MedPath

Remote Mindfulness Training Following Early Life Adversity

Phase 1
Completed
Conditions
Stress
Mindfulness
Early Life Adversity
Interventions
Behavioral: Mindfulness
Behavioral: Coping
Registration Number
NCT05516108
Lead Sponsor
University of Pittsburgh
Brief Summary

This study will test the feasibility of delivering smartphone-based mindfulness and coping interventions to a sample of emerging/young adults with a history of early life adversity (ELA). 80 participants with a history of ELA will be randomly assigned to complete a two-week mindfulness training intervention or matched coping control intervention, both involving 14 foundational audio-guided lessons and practice prompts randomly delivered 3x daily. At baseline, post-intervention, and one-month follow-up lab assessments, participants will complete questionnaires and provide blood samples for assessment of markers of inflammation. Data assessing subjective and physiological stress in daily life will be collected during the intervention and for one week before, immediately after, and one month after the intervention. Passive sensor data will be continuously collected from participants' smartphones and wearable devices to develop exploratory models that estimate and predict daily life stress. Data will be used to evaluate feasibility and acceptability of interventions and assessments in an ELA sample, test effects of mindfulness training on daily life stress and markers of inflammation in an ELA sample, and develop exploratory machine learning models of stress from passive sensor data.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
81
Inclusion Criteria
  • Ages 18-29 years
  • English speaking
  • History of moderate-to-severe physical, emotional, or sexual abuse in childhood
  • Data-enabled Android or iOS smartphone
  • Able to meet study requirements
Exclusion Criteria
  • Self-reported diagnosis of chronic physical disease (e.g., cancer, HIV, heart disease, diabetes, bleeding disorder)
  • Self-reported diagnosis of chronic mental disorder (e.g., schizophrenia, personality disorder, or psychotic illness), major neurological disorder, or suicidal thoughts or wishes at baseline
  • Substance use disorder
  • Medication use that interferes with HPA-axis activity (e.g., corticosteroids), autonomic activity (e.g., antihypertensive medication), inflammatory activity (e.g., cholesterol medications), or blood clotting
  • Current antibiotic, antiviral, or antimicrobial treatment
  • Shift workers
  • Pregnancy
  • Regular systematic mind-body practice (>2 times per week)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
MindfulnessMindfulnessMindfulness intervention involving 14 foundational audio-guided lessons plus daily brief practice prompts. Lessons train meditation techniques for 3 mindfulness skills: concentration, sensory clarity, and equanimity. Practice prompts delivered 3x daily build on the skills trained in each lesson.
CopingCopingCoping intervention involving 14 foundational audio-guided lessons plus daily brief practice prompts. Lessons train techniques for 3 coping skills: reflection, reappraisal, and problem solving. Practice prompts delivered 3x daily build on the skills trained in each lesson.
Primary Outcome Measures
NameTimeMethod
Feasibility of safe implementation: Incidence of treatment-emergent increases in mental health symptomsassessed across the entire 8-week study period

Safety benchmark: \<10% of participants showing substantial (\>2SD) increases in anxiety, trauma, or depressive symptoms (using PROMIS Anxiety and Depression scales and Posttraumatic Stress Disorder Checklist-Civilian scale described in other outcomes below) combined to create treatment-emergent symptom rate

Feasibility of recruitmentassessed pre-enrollment

Recruitment benchmark: \>10% of people screened will be eligible and \>60% of those eligible will enroll

Change in Daily Life Physiological Stress Reactivitychange in HR reactivity assessed for 1 week at three timepoints: pre-intervention, post-intervention (an average of 3 weeks), and one-month follow-up (an average of 7 weeks)

Heart Rate (HR) measured continuously and analyzed in response to daily life stress assessed via EMA

Feasibility of retentionassessed across the entire 8-week study period

Retention benchmark: \>80% retention through intervention and \>75% retention through follow-up

Acceptability: Treatment Expectanciesassessed post-intervention (an average of 4 weeks) and one-month follow-up (an average of 8 weeks)

Acceptability of interventions, with benchmark of \>80% of participants giving positive ratings of treatment expectancies (\>3 on 6-item Credibility/Expectancy Questionnaire)

Change in Daily Life Subjective Stress: Daily stress eventschange in stress assessed for 1 week at three timepoints: pre-intervention, post-intervention (an average of 3 weeks), and one-month follow-up (an average of 7 weeks)

Daily stress events assessed daily via end-of day diary

Change in Daily Life Subjective Stress: Daily Perceived Stresschange in stress assessed for 1 week at three timepoints: pre-intervention, post-intervention (an average of 3 weeks), and one-month follow-up (an average of 7 weeks)

Daily perceived stress assessed daily via end-of day diary

Change in Circulating Inflammatory Markerschange from pre-intervention to post-intervention (an average of 4 weeks) and one-month follow-up (an average of 8 weeks)

Circulating IL-6 assessed via dried blood spot (DBS)

Feasibility of adherenceassessed across the entire 8-week study period

Adherence benchmark: average completion of \>85% of intervention lessons, \>60% of practice prompts, \>75% of ambulatory assessments, and mobile sensor data on \>75% of days

Change in Daily Life Subjective Stress: State Perceived Stresschange in stress assessed for 1 week at three timepoints: pre-intervention, post-intervention (an average of 3 weeks), and one-month follow-up (an average of 7 weeks)

State perceived stress assessed four times daily via Ecological Momentary Assessment (EMA)

Change in Daily Life Subjective Stress: Stress events in the past 2.5 hourschange in stress assessed for 1 week at three timepoints: pre-intervention, post-intervention (an average of 3 weeks), and one-month follow-up (an average of 7 weeks)

Stress events assessed four times daily via Ecological Momentary Assessment (EMA)

Secondary Outcome Measures
NameTimeMethod
Change in Daily Life Positive Affect: Dailychange in affect assessed for 1 week at three timepoints: pre-intervention, post-intervention (an average of 3 weeks), and one-month follow-up (an average of 7 weeks)

Daily positive affect (composite of 9 positive affect items across 3 subscales: happiness (happy, pleased, and cheerful), calm (calm, at-ease, and relaxed), and vigor (lively, full-of-pep, and energetic)) assessed daily via end-of day diary

Change in Daily Life Negative Affect: Statechange in affect assessed for 1 week at three timepoints: pre-intervention, post-intervention (an average of 3 weeks), and one-month follow-up (an average of 7 weeks)

State negative affect assessed four times daily via Ecological Momentary Assessment (EMA)

Change in Daily Life Social Interactions: Interactions in the past 2.5 hourschange in interactions assessed for 1 week at three timepoints: pre-intervention, post-intervention (an average of 3 weeks), and one-month follow-up (an average of 7 weeks)

Social interactions assessed four times daily via Ecological Momentary Assessment (EMA)

Change in Daily Life Positive Affect: Statechange in affect assessed for 1 week at three timepoints: pre-intervention, post-intervention (an average of 3 weeks), and one-month follow-up (an average of 7 weeks)

State positive affect assessed four times daily via Ecological Momentary Assessment (EMA)

Change in Daily Life Negative Affect: Dailychange in affect assessed for 1 week at three timepoints: pre-intervention, post-intervention (an average of 3 weeks), and one-month follow-up (an average of 7 weeks)

Daily negative affect (composite of 9 negative affect items across 3 subscales: anxiety (on edge, nervous, and tense), depression (sad, depressed, and unhappy), and hostility (hostile, resentful, and angry)) assessed daily via end-of day diary

Change in Daily Life Social Interactions: Dailychange in interactions assessed for 1 week at three timepoints: pre-intervention, post-intervention (an average of 3 weeks), and one-month follow-up (an average of 7 weeks)

Social interactions assessed daily via end-of day diary

Change in Daily Life Mindfulness: Awarenesschange in mindfulness assessed for 1 week at three timepoints: pre-intervention, post-intervention (an average of 3 weeks), and one-month follow-up (an average of 7 weeks)

Mindful awareness assessed via end-of-day diary using 3-item scale ("Today, I paid attention to what I was doing in the present moment" / "Today, I noticed body sensations come and go" / "Today, I noticed pleasant and unpleasant thoughts and emotions")

Change in Daily Life Mindfulness: Acceptancechange in mindfulness assessed for 1 week at three timepoints: pre-intervention, post-intervention (an average of 3 weeks), and one-month follow-up (an average of 7 weeks)

Mindful acceptance assessed via end-of-day diary using 2-item scale ("Today, I was able to step back and be aware of distressing thoughts, emotions, and sensations, without being taken over by them" / Today, I did not want to feel the way I was feeling")

Trial Locations

Locations (1)

University of Pittsburgh

🇺🇸

Pittsburgh, Pennsylvania, United States

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