Augmented Mindfulness Training for Resilience in Early Life
Condition: Adolescents With Early Life Stress
MeSH terms: Stress, Psychological
Study type: Interventional

Summary: 
      This project aims to determine whether neurofeedback augmented mindfulness intervention
      increases the plasticity in brain areas affected by exposure to early life adversity in
      youth. The study will first establish the augmented mindfulness training protocol targeting
      the posterior cingulate cortex (PCC) with real-time fMRI neurofeedback for use with healthy
      control and ELA-exposed youth. Next, in addition to ongoing data collection with healthy
      controls, ELA-exposed youth will be randomly assigned to either complete the neurofeedback
      augmented mindfulness training (AMT) or sham condition protocol. Effect of augmented
      mindfulness training on state measures of mindfulness, perceived stress, and affect will be
      examined.
    

Detailed description: 
      Early life adversity (ELA) is a major public health crisis that results in significant
      disruptions in neurobiological processes and long-term psychiatric and health consequences,
      yet very little is known about interventions that may prevent them and the optimal time to do
      so. Not only is ELA associated with earlier onset and greater severity and comorbidity of
      depression, anxiety, and substance abuse, these individuals also evidence significantly
      poorer responses to psychological and pharmacological interventions when treated for these
      conditions. Consequently, there is a dire need to develop preventive interventions that
      target individuals with ELA exposure. The first step in this process is to establish
      malleability of neural mechanisms disrupted by ELA exposure to acute interventions. We use
      augmented mindfulness training, that is, a standard mindfulness training combined with
      real-time functional magnetic resonance imaging neurofeedback (rtfMRI-nf) to influence and
      increase the plasticity of brain areas affected by ELA, in turn affecting state changes in
      symptoms in youth with ELA exposure. These fMRI tasks are designed to engage the PCC and
      mindfulness practice.

      Over the course of three years, 120 eligible youth with early life adversity or healthy
      controls will be recruited into the study. All healthy controls will receive AMT, and
      ELA-exposed youth will be randomly assigned to AMT, consisting of real-time fMRI with
      neurofeedback during mindfulness practice, or Sham, consisting of artificially calculated
      neurofeedback signals during mindfulness practice. Adolescents will complete self-report
      measures to assess state affective symptoms before and after receiving mindfulness training
      and scanning, and again one week later.
    

Intervention name(s): AMT; Sham
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The session will be done on an individual basis. AMT group will receive neurofeedback training from the PCC while focusing on the physical sensations of the breath. The session will last one hour, including 3 neurofeedback runs during which subjects will undergo three conditions across three consecutive blocks: Rest (30s), Describe (view an adjective and decide whether the word describes them; 20s), and Focus on the Breath with neurofeedback (70s).; The session will be done on an individual basis. Sham group will receive artificial neurofeedback while focusing on the physical sensations of the breath. The session will last one hour, including 3 sham neurofeedback runs during which subjects will undergo three conditions across three consecutive blocks: Rest (30s), Describe (view an adjective and decide whether the word describes them; 20s), and Focus on the Breath with artificial neurofeedback (70s).
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: ELA-exposed youth are randomly assigned to receive augmented mindfulness training with real-time neurofeedback or a sham condition.
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: Early life adversity; Adolescents; Mindfulness; Neurobiology; Stress and resilience