Mindfulness and Resilience in Adolescence (MYRIAD) Project
This blog post describes in a bit more detail our new Wellcome Trust Strategic Award, Mindfulness and Resilience in Adolescence: The MYRIAD Project
Mental ill health places an enormous burden on society, creates untold suffering and often starts in adolescence. The Department of Health recently stated that, “By promoting good mental health and intervening early, particularly in the crucial childhood and teenage years, we can help to prevent mental illness from developing and mitigate its effects when it does” 1. Prevention and intervention during this period is important because we know that mental health problems most commonly start during adolescence: 75% of mental health problems begin before the age of 24, and half by age 15 2. The graph below shows that the most frequent age of onset for depression is between the ages of 13 and 15 3. This type of early onset depression can go on to be a lifelong, recurrent condition, which creates one of the largest potential burdens in terms of years lived with disability 4.
The MYRIAD project will look at whether and how mindfulness training can be used to prevent depression and build resilience during early adolescence. Our 7-year study is based on the theory that depression, and the behavioural problems that often accompany it, can be linked to a particular difficulty in the ability to activate mental control processes to support problem solving and other aspects of day-to-day behaviour during times of emotional distress. An example of this is the ability to ‘respond not react’ in emotionally stressful situations. That is to say, being able to step back from over-learned automatic ways of reacting and choose to respond more resiliently.
Mindfulness training (MT) has been shown to be effective in adults in preventing depression and reducing emotional distress 5-7. Our programme of work will consider whether mindfulness training (MT) in adolescence has the potential to shift the secondary school-age population away from mental ill health and towards improved mental health by helping people to pay attention. This is key for everyone: from young people at high risk of mental ill health to those who are thriving but who nevertheless might be susceptible to stress and anxiety inside and outside school.
The project therefore takes a public health approach, looking at the whole population of young people, rather than simply those at high risk. Such an approach can be traced to the seminal work of Geoffrey Rose 8, and has more recently been applied by Felicia Huppert, a member of the MYRIAD project team, to interventions intended to promote mental health 9.
We will be evaluating the Mindfulness in Schools curriculum. Inspired by a talk by Felicia Huppert and underpinned by their personal mindfulness practice, three teachers Richard Burnett, Chris Cullen and Chris O’Neill developed a syllabus over several years that they called Dot b (standing for pause and breathe or be). This syllabus was designed to teach mindfulness skills within the normal school curriculum, and to show young people how to generalise these skills to daily life. Our programme of research will evaluate the Dot b mindfulness curriculum.
The first theme in the MYRIAD project examines the neurocognitive mechanisms underlying mindfulness and resilience in adolescence (led by Tim Dalgleish and Sarah-Jayne Blakemore). The second theme considers how it might be possible to scale up the delivery of mindfulness training to young people (led by Mark Williams and Willem Kuyken). The third theme will be a large-scale cluster randomised controlled trial to investigate the effectiveness and cost-effectiveness of mindfulness training in schools, with 5700 young people in 76 schools followed up over several years (led by Willem Kuyken).
Our pilot work 10 and recent meta-analyses and systematic reviews 11 conclude that mindfulness training is acceptable, feasible and shows promising effects on a range of interesting outcomes. There is a great deal of enthusiasm amongst teachers, parents and school leadership teams. Such enthusiasm is welcome, but it is running ahead of the evidence and is no basis for policy decisions or allocation of resources. Like other areas in the mindfulness field, there is a pressing need for high quality, adequately powered studies, with robust measures and adequate longer follow-ups to assess effectiveness and cost-effectiveness of mindfulness interventions for young people.
A team has come together to set up the MYRIAD project and we look forward to reporting its outcomes as we progress. Our work to date suggests that mindfulness training can prevent depressive relapse and recurrence in adults 12 and may provide an alternative to maintenance anti-depressants 13,14. Can we have a similar impact on the mental health of young people, changing the trajectory of risk for their futures? It is these questions that we hope to answer over the next seven years.
If you would like to learn more, please watch this short video, which describes mindfulness training from the perspectives of young people, teachers and some of the scientists.
Mark Williams, Willem Kuyken, Sarah-Jayne Blakemore and Tim Dalgleish
The MYRIAD Project is currently recruiting schools and school teachers. If you are interested in participating in the project, and would like to learn more about the studies that we are recruiting for, and how to take part, please contact us:
The MYRIAD Project Team
The MYRIAD Project Team
Mark Williams and Willem Kuyken (University of Oxford), Sarah-Jayne Blakemore (University College London) & Tim Dalgleish (MRC Cognition & Brain Sciences Unit, Cambridge)
Mark Greenberg (Penn State), Tamsin Ford, Obi Ukoumunne (Exeter), Sarah Byford (KCL), Susan Gathercole (MRC CBU), Russell Viner (UCH) & Phil Zelazo (Minnesota)
Alan Stein, Chris Fairburn (Oxford), Iroise Dumontheil (Birkbeck), Maarten Speekenbrink (UCL) Patrick Smith (IoPPN, KCL), Duncan Astle (MRC CBU, Ian Goodyer, Felicia Huppert (Cambridge) & Fergus Crowe (NCB),
Katherine Weare (Exeter), Richard Burnett & Chris Cullen (school teachers)
Oxford Research Team:
Catherine Crane, Project Manager, Daniel Brett, Research Coordinator, Liz Lord, Mindfulness Teacher-Trainer, Stephanie Wilde, Postdoctoral Researcher, Anna Sonley, Research Assistant, Laura Taylor, Research Assistant.
Declaration of interests
Willem Kuyken receives no payment for public engagement or consultancy, and any remuneration is paid in full to the not-for-profit charity Oxford Mindfulness Foundation. He is Director of the OMC and Principal Investigator of several NIHR and Wellcome Trust grants evaluating MBCT.
Mark Williams is co-author of Mindfulness, Finding Peace in a Frantic World and receives royalties from its sales. MW is also the author of a number of other books about mindfulness and receives royalties from their sales.
- Department of Health. No health without mental health. London: Department of Health, 2011.
- Kessler RC, Berglund P, Demler O, Jin R, Walters EE. Lifetime prevalence and age-of-onset distributions’ of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry 2005; 62(6): 593-602.
- Williams JMG, Barnhofer T, Crane C, et al. Pre-adult onset and patterns of suicidality in patients with a history of recurrent depression. Journal of Affective Disorders 2012; 138(1-2): 173-9.
- World Health Organization. Health statistics and information systems: Disease burden. Geneva, Switzerland: World Health Organization; 2011.
- Chiesa A, Serretti A. Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. J Altern Complem Med 2009; 15(5): 593-600.
- Chiesa A, Serretti A. Mindfulness based cognitive therapy for psychiatric disorders: A systematic review and meta-analysis. Psychiatry Research 2011; 187(3): 441-53.
- Chiesa A, Serretti A. Mindfulness Based Cognitive Therapy for Major Depression: A Systematic Review and Meta-Analysis. European Psychiatry 2010; 25.
- Rose G. Strategy of preventive medicine. Oxford: Oxford University Press; 2008.
- Huppert FA. A new approach to reducing disorder and improving well-being. Perspect Psychol Sci 2009;4(1): 108-11.
- Kuyken W, Weare K, Ukoumunne OC, et al. Effectiveness of the Mindfulness in Schools Programme: non-randomised controlled feasibility study. British Journal of Psychiatry 2013; 203(2): 126-31.
- Zenner C, Herrnleben-Kurz S, Walach H. Mindfulness-based interventions in schools-a systematic review and meta-analysis. Frontiers in psychology 2014; 5.
- Piet J, Hougaard E. The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: A systematic review and meta-analysis. Clinical Psychology Review 2011; 31(6): 1032-40.
- Kuyken W, Byford S, Taylor RS, et al. Mindfulness-Based Cognitive Therapy to Prevent Relapse in Recurrent Depression. Journal of Consulting and Clinical Psychology 2008; 76(6): 966-78.
- Kuyken W, Hayes R, Barrett B, et al. Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): A randomised controlled trial. The Lancet 2015.
Oxford Mindfulness Centre
The Oxford Mindfulness Centre (OMC) is an internationally recognised centre of excellence at the University of Oxford, and has been at the forefront of research and development in the field of mindfulness. The OMC works to advance the understanding of evidence-based mindfulness through research, publication, training and dissemination. Our world leading research investigates the mechanisms, efficacy, effectiveness, costeffectiveness and implementation of mindfulness. We offer a wide range of training, education, and clinical services, all taught by leading experts and teachers in the field, who are training the next generation of MBCT researchers, teachers and trainers. We actively engage in collaborative partnership to shape the field and influence policy nationally and internationally. Through the charitable work of the OMC, we are improving the accessibility of MBCT for those most in need.