The effect of mindfulness-based stress reduction (MBSR) Training on emotion regulation during voluntary inpatient care for youth with mixed mental health conditions

Adolescence is a sensitive period for emotional and cognitive development, with heightened risk for mental health challenges, particularly in individuals with ADHD and affective disorders. While Mindfulness-Based Stress Reduction (MBSR) improves emotion regulation and cognition in healthy populations, its effects in clinically complex adolescents are less understood. This pilot randomized controlled trial (RCT) examined the exploratory impact of an 8-week MBSR program on behavioral performance and neural processing in 31 adolescents (12–18 years) enrolled in a live-in mental health program, with 14 assigned to MBSR and 17 to a non-MBSR group receiving standard care. Participants completed a modified emotional oddball task while behavioral responses and event-related potentials (ERPs) were recorded. Results suggested that routine care with integrated MBSR was associated with selectively enhanced performance for fearful stimuli. Participants in the MBSR group showed shorter baseline-adjusted reaction times to fear-related stimuli and to targets following other targets, possibly reflecting improved task-relevant processing. ERP analyses detected no significant Group × Condition interactions for the P100 or P300 components, providing no evidence of broad changes in early sensory or attentional processing. In contrast, the MBSR group showed smaller baseline-adjusted Late Positive Potential (LPP) amplitudes for fearful stimuli but larger amplitudes for targets following fearful or other target stimuli, possibly reflecting attenuated sustained neural reactivity to threat and selective engagement with behaviorally relevant events. These patterns suggest that integrating MBSR into routine care may be associated with improved behavioral performance and selective modulation of later neural processing, potentially supporting rapid attentional engagement and efficient allocation of cognitive resources in adolescents with ADHD and affective disorders. This study suggests that mindfulness may have potential for supporting emotion regulation and attentional efficiency in clinical youth, while highlighting the need for larger-scale trials and examination of the long-term durability of these effects. Registered Clinical Trial (RCT) This study is part of a registered clinical trial. The trial protocol was registered with ClinicalTrials.gov under the registration identifier: NCT01307943.