A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): a pragmatic randomised controlled trial.
A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): a pragmatic randomised controlled trial.
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DOI：
10.1016/s2468-2667(17)30231-1
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发表时间：
2018-03
期刊：
影响因子：
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通讯作者：
Jones PB
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文献类型：
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作者：
Galante J;Dufour G;Vainre M;Wagner AP;Stochl J;Benton A;Lathia N;Howarth E;Jones PB
上大学的年轻人越来越多，导致人们担心学生心理健康服务的需求不断增加。我们的目的是评估是否正念课程提供给大学生将提高他们的应变能力的压力。我们在英国剑桥大学做了这个实用的随机对照试验。年龄在18岁或以上，没有严重精神疾病或危机（自我评估）的学生被随机分配（1：1），通过远程调查软件使用计算机生成的随机数字，接受适合大学生的8周正念课程（学生正念技能[MSS]）加上心理健康支持，或者像往常一样单独接受心理健康支持。参与者和研究管理团队知道分组，但分组对研究人员、结局评估员和研究统计学家隐瞒。主要结局是检查期间自我报告的心理困扰，采用常规评价结局测量中的临床结局（CORE-OM）进行测量，分数越高表示越痛苦。该试验在澳大利亚和新西兰临床试验注册处注册，编号ACTRN 12615001160527。在2015年9月28日至2016年1月15日期间，我们将616名学生随机分配到MSS组（n=309）或照常支持组（n=307）。453名（74%）参与者在考试期间完成了CORE-OM，182名（59%）MSS参与者完成了至少一半的课程。在检查期间，MSS与支持如常相比降低了痛苦评分，237名MSS参与者的平均CORE-OM评分为0.87（SD 0.50），而216名支持如常参与者的平均CORE-OM评分为1.11（0.57（调整后的平均差异为−0·14，95% CI为−0·22至−0·06; p=0·001），显示出中等效应量（β −0·44，95% CI为−0·60至−0·29; p<0·0001）。在214名参与者中，有123名（57%）的患者的痛苦评分高于可接受的临床阈值，而在MSS组中，235名参与者中有88名（37%）。平均而言，六名学生（95% CI 4至10）需要提供MSS课程，以防止一个经历临床水平的痛苦。没有参与者出现与自残、自杀或伤害他人有关的不良反应。我们的研究结果表明，提供正念训练可能是更广泛的学生心理健康策略的有效组成部分。需要进一步的比较有效性研究，包括非特异性影响的控制，以确定一系列额外的，有效的干预措施，以提高大学生的压力恢复能力。剑桥大学和国家健康研究所合作，在英格兰东部的应用健康研究和护理的领导地位。
The rising number of young people going to university has led to concerns about an increasing demand for student mental health services. We aimed to assess whether provision of mindfulness courses to university students would improve their resilience to stress. We did this pragmatic randomised controlled trial at the University of Cambridge, UK. Students aged 18 years or older with no severe mental illness or crisis (self-assessed) were randomly assigned (1:1), via remote survey software using computer-generated random numbers, to receive either an 8 week mindfulness course adapted for university students (Mindfulness Skills for Students [MSS]) plus mental health support as usual, or mental health support as usual alone. Participants and the study management team were aware of group allocation, but allocation was concealed from the researchers, outcome assessors, and study statistician. The primary outcome was self-reported psychological distress during the examination period, as measured with the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE–OM), with higher scores indicating more distress. The primary analysis was by intention to treat. This trial is registered with the Australia and New Zealand Clinical Trials Registry, number ACTRN12615001160527. Between Sept 28, 2015, and Jan 15, 2016, we randomly assigned 616 students to the MSS group (n=309) or the support as usual group (n=307). 453 (74%) participants completed the CORE–OM during the examination period and 182 (59%) MSS participants completed at least half of the course. MSS reduced distress scores during the examination period compared with support as usual, with mean CORE–OM scores of 0·87 (SD 0·50) in 237 MSS participants versus 1·11 (0·57) in 216 support as usual participants (adjusted mean difference −0·14, 95% CI −0·22 to −0·06; p=0·001), showing a moderate effect size (β −0·44, 95% CI −0·60 to −0·29; p<0·0001). 123 (57%) of 214 participants in the support as usual group had distress scores above an accepted clinical threshold compared with 88 (37%) of 235 participants in the MSS group. On average, six students (95% CI four to ten) needed to be offered the MSS course to prevent one from experiencing clinical levels of distress. No participants had adverse reactions related to self-harm, suicidality, or harm to others. Our findings show that provision of mindfulness training could be an effective component of a wider student mental health strategy. Further comparative effectiveness research with inclusion of controls for non-specific effects is needed to define a range of additional, effective interventions to increase resilience to stress in university students. University of Cambridge and National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England.