Assessing the effects of digital meditation on the cognitive function of adolescents with childhood trauma

INTERVENTION: Study participants were cluster‐randomized into either the internal‐attention intervention (IAI) or external‐attention intervention (EAI) or no intervention (NI). Cluster randomization was based on enrollment in pre‐existing after‐school groups. Both IAI and EAI were self‐administered on digital tablet applications for up to 30 minutes of practice per session (25 minutes training interspersed with short 1 min breaks every 5 minutes), for 30 sessions over 6 weeks. To facilitate full adherence and troubleshoot any technical issues, a research staff member was present during all after‐school group training sessions; participants sat in a group, yet, performed their individual training sessions. The intervention arms were double‐blinded; both IAI and EAI arms were experimental, hence, neither the participants nor the research staff interacting with the participants had any knowledge as per the relative efficacy of one or the other arm, and the NI arm did not have knowledge of the other IAI/EAI arms, thereby, equating placebo effects in all study arms as much as possible. Caregivers and teachers were also intervention blind. At the end of each intervention session, progress and performance data were automatically transferred to a secure study data server in de‐identified format. Participants in the IAI group practiced attending to the sensations of their breath, with monitoring guided using a digital app – Meditrain – which recently revealed benefits on sustained attention in healthy young adults (Ziegler et al., Nature Human Behaviour, 2019 in press). Participants were instructed to acknowledge internally distracting thoughts when they occurred during the practice, then disengage from the thought and shift their attention back to their breath. Participants practiced attention to breath in adaptive trial durations starting as short as 10 seconds and progressively building up to several minutes of breath focus. Trial dur CONDITION: Disturbance of activity and attention in adolescents with a history of traumatic early childhood experiences ; Mental and Behavioural Disorders ; Disturbance of activity and attention PRIMARY OUTCOME: ; 1. Functional connectivity of the dorsal anterior cingulate cortex region is measured using resting‐state functional magnetic resonance imaging at baseline time 1 and post‐intervention time 2.; 2. Sustained attention and interference resolution is measured using computerised cognitive assessments at baseline time 1 and post‐intervention time 2.; 3. ADHD symptoms are measured using caregiver‐based ADHD ratings at baseline time 1, post‐intervention time 2 and one‐year follow‐up time 3.; SECONDARY OUTCOME: Academic performance is measured using the teacher‐rated observations of academic performance recorded on the Academic Performance Rating scale at post‐intervention time 2 and one‐year follow‐up time 3. INCLUSION CRITERIA: Reported a history of childhood trauma as per the Childhood Trauma Questionnaire (Bernstein et al., 2003).