Researchers at the New York University College of Nursing (NYUCN), the University of Miami, and the Lionheart Foundation in Boston, found that mindfulness training, a meditation-based therapy, can improve attention skills in incarcerated youth, paving the way to greater self-control over emotions and actions. It is the first study to show that mindfulness training can be used in combination with cognitive behavioral therapy to protect attentional functioning in high-risk incarcerated youth.
Their study, “Mindfulness Training Improves Attentional Task Performance in Incarcerated Youth: A Group Randomized Controlled Intervention Trial,” published in the on-line journal, Frontiers in Psychology, holds promise for new strategies in reducing anti-social behavior among at-risk youth.
The researchers followed 267 incarcerated males, ages 16 to 18, over a 4-month period. The researchers found that participation in an intervention that combined cognitive behavioral therapy with mindfulness training (or “CBT/MT”), called Power Source, had a protective effect on youths’ attentional capacity. This research is the largest controlled study of mindfulness training for youth to date.
“The CBT/MT approach responds to the significant childhood psychosocial hardships that most incarcerated youths have experienced, including exposure to violence, poverty, and physical and emotional abuse by caregivers,” explained principal investigator Noelle R. Leonard, PhD, a Senior Research Scientist at NYUCN. “These experiences impair cognitive control processes, such as attention regulation, which is vital for the self-regulation of feelings and actions. The antisocial behavior prevalent among youthful offenders is the result of an ongoing interplay between this psychosocial adversity and deficits in cognitive control processes, particularly attention.”
Improving attention can lead to better self-control. Reflecting on the impact of the intervention, one study participant stated, “Just yesterday. Got into an altercation with a guy in the kitchen. Guy said, ‘We’re gonna fight.’ At first thought, my initial response was to fight. Then I thought about the consequences – I'd lose my job [in the prison kitchen], don’t want to go to court and don’t want to hear the judge mouth about my fights.” Attention to the goal of staying out of trouble allowed this participant to consider an alternative to fighting.
Why it works:
“Mindfulness meditation can be seen as involving two components: self-regulation of attention and non-judgmental awareness,” said Dr. Leonard. “The practice involves training youth to attend to something as simple as the sensations associated with breathing. While our minds will invariably wander to other thoughts or get distracted by things in the environment, by repeatedly returning attention back to the breath in a non-judgmental way, we are building attentional capacity to interrupt the cycle of automatic and reactive thoughts."
The mindfulness training is complemented by exercises that focus on taking responsibility for offending behavior and increasing motivation for engaging in non-violent, pro-social behaviors. “Although we don’t have direct evidence for this yet, we hypothesize that this repeated practice can translate into maintaining a focus on pro-social or non-violent goals in the course of youths’ daily lives, amidst the harsh conditions of incarceration or in the context of anti-social peers” added Dr. Leonard.
“Mindfulness training helps youth consider more adaptive alternatives,” added Dr. Bethany Casarjian of the Lionheart Foundation, who developed the Power Source intervention and co-authored the study. “It creates a gap between triggers for offending behavior and their responses. They learn to not immediately act out on impulse, but to pause and consider the consequences of a potential offending and high risk behavior.”
Study design and results:
Study participants were randomly assigned to one of two groups based upon the prison dormitory where they resided: the intervention group received cognitive-behavioral/mindfulness training and the control group received an evidence-based cognitive-perception intervention focusing on attitudes and beliefs about substance use and violence. Participants completed a computerized Attention Network Test (ANT) prior to the intervention and four months later.
The researchers found that this high-stress period of incarceration led to declines in attentional task performance for all subjects. This poorer performance over time might be accounted for by the unrelenting stress on cognitive control which is necessary for complex problem solving, emotion regulation, and behavioral inhibition.
However, the CBT/MT intervention group showed significantly less of a decline in attentional task performance as compared to the control group. Moreover, within the CBT/MT group, the attentional task performance among those who practiced outside of intervention sessions remained stable compared to those who did not practice outside of the intervention sessions. These findings indicate that a multi-session CBT/MT intervention can be effective in limiting degradation in attentional performance in incarcerated youth, thus providing a protective effect on offending youths’ functional attentional impairments during incarceration in a high-security urban jail.
In line with the current findings, co-author Amishi P. Jha, PhD of the University of Miami, has reported that protracted periods of high stress, such as preparing for military deployment, degrades cognitive control functions such as attention and working memory.
“Cognitive control processes like attention are involved in decision making and emotion regulation,” said Dr. Jha. “With degraded attention, the chances of impulsive and risky decision making, as well as emotional reactivity are greater.”
The current results suggest that strengthening attention through mindfulness training may be a key route for reducing recidivism among young offenders, and highlight the need to teach detained youth strategies to improve cognitive and emotional control in the stressful detainment environment. In particular, training methods that allow youth to actively engage in exercises on their own to improve cognitive control may be ideal in conjunction with structured intervention activities or psychotherapy to help youth cultivate resilience by building their capacity for cognitive control while detained and after release.
"Finally", Dr. Leonard added, "We know that incarceration is not good for youth, and with this study, we have direct evidence that incarceration depletes the very processes youth need to strengthen in order to steer their developmental trajectory in a more pro-social, law-abiding direction."
The research was funded by the National Institute on Drug Abuse (NIDA; R01 DA 024764)
Additional authors who contributed to “Mindfulness Training Improves Attentional Task Performance in Incarcerated Youth: A Group Randomized Controlled Intervention Trial” were: Charles M. Cleland, PhD, Marya V. Gwadz, PhD, and Zohar Massey from NYUCN and Merissa Goolsarran and Cristina Garcia from the University of Miami.
About the Center for Drug Use and HIV Research (CDUHR)
CDUHR, funded by the National Institute on Drug Abuse, is the first center for the socio-behavioral study of substance use and HIV in the United States. The Center is dedicated to increasing the understanding of the substance use-HIV/AIDS epidemic, particularly among individuals in high-risk contexts. The Center's theme is "Discovery to Implementation & Back: Research Translation for the HIV/Substance Use Epidemic." The Center facilitates the development of timely new research efforts, enhances implementation of funded projects and disseminates information to researchers, service providers and policy makers.
About New York University College of Nursing
NYU College of Nursing is a global leader in nursing education, research, and practice. It offers a Bachelor of Science in Nursing, a Master of Arts and Post-Master’s Certificate Programs, a Doctor of Philosophy in Research Theory and Development, and a Doctor of Nursing Practice degree. For more information, visit www.nyu.edu/nursing.