Breath-focused mindfulness and compassion training in parent-child dyads: a pilot intervention study
Data files
May 12, 2025 version files 39.75 KB
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CoCo_ms_Dataset_Revised_Dryad_Submission.xlsx
32.96 KB
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README.md
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Abstract
Background: Depression in children is a concerning societal issue, and can be associated with poor academic performance, school dropout and poor overall quality of life. Additionally, child depression is often associated with parallel stress and depression in parents.
Objective: This scenario highlights the urgent need for development and implementation of accessible and scalable solutions that may co-benefit child and parent mental well-being.
Methods: This pilot study introduced "Cooperative Compassion" (CoCo), a parent-child co-training digital application aimed at promoting mindfulness and compassion through brief, performance-adaptive sessions. A community sample of 24 parent-child dyads (children’s mean age: 9.5 years, 14 females/10 males, 11 Caucasian/5 Asian/7 mixed race/1 other race; parents’ mean age: 44.5 years, 20 females/4 males, 14 Caucasian/8 Asian/2 mixed race) of high average affluence socio-economic scores participated in the study. These parent-child dyads completed 30 sessions of CoCo training over three months with baseline and post-intervention assessments occurring within 2 weeks of training initiation/completion, respectively.
Results: The program was feasible, with 80% of families completing over 90% of sessions and providing positive feedback. Mental health assessments showed a non-significant effect in the expected direction in children’s depression scores (Cohen’s d=-0.19, 95% Confidence Interval (95% CI) [-8.89 to 1.74], P=.07) and significant reductions in parental stress (d=-0.41, 95% CI [-2.63 to -0.16], P=.02), anxiety (d=-0.47, 95% CI [-2.67 to -0.20], P=.02), and depression (d=-0.50, 95% CI [-3.25 to -0.08], P=.03), with sustained benefits at the 3-month follow-up. Parental mindfulness improvements were correlated with stress reduction (rho=-0.45, P=.03). On an emotion bias task utilized as an objective assessment of cognition, children demonstrated improved processing speed post-intervention (d=0.54, 95% CI [0.012 to 0.083], P=.005), and a marginal improvement was also observed in parents (d= 0.19, 95% CI [-0.004 to 0.030], P=.05). Cortical source imaging of EEG recordings acquired simultaneous to an attention-to-breathing assessment showed significant reduction in task-related default mode network (DMN) activity (d=-0.62, 95% CI [-.0096 to -.0002], P=.01).
Conclusions: Post CoCo intervention decrease in DMN activity on the attention-to-breath task in parent-child dyads may be indicative of cortical plasticity reflecting reduced mind-wandering and thereby, enhanced focus after training. The current promising behavioral and cognitive results suggest the need for a larger sample size and a randomized controlled study design. Overall, these findings highlight the potential for brief, digital mindfulness and compassion co-training to improve family mental health and well-being.
Description of the Data and file structure
The xlsx file contains the study data corresponding to (1) Demographics 24 Dyads (2) Training Feasibility (TF) survey
(3)
Spreadsheet (1) - Demographics 24 Dyads
Dyad_ID: ID starting with the prefix PJ assigned to each parent-child dyad
Child Age Bins: Children’s age in years; 1 = 5-10 Years Old; 2 = 11-15 Years Old
Child Gender: Children’s Gender, 1: male, 2: female
Child Race: Children’s race, 1: Caucasian; 2: Black/African American; 3: Native Hawaiian or Other Pacific Islander; 4: Asian; 5: Native American; 6: More than one ethnicity; 7: Other
Child_Ethnicity:Children’s Ethnicity, 1. Hispanic 2. Non Hispanic 3. Other
Parent Age Bins: Parents’ age in years; 3 = 25-35 Years Old; 4 = 35-45 Years Old; 5 = 45-55 Years Old
Parent Gender: Parents’ Gender, 1: male, 2: female
Parent Race: Parents’ race, 1: Caucasian; 2: Black/African American; 3: Native Hawaiian or Other Pacific Islander; 4: Asian; 5: Native American; 6: More than one ethnicity; 7: Other
Parent_Ethnicity:Parents’ Ethnicity, 1. Hispanic 2. Non Hispanic 3. Other
SES_Score: Parents’ Socioeconomic status (SES) scores, 0-2 (low affluence), 3-5 (middle affluence), >5 (high affluence)
Spreadsheet (2) -Training Feasibility (TF) survey
TF1: We enjoyed the training.
TF2: We felt frustrated after the training.
TF3: We felt satisfied with the training.
TF4: We felt tired after the training.
TF5: The training was easy to understand.
TF6: The training was difficult to use.
TF7: The training was easy to navigate.
TF8: We were worried about our data security.
TF9: The training was easy to initiate each day.
TF10 The training fit in our daily schedule.
TF11: The training time passed by quickly.
TF12: The training felt therapeutic.
TF13: The training felt useless.
TF14: We would recommend this training outside of this study.
TF15: We would recommend this training to others.
TF16: This training positively affected our family’s life.
Spreadsheet (3) - Behaviors
Dyad_ID: ID starting with prefix PJ assigned to each parent-child dyad
Pre_Tscore_cdi_Child: Pre Child Depression Index (CDI ) T-Score by children
Pre_Tscore_cdi_Parents: Pre Child Depression Index (CDI ) T-Score by parents
Pre_GAD7_Anxiety_Parent: Pre General Anxiety Disorder-7 score parent
Pre_Depression_phq9_Parent: Pre Patient Health Questionnaire (PHQ-9) depression score parent
Pre_Stress_DASS_Parent: Pre Stress score on Depression Anxiety Stress Scale-21 parent
Pre_Mindfulness_Parent: Pre Mindful Attention Awareness Scale score parent
Final Breathe Level: Final level of breath focused training reached by parent-child dyad
Total Sessions: Total training session completed by parent-child dyad
Post_Tscore_cdi_Child: Post Child Depression Index (CDI ) T-Score by children
Post_Tscore_cdi_Parents: Post Child DePostssion Index (CDI ) T-Score by parents
Post_GAD7_Anxiety_Parent: Post General Anxiety Disorder-7 score parent
Post_Depression_phq9_Parent: Post Patient Health Questionnaire (PHQ-9) depression score parent
Post_Stress_DASS_Parent: Post Stress score on DePostssion Anxiety Stress Scale-21 parent
Post_Mindfulness_Parent: Post Mindful Attention Awareness Scale score parent
FollowUp_T_cdi_Child_score: Follow-up Child Depression Index (CDI ) T-Score by children
FollowUp_T_cdi_Parent_score: Follow-up Child DeFollow-upssion Index (CDI ) T-Score by parents
FollowUp_anxietyscore_parent: Follow-up General Anxiety Disorder-7 score parent
FollowUp_depressionscore_phq9_Parent: Follow-up Patient Health Questionnaire (PHQ-9) depression score parent
FollowUp_DASS_Stress_Parent: Follow-up Stress score on DeFollow-upssion Anxiety Stress Scale-21 parent
FollowUp_mindfulnesscore_parent: Follow-up Mindful Attention Awareness Scale score parent
Spreadsheet (4) - Cognitive
Dyad_ID: ID starting with prefix PJ assigned to each parent-child dyad
Pre_Child_speed_neutral: Pre speed for neutral faces in children
Pre_Child_speed_happy: Pre speed for happy faces in children
Pre_Child_speed_angry: Pre speed for angry faces in children
Pre_Child_speed_sad: Pre speed for sad faces in children
Pre_Child_speed_all: Pre speed for all faces in children
Post_Child_speed_neutral: Post speed for neutral faces in children
Post_Child_speed_happy: Post speed for happy faces in children
Post_Child_speed_angry: Post speed for angry faces in children
Post_Child_speed_sad: Post speed for sad faces in children
Post_Child_speed_all: Post speed for all faces in children
Diff_Child_Speed_PostPre: Difference between Post and Pre speed for all faces in children
Pre_Parent_speed_neutral: Pre speed for neutral faces in Parents
Pre_Parent_speed_happy: Pre speed for happy faces in Parents
Pre_Parent_speed_angry: Pre speed for angry faces in Parents
Pre_Parent_speed_sad: Pre speed for sad faces in Parents
Pre_Parent_speed_all: Pre speed for all faces in Parents
Post_Parent_speed_neutral: Post speed for neutral faces in Parents
Post_Parent_speed_happy: Post speed for happy faces in Parents
Post_Parent_speed_angry: Post speed for angry faces in Parents
Post_Parent_speed_sad: Post speed for sad faces in Parents
Post_Parent_speed_all: Post speed for all faces in Parents
Diff_Parent_Speed_PostPre: Difference between Post and Pre speed for all faces in Parents
Spreadsheet (5) - Neural
Dyad_ID: ID starting with prefix PJ assigned to each parent-child dyad
Group: Rows for Child and Parents Group
FPN_pre: Fronto-parietal network source activity at Pre
CON_pre: Cingulo-opercular network source activity at Pre
DMN_pre: Default mode network source activity at Pre
FPN_post: Fronto-parietal network source activity at Post
CON_post: Cingulo-opercular network source activity at Post
DMN_post: Default mode network source activity at Post
FPN_postpre: Fronto-parietal network source activity at Post-Pre Difference
CON_postpre: Cingulo-opercular network source activity at Post-Pre Difference
DMN_postpre: Default mode network source activity at Post-Pre Difference
Sharing/access Information
Links to other publicly accessible locations of the data: N/A
Was data derived from another source? No
Human subjects data
Signed informed consent was obtained from the parents and signed assent was obtained from the children for study participation following the guidelines outlined in the Declaration of Helsinki. The study protocol was approved by the institutional review board of the University of California San Diego (protocol #180140). The study data were de-identified by taking out protected health information such as names, dates, and place of birth or anything else that is listed by Health Insurance Portability and Accountability Act (HIPPA) compliance.
Participants. A total of 24 parent-child dyads participated in the current study. Dyads were recruited from local schools and university-affiliated pediatric clinics in the San Diego area through flyer advertisements and clinic referrals, respectively. Signed informed consent was obtained from the parents and signed assent was obtained from the children for study participation following the guidelines outlined in the Declaration of Helsinki. The study protocol was approved by the institutional review board of the University of California San Diego (protocol #180140). The study data were de-identified by taking out protected health information such as names, dates, and place of birth or anything else that is listed by Health Insurance Portability and Accountability Act (HIPPA) compliance. All the parent-child dyads were paid $250 for completing all assessments and digital training.
Also, all children and parents were right-handed and had normal or corrected-to-normal vision. Children were assessed on the Child Depression Index (CDI (Kovacs, 2012)) and study inclusion was based on CDI scores in the average and above-average range (T-score>40). Exclusion was based on any self-reported severe illness for parent or child that would not allow time for study participation. All parents were healthy and did not report any current diagnoses or medications.
Sample Size and Power. This single-arm study was powered to detect medium effect size (Cohen d>0.5) comparing pre- versus post-intervention differences at β power of 0.8 and α level of 0.05 for each assessment measure. Effect sizes were calculated a priori using the G*Power software (Faul et al., 2009).
Feasibility. We assessed intervention feasibility by monitoring the total number of assigned intervention sessions completed. Additionally, parents completed a feasibility survey at end of study that we have standardized in previous digital training studies (Mishra et al., 2016). The survey queried 16 questions about the training as elaborated in the Results (Table 2) and each question required a response on a seven-point Likert scale. The Cronbach α measure of reliability for the training survey was high (α = 0.92).
Assessments. Each parent-child dyad made two visits (baseline [pre-intervention] and three-months later [post-intervention]) to the Neural Engineering and Translational Labs (NEATLabs) and participated in behavioral and neurocognitive assessments. Behavioral assessments were also completed online at a 3-month follow-up after intervention completion.