Effectiveness of Adolescent-Centered Mindfulness on Risky Behaviors, Resilience, and Distress Tolerance in Adolescents

AUTHORS

Simin Hosseinian 1 , Roghieh Nooripour ORCID 1 , *

1 Department of Counseling, Faculty of Educational Sciences and Psychology, Alzahra University, Tehran, Iran

How to Cite: Hosseinian S , Nooripour R. Effectiveness of Adolescent-Centered Mindfulness on Risky Behaviors, Resilience, and Distress Tolerance in Adolescents, Int J High Risk Behav Addict. Online ahead of Print ; In Press(In Press):e93481. doi: 10.5812/ijhrba.93481.

ARTICLE INFORMATION

International Journal of High Risk Behaviors and Addiction: In Press (In Press); e93481
Published Online: November 9, 2019
Article Type: Research Article
Received: May 12, 2019
Revised: September 28, 2019
Accepted: October 17, 2019
Uncorrected Proof scheduled for 8 (4)
Crossmark

Crossmark

CHEKING

READ FULL TEXT
Abstract

Background: Adolescent delinquency in today’s era is the distress of many professionals, including psychologists, sociologists, and criminologists.

Objectives: The aim of this research was to explore the effectiveness of adolescent-cantered mindfulness training on risky behaviors, resilience and distress tolerance among adolescents in juvenile correction and rehabilitation center.

Methods: This research was a quasi-experimental study with pretest-posttest and control group. A random sampling method was used to select 30 people in the experimental and control groups at Tehran’s Juvenile Correction and Rehabilitation Center in 2019. After the pre-test, they were randomly assigned to the control and experimental groups (n = 15). The control group did not receive any training and just were taken pre-test and post-test. The Iranian Adolescents Risk-Taking Scale, Distress Tolerance Scale and Connor-Davidson Resilience Scale were used in this research. Mean, standard deviation, Levene’s tests, multivariate analysis of variance, multivariate covariance test were performed to analyze data by SPSS V. 22 software.

Results: The results showed that intervention in adolescents at the juvenile correction and rehabilitation center has an important impact on risky behavior, resilience, and distress tolerance.

Conclusions: Owing to the effect of mindfulness on adolescents, this method can be used in interventions related to mental health.

Keywords

Adolescent Mindfulness Risky Behaviors Resilience Distress Tolerance Juvenile Correction and Rehabilitation Center

Copyright © 2019, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

1. Background

The adolescent faces rapid physical growth that is emotionally immature, in terms of limited experience, and fragile and vulnerable in cultural terms. The rate of change in this period is so high that the only infant stage surpasses it. Ineffective coping strategies will cause various behavioral problems during this period (1).

By providing empirical evidence, health professionals have proven that the main causes of mortality in adolescents and young people are cases where the most important underlying cause is harmful behaviors. This fact has led psychologists to study and then research the relationship between human behaviors and health because adolescence is a critical period of life with important behavior patterns that can affect the whole person’s life. In adolescence, a person determines own position in the family, friends, and society. In adolescence years, people experience learning and therefore, face a variety of risks (2). Misleading decisions may lead to risky behaviors.

Juveniles are one of the most vulnerable individuals in society against risky behaviors. According to Iran’s medical statistics, the most common causes of infections among young people under the age of 25 in Iran are primarily alcohol injuries, drug abuse, and suicide. Obviously, any lesion and failure in the physical and psychological health of adolescents and, as a result, the reduction of the capabilities of this locomotive body will inevitably lead to a lack of progress in society and will not delay their physical and mental health. In the long time, it affects the health of society, so their issues and concerns need to be given more attention (3).

Another variable associated with risky behaviors is distress tolerance. Distress tolerance is an important factor in individual differences, which refers to the capacity for experiencing and tolerance of emotional distress (4). Those who are at a low level of distress tolerance describe emotional distress as unbearable, evaluating emotional disturbances as unacceptable, trying to relieve the negative emotional state and being able to focus their attention on a subject other than their emotional distress (5). These people struggle hard to avoid the experience of negative emotions. If they are unlikely to avoid, they will resort to unhealthy ways to overcome the annoying emotional state. If this inappropriate strategy is not beneficial, it is likely that their entire energy will be concentrated on their excitements, which will ultimately disrupt their functions (6).

The study of Vujanovic et al. (7) showed that distress tolerance is a coping method as a mediator in the relationship between the severities of post-traumatic stress symptoms. The results of Burns et al. (8), which aimed to determine the mediating role of distress and impulsivity, showed that distress tolerance plays a role in mediating them, and individuals turn out to be risky behaviors would escape the stress and psychological distress. Therefore, owing to these problems, one should pay more attention to the psychological problems of adolescents, and they can be addressed by obtaining appropriate methods of emotional regulation and appropriate management practices, as well as teaching appropriate strategies for dealing with stressful issues for proper management. They are excited and have better resilience in dealing with the disadvantages of their lives.

One of the issues that have been studied in adolescents’ resilient is that deficiencies in this field can have harmful consequences such as delinquency. Understanding of resilience can be effective in the field of clinical care (especially counseling), educational planning, teaching classes, and recognition of adolescent growth (9).

Resilient people are resistant to problems, and, if necessary, accept non-recoverable conditions. Some researchers believe that if therapists focus on building persuasive beliefs and behaviors, they will be more effective than those that focus on beliefs and behaviors that prevent resilience (10).

In this regard, third-generation therapies have surpassed training in improving the psychological status of chronic patients, and have been able to validate the need for alternative cognitive-behavioral therapies. In this way, more emphasis has been placed on textual and experimental features in psychological experiences. In this type of training, instead of changing cognition, individual’s psychological relationship with thoughts and feelings would be increased. The purpose of this training is to help individuals to achieve a more valuable and satisfying life through increased psychological flexibility rather than focusing solely on cognitive rehabilitation. In the meantime, adolescent-centered mindfulness training is a kind of psycho-educational training that helps adolescents to practice mental-physical mediation and aimed to reduce stress and improve mental health (11). The main mechanism of this training is to pay attention to self-control by focusing attention on the stimulus in the neutral triggers a suitable environment. In this therapeutic pattern, the mindfulness deliberates focus of the adolescent towards the current experience by non-judgmental character with acceptance. Many studies have been conducted, especially in recent years that have addressed the effects of mindfulness in clinical areas, which indicate the positive effects of this training on depression, anxiety, and stress. According to Javedani et al. (12), mindfulness can be considered an effective training to increase resilience and reduce the rumination of women.

Considering that most studies have been devoted to children and adults and few studies have been conducted on adolescents in the Juvenile Correction and Rehabilitation Center; thus training is required to improve their psychological state. In this field, mindfulness training has been used to reduce the psychological problems of different societies. But it is important to note that these skills need to be adapted for use in adolescence, which has been neglected in researches. Therefore, the present study focuses on adolescent-cantered mindfulness training among adolescents in order to investigate its effect on risky behaviors, resilience, and distress tolerance.

2. Methods

This research is a quasi-experimental study with pre-test, post-test, and control group that statistical population is all adolescents were aged 14 to 16 years old in Tehran’s Juvenile Correction and Rehabilitation Center in 2019.

A list of adolescents was presented and samples were selected randomly. Firstly, a list of all the adolescents at the Juvenile Correction and Rehabilitation Center was received from the authorities. Some adolescents did not have much time to finish their freedom so they were excluded from the general list. The rest of the subjects had equal shares for selection, so a random sampling method was used to select 30 people in experimental and control groups. After the pre-test, they were randomly assigned to the control and experimental groups (n = 15).

The experimental group was trained by a 90-minute adolescent-cantered mindfulness training of Bordick (13). This therapeutic package has been used in Hossein’s research (14).

The inclusion criteria for research were ages 14 - 18, non-drug abuse and substance dependence, lack of psychosocial drugs, lack of grief experience in the past 6 months such as divorce and close relatives, participants at the same time should not participate in any psychological training course and should not suffer from acute and chronic physical illness (according to their health records and counselling). Also, the exclusion criteria were more than two absences from the sessions, dealing with severe stressful events, or lack of corporation with the class assignments and reluctance to continue the research.

All participants were informed with consent to comply with ethical principles. After the end of the training, all subjects (experimental group and control group) were asked to complete the same questionnaires. The participants were assured that the method in which the results of the research report were to guarantee their rights.

Iranian Adolescents Risk-Taking Scale was used in this research. By reviewing valid and promising tools in the field of risk management such as the Risk Assessment Questionnaire for adolescents (15) and the Risk Management System for Young People (YRBSS), and considering the cultural conditions and social constraints of the Iranian society, it was adopted on 38 items by Zadeh Mohammadi et al. (16). It assesses 7 subscales of high-risk behaviors, including dangerous driving, violence, cigarette smoking, substance abuse, alcohol consumption, sexual behavior, and relationship with the opposite sex that in this research we used the total score of them. Respondents reported this scale by agreeing or disagreeing with a five-point scale from completely agree (score 5) to completely disagree (score 1). Cronbach’s alpha of this instrument for total score was 0.94 (16).

Distress Tolerance Scale was developed by Simons and Gaher (4) that items of this scale measure distress tolerance based on individual abilities to tolerate emotional distress, distressed mental evaluation, attention to negative emotions in case of occurrence, and regulatory measures to relieve distress. This scale has 15 items and 4 sub-scales. Its sub-scales include emotional distress tolerance, absorption by negative emotions, estimation of mental distress and set efforts to relieve distress on a five-point scale, including: (1) I totally agree, (2) I agree (3) to I agree and disagree, (4) I agree a bit, (5), and I totally disagree (4). The alpha coefficients for these subscales were 0.72, 0.88, and 0.87, respectively and 0.82 for the whole scale. Alavi et al. (17) also reported a high internal consistency for the whole scale (0.71) and a moderate validity for the subscales of tolerance, absorption, evaluation and regulation of 0.54, 0.42, 0.56, and 0.58, respectively.

Connor-Davidson Resilience Scale was developed by Conner and Davidson (18), it has 25 items, and the score is scored based on a Likert scale between zero (completely false) and four (always true). So the maximum score in this questionnaire is 100, and the score for each subject is equal to the total score or the total values obtained from each of the questions. The higher the individual’s score shows the greater the resonance. To use this test in Iran by Khoshouei (19), Cronbach’s alpha method was used to calculate its reliability and to use for the factor analysis method to determine the validity of the test. The reliability of the scale was 93%, which was fully consistent with the reliability reported by the scale makers. The validity of this questionnaire in domestic surveys was calculated using the correlation coefficient of each item with a total score of 0.41 to 0.64 and its validity was 0.89 by Cronbach’s alpha.

The summary of adolescent-cantered mindfulness training’s sessions is as follows:

The first-third sessions: Introducing adolescent-cantered mindfulness training and its definition and explaining the reasons for the implementation of this training for the participants, explaining how to plan for mindfulness exercises and incorporate these exercises into daily life, notes about mindful exercises, training and practice exercises on meditating mindfulness exercises (sitting, kneeling, full lute mode, hand position), and giving homework.

The fourth-sixth sessions: Talk about the participants’ experience of mindfulness and repetition of conscious mindful breathing and body scan training. Teaching of being mindful at the present with by the help of a glass of water, perform basic breathing exercises, talk about the participants’ experience of mind-boggling exercises and educating the mind-consciousness toward five senses (eating consciously, listening consciously, touching the conscious mind, smelling conscious, knowing) and giving homework.

The seventh-eighth sessions: Repetitive basal exercises exercise mindfulness of emotions and thoughts. Review exercises of previous sessions (mindful breathing and exercises). Performing a good memorial meditation, replicating basic breathing and body scans, notes about mindfulness experience and exercises.

3. Results

A total number of 30 boy adolescents were included in this study (15 persons in each group) that mean and standard deviation of the subjects in the experimental and control groups were 13.69 ± 3.75 and 13.46 ± 3.41, respectively. The education level was as; 10 persons were elementary, 11 persons were secondary and 9 persons were high school. Type of crime was as 10 people had rubbery crime, 6 people had drug crime and 14 people were involved in street fighting.

In Table 1, the mean and standard deviation of risky behaviors, resilience, and components of distress tolerance are presented.

Table 1. Descriptive Statistics of Risky Behaviors, Resilience and Components of Distress Tolerance in the Pre-Test and Post-Test of the Experimental and Control Groupsa
Variable, GroupNumberPre-TestPost-Test
Risky behaviors
Experimental15118.21 ± 11.6385.93 ± 6.25
Control15115.47 ± 11.16116.51 ± 11.84
Resilience
Experimental1549.01 ± 6.5368.6 ± 10.41
Control1549.74 ± 6.4048.54 ± 6.98
Total score of distress tolerance
Experimental1547.56 ± 4.5862.84 ± 7.96
Control1547.12 ± 4.1447.66 ± 4.35
Emotional distress tolerance
Experimental1527.12 ± 5.5739.18 ± 7.21
Control1527.56 ± 5.0327.71 ± 5.46
Absorption by negative emotions
Experimental158.93 ± 2.5310.40 ± 3.96
Control158.58 ± 2.108.17 ± 2.44
Estimation of mental distress
Experimental159.89 ± 2.9611.24 ± 3.76
Control159.13 ± 2.699.97 ± 2.11
Set efforts to relieve distress
Experimental158.86 ± 2.7411.38 ± 3.60
Control158.15 ± 2.328.01 ± 2.18

aValues are expressed as mean ± SD.

According to Table 1, there was no significant difference between mean scores of risky behaviors, resilience, and components of distress tolerance in the experimental and control group in the pre-test phase. While the mean of total score of risky behaviors after adolescent-cantered mindfulness training in the experimental group was decreased from (118.11 ± 11.63) to (85.93 ± 6.25), the total score of distress tolerance after adolescent-cantered mindfulness training in the experimental group was increased from (47.56 ± 4.84) to (62.88 ± 7.96) and the mean score of resilience after the adolescent-cantered mindfulness training in the experimental group was increased from (49.01 ± 6.53) to (68.6 ± 10.41).

For the homogeneity analysis of variances, the standard method is the Box’s M Test, which shows the homogeneity of variance-covariance matrices between dependent variables among independent groups.

Table 2. Results of Multivariate Analysis of Variance Analysis in Mean of Difference Scores (Pre-Test-Post-Test), Risky Behaviors, Resilience and Components of Distress Tolerance in the Experimental and Control Groups
TestValuedf1df2F ValueP Value
Pillai’s trace0.64812828.5480.001
Wilks’ lambda053112828.5480.001
Hotelling’s trace1.7812828.5480.001
Roy’s largest root1.7812828.5480.001

Based on the results of Table 2, there is a significant difference between the experimental group and the control group after the adolescent-cantered mindfulness training (P = 0.001) at least in one of the components of risky behaviors, resilience, and distress tolerance.

One of the assumptions of the use of covariance analysis is homogeneity of intragroup variance in pre-test data, which was used to examine the variance homogeneity within the group of Levene’s test and, given that the F value of Levene’s was not significant at α = 0.05; therefore, the intra-group variance was homogeneous and the regression slope and the use of covariance analysis test were used to examine the hypothesis with the homogeneous assumption of the variance of the pre-test data valid.

Table 3. Results of Multivariate Covariance Analysis of Mean Post-Test Scores of Research Variables in the Experimental and Control Groups
dfMean of ScoreF ValueP ValueEffect Size
Risky behaviors11739.9519.640.0010.31
Resilience12193.4724.710.0010.39
Total score of distress tolerance17622.2556.040.0010.35
Emotional distress tolerance12308.5426.910.0010.33
Absorption by negative emotions12194.3825.510.0010.30
Estimation of mental distress12256.2121.140.0010.29
Set efforts to relieve distress12719.3823.360.0010.34

As shown in Table 3, all F values are significant and showed that the scores in risky behaviors, resilience, and components of distress tolerance in the post-test step were significantly more than those in the control group. The amount of effect size showed that 31% of the changes in the risky behaviors, 39% of the changes in resilience, and 35% of the changes in the total score of distress tolerance were in the experimental group as a result of adolescent-cantered mindfulness training.

4. Discussion

The purpose of this study was to investigate the effectiveness of adolescent-cantered mindfulness training on risky behaviors, resilience and distress tolerance among adolescents in juvenile correction and rehabilitation center. The results showed that adolescent-cantered mindfulness training was effective in them. This finding is consistent with the research of Yusainy and Lawrence (20), Bohlmeijer et al. (21), and Williams et al. (22). In explaining this finding it can be said that theoretically, mindfulness focuses more on emotions. In other words, it can be said that mindfulness increases the attention of the individual towards the positive emotional and mental health and the feeling of trust in life, deep sympathy, and real acceptance of life events. Because one important aspect of mindfulness is that people learn to deal with emotions and negative thoughts and experience mental affairs positively. Also, mindfulness can be effective in controlling these disorders by increasing control over visual clues about alcohol and drug use. So, the practice of mindfulness increases the ability of users to tolerate negative emotional states and enables them to effectively counteract that a state can reduce risky behaviors.

In fact, the exercise of mindfulness exercises can increase our awareness of our body, emotions, and thoughts. Accordingly, it can be concluded that reducing stress relies on the basics and components that are directly related to emotion regulation so the reduction of risky behaviors. Also, owing to the impact of adolescent-cantered mindfulness training on juvenile correction and rehabilitation center, in a few studies have been investigated on the increasing distress tolerance, it was found that this training can be effective in maintaining resilience. Hoge et al. (23) reported in their study that mindfulness the ability to deal with psychological stress. Mindfulness has an effect on increasing the awareness of people about the present moment, through techniques such as attention to breathing and body and focusing awareness for existing conditions on the cognitive system and information processing by reducing stress and negative emotions in the individual and increasing coping skills. This would enhance the resilience and distress tolerance in challenges.

On the other hand, in explaining the effect on distress tolerance, it can be noted that the insight which mindfulness provides the consciousness within the presentation of human qualities and capabilities for growth has been related to tolerance of distress in dealing with tension issues that these representations are dreams and goals, the ultimate meaning of life, belief in one’s unity, independence, hope and optimism, cognitive qualities (such as moral reasoning, insight, interpersonal awareness, self-esteem, ability to design, creativity), behavioral and social competence, emotional stability and emotion management, happiness, recognition of emotions and emotional skills, the ability to recognize negative emotions and appropriate training of issues, not only through the reduction of negative syndrome, but also effectively and directly, it can change the possibility of vulnerability to tolerate distress and more resilience by creation of positive emotions and the ability of meaning (24).

In the case of the adolescent-centered mindfulness mechanism for distress tolerance of delinquency adolescents, it is necessary to state that by using the channel change technique can help adolescents to detect issues that were relaxing and pleasant for them, and whenever they became aware of their distress, they focused on the issues that were identified. Gradually by changing the channel from a stressful position to calm thoughts, the mind is re-wired and the person is less distress. Adolescent-centered mindfulness is the main element in raising awareness about empowerment and optimal responses in critical situations to avoid distress experience and always serves as a potentially persistent stimulant. Adolescent-centered mindfulness provides a different way of confronting inefficient thoughts and emotions associated with it, such as distress. This approach can help rid people of automatic thoughts, habits and unhealthy behavior patterns and thus play an important role in reducing distress (25).

Adolescent-centered mindfulness may protect a person against the bad functioning of the mood associated with distress tolerance, which is one of the factors of risky behaviors by increasing the cognitive confrontational processes, such as re-evaluating positively and enhancing emotional adjustment skills such as distress tolerance. Therefore, since tolerance of distress is correlated to resilience, it is expected that through regular exercises of adolescent-centered mindfulness, positive changes can occur in some of the psychological functions such as reducing stress and emotional control, and ultimately leading to improved risky behaviors of the juvenile delinquents. If the necessary skills could be achieved for changing the challenges based on mindfulness, so it could increase the resilience, physical progress, and stress adjustment in later life of individuals, which the results of this study confirm this point. Adolescent-centered mindfulness training involves consciousness consciously based on special emotions, such as the physical sensation of the body from one moment to another. However, the mind distorts thoughts, emotions, voices or other physical emotions, the content of consciousness is remembered, and then attention is slowly but seriously directed towards the protected objects. This process is repeated over and over again and is repeated again in the daily stage of widespread vigilance practice. This distinct metacognitive vision moment is facilitated by teaching attention to the content of thoughts in the same way that they begin and they are allowed to go out of consciousness and then return to the focus of attention (26).

This training can be used as the main approach to adolescent counseling. It should be noted that the present research was performed only on the boy’s adolescents of juvenile correction and rehabilitation center, so the generalization of the results to other groups should be performed cautiously. Also, the impossibility of implementing the follow-up phase was one of the limitations of the present study. It is suggested for researchers that mindfulness can be trained to other groups, and should be as a follow-up as possible in order to investigate the stability of the effects of the training. It is suggested that various studies should be conducted in different populations (age, education, etc.). These components can also be studied alone or in combination with cognitive-behavioral and drug intervention. The strength of training is that the enforcement constraints do not have a high standard, and they provide timely detection, evaluation, and follow-up, and reveal causal relationships.

Therefore, in the case of controlling the interpersonal and interpersonal outcomes of risky behaviors by mindfulness can reduce the incidence of risky behaviors in delinquent adolescents. As a result, officials and practitioners of correctional centers can consider mindfulness program in their long-term planning in order to reduce the frequency of occurrence and reduce the function of risky behaviors in juvenile offenders and in order to prevent personal, familial and social consequences of this problem, and to save money to the authorities and institutions at many human costs. In general, according to the findings of this study, the adolescent-centered mindfulness can help therapists to provide appropriate techniques and exercises in delinquent adolescents by facilitating therapeutic interventions, and use it in the field of psychological training.

Footnotes

References

  • 1.

    Gilman R. The relationship between life satisfaction, social interest, and frequency of extracurricular activities among adolescent students. J Youth Adolesc. 2001;30(6):749-67. doi: 10.1023/a:1012285729701.

  • 2.

    Nooripour R, Hosseinian S, Afrouz GA, Bakhshani NM. Effectiveness of neurofeedback on executive functions and tendency toward high-risk behaviors in adolescents with attention deficit hyperactivity disorder. Int J High Risk Behav Addiction. 2018;7(4). e82012. doi: 10.5812/ijhrba.82012.

  • 3.

    Alimoradi Z, Kariman N, Simbar M, Ahmadi F. Contributing factors to high-risk sexual behaviors among iranian adolescent girls: A systematic review. Int J Community Based Nurs Midwifery. 2017;5(1):2-12. [PubMed: 28097173]. [PubMed Central: PMC5219561].

  • 4.

    Simons JS, Gaher RM. The distress tolerance scale: Development and validation of a self-report measure. Motiv Emot. 2005;29(2):83-102. doi: 10.1007/s11031-005-7955-3.

  • 5.

    Horenstein A, Potter CM, Heimberg RG. How does anxiety sensitivity increase risk of chronic medical conditions? Clin Psychol Sci Pract. 2018;25(3). e12248. doi: 10.1111/cpsp.12248.

  • 6.

    Boyes ME, Hasking PA, Martin G. Adverse life experience and psychological distress in adolescence: Moderating and mediating effects of emotion regulation and rumination. Stress Health. 2016;32(4):402-10. doi: 10.1002/smi.2635. [PubMed: 25764473].

  • 7.

    Vujanovic AA, Rathnayaka N, Amador CD, Schmitz JM. Distress tolerance: Associations with posttraumatic stress disorder symptoms among trauma-exposed, cocaine-dependent adults. Behav Modif. 2016;40(1-2):120-43. doi: 10.1177/0145445515621490. [PubMed: 26681735].

  • 8.

    Burns EE, Fischer S, Jackson JL, Harding HG. Deficits in emotion regulation mediate the relationship between childhood abuse and later eating disorder symptoms. Child Abuse Negl. 2012;36(1):32-9. doi: 10.1016/j.chiabu.2011.08.005. [PubMed: 22265934].

  • 9.

    Carlsen K, Haddad N, Gordon J, Phan BL, Pittman N, Benkov K, et al. Self-efficacy and resilience are useful predictors of transition readiness scores in adolescents with inflammatory bowel diseases. Inflamm Bowel Dis. 2017;23(3):341-6. doi: 10.1097/MIB.0000000000001038. [PubMed: 28178002].

  • 10.

    Sandler I, Ingram A, Wolchik S, Tein JY, Winslow E. Long-term effects of parenting-focused preventive interventions to promote resilience of children and adolescents. Child Dev Perspect. 2015;9(3):164-71. doi: 10.1111/cdep.12126. [PubMed: 30854024]. [PubMed Central: PMC6407875].

  • 11.

    Kallapiran K, Koo S, Kirubakaran R, Hancock K. Review: Effectiveness of mindfulness in improving mental health symptoms of children and adolescents: A meta-analysis. Child Adolesc Ment Health. 2015;20(4):182-94. doi: 10.1111/camh.12113.

  • 12.

    Javedani M, Aerabsheybani H, Ramezani N, Aerabsheybani K. The effectiveness of mindfulness-based cognitive therapy (MBCT) in increasing infertile couples’ resilience and reducing anxiety, stress, and depression. NeuroQuantology. 2017;15(3). doi: 10.14704/nq.2017.15.3.1088.

  • 13.

    Bordick D. Monshahi G, Free M, Hosseini L, Tayebi Nayini P, translators. [A guide to teaching mindfulness skills to children and adolescents]. Isfahan: Khorasgan Azad University; 2017. Persian.

  • 14.

    Hosseini L. [The effectiveness of child-centered mindfulness education on social adjustment, happiness, anxiety, and depression symptoms in 8-12 year old children in Isfahan] [dissertation]. Isfahan Islamic Azad University; 2017. Persian.

  • 15.

    Gullone E, Moore S, Moss S, Boyd C. The adolescent risk-taking questionnaire: Development and psychometric evaluation. J Adolesc Res. 2016;15(2):231-50. doi: 10.1177/0743558400152003.

  • 16.

    Zadeh Mohammadi A, Ahmadabadi Z, Heidari M. [Construction and Assessment of Psychometric Features of Iranian Adolescents Risk-Taking Scale]. Iran J Psychiatr Clin Psychol. 2011;17(3):218-25. Persian.

  • 17.

    Alavi K, Amin-Yazdi A, Modarres Gharavi M, Salehi Fadardi J. [Effectiveness of group dialectical behavior therapy (based on core mindfulness, distress tolerance and emotion regulation components) on depressive symptoms in university students]. J Fund Ment Health. 2011;13(2):124-35. Persian.

  • 18.

    Connor KM, Davidson JR. Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76-82. doi: 10.1002/da.10113. [PubMed: 12964174].

  • 19.

    Khoshouei MS. Psychometric evaluation of the connor-davidson resilience scale (CD-RISC) using Iranian students. Int J Test. 2009;9(1):60-6. doi: 10.1080/15305050902733471.

  • 20.

    Yusainy C, Lawrence C. Relating mindfulness and self-control to harm to the self and to others. Pers Indiv Differ. 2014;64:78-83. doi: 10.1016/j.paid.2014.02.015.

  • 21.

    Bohlmeijer E, Prenger R, Taal E, Cuijpers P. The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: A meta-analysis. J Psychosom Res. 2010;68(6):539-44. doi: 10.1016/j.jpsychores.2009.10.005. [PubMed: 20488270].

  • 22.

    Williams JM, Duggan DS, Crane C, Fennell MJ. Mindfulness-based cognitive therapy for prevention of recurrence of suicidal behavior. J Clin Psychol. 2006;62(2):201-10. doi: 10.1002/jclp.20223. [PubMed: 16342287].

  • 23.

    Hoge EA, Bui E, Marques L, Metcalf CA, Morris LK, Robinaugh DJ, et al. Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: Effects on anxiety and stress reactivity. J Clin Psychiatry. 2013;74(8):786-92. doi: 10.4088/JCP.12m08083. [PubMed: 23541163]. [PubMed Central: PMC3772979].

  • 24.

    McKay M, Wood JC, Brantley J. The dialectical behavior therapy skills workbook: Practical DBT exercises for learning mindfulness, interpersonal effectiveness, emotion regulation and distress tolerance. ReadHowYouWant.com; 2010.

  • 25.

    Brown KW, West AM, Loverich TM, Biegel GM. Assessing adolescent mindfulness: Validation of an adapted mindful attention awareness scale in adolescent normative and psychiatric populations. Psychol Assess. 2011;23(4):1023-33. doi: 10.1037/a0021338. [PubMed: 21319908].

  • 26.

    Greco LA, Baer RA, Smith GT. Assessing mindfulness in children and adolescents: Development and validation of the child and adolescent mindfulness measure (CAMM). Psychol Assess. 2011;23(3):606-14. doi: 10.1037/a0022819. [PubMed: 21480722].

  • COMMENTS

    LEAVE A COMMENT HERE: