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Cited by 516Mindfulness and Compassion InterventionsStudent Stress and CopingDigital Mental Health Interventions

A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): a pragmatic randomised controlled trial

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Galante, Julieta, Dufour, Géraldine, Vainre, Maris, Wagner, Adam P, Stochl, Jan, Benton, Alice, Lathia, Neal, Howarth, Emma +1 more·2018·The Lancet Public Health
DOI 10.1016/s2468-2667(17)30231-1PMC PMC5813792
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Abstract

BACKGROUND: The rising number of young people going to university has led to concerns about an increasing demand for student mental health services. We aimed to assess whether provision of mindfulness courses to university students would improve their resilience to stress. METHODS: We did this pragmatic randomised controlled trial at the University of Cambridge, UK. Students aged 18 years or older with no severe mental illness or crisis (self-assessed) were randomly assigned (1:1), via remote survey software using computer-generated random numbers, to receive either an 8 week mindfulness course adapted for university students (Mindfulness Skills for Students [MSS]) plus mental health support as usual, or mental health support as usual alone. Participants and the study management team were aware of group allocation, but allocation was concealed from the researchers, outcome assessors, and study statistician. The primary outcome was self-reported psychological distress during the examination period, as measured with the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM), with higher scores indicating more distress. The primary analysis was by intention to treat. This trial is registered with the Australia and New Zealand Clinical Trials Registry, number ACTRN12615001160527. FINDINGS: Between Sept 28, 2015, and Jan 15, 2016, we randomly assigned 616 students to the MSS group (n=309) or the support as usual group (n=307). 453 (74%) participants completed the CORE-OM during the examination period and 182 (59%) MSS participants completed at least half of the course. MSS reduced distress scores during the examination period compared with support as usual, with mean CORE-OM scores of 0·87 (SD 0·50) in 237 MSS participants versus 1·11 (0·57) in 216 support as usual participants (adjusted mean difference -0·14, 95% CI -0·22 to -0·06; p=0·001), showing a moderate effect size (β -0·44, 95% CI -0·60 to -0·29; p<0·0001). 123 (57%) of 214 participants in the support as usual group had distress scores above an accepted clinical threshold compared with 88 (37%) of 235 participants in the MSS group. On average, six students (95% CI four to ten) needed to be offered the MSS course to prevent one from experiencing clinical levels of distress. No participants had adverse reactions related to self-harm, suicidality, or harm to others. INTERPRETATION: Our findings show that provision of mindfulness training could be an effective component of a wider student mental health strategy. Further comparative effectiveness research with inclusion of controls for non-specific effects is needed to define a range of additional, effective interventions to increase resilience to stress in university students. FUNDING: University of Cambridge and National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England.

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  • Mindfulness training, including MBSR and MBCT, has been shown to improve symptoms of anxiety, depression, stress, and other mental states.

    “As both a skill and a therapy, mindfulness has been shown to improve symptoms of anxiety, depression, stress, and other mental states (Galante et al. 2018; Ji et al. 2021; Johannsen et al. 2022; Zhu et al. 2021).”

    From Changes in Mental Health and EEG Biomarkers of Undergraduates Under Different Patterns of Mindfulness (2024) · cites this paper as Galante et al. 2018

    The Introduction reports evidence that mindfulness training improves anxiety and depression symptoms, and the Results report reduced distress and improved wellbeing in students taking the MSS course. The paper mentions an earlier MBSR trial, but its own intervention was MSS; the supplied passages do not establish the claim for MBCT. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Systematic reviews show that meditation and mindfulness-based intervention programs improve resilience to stress, anxiety and depression among university students and other populations, whether delivered offline or online.

    “Systematic reviews conducted on the effectiveness of meditation programs and mindfulness-based intervention programs led to improvements in resilience to stress, anxiety and depression among university students and other populations, whether delivered offline [9] or online [10–14].”

    From Effectiveness of online mindfulness interventions on medical students’ mental health: a systematic review (2021) · cites this paper as [9]

    The Introduction reports that systematic reviews found evidence of improvement in depression and anxiety symptoms, but describes the evidence for university students as preliminary and inconsistent. The Methods describe this paper’s own intervention as face-to-face, and the Introduction defines reduced examination-period distress as an indicator of resilience to stress. Thus the paper supports the offline intervention’s relevance, but it is a randomised trial—not itself a systematic review establishing improvements in all three outcomes. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • None of neuroscientific studies have explored whether and how brief mindfulness training influences certain psychological features especially social support in college students during the COVID-19 pandemic.

    “However, none of neuroscientific studies have explored whether and how brief mindfulness training influences certain psychological features especially social support in college students during the COVID-19 pandemic.”

    From Changes in Mental Health and EEG Biomarkers of Undergraduates Under Different Patterns of Mindfulness (2024) · cites this paper as Galante et al. 2018

    The Introduction reviews earlier mindfulness studies in university students, but does not assess whether neuroscientific studies examined social support. The paper’s trial predates COVID-19, and searches for neuroscientific research, social support, and the pandemic found no passage addressing the claimed research gap. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • Personality traits are relatively stable through time but can be enhanced through specific interventions.

    “Although personality traits are relatively stable through time they are not cast in stone and can be enhanced, as research has shown, through specific interventions (for reviews and metanalyses see Galante et al., 2018; Gilmartin et al., 2017; Jayawardene et al., 2017; McConville et al., 2017; Quaglia et al., 2016; Spinelli et al., 2018).”

    From Specific mindfulness traits protect against negative effects of trait anxiety on medical student wellbeing during high-pressure periods (2021) · cites this paper as Galante et al., 2018

    The Introduction defines resilience to stress as reduced psychological distress during examinations, and the Results report improved distress and wellbeing after mindfulness training. Neither section addresses whether personality traits are stable over time or can be enhanced by interventions (searched: personality, trait, stability). (LLM, conf=0.72)

    Experimental — accuracy not yet measured

  • The key skills taught during MT can protect against deterioration in mental health during periods of stress in older students, even if there are no apparent MT-related mental health benefits prior to the onset of stress.

    “We know from trials in older students that the key skills taught during MT can protect against deterioration in mental health during periods of stress, even if there are no apparent MT-related mental health benefits prior to the onset of stress.11”

    From The impact of mindfulness training in early adolescence on affective executive control, and on later mental health during the COVID-19 pandemic: a randomised controlled trial (2022) · cites this paper as [11]

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Authors
Galante, J., Dufour, G., Vainre, M., Wagner, A. P., Stochl, J., Benton, A., Lathia, N., Howarth, E., & Jones, P. B.
Affiliations
  • University of Cambridge (GB)
  • National Institute for Health and Care Research (GB)
  • University of East Anglia (GB)
  • University College London (GB)
Corresponding author
Galante, Julieta
ORCID
Venue
The Lancet Public Health
Publisher
Elsevier BV
Published
2018-02
Volume
3
Issue
2
Pages
e72-e81
ISSN
2468-2667 (ISSN-L)
DOI
10.1016/s2468-2667(17)30231-1
PMC
PMC5813792
OpenAlex
W2778288638
Cited by
516
References
31
Citations by year
2026: 42 · 2025: 69 · 2024: 67 · 2023: 68 · 2022: 71 · 2021: 86 · 2020: 56 · 2019: 46 · 2018: 9 · 2017: 1
FWCI
37.99
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UEA Digital Repository (University of East Anglia) (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Apollo (University of Cambridge) (submittedVersion, cc-by)
  • Apollo (cc-by)
Funders
  • National Institute for Health Research
  • University of Cambridge
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
mindfulness-based interventions, stress resilience, university students, student mental health, psychological distress, exam period, mental health support, CORE-OM, student well-being, academic stress, student satisfaction, student engagement, student attendance
MeSH terms
Adolescent, Adult, Female, United Kingdom, Health Promotion, Humans, Male, Mental Health Services, Stress, Psychological, Student Health Services, Students, Universities, Program Evaluation, Resilience, Psychological, Young Adult, Mindfulness

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