Efficacy of a mindfulness-based programme with and without virtual reality support to reduce stress in university students: A randomized controlled trial

Marta Modrego-Alarcón; Yolanda López-Del-Hoyo; Javier García-Campayo; Adrián Pérez-Aranda; Mayte Navarro-Gil; María Beltrán-Ruiz; Héctor Morillo; Irene Delgado-Suarez; Rebeca Oliván-Arévalo; Jesus Montero-Marin

doi:10.1016/j.brat.2021.103866

Efficacy of a mindfulness-based programme with and without virtual reality support to reduce stress in university students: A randomized controlled trial

Behav Res Ther. 2021 Jul:142:103866. doi: 10.1016/j.brat.2021.103866. Epub 2021 Apr 26.

Affiliations

¹ Health Research Institute of Aragon (IIS Aragón), Zaragoza, Spain; Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain; Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain.
² Health Research Institute of Aragon (IIS Aragón), Zaragoza, Spain; Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain; Miguel Servet University Hospital, Zaragoza, Spain.
³ Health Research Institute of Aragon (IIS Aragón), Zaragoza, Spain; AGORA Research Group; Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain; Department of Basic Psychology, Autonomous University of Barcelona, Cerdanyola Del Vallès, Spain. Electronic address: aparanda@iisaragon.es.
⁴ Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain; Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain.
⁵ Health Research Institute of Aragon (IIS Aragón), Zaragoza, Spain; Primary Care Prevention and Health Promotion Research Network (RedIAPP), Zaragoza, Spain.
⁶ AGORA Research Group; Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain.
⁷ Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.

PMID: 33957506
DOI: 10.1016/j.brat.2021.103866

Abstract

Objectives: To evaluate the efficacy of a mindfulness-based programme (MBP) for reducing stress in university students and its action mechanisms and to explore the capacity of virtual reality (VR) exposure to enhance adherence to the intervention.

Methods: This randomized controlled trial (RCT) involved assessment time points of baseline, posttreatment, and 6-month follow-up. A total of 280 students from two Spanish universities were randomly assigned to 'MBP', 'MBP + VR', or 'Relaxation' (active controls). Perceived stress posttreatment was the primary outcome; wellbeing and academic functional outcomes were assessed as well. Multilevel mixed-effects models were performed to estimate the efficacy of the programme.

Results: Both 'MBP' (B = -2.77, d = -0.72, p = .006) and 'MBP + VR' (B = -2.44, d = -0.59, p = .014) were superior to 'Relaxation' in improving stress, as well as most of the secondary outcomes, with medium-to-large effects posttreatment and at follow-up. The long-term effects of MBPs on stress were mediated by mindfulness and self-compassion in parallel. Treatment adherence was improved in the 'MBP + VR' group, with higher retention rates and session attendance (p < .001).

Conclusions: This RCT supports the efficacy of an MBP compared to relaxation for reducing stress in university students through mindfulness and self-compassion as mechanisms of change. VR exposure may enhance treatment adherence.

Trial registration: ClinicalTrials.gov NCT03771300.

Keywords: Mindfulness; Psychological wellbeing; Randomized controlled trial; Stress; University students; Virtual reality.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Empathy
Humans
Mindfulness*
Students
Universities
Virtual Reality*

Associated data

ClinicalTrials.gov/NCT03771300