect size statistic, corrected for small sample size bias (Hedges’ g). Meta-analysis, assuming random effects models, was used to quantitatively synthesize results across studies using Comprehensive Meta-Analysis 3.0.

Results:  The search yielded 2,512 record hits and the full text of 72 studies were screened for inclusion. After full text screening, five studies, two randomized controlled studies and three quasi-experimental studies, met all criteria. The studies were comprised of four journal articles and one dissertation reporting results for a total of 188 youth between the ages of 5-18 (M = 13.26) who met criteria for an anxiety disorder (primarily diagnosed with PTSD, GAD, Social Anxiety and Unspecified Anxiety disorder). The participants included a diverse group of youth from five different countries. Risk of bias varied across studies. Meta-analytic results suggest a moderate and significant effect at post test (g = 0.62; 95% CI = 0.20, 1.04, p = 0.004); however, there were not enough studies reporting longer-term effects to conduct meta-analysis. Heterogeneity was moderate (I² = 47.22) and not statistically significant (Q = 7.58, df = 4 p = .11), thus moderator analyses were not warranted.

Conclusions and Implications: This systematic review and meta-analysis aimed to add to the research base for MBI’s for youth with anxiety disorders.  The findings of this review suggest that MBI’s for the treatment of anxiety in youth with anxiety disorders are moderately effective immediately following treatment; however, it is not clear whether these effects sustain over time. Methodological shortcomings and gaps in the evidence-base and practice and research implications will be discussed.