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CBT/Mindfulness May Reduce Incarcerated Youths' Anti-Social Behavior

Researchers at the New York University College of Nursing, the University of Miami, and the Lionheart Foundation in Boston found that mindfulness training, a meditation-based therapy, can improve attention skills in incarcerated youths, 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 (CBT) to protect attentional functioning in high-risk incarcerated youths.

Their study, “Mindfulness Training Improves Attentional Task Performance in Incarcerated Youth: A Group Randomized Controlled Intervention Trial,” published in Frontiers in Psychology, holds promise for new strategies in reducing anti-social behavior among at-risk youths.

The researchers followed 267 incarcerated males, aged 16 to 18, over a four-month period. The researchers found that participation in an intervention that combined CBT with mindfulness training (CBT/MT), called Power Source, had a protective effect on youths’ attentional capacity. This research is the largest controlled study of mindfulness training for youths 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,” explains principal investigator Noelle R. Leonard, PhD, a senior research scientist at the College of Nursing. “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.

“Mindfulness meditation can be seen as involving two components: self-regulation of attention and nonjudgmental awareness,” says 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 nonjudgmental 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 nonviolent, 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 nonviolent goals in the course of youths’ daily lives, amidst the harsh conditions of incarceration or in the context of anti-social peers” adds Leonard.

“Mindfulness training helps youth consider more adaptive alternatives,” adds Bethany Casarjian, PhD, of the Lionheart Foundation, who developed the Power Source intervention and coauthored 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 participants were randomly assigned to one of two groups based upon the prison dormitory where they resided: the intervention group received CBT/MT 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 with the control group. Moreover, within the CBT/MT group, the attentional task performance among those who practiced outside of intervention sessions remained stable compared with those who did not practice outside of the intervention sessions. These findings indicate that a multisession 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, coauthor 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,” says 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 youths strategies to improve cognitive and emotional control in the stressful detainment environment. In particular, training methods that allow youths 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 youths cultivate resilience by building their capacity for cognitive control while detained and after release.

"Finally," Leonard adds, "we know that incarceration is not good for youths, 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."

— Source: New York University