{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T05:16:03Z","timestamp":1787980563303,"version":"build-2784847793"},"reference-count":50,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Psychiatry"],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"\n Importance<\/jats:title>\n Depression most commonly first emerges during adolescence, making early prevention critical. While school-based mindfulness training (SBMT) offers a scalable prevention approach with broad reach, evidence of its effectiveness is mixed, and there is a compelling case for a more personalized approach to prevention.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To develop a data-driven algorithm from baseline characteristics to predict which adolescents are most likely to benefit from SBMT.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n The My Resilience in Adolescence (MYRIAD) cluster randomized clinical trial was conducted from October 2016 to July 2018. In this secondary analysis, school-level nested cross-validation was used to train and evaluate machine learning models for predicting individualized benefit from SBMT. Participants were students aged 11 to 13 years at baseline from broadly representative secondary schools across England, Scotland, Wales, and Northern Ireland. Data analysis was performed from April 2023 to October 2025.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n SBMT teaching core mindfulness skills through psychoeducation, class discussion, and practices, compared with standard social-emotional learning (teaching as usual).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Change in depressive symptoms from preintervention to postintervention measured by the Center for Epidemiologic Studies Depression scale. Causal forest (CF) and elastic net regression (ENR) models computed personalized advantage index scores quantifying individual expected benefit from SBMT vs teaching as usual.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 8376 adolescents from 84 UK secondary schools, the mean (SD) age at baseline was 12.2 (0.6) years; there were 4509 (54.9%) female participants and 3547 (43.2%) male participants. CF showed acceptable calibration (mean [SE] best linear predictor slope\u2009=\u20090.78 [0.15]), while ENR demonstrated modest predictive performance (\n r<\/jats:italic>\n \u2009=\u20090.29;\n \n R\n 2<\/jats:sup>\n <\/jats:italic>\n \u2009=\u20090.09; root mean square error\u2009=\u200910.3). Both the CF and ENR models identified a subset of adolescents predicted to benefit from SBMT, but group differences in outcomes were negligible (CF:\n d<\/jats:italic>\n \u2009=\u20090.07; 95% CI, 0.02-0.12;\n P<\/jats:italic>\n \u2009=\u2009.007; ENR:\n d<\/jats:italic>\n \u2009=\u20090.08; 95% CI, 0.02-0.13;\n P<\/jats:italic>\n \u2009=\u2009.004). Top predictive features from the CF model were symptom severity (eg, low-to-moderate depression and anxiety predicted greater SBMT benefit) and several school factors with nonlinear patterns. ENR emphasized school-level characteristics with minimal differentiation.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This study found that machine learning identified a subgroup with statistically detectable but clinically trivial differential intervention response. These findings highlight the substantial challenges in achieving clinically useful personalization in universal school-based prevention programs.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n isrctn.org Identifier:\n ISRCTN86619085<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamapsychiatry.2025.4638","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T16:30:39Z","timestamp":1771432239000},"page":"389","source":"Crossref","is-referenced-by-count":2,"title":["Predicting Adolescent Response to School-Based Mindfulness"],"prefix":"10.1001","volume":"83","author":[{"given":"Christian A.","family":"Webb","sequence":"first","affiliation":[{"name":"Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts"},{"name":"Department of Psychiatry, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyu","family":"Ren","sequence":"additional","affiliation":[{"name":"Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, Massachusetts"},{"name":"Department of Psychiatry, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena","family":"Hinze","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Dalgleish","sequence":"additional","affiliation":[{"name":"Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom"},{"name":"Department of Psychology, University of Cambridge, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasmin Jane","family":"Ford","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark T.","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Department of Human Development and Family Studies, The Pennsylvania State University, University Park"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus","family":"Montero-Marin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom"},{"name":"Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de D\u00e9u, Sant Boi de Llobregat, Barcelona, Spain"},{"name":"Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), Madrid, Spain"},{"name":"Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem","family":"Kuyken","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"12","key":"yoi250080r1","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1038\/nrn2513","article-title":"Why do many psychiatric disorders emerge during adolescence?","volume":"9","author":"Paus","year":"2008","journal-title":"Nat Rev Neurosci"},{"issue":"9","key":"yoi250080r2","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1016\/S2215-0366(23)00193-1","article-title":"Age of onset and cumulative risk of mental disorders: a cross-national analysis of population surveys from 29 countries.","volume":"10","author":"McGrath","year":"2023","journal-title":"Lancet Psychiatry"},{"key":"yoi250080r3","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/j.jad.2024.03.074","article-title":"Global burden of depression or depressive symptoms in children and adolescents: a systematic review and meta-analysis.","volume":"354","author":"Lu","year":"2024","journal-title":"J Affect Disord"},{"issue":"1","key":"yoi250080r4","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1038\/s41380-021-01161-7","article-title":"Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies.","volume":"27","author":"Solmi","year":"2022","journal-title":"Mol Psychiatry"},{"issue":"10258","key":"yoi250080r5","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019.","volume":"396","author":"GBD 2019 Diseases and Injuries Collaborators","year":"2020","journal-title":"Lancet"},{"issue":"3","key":"yoi250080r6","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1037\/abn0000410","article-title":"Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005-2017.","volume":"128","author":"Twenge","year":"2019","journal-title":"J Abnorm Psychol"},{"issue":"10352","key":"yoi250080r7","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1016\/S0140-6736(22)01012-1","article-title":"Depression in young people.","volume":"400","author":"Thapar","year":"2022","journal-title":"Lancet"},{"issue":"1","key":"yoi250080r9","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.jaac.2018.07.896","article-title":"Systematic review and meta-analysis: adolescent depression and long-term psychosocial outcomes.","volume":"58","author":"Clayborne","year":"2019","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"3","key":"yoi250080r10","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1001\/archpsyc.59.3.225","article-title":"Mental health, educational, and social role outcomes of adolescents with depression.","volume":"59","author":"Fergusson","year":"2002","journal-title":"Arch Gen Psychiatry"},{"issue":"4","key":"yoi250080r11","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1037\/ccp0000951","article-title":"Preventing depression: challenges and innovations.","volume":"93","author":"Cuijpers","year":"2025","journal-title":"J Consult Clin Psychol"},{"issue":"4","key":"yoi250080r12","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1037\/ccp0000930","article-title":"Effectiveness of school-based depression prevention interventions: an overview of systematic reviews with meta-analyses on depression outcomes.","volume":"93","author":"Grant","year":"2025","journal-title":"J Consult Clin Psychol"},{"issue":"4","key":"yoi250080r13","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1037\/ccp0000913","article-title":"Telehealth-delivered depression prevention: short-term outcomes from a school-based randomized controlled trial.","volume":"93","author":"Young","year":"2025","journal-title":"J Consult Clin Psychol"},{"issue":"4","key":"yoi250080r14","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1037\/ccp0000912","article-title":"Evaluating hypothetical prevention strategies for internalizing symptoms in the general population and at-risk children.","volume":"93","author":"Dall\u2019Aglio","year":"2025","journal-title":"J Consult Clin Psychol"},{"issue":"4","key":"yoi250080r15","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1037\/ccp0000921","article-title":"A randomized controlled trial of an online mindfulness program for adolescents at risk for internalizing problems.","volume":"93","author":"Garber","year":"2025","journal-title":"J Consult Clin Psychol"},{"issue":"4","key":"yoi250080r16","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1037\/ccp0000924","article-title":"Effects on family functioning and the home environment of a family-based preventive intervention for children of parents with severe mental illness: a randomized controlled trial.","volume":"93","author":"Gj\u00f8de","year":"2025","journal-title":"J Consult Clin Psychol"},{"issue":"4","key":"yoi250080r17","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1037\/ccp0000916","article-title":"A pilot randomized controlled trial of a brief intervention targeting positive valence systems function to prevent internalizing symptoms in college students.","volume":"93","author":"Long","year":"2025","journal-title":"J Consult Clin Psychol"},{"issue":"4","key":"yoi250080r18","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1037\/ccp0000918","article-title":"Equity and inclusion in prevention: depression prevention in Black and White American youth.","volume":"93","author":"Seely","year":"2025","journal-title":"J Consult Clin Psychol"},{"issue":"4","key":"yoi250080r19","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1037\/ccp0000936","article-title":"Future directions in depression prevention.","volume":"93","author":"Batterham","year":"2025","journal-title":"J Consult Clin Psychol"},{"issue":"3","key":"yoi250080r20","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1136\/ebmental-2021-300396","article-title":"Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial.","volume":"25","author":"Kuyken","year":"2022","journal-title":"Evid Based Ment Health"},{"issue":"3","key":"yoi250080r21","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1136\/ebmental-2022-300439","article-title":"School-based mindfulness training in early adolescence: what works, for whom and how in the MYRIAD trial?","volume":"25","author":"Montero-Marin","year":"2022","journal-title":"Evid Based Ment Health"},{"issue":"1","key":"yoi250080r22","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1177\/21677026221076832","article-title":"The development and internal evaluation of a predictive model to identify for whom mindfulness-based cognitive therapy (MBCT) offers superior relapse prevention for recurrent depression versus maintenance antidepressant medication.","volume":"11","author":"Cohen","year":"2023","journal-title":"Clin Psychol Sci"},{"issue":"1","key":"yoi250080r23","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1146\/annurev-clinpsy-050817-084746","article-title":"Treatment selection in depression.","volume":"14","author":"Cohen","year":"2018","journal-title":"Annu Rev Clin Psychol"},{"issue":"9","key":"yoi250080r24","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1037\/ccp0000763","article-title":"Which adolescents are well-suited to app-based mindfulness training? a randomized clinical trial and data-driven approach for personalized recommendations.","volume":"90","author":"Webb","year":"2022","journal-title":"J Consult Clin Psychol"},{"issue":"7","key":"yoi250080r25","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1017\/S0033291718001708","article-title":"Personalized prediction of antidepressant v. placebo response: evidence from the EMBARC study.","volume":"49","author":"Webb","year":"2019","journal-title":"Psychol Med"},{"issue":"11","key":"yoi250080r26","doi-asserted-by":"publisher","DOI":"10.2196\/41566","article-title":"Personalized prediction of response to smartphone-delivered meditation training: randomized controlled trial.","volume":"24","author":"Webb","year":"2022","journal-title":"J Med Internet Res"},{"issue":"4","key":"yoi250080r27","doi-asserted-by":"publisher","first-page":"e207","DOI":"10.1016\/S2589-7500(21)00042-X","article-title":"Progress towards clinically informative data-driven decision support tools in psychotherapy.","volume":"3","author":"Webb","year":"2021","journal-title":"Lancet Digit Health"},{"issue":"1","key":"yoi250080r28","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1186\/s13063-017-1917-4","article-title":"The effectiveness and cost-effectiveness of a mindfulness training programme in schools compared with normal school provision (MYRIAD): study protocol for a randomised controlled trial.","volume":"18","author":"Kuyken","year":"2017","journal-title":"Trials"},{"issue":"1","key":"yoi250080r29","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1186\/s13063-021-05213-9","article-title":"Update to the effectiveness and cost-effectiveness of a mindfulness training programme in schools compared with normal school provision (MYRIAD): study protocol for a randomised controlled trial.","volume":"22","author":"Montero-Marin","year":"2021","journal-title":"Trials"},{"issue":"3","key":"yoi250080r30","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1177\/014662167700100306","article-title":"The CES-D Scale: a self-report depression scale for research in the general population.","volume":"1","author":"Radloff","year":"1977","journal-title":"Appl Psychol Meas"},{"issue":"11","key":"yoi250080r31","doi-asserted-by":"publisher","first-page":"1337","DOI":"10.1097\/00004583-200111000-00015","article-title":"Psychometric properties of the strengths and difficulties questionnaire.","volume":"40","author":"Goodman","year":"2001","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"1","key":"yoi250080r32","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1186\/1477-7525-5-63","article-title":"The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation.","volume":"5","author":"Tennant","year":"2007","journal-title":"Health Qual Life Outcomes"},{"issue":"6","key":"yoi250080r33","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1007\/s11121-022-01361-9","article-title":"Universal mindfulness training in schools for adolescents: a scoping review and conceptual model of moderators, mediators, and implementation factors.","volume":"23","author":"Tudor","year":"2022","journal-title":"Prev Sci"},{"issue":"2","key":"yoi250080r34","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1007\/s12671-018-0982-4","article-title":"Mindfulness training in UK secondary schools: a multiple case study approach to identification of cornerstones of implementation.","volume":"10","author":"Wilde","year":"2019","journal-title":"Mindfulness (N Y)"},{"issue":"1","key":"yoi250080r35","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0083875","article-title":"The personalized advantage index: translating research on prediction into individualized treatment recommendations: a demonstration.","volume":"9","author":"DeRubeis","year":"2014","journal-title":"PLoS One"},{"issue":"1","key":"yoi250080r36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v033.i01","article-title":"Regularization paths for generalized linear models via coordinate descent.","volume":"33","author":"Friedman","year":"2010","journal-title":"J Stat Softw"},{"issue":"2","key":"yoi250080r37","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1214\/18-AOS1709","article-title":"Generalized random forests.","volume":"47","author":"Athey","year":"2019","journal-title":"Ann Stat"},{"key":"yoi250080r39","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v045.i03","article-title":"mice: Multivariate imputation by chained equations in R.","volume":"45","author":"van Buuren","year":"2011","journal-title":"J Stat Softw"},{"issue":"3","key":"yoi250080r40","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1080\/00223891.2018.1530680","article-title":"Rebutting existing misconceptions about multiple imputation as a method for handling missing data.","volume":"102","author":"van Ginkel","year":"2020","journal-title":"J Pers Assess"},{"issue":"9","key":"yoi250080r41","doi-asserted-by":"publisher","first-page":"1322","DOI":"10.1016\/j.cjca.2020.11.010","article-title":"Missing data in clinical research: a tutorial on multiple imputation.","volume":"37","author":"Austin","year":"2021","journal-title":"Can J Cardiol"},{"issue":"8","key":"yoi250080r43","doi-asserted-by":"publisher","first-page":"2335","DOI":"10.1038\/s41380-024-02500-0","article-title":"Developing an individualized treatment rule for veterans with major depressive disorder using electronic health records.","volume":"29","author":"Zainal","year":"2024","journal-title":"Mol Psychiatry"},{"key":"yoi250080r44","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2025.118117","article-title":"Mindfulness in the school curriculum? a nationwide cluster-randomized trial of the effectiveness of implementing a mindfulness-based intervention for 9-16-year-olds students in Danish elementary schools.","volume":"378","author":"Juul","year":"2025","journal-title":"Soc Sci Med"},{"issue":"1","key":"yoi250080r45","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1038\/s41398-025-03394-4","article-title":"Personalized prediction of negative affect in individuals with serious mental illness followed using long-term multimodal mobile phenotyping.","volume":"15","author":"Webb","year":"2025","journal-title":"Transl Psychiatry"},{"issue":"11","key":"yoi250080r46","doi-asserted-by":"publisher","first-page":"5146","DOI":"10.1017\/S0033291722002161","article-title":"Predicting states of elevated negative affect in adolescents from smartphone sensors: a novel personalized machine learning approach.","volume":"53","author":"Ren","year":"2023","journal-title":"Psychol Med"},{"issue":"7","key":"yoi250080r47","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.19054","article-title":"Tracking psychopathology dimensions through passive smartphone sensing: promises, pitfalls, and pathways to clinical integration.","volume":"8","author":"Webb","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"10036","key":"yoi250080r48","doi-asserted-by":"publisher","first-page":"2423","DOI":"10.1016\/S0140-6736(16)00579-1","article-title":"Our future: a Lancet commission on adolescent health and wellbeing.","volume":"387","author":"Patton","year":"2016","journal-title":"Lancet"},{"issue":"3","key":"yoi250080r50","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1080\/09638237.2023.2210668","article-title":"Mental health in adolescence: the role of schools-based social emotional teaching.","volume":"32","author":"Kuyken","year":"2023","journal-title":"J Ment Health"},{"key":"yoi250080r8","first-page":"225","volume-title":"Child Psychopathology","author":"Hammen","year":"2014","edition":"3rd ed"},{"key":"yoi250080r42","doi-asserted-by":"crossref","DOI":"10.1201\/9780367816377","volume-title":"Hands-On Machine Learning With R","author":"Boehmke","year":"2019"},{"key":"yoi250080r38","unstructured":"OSF. Code for MYRIAD trial analyses. Accessed January 16, 2026. https:\/\/osf.io\/4ftq7\/files"},{"key":"yoi250080r49","unstructured":"American Psychological Association. Mental health effects of poverty, hunger and homelessness on children and teens. Accessed June 3, 2025. https:\/\/www.apa.org\/topics\/socioeconomic-status\/poverty-hunger-homelessness-children"}],"container-title":["JAMA Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/articlepdf\/2844884\/jamapsychiatry_webb_2026_oi_250080_1774053087.37685.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T15:01:25Z","timestamp":1775055685000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/fullarticle\/2844884"}},"subtitle":["A Secondary Analysis of the MYRIAD Trial"],"short-title":[],"issued":{"date-parts":[[2026,4,1]]},"references-count":50,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamapsychiatry.2025.4638","relation":{},"ISSN":["2168-622X"],"issn-type":[{"value":"2168-622X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4,1]]}}}