Ruminative thinking involves repetitively dwelling on negative experiences. A high level of ruminative thinking is a risk factor for depressive and anxiety disorders and is also a major feature of these disorders. Mindfulness offers a way to attend to negative experience and let content of thinking arise and fall without elaboration.
Reducing ruminative thinking may be a way to reduce the risk of developing future psychological disorders. Hilt et al. [Journal of Clinical Child and Adolescent Psychology] tested whether a mobile mindfulness app could reduce ruminative thinking in adolescents.
The researchers randomly assigned 152 adolescents (average age = 14; 59% female; 82% Caucasian) with high levels of rumination to a mindfulness or a mood-monitoring only group. Both groups downloaded the mobile CARE app on their smartphones. The app requested participants to rate their rumination and mood three times daily: once before and after school, and once before bedtime.
After completing ratings, mindfulness group participants engaged in mindfulness meditations of varying lengths depending on the free time they had available.
Meditations were guided by written instruction (1 minute meditations) or audio recordings (3-12 minute meditations). The meditations involved focus on the breath, body sensations, or sound. Meditation opportunities were provided 67% of the time at the end of rating sessions, and 85% of the time when participants reported sadness or anxiety. The mood-monitoring only group rated rumination and mood without the opportunities for meditation.
After three weeks, participants were no longer prompted to use the app but could continue using it if they liked. Participants were assessed at baseline, post-treatment, and 6-week, 12-week, and 6-month follow-up on self-report measures of rumination, depression, and anxiety.
The results show the mindfulness group had significantly reduced levels of rumination (d=0.43), depression (d=0.24), and anxiety (d=0.25) compared to controls at immediate post-test. The aggregate rumination scores (but not depression and anxiety scores) in the mindfulness group remained significantly lower than controls at 6-week follow-up, but not on the subsequent follow-ups.
A mediation analysis showed that post-treatment decreases in depression and anxiety were due to the decreased rumination scores predicted by the mindfulness group.
The study shows that brief app-prompted mindfulness meditations can reduce rumination, depression, and anxiety in ruminative adolescents better than mood-monitoring alone. These effects are not long-lasting and tend to fade within 6-12 weeks.
The study is important because most adolescents who ruminate do not receive any professional psychological care, and an inexpensive, easily deployable app may reduce some degree of rumination. The study is limited by the absence of a no treatment control or a meditation app without mood-monitoring.
Hilt, L. M., Swords, C. M., & Webb, C. A. (2023). Randomized Controlled Trial of a Mindfulness Mobile Application for Ruminative Adolescents. Journal of Clinical Child & Adolescent Psychology.
Link to study