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MINDFULNESS IN CLASSROOM: EFFECT OF A MINDFULNESS-BASED RELAXATION CLASS ON COLLEGE STUDENTS' STRESS, RESILIENCE, SELF-EFFICACY AND PERFECTIONISM.

The transitory period for a young adult coincides with college life which is often characterized with many challenges including academic pressures, interpersonal distress, homesickness, loneliness, isolation, financial burdens, managing novel freedoms, and experiencing life as an adult (Kadison & DiGeronimo, 2004; Mowbray, Megivern, Mandiberg, Strauss, Stein, Collins, & Lett, 2006). As a result, students' inability to effectively cope with the challenges of college life may lead to a number of detrimental outcomes, including increased stress levels which can negatively affect students' health and well-being, as well as their academic performance. In fact, American College Health Association (2016) has identified stress as the most impactful factor on academic performance with 31.8 % students reported having experienced stress. However, high levels of stress as well as the severity of psychological symptoms alone may not predict college success, but rather how an individual copes with the challenges and stressors during their time at university (Hartley, 2012). Factors such as increased resilience, self-efficacy and healthy perfectionism have not only been shown to positively influence health and well-being in the college student population (Tugade, Fredrickson, & Feldman Barrett, 2004), but also have implications on students' academic achievement (Chemers, Hu and Garcia, 2001; Becker & Gable, 2009; Chemers et al., 2001; Hsieh, Sullivan, & Guerra, 2007; Johnson, Taasoobshirazi, Kestler, & Cordova, 2015; Enns, Cox, & Clara, 2002; Rice, Bair, Castro, Cohen, & Hood, 2003; Neumeister, 2004; Miquelon, Vallerand, Grouzet, & Cardinal, 2005). One technique that has been shown to be beneficial for the enhancement of the overall health and well-being with college students, as well as in an integration on the academic curriculum is the practice of mindfulness (i.e., Bergen-Cico, Possemato, & Cheon, 2013; de Bruin, Meppelink, & Bogels, 2015; Keng,

Smoski, & Robins, 2011). Greeson, Juberg, Maytan, James and Rogers (2014) have particularly emphasized the importance mindfulness-based approaches with college student populations due to the young adulthood being associated with frequent changes and uncertainty. While mindfulness training has been shown to be beneficial with college students populations, researchers are seeking for better ways to implement mindfulness training with college students who may already feel overburdened with commitments and may be skeptical and resistant to mindfulness training (Rogers, 2013). Compounded to this, research indicates that institutions of higher education are experiencing challenges with student utilization of student support services due to factors such as lack of time, perceived stigma, confidentiality concerns, fear, skepticism, and insurance coverage (Eisenberg, Hunt, & Speer 2012; Givens & Tjia, 2002). As a result, Eisenberg and colleagues (2012) have stated that: "...salient theme becomes evident: novel interventions approaches are needed to supplement traditional approaches..." (p.222). Thus, one way to overcome the above-mentioned challenges is to offer mindfulness interventions that are already a part of students' academic curriculum which may provide a more proactive approach that would allow college students to take care of their health and well-being as well as to make progress towards their degree.

Mindfulness and Stress, Self-Efficacy, Resilience and Perfectionism

One of the most commonly used definition of mindfulness is "the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to the unfolding of experience moment by moment" (Kabat-Zinn 2003,p. 145). A number of mindfulness intervention studies have been conducted amongst college students with results demonstrating positive effects on the reductions in stress and improvements in the overall health and well-being (i.e., Deckro, Ballinger, Hoyt, Wilcher, Dusek, Myers, Benson, 2002; de Vibe, Solhaug, Tyssen, Friborg, Rosenvinge, Sorlie, & Bjorndal, 2013; Oman, Shapiro, Thoresen, Plante, & Flinders, 2008; Palmer and Rodger, 2009; Warnecke, Quinn, Ogden, Towle, & Nelson, 2011; Weinstein, Brown & Ryan, 2009). Shapiro, Brown and Astin (2008) have also provided implications for the positive benefits of mindfulness meditation due to its positive effects on students' achievement of academic goals and mental health, resulting in the education of a "whole person". Research on mindfulness and resilience, while scarce, has revealed a positive relationship between the two constructs (Keye & Pidgeon, 2013; McGillivray & Pidgeon, 2015). In addition, research between mindfulness and adaptive perfectionism (Hinterman, Burns, Hopwood, & Rogers, 2012; Short and Mazmanian, 2013), and mindfulness and self-efficacy with students (Greason & Cashwell, 2009; Unsworth, 2015; Hanley, Palejwala, Hanley, Canto, & Garland, 2015) albeit minimal, has shown positive results. Though these studies generally support the relationship between mindfulness, the research is still in its infant stages and, some contrasting result also exists. For example, Caldwell and colleagues (2010) reported statistically insignificant findings between mindfulness intervention and regulatory self-efficacy. Thus, due to the scarcity and inconclusiveness of research in this area, more research may be warranted to confirm the relationship between the above-mentioned constructs.

Several research studies have investigated the effectiveness of mindfulness interventions that are a part of students' academic curriculum with results revealing encouraging results as it relates to stress reduction and improvements in the overall well-being (i.e., Bergen-Cico et al., 2013; Collard, Avny, & Boniwell, 2008; de Bruin et al., 2015; Caldwell, Harrison, Adams,

Quin & Greeson, 2010; Schure, Christopher & Christopher, 2008; Shapiro, Schwartz, & Bonner, 1998). However, the above-mentioned studies did not utilize a control group, which raises a degree of uncertainty of whether these changes were in fact due to mindfulness practice. To that end, there is a need to conduct mindfulness interventions that are a part of the academic curriculum that also incorporate control and experimental groups. However, research that included both control and experimental groups, while positive, is still scarce (Bergen-Cico et al., 2013; Caldwell, Emery, Harrison & Greeson, 2011; Gallego, Aguilar-Parra, Cangas, Langer, & Mafias, 2014). Therefore, the purpose of this study was to evaluate the effect of a seven-week mindfulness-based relaxation course on undergraduate students' stress, resilience, self-efficacy, and perfectionism in a two-group pre- and post-test study design. In terms of the length of the intervention, to our knowledge this is one of the first studies to determine the effect of a seven-week class as a part of the students' academic curriculum in a two-group pre- and post-test study design.

Method

Design and Participants

Participants for this human subjects institutional review board approved study included a total of N = 71 participants (experimental group: n = 35; control group: n = 36), ages 18- 40 (M= 21.46, SD = 3.33). Participants in the experimental group consistent of the students enrolled in a 90-minute mindfulness-based relaxation class that met two times per week over the course of 7 weeks. The data was collected in two relaxation classes over the course of one semester. Participants in the control group were recruited from three other physical education courses, including badminton, rock climbing, and walking class. These physical activity courses were deemed an appropriate control group due to their emphasis on achieving healthy mind and body in the context of physical activity. These three activity courses were randomly selected amongst other activity courses and participants were given an option to participate in the study.

Procedure

The mindfulness based relaxation class serving, as the primary intervention in this study was a one credit elective course that fulfilled a general education requirement for degree attainment (Appendix A). The course was designed with a consistent and strong emphasis on mindfulness training and included many different meditative and movement based exercises. The concept of mindfulness meditation was introduced during the first class session and remained a ubiquitous theme for the duration of the course. The structure of the class began with a formal meditation practice where the students were encouraged to sit in silence, observe their breath, and take notice of any thoughts that emerged into consciousness at a given time. Students were encouraged to reflect on their experiences after each session and this format was continued throughout the remainder of the class. The practice of mindfulness meditation started with 5 minutes and was progressively increased to 20 minutes of practice. The instructor continually emphasized maintaining an open and nonjudgmental mind during each activity practiced. The class also followed a systematic schedule, which incorporated several brief lectures and discussions on mindfulness, stress, coping skills, inspiration, relaxation techniques, and exercises (i.e., guided imagery, progressive body relaxation, breathing techniques, body scan exercises, Tai chi, qi gong, yoga). All of the topics discussed were specifically aligned with college life and how mindfulness could influence student appraisal of their academic experience.

Instrumentation

The Perceived Stress Scale (PSS; Cohen, Kamarck, & Mermelstien, 1983) is a 10-item questionnaire that is used to determine an individual's perceived stress levels over the course of last month (Cohen, 1994). Items are rated on a 5-point Likert scale ranging from 0 (never) to 4 (very often), with four of the questions reversed scored. An example of a question is; "In the last month, how often have you felt nervous and 'stressed'?". Another questions asks: "In the last month, how often have you been angered because of things that are out of your control?" PSS scores around 13 are considered average, while scores around 20 reflect high levels of stress. Cronbach's alpha for PSS has been found between .70 (Lee, 2012) and .85 (Cohen, 1994). Roberti, Harrington, & Storch (2006) supported reliability and validity of the PSS in college student population, and Lee (2012) also reported test-retest reliability >.70 across twelve studies with adult populations.

The Brief Resilience Scale (BRS; Smith, Dalen, Wiggins, Tooley, Christopher, & Bernard, 2008). The BRS scale was developed to assess resilience as bouncing back from stress, whether it is related to resilience resources or to important health outcomes. Out of the six items, three items are positively and three items are negatively worded. The responses varying from 1 (strongly disagree) to 5 (strongly agree) are added for all six items giving a range from 6-30 with the final score being the mean of the six items. An example of a question is: "I tend to bounce back quickly after hard times." Reliability analysis using Cronbach's alpha was .93 with college student population (Amat, Subhan, Jaafar, Mahmud, & Johari, 2014), and between .80 -.91 with two undergraduate college samples and a cardiac rehabilitation sample (Smith et al., 2008).

The General Self-Efficacy Scale (GSE; Schwarzer & Jerusalem, 1995). The scale was created to assess a general sense of perceived self-efficacy or a belief that one can perform a novel or difficult task, or cope with adversity in various domains of human functioning. Items are rated on a 4-point Likert scale ranging from 'Not At All True'=l to 'Exactly True'=4. The responses to all 10 items are summed up to yield the final composite score with a range from 10 to 40. An example of a question is: "I can always manage to solve difficult problems if I try hard enough." Zhang, & Schwarzer (1995) confirmed internal consistency of the GSE of .91 with the Chinese university student population. Scholz, Dona, Sud and Schwarzer (2002) psychometric findings from 25 countries revealed Cronbach's alphas ranging from .75 to .91.

The Multidimensional Perfectionism Scale (MPS; Hewitt & Flett, 1991). The MPS is a 45-item scale measuring three dimensions of perfectionism (1) self-oriented (SO) defined as intrinsic goals and standards that are set by the individual (e.g.,"One of my goals is to be perfect in everything I do"), (2) other-oriented (OO) defined as unrealistic standards placed on others by the individual (e.g., "I have high expectations for the people who are important to me"), and (3) socially prescribed (SP) defined as standards and expectations imposed on the individuals by others (e.g., "The better 1 do, the better I am expected to do. My family expects me to be perfect"). Each dimension consists of 15 items with the responses for varying from 1 (disagree) to 7 (agree) that are being are added for each of the three dimensions of perfectionism. Suddarth & Slaney (2001) research with college students reported reliability coefficients of .90, .75, and .85 for the self-oriented, other-oriented, and socially-prescribed perfectionism, while Hewitt and Flett (1991) reported reliability coefficients of .88 for self-oriented perfectionism, .74 for other-oriented perfectionism, and .81 for socially prescribed perfectionism.

Results

The mixed Way-ANOVA analysis was used to examine the impact of mindfulness intervention and non-mindfulness intervention conditions on college students' perceived stress, resilience, self-efficacy and perfectionism across two time periods (pre- and posttest). The results from statistical analysis were reported in Table 1, Table 2 and Figures 1-3.

Perceived Stress Scale

The Mixed ANOVA results indicated that there was a significant interaction effect between the time of the intervention and the control and experimental groups' stress levels (F(l,49) = 4.474, p = .039, n2 =084; Table 1). Specifically, the results revealed that even though the experimental group started with higher levels of stress at pre-test (M= 20.30, SD = 6.16) compared to the control group (pre-test M = 18.38; SD = 6.31), the experimental group demonstrated larger decreases and lower overall stress levels at the post-test (M = 17.06, SD = 7.05) compared to the control group's post-test (M = 17.66, SD = 5.91; Table 2). In summary, these results indicate larger, statistically significant positive effects of the mindfulness intervention on the experimental group stress levels compared to the control group (Figure 1).

The Brief Resilience Scale

The Mixed ANOVA results indicated that there was a statistically significant interaction effect between the time of the intervention and the control and experimental groups' resilience levels (F(\,49) = 5.827, p = .020, T|2 = .106; Table 1). Specifically, the results indicated that even though experimental group started with lower levels of resilience at pre-test (M = 3.18, SD = .77) compared to the control group (M= 3.45, SD = .59), the experimental group demonstrated larger increases and higher overall levels of resilience at post-test (M = 3.58, SD = .70) compared to the control group's post-test (M =3.53, SD = .57; see Table 1). In summary, these results indicate larger, statistically significant positive effects of the mindfulness intervention on the experimental group resilience levels compared to the control group (Figure 2).

The General Self-Efficacy Scale

The Mixed ANOVA analysis results indicated that there was a statistically significant interaction effect between the time of the intervention and the control and experimental groups' self-efficacy levels (F(1,49) = 7.698, p = .008, n2 = .136; Table 1). Specifically, the results indicated that even though experimental group started with lower levels of self-efficacy at pre-test (M = 30.53, SD = 3.71) compared to the control group (M = 32.42, SD = 4.37), the experimental group demonstrated larger increases and higher levels of self-efficacy at post-test (M = 32.00, SD = 3.96) compared to the control group (M =31.85, SD = 4.05; Table 2). In fact, the control group's self-efficacy scores decreased at post-test. In summary, these results indicate larger, statistically significant positive effects of the mindfulness intervention on the experimental group self-efficacy levels compared to the control group (Figure 3).

Multidimensional Perfectionism Scale

Mixed ANOVA analysis results indicated no statistically significant effects for the Multidimensional Perfectionism scale.

Conclusion

This study was designed to examine the impact of a seven-week mindfulness-based relaxation academic course on students' stress levels, resilience, self-efficacy, and perfectionism in a two-group post-test study design. The results of this study revealed statistically significant interaction effect of the time of the intervention and stress, resilience and self-efficacy measures, while the measures of perfectionism did not result in statistically significant findings.

Stress

The results revealed a statistically significant interactions effect between the time of the intervention and the stress levels for the experimental and control groups. Specifically, experimental group displayed larger, statistically significant decreases in stress and lower overall levels of stress at the end of the mindfulness intervention compared to the control group. Interestingly, even though the experimental group initially started with higher levels of stress compared to the control group, experimental group finished with lower overall stress levels at the end of the intervention compared to the control group. These findings are consistent with the previous research that demonstrated the effectiveness of mindfulness in stress reduction with college students and improvement in overall health and well-being (i.e., Deckro et al., 2002; Keng et al., 2011; Eberth & Sadlmeir, 2012; Song & Linguist, 2015; Oman et al., 2008; Warnecke et al., 2011) and further support the utilization of mindfulness as a facilitator of stress reduction with college students. These findings are especially relevant due to college students facing pervasive challenges associated with the university life, and as indicated by ACHA (2016), stress has been identified as the number one impediment to students' academic performance. Moreover, these results add to the paucity of research that focused on the effects of mindfulness interventions that are a part of academic curriculum (i.e., Bergen-Cico et al., 2013; de Bruin et al., 2015; Caldwell et al., 2010; Collard et al., 2008; Schure et al., 2008; Shapiro et al., 1998). Thus, these results demonstrate the potential of mindfulness interventions as a part of academic curriculum as a way of helping students reduce stress and derive positive benefits associated with stress reduction, and ultimately derive improvements on their general health-and well-being and academic success. Furthermore, the findings of this study add positive findings to the minimal of research (Bergen-Cico et al., 2013; Caldwell et al., 2011; Gallego et al., 2014) that examined the effect of mindfulness interventions as a part of academic curriculum that used both experimental and control groups.

Resilience

The results revealed a statistically significant interactions effect between the time of the intervention and the resilience levels for the experimental and control groups. Specifically, students who participated in the mindfulness intervention reported larger, statistically significant increases and higher overall levels of resilience at the end of the intervention compared to the participants who did not receive mindfulness training. Interestingly, even though the resilience was initially lower for the experimental group, the post-test scores revealed higher levels of resilience for the experimental group compared to the control group. These findings contribute to the scarcity of research (Keye & Pidgeon, 2013; McGillivray & Pidgeon, 2015) that suggested a positive relationship between mindfulness and resilience amongst college students. Subsequently, these findings are of paramount importance for college students due to resilience being a mediating factor for a number of positive outcomes, including overall academic success (Johnson et al., 2015), time-to-credit completion (Hartley, 2013) and increases in functioning and overall health and well-being (Hartley, 2012; Tugade et al., 2004). Moreover, the results of this study suggest that implementation of a mindfulness-based relaxation course that is a part of students' academic curriculum may be especially beneficial for increasing resilience with college students.

Self-Efficacy

The results revealed a statistically significant interactions effect between the time of the intervention and the levels of self-efficacy for the experimental and control groups. Specifically, the findings of this study revealed larger statistically significant post-intervention increases in self-efficacy for the experimental group compared to the control group. In fact, experimental group started with lower levels of self-efficacy compared to the control group and ended up with higher levels of self-efficacy compared to the control group. These findings offer encouraging results by adding to the sparse (Greason & Cashwell, 2009; Unsworth, 2015; Hanley et al., 2015) and inconclusive (Caldwell et al., 2010) research on the relationship between mindfulness and self-efficacy. This is especially relevant due to self-efficacy demonstrating to be a mediator to a number of positive outcomes with college students, including health, optimism, overall satisfaction in college, and academic expectations, performance and success (Becker & Gable, 2009; Chemers et al., 2001; Hsieh et al., 2007). More importantly, these results allude to the potential of implementation of an academic mindfulness-based course as a way of increasing self-efficacy with college students. The results of the study did not reach statistical significant findings on the measures of multidimensional perfectionism. Further future research may be warranted in this area due to adaptive perfectionism serving as a mediator to a number of positive outcomes with college students.

Overall, these findings provide support for mindfulness-based classes that are a part of academic curriculum as a way of helping students derive positive benefits. Thus, by infusing mindfulness-based courses in the academic curriculum, institutions of higher education can potentially overcome challenges related to effective utilization of student support services, and in turn provide a more proactive approach to assisting students instead of having students wait to seek the necessary counseling help after the occurrence of a crisis occurs. In addition, by embedding mindfulness interventions within the academic curriculum, students can improve their overall health and well-being, and at the same time, meet their academic goals and make progress towards their degree. Considering these findings, university settings are encouraged to consider utilizing mindfulness-based courses as a part of academic curriculum.

Limitations and Future Research

While the results of this study offer some promising insights, this study has limitations, which may need to be taken into consideration by future researchers. Firstly, different intervention lengths may need to be explored to determine the dosage that may produce most optimal results. In addition, studies with a larger sample size as well as longitudinal studies may be warranted to further confirm the intervention benefits. Lastly, future studies may consider an implementation of a measure of mindfulness which may offer an additional degree of assurance about the effectiveness of the mindfulness intervention.

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ZELJKA VIDIC, PH.D.

Western Michigan University

NICHOLAS CHERUP

University of Miami
Table 1: Mixed ANOVA Interaction Effect between the Time Period
(Pre-and Post-test) and Groups (Control and Experimental)

dr                St. Error  F      P     n2

PSS 1             49         4.474  .039  .084
BRS 1             49         5.827  .020  .106
GSE 1             49         7.698  .008  .136
SO Perfectionism  49          .028  .161  .040
OO Perfectionism  49          .230  .634  .005
SP Perfectionism  44          .404  .528   008

(*)p < .05 if -partial eta squared

Table 2: Descriptive Statistics for the Control and Experimental Groups

                       PRETEST             POST-TEST
                   n   M        SD     n   M          SD

PSS  EXPERIMENTAL  30   20.30    6.16  30  17.06       7.05
     CONTROL       21   18.38    6.31  21  17.66       5.91
     OVERALL       51   19.50    6.23  51  17.31       6.55
BRS  EXPERIMENTAL  30    3.18    0.77  30   3.58       0.70
     CONTROL       21    3.45    0.59  21   3.53       0.57
     OVERALL       51    3.29    0.71  51   3.56       0.65
GSE  EXPERIMENTAL  30   30.53    3.71  31  32.00       3.96
     CONTROL       21   32.42.   4.37  21  31.85       4.05
     OVERALL       51   31.31.   4.06  51   3.94.      3.96.
MPS
SOP  EXPERIMENTAL  30   70.10   14.56  30  73.86      17.44
     CONTROL       21   72.80   19.08  21  71.04      19.20
     OVERALL       51   71.21   16.78  51  72.50      18.05
OOP  EXPERIMENTAL  30   61.60   10.16  30  63.13      14.17
     CONTROL       21   57.61   14.37  21  57.38      13.41
     OVERALL       51   59.96   12.10  51  60.76      14.02
SPP  EXPERIMENTAL  30   56.56   13.13  30  61.40      12.16
     CONTROL       21   58.09   14.28  21  60.47      15.72
     OVERALL       51   57.19   13.49  51  61.01      13.59
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Author:Vidic, Zeljka; Cherup, Nicholas
Publication:College Student Journal
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Date:Mar 22, 2019
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