Examining the Efficacy of Mindfulness Cognitive Therapy to Reduce Anxiety Symptoms in Children

University of Calgary PRISM: University of Calgary's Digital Repository Graduate Studies The Vault: Electronic Theses and Dissertations 2019-11 Examining the Efficacy of Mindfulness Cognitive Therapy to Reduce Anxiety Symptoms in Children Syeda, Maisha M. Syeda, M. M. (2019). Examining the Efficacy of Mindfulness Cognitive Therapy to Reduce Anxiety Symptoms in Children (Unpublished doctoral thesis). University of Calgary, Calgary, AB. http://hdl.handle.net/1880/111236 doctoral thesis University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission. Downloaded from PRISM: https://prism.ucalgary.ca UNIVERSITY OF CALGARY Examining the Efficacy of Mindfulness Cognitive Therapy to Reduce Anxiety Symptoms in Children by Maisha Musarrat Syeda A THESIS SUBMITTED TO THE FACULTY OF GRADUATE STUDIES IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY GRADUATE PROGRAM IN EDUCATIONAL PSYCHOLOGY CALGARY, ALBERTA NOVEMBER, 2019 © Maisha Musarrat Syeda 2019 i Abstract Anxiety disorders are a prevalent childhood psychopathology and can lead to significant distress and interference in children’s daily functioning. Hence, there is a consistent need for empirically supported interventions to alleviate children’s distress associated with anxiety issues. One promising intervention for childhood anxiety that warrant further empirical attention is Mindfulness-based Cognitive Therapy (MBCT). A randomized controlled trial with waitlist controls was employed to examine the effects of MBCT to reduce anxiety symptoms in children, who were aged 9-12. The study also examined whether participation in MBCT was associated with mindfulness growth and improvements in emotional reactivity in children. Stratified randomization procedure, having participants’ anxiety symptom severity and sex as co-variates, was carried out to assign participants into either the intervention (n = 12) or control (n = 13) group. The intervention group completed a 12-week manualized MBCT program, and self- and parent-reports of child’s anxiety symptoms were collected at baseline screening, post-MBCT, and a one-month follow-up. Intervention participants also reported on their mindfulness and emotional reactivity at pre-, mid-, and post-MBCT, and a one-month follow-up. Self- and parent- reports of anxiety were also collected at baseline screening and post-MBCT for the control group. Intervention parents reported significant decreases in the number and severity of their child’s anxiety symptoms from baseline screening to post-MBCT, and this effect was maintained a month after intervention. There were no significant differences in the number and severity of parent-reported anxiety symptoms in the control group while control participants were waiting to receive MBCT. Both control and intervention participants did not report significant changes in their anxiety symptoms from baseline screening to post-MBCT. However, intervention participants who did report some decreases in their anxiety symptoms from baseline screening to ii post-MBCT, decreases in their anxiety symptoms significantly correlated with increases in their mindfulness at mid-MBCT. Finally, intervention participants did not report any significant change in their emotional reactivity from before to after intervention. Implications of these findings, along with limitations and future direction for research, are discussed. iii Acknowledgements Firstly, I wish to express my sincere gratitude to my supervisor, Dr. Jac Andrews for his continuous support of my Ph.D. research, for his encouragement, advocacy, and genuine enthusiasm for my work. His guidance has taught me to navigate obstacles and bring creativity to my research, a contribution that I appreciate dearly, and was so important to my growth as a researcher. Besides my supervisor, I thank the rest of my supervisory committee: Dr. Michelle Drefs and Dr. Sal Mendaglio. I thank them for their continuous encouragement and guidance, but also for asking me the hard questions. Their insightful ideas, questions, and feedback helped me to think more critically about my research. Undertaking of my Ph.D. research took learning, courage, and aspirations. Along with my supervisor and supervisory committee, I would like to acknowledge the many research mentors that I had the opportunities to learn from in my undergraduate and graduate training. Their teachings uniquely and collectively have evolved my thinking, skills, and readiness to conduct my research. Additionally, I thank my mindfulness teachers and clinical supervisors in Canada and Washington, District of Columbia; their teaching and mentorship have deepened my perspectives on the human mind, suffering, and resilience. The support of the administration team of the Werklund School of Education and community partners was integral to the implementation of my study. Jim Baker and Brenda McDougall were immensely helpful in finding and booking appropriate space to ensure that my study ran smoothly. The custodial staff of Werklund always checked in with me to make sure the study space was inviting for my study participants. I also thank my research assistant, Ivneet Brar, who worked so diligently to enter the study data. I appreciate her contribution of time as iv well as her enthusiastic interest in learning about mindfulness and anxiety. Then, I am grateful for my partnership with Calgary area schools that allowed me to reach out to the community and recruit participants. Additionally, I gratefully acknowledge the funding sources that made my Ph.D. research possible. I was funded by the Social Sciences and Humanities Research (2-year doctoral fellowship) for the last two years of my Ph.D. studies. My work was also supported by the University of Calgary-Vice President Research-Doctoral Dissertation Grant, Queen Elizabeth-II Scholarship, as well as local academic scholarships from the University of Calgary. Then, I thank my family for their unconditional love and support in the pursuit of all my learning. Papa taught me about humility and work ethics; Maa’ji taught me about the importance of advocating for others. My sister, Nashita, reminds me every day how empowering it can be to own one’s individuality. These values guided me in all aspect of my Ph.D. research and heavily influenced my personal development as a researcher and clinician. I am also very fortunate to have unwavering support from my friends. They celebrated my highs, but they also lifted me during the lows. I thank them for listening, validating, consulting, and be pillars of strength, unity, and inspiration for me. A speciate note of gratitude to the Three Musketeers. Their friendship to support me doing the best I can helped me to cope through and even thrive during the most challenging times of my Ph.D. journey. Lastly, I express my gratitude to the children and their parents who participated in this study. Their time, interests, and engagement made this study possible. I thank them for joining me in learning about mindfulness. v Dedication To the seven-year-old girl for whom the thought of attending after-school activities evoked intense separation anxiety, but she struggled to explain to the others the dragons that were growling inside. vi Table of Contents Abstract ............................................................................................................................................ i Acknowledgements ........................................................................................................................ iii Dedication ....................................................................................................................................... v Table of Contents ........................................................................................................................... vi List of Tables ................................................................................................................................ xii List of Abbreviations ................................................................................................................... xiii Chapter One: Introduction .............................................................................................................. 1 Interventions for Childhood Anxiety ...................................................................................... 3 MBCT for Childhood Anxiety ................................................................................................ 4 Statement of the Problem ......................................................................................................... 6 Purpose of the Study ................................................................................................................. 7 Overview of the Study .............................................................................................................. 7 Overview of the Dissertation .................................................................................................... 8 Chapter Two: Literature Review .................................................................................................. 10 Childhood Anxiety .................................................................................................................

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