Effects of Mindfulness and Life-Skills Training on Emotion Regulation and Anxiety Symptoms in Chinese Migrant Children: A Randomized Controlled Trial.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Training based on problem-solving skills can effectively improve students' critical thinking, increase their ability to cope with emotions and stress, reduce physical and verbal aggression as well as interpersonal conflict, and improve social competence.

“Studies have shown that training based on problem-solving skills can effectively improve students' critical thinking, increase their ability to cope with emotions and stress, reduce physical and verbal aggression as well as interpersonal conflict, and improve social competence [69].”

• cites [69] 69. Savoji AP, Ganji K. Increasing mental health of University students through life skills training (LST). Proc Soc Behav Sci 2013;84:1255e9. sourcePartly supported

  The Discussion reports that life skills training improved university students’ mental health and coping with stress, with fewer interpersonal problems. The program included problem-solving and critical-thinking sessions, but the paper does not show that problem-solving training specifically improved critical thinking or emotion management, reduced physical or verbal aggression, or improved social competence. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Expressive suppression implies an intentional inhibition of behaviors associated with negative emotions.

“It is different to expression suppression, which implies an intentional inhibition of behaviors associated with negative emotions [25].”

• cites [25] 25. Gotlib IH, Joormann J. Cognition and depression: Current status and future directions. Annu Rev Clin Psychol 2010;6:285e312. http://DxDoiOrg/ 101146/AnnurevClinpsy121208131305. sourceCould not verify

  The ‘Cognitive Biases and Emotion Regulation in Depression’ section mentions emotion suppression as a regulation strategy but does not define expressive suppression. The ‘Inhibition and Cognitive Control’ section discusses suppressing thoughts and processing negative material, not intentionally inhibiting behaviors associated with negative emotions. Searches for expressive suppression and behavioral expression found no passage addressing the claimed definition; page numbers were unavailable in our copy. (LLM, conf=0.74)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

One of the mechanisms of mindfulness practice is thought to be exposure, which enables a person to experience emotions with greater objectivity and less reactivity.

“One of the mechanisms of mindfulness practice is thought to be exposure, which enables a person to experience emotions with greater objectivity and less reactivity [64].”

• cites [64] 64. Shapiro SL, Carlson LE, Astin JA, et al. Mechanisms of mindfulness. J Clin Psychol 2006;62:373e86. sourcePartly supported

  The Additional Mechanisms section identifies exposure as a potential mechanism of mindfulness practice. But it says reperceiving enables a person to experience emotions with greater objectivity and less reactivity, which in turn increases exposure to difficult emotional states; the claim assigns that enabling role to exposure. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Positive childhood experiences such as having a supportive mentor can improve long-term mental and relational health.

“and positive childhood experiences such as having a supportive mentor can improve long-term mental and relational health [42].”

• cites [42] 42. Bethell C, Jones J, Gombojav N, et al. Positive childhood experiences and adult mental and relational health in a Statewide sample: Associations across adverse childhood experiences levels. JAMA Pediatr 2019;173: e193007. sourcePartly supported

  The Methods (Key Measures; page unavailable) include having nonparent adults who took a genuine interest in the child, consistent with the example of a supportive mentor. The Abstract (Meaning; page unavailable) reports an association between positive childhood experiences and adult mental and relational health, and says promoting those experiences may reduce problems. It does not establish that a supportive mentor causes improved long-term health, as “can improve” suggests. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

May combine two claims.

Mindfulness training has previously been shown to improve emotional regulation, which can modulate emotional responses to negative feelings associated with anxiety, and promote emotional balance.

“Mindfulness training (MT) has previously been shown to improve emotional regulation, which can modulate emotional responses to negative feelings associated with anxiety, and promote emotional balance [10].”

• cites [10] 10. Wu R, Liu L-L, Zhu H, et al. Brief mindfulness meditation improves emotion processing. Front Neurosci Switz 2019;13:1074. sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

The broaden-and-build theoretical model suggests that fostering mindfulness encourages an upward spiral of positive emotions because mindfulness as a personal resource can augment positive reappraisal.

“The broaden-and-build theoretical model suggests that fostering mindfulness encourages an upward spiral of positive emotions because mindfulness as a personal resource can augment positive reappraisal [29].”

• cites [29] 29. Garland EL, Fredrickson B, Kring AM, et al. Upward spirals of positive emotions counter downward spirals of negativity: Insights from the broaden-and-build theory and affective neuroscience on the treatment of emotion dysfunctions and deficits in psychopathology. Clin Psychol Rev 2010;30:849e64. sourceSupported

Classified as probably not a substantial claim.

Mental health issues are often attributed to failures in emotional regulation.

“Mental health issues are often attributed to failures in emotional regulation [9].”

• cites [9] 9. Heatherton TF, Wagner DD. Cognitive neuroscience of self-regulation fail- ure. Trends Cogn Sci 2011;15:132e9. sourcePartly supported

  The Abstract describes self-regulatory failure as a core feature of many mental health problems. The “Regulation of Emotions” section reports disrupted emotion-regulation circuitry in major depressive disorder and borderline personality disorder, but does not extend that specific finding to mental health issues generally. Our copy provides no page numbers for these passages. (LLM, conf=0.82)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Expressive suppression is a defense mechanism used to cope with negative emotions, but associated with longer-term depression and anxiety.

“while expressive suppression is a defense mechanism used to cope with negative emotions, but associated with longer-term depression and anxiety [26].”

• cites [26] 26. Eftekhari A, Zoellner LA, Vigil SA. Patterns of emotion regulation and psychopathology. Anxiety Stress Coping 2009;22:571e86. http:// DxDoiOrg/101080/10615800802179860. sourcePartly supported

  The paper describes expressive suppression as an emotion-regulation strategy that inhibits emotional responses, and its Discussion reports higher depression and anxiety among participants with a low-regulation pattern that included moderate suppression (page numbers unavailable). It does not establish a longer-term association with depression and anxiety, nor does it characterize expressive suppression specifically as a defense mechanism. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Cognitive reappraisal is correlated with adaptive outcomes, such as lower depression.

“Cognitive reappraisal is correlated with adaptive outcomes, such as lower depression [25]”

• cites [25] 25. Gotlib IH, Joormann J. Cognition and depression: Current status and future directions. Annu Rev Clin Psychol 2010;6:285e312. http://DxDoiOrg/ 101146/AnnurevClinpsy121208131305. sourceSupported

Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based).

Migrant students with intermediate social integration showed no change in emotion regulation.

“Migrant students with intermediate social integration showed no change.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The practice of mindfulness skills can help individuals experience painful sensations without reactivity.

“One study found that the practice of mindfulness skills can actually help individuals experience painful sensations without reactivity [66].”

• cites [66] 66. Baer RA. Mindfulness training as a clinical intervention: A conceptual and empirical review. Clin Psychol Sci Pract 2003;10:125e43. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Mindfulness emphasizes bringing sensations, feelings, and thoughts into awareness with nonjudgmental acceptance.

“Mindfulness emphasizes on bringing sensations, feelings, and thoughts into awareness with nonjudgmental acceptance [28].”

• cites [28] 28. Hill CLM, Updegraff JA. Mindfulness and its relationship to emotional regulation. Emotion 2012;12:81e90.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

By paying conscious attention to negative emotional states, people learn from experience that there is no need to fear or avoid such emotions, as they will eventually disappear.

“By paying conscious attention to negative emotional states, people learn from experience that there is no need to fear or avoid such emotions, as they will eventually disappear [65].”

• cites [65] 65. Segal ZV, Teasdale JD, Williams JM, et al. The mindfulness-based cognitive therapy adherence scale: Inter-rater reliability, adherence to protocol and treatment distinctiveness. Clin Psychol Psychother 2002;9:131e8. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Migrant children with low social integration may have fewer emotion regulation skills than older youth populations.

“They may have fewer emotion regulation skills than do older youth populations [59].”

• cites [59] 59. Zeman J, Cassano M, Perry-Parrish C, et al. Emotion regulation in children and adolescents. J Dev Behav Pediatr 2006;27:155e68. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Lower levels of harm avoidance are often described as fearless, carefree, sociable, and energetic.

“Lower levels of harm avoidance are often described as fearless, carefree, sociable, and energetic [60].”

• cites [60] 60. Markett S, Montag C, Reuter M. Anxiety and harm avoidance. In: Neuro- imaging Personality, Social Cognition, and Character. 2016:91e112. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Practicing mindfulness may have led to increased awareness of physical symptoms rather than a true increased incident of physical sensations.

“Practicing mindfulness may have led to increased awareness of physical symptoms rather than a true increased incident of physical sensations.”

May combine two claims.

LS training has been found to have positive effects on youth depression, anxiety, self-esteem, anger, addiction, and interpersonal conflicts.

“LS training, as one approach, has been found to have positive effects on youth depression, anxiety, selfesteem, anger, addiction, and interpersonal conflicts [39,40].”

• cites [39] 39. Jamali S, Sabokdast S, Nia HS, et al. The effect of life skills training on mental health of Iranian middle school students: A preliminary study. Iran J Psychiatry 2016;11:269.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [40] 40. Luna-Adame M, Carrasco-Giménez TJ, Del Mar Rueda-Garcý M. Evaluation of the effectiveness of a smoking prevention program based on the 'Life Skills Training' approach. Health Educ Res 2013;28:673e82. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

This finding is consistent with findings from high-income settings that showed mindfulness reducing anxiety symptoms in primary school students.

“This finding is consistent with findings from high-income settings that showed mindfulness reducing anxiety symptoms in primary school students [49,61].”

• cites [49] 49. Strohmaier S, Jones FW, Cane JE. Effects of length of mindfulness practice on mindfulness, depression, anxiety, and stress: A randomized controlled experiment. Mindfulness (N Y) 2021;12:198e214. sourceNot checked — no full text of the source
• cites [61] 61. Napoli M, Krech PR, Holley LC. Mindfulness training for elementary school students: The attention academy. J Appl Sch Psychol 2005;21:99e125. sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

Research on emotional and behavioral problems among low-income and gifted adolescents in China suggests that mindfulness plus LS interventions may have potential benefits in reducing emotional and behavioral problems.

“For instance, research on emotional and behavioral problems among lowincome and gifted adolescents in China suggests that mindfulness plus LS interventions may have potential benefits in reducing emotional and behavioral problems [43].”

• cites [43] 43. Huang C-C, Chen Y, Jin H, et al. Mindfulness, life skills, resilience, and emotional and behavioral problems for gifted low-income adolescents in China. Front Psychol 2020;11:594.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Increased self-efficacy in adolescents has been associated with lower prevalence of anxiety symptoms.

“Specifically, increased self-efficacy in adolescents has been associated with lower prevalence of anxiety symptoms [63].”

• cites [63] 63. Muris P. Relationships between self-efficacy and symptoms of anxiety disorders and depression in a normal adolescent sample. Personal Individ Differ 2002;32:337e48.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

A combined mindfulness and LS intervention is likely more effective than either individual intervention alone as it would simultaneously emphasize both the psychological states and behavioral practices.

“A combined mindfulness and LS intervention is likely more effective than either individual intervention alone as it would simultaneously emphasize both the psychological states and behavioral practices.”

• AssumptionRests on an assumption: No study has examined the combined effects of MT plus LS mentorship on emotion regulation and anxiety symptoms among Chinese migrant children.

May combine two claims.

Both LS training and MT have the potential to reduce mental health problems in children and adolescents.

“Both LS training and MT, which concentrate on psychological change and skill development, respectively, have the potential to reduce mental health problems in children and adolescents [36].”

• cites [36] 36. Huang CC, Chen Y, Greene L, et al. Resilience and emotional and behavioral problems of adolescents in China: Effects of a short-term and intensive mindfulness and life skills training. Child Youth Serv Rev 2019;100:291e7.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Higher social integration would mitigate the adverse effects of social exclusion on children's mental health issues as a buffering role.

“Higher social integration would mitigate the adverse effects of social exclusion on children's mental health issues as a buffering role [18].”

• cites [18] 18. Arslan G. Social exclusion, social support and psychological Wellbeing at school: A study of mediation and moderation effect. Child Indic Res 2018; 11:897e918. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Migrant children face challenges with social integration.

“challenges with social integration [4]”

• cites [4] 4. Chen X, Li D, Xu X, et al. School adjustment of children from rural migrant families in urban China. J Sch Psychol 2019;72:14e28. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Mental health outcomes may take time to show benefits.

“Research has shown that mental health outcomes may take time to show benefits [70].”

• cites [70] 70. Tam CC, Li X, Benotsch EG, et al. A resilience-based intervention pro- gramme to enhance psychological well-being and Protective factors for rural-to-urban migrant children in China. Appl Psychol Health Well Being 2020;12:53e76. sourceNot checked — no full text of the source

May combine two claims.

Difficulties in social integration and acculturation result in weak social adaptability and poor emotion regulation.

“Difficulties in social integration and acculturation result in weak social adaptability and poor emotion regulation [4].”

• cites [4] 4. Chen X, Li D, Xu X, et al. School adjustment of children from rural migrant families in urban China. J Sch Psychol 2019;72:14e28. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The Cronbach's alpha of the MASC-C in the current sample of ages 9-17 years was 0.92.

“The Cronbach's a of the MASC-C in the current sample of ages 9e 17 years was 0.92, which was similar to that of published studies [44,51].”

• cites [44] 44. Yao S, Tao Z, Zhu X, et al. Reliability and validity of the Chinese version of the multidimensional anxiety scale for children among Chinese secondary school students. Child Psychiatry Hum Dev 2007;38:1e16. sourceNot checked — no full text of the source
• cites [51] 51. Tan F, Wu W, Yao S. A comparison between factor structure Invariance of Multidimensional anxiety scale for Chinese and Italian children sample. Chinese J Clin Psychol 2010;18:704e6.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

SPSS 25.0 was used to generate random numbers to randomly distribute migrant children into the intervention group.

“Then, SPSS 25.0 was used to generate random numbers, to randomly distribute migrant children into the intervention group until the number of migrant children in the intervention group met the required sample size.”

May combine two claims.

The MASC-C has verified reliability and validity in Chinese children and adolescents aged 14-19 years and 7-9 years.

“The reliability and validity of MASC-C has been verified in a sample of Chinese children and adolescents aged 14e19 years (Cronbach's a ¼ 0.91, intra-class correlation coefficient ¼ 0.84 [49]) and 7e9 years (Cronbach's a ¼ 0.86 [50]).”

• cites [49] 49. Strohmaier S, Jones FW, Cane JE. Effects of length of mindfulness practice on mindfulness, depression, anxiety, and stress: A randomized controlled experiment. Mindfulness (N Y) 2021;12:198e214. sourceNot checked — no full text of the source
• cites [50] 50. Mohammadzadeh M, Awang H, Shahar HK, et al. The effects of a life skills- based intervention on emotional health, self-esteem and coping mecha- nisms in Malaysian institutionalised adolescents: Protocol of a multi- centre randomized controlled trial. Int J Educ Res 2017;83:32e42. sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The analysis adjusted for student's gender, grade, parental education, and annual household income.

“Adjusted the associated factors including student's gender, grade, parental education, and annual household income in the analysis.”

Classified as probably not a substantial claim.

A final sample size of 653 children was chosen to allow for 20% loss to follow-up.

“To adjust for nonadherence, we chose a final sample size of 653 children (285 in two intervention arms and 368 in the control arm; Figure 1) to allow for 20% loss to follow-up.”

May combine two claims.

The ERQ-CA-C has acceptable internal consistency and eight-week test-retest reliability.

“The ERQ-CA-C has been reported to have acceptable internal consistency (Cronbach's a ¼ 0.79 for reappraisal and 0.75 for suppression) and eight-week test-retest reliability (r ¼ 0.73 for reappraisal and 0.70 for suppression).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The Cronbach's alpha of the ERQ-CA-C for the present sample was 0.84 for reappraisal and 0.72 for suppression.

“The Cronbach's a of the ERQ-CA-C for the present sample was 0.84 for reappraisal and 0.72 for suppression.”

Probably not a substantial claim: may not pass S3 (load-bearing).

A training assessment was implemented to ensure that the volunteers had the capability to guide the intervention groups.

“A training assessment was implemented to ensure that the volunteers had the capability to guide the intervention groups.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Annual household income and parental education were significantly higher in children with high and intermediate social integration compared to students with low social integration.

“Annual household income and parental education were significantly higher in children with high and intermediate social integration compared to students with low social integration.”

Classified as probably not a substantial claim.

All other migrant children in the same class not enrolled in the intervention arms were automatically included in the control group.

“To ensure comparability of the control group, all other migrant children in the same class not enrolled in the intervention arms were automatically included in the control group.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The interventions were standardized in delivery across instructors, and manualized, structured protocols were used to deliver the interventions.

“The interventions were standardized in delivery across instructors, and manualized, structured protocols were used to deliver the interventions.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Migrant children face impaired academic function.

“and impaired academic function [5].”

• cites [5] 5. Lu S, Lin YT, Vikse JH, et al. Well-being of migrant and left-behind children in China: Education, health, parenting, and personal values. Int J Soc Welf 2016;25:58e68. sourceNot checked — no full text of the source

May combine two claims.

Individuals with high level of mindfulness have more positive emotion and better emotional regulation compared to individuals with low level of mindfulness.

“Compared individuals with low level of mindfulness, individuals with high level of mindfulness have more positive emotion and better emotional regulation [28].”

• cites [28] 28. Hill CLM, Updegraff JA. Mindfulness and its relationship to emotional regulation. Emotion 2012;12:81e90.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

Stressors arising from a high-stakes educational system and parental pressures may outweigh the benefits of an intervention that targets only the students.

“In addition, stressors arising from a high-stakes educational system and parental pressures may outweigh the benefits of an intervention that targets only the students.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

Children in private migrant schools may have needed the most help.

“In our study, highly integrated migrant children benefited the most from the intervention when in fact, children in private migrant schools may have needed the most help.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The five participating schools had variabilities in implementation logistics such as time, space, and administrative support that may have affected intervention efficacy.

“Second, the five participating schools had variabilities in implementation logistics such as time, space, and administrative support that may have affected intervention efficacy.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

The migrant children who participated in the intervention may have been concerned that they were receiving an additional weekly educational program because they had psychological problems.

“Third, the migrant children who participated in the intervention may have been concerned that they were receiving an additional weekly educational program because they had”

Probably not a substantial claim: may not pass S3 (load-bearing).

The intervention was only conducted among students in grades 4 to 8.

“Fourth, the intervention was only conducted among students in grades 4 to 8.”

Classified as probably not a substantial claim. May combine two claims.

The study was a rigorously designed randomized controlled trial with a large sample size and rich social integration data.

“First, it was a rigorously designed randomized controlled trial with a large sample size and rich social integration data.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Study participants completed the postintervention survey right before final examinations, which may have increased their anxiety symptoms and masked the positive intervention effects.

“First, study participants completed the postintervention survey right before final examinations, which may have increased their anxiety symptoms and masked the positive intervention effects.”

Classified as probably not a substantial claim.

The three-month follow-up was conducted during the Chinese New Year Festival by chance.

“Moreover, the three-month follow-up was conducted during the Chinese New Year Festival by chance.”

Probably not a substantial claim: may not pass S2 (checkable).

The use of preventive interventions using community volunteers can bridge the gap until enough mental health professionals can be trained.

“The use of preventive interventions using community volunteers can bridge the gap until enough mental health professionals can be trained.”

May combine two claims.

In China, not enough professional psychologists work with school-age children and private migrant schools often lack psychologists.

“In China, not enough professional psychologists work with school-age children and private migrant schools often lack psychologists [73,74].”

• cites [73] 73. Ju K, Tao H, Ji W, et al. Experience in carrying out classified early warning intervention for "family-school-hospital-community" psychological crisis for primary and secondary school students in Changning District, Shanghai. J Educ Biol 2022;10.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [74] 74. Ye L. Investigation and feasibility study of the professionalization of psy- chological teachers in regional junior high schools: Taking Hongkou Dis- trict of Shanghai as an example. Mental Health Educ Prim Second Sch 2020;1:65e8.Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

Improving social integration, parental support, and normalizing mental health education may help enhance any benefit derived from future interventions.

“Improving social integration, parental support, and normalizing mental health education may help enhance any benefit derived from future interventions.”