Growth, Empowerment, and Mindfulness (GEM): A Mindfulness-based Intervention to Address Mental Health in Young Adults With Early Life Adversity

Growth, Empowerment, and Mindfulness (GEM): Pilot Trial of a Mindfulness-based Intervention to Address Mental Health in Young Adults With Early Life Adversities

The goal of this clinical trial (single-arm feasibility study) is to examine the feasibility, acceptability, and preliminary efficacy of a mindfulness-based, app-delivered intervention to address mental health and emotion regulation challenges in young adults with early life adversities (ELAs).

The main questions it aims to answer is:

- Will young adults find the Growth, Empowerment, and Mindfulness (GEM) intervention to be both feasible and acceptable, as demonstrated by participants' engagement and quantitative/qualitative feedback?

Additionally, it aims to answer:

• Will GEM intervention demonstrate preliminary efficacy in improving outcome measures including depression, anxiety?
• Are improvements in mindfulness and sleep, as well as reductions in rumination, mechanisms of action underlying the improvements in psychological and behavioral outcomes of the intervention?

Participants will be asked to:

• participate in GEM, which integrates app-based intervention content, formal and informal mindfulness practices, weekly Zoom group sessions, and ecological momentary intervention (EMI) delivery
• complete baseline, post-intervention, and 3-month follow-up assessments
• complete weekly assessments and daily ecological momentary assessments (EMAs) during the intervention delivery
• wear Fitbit for researchers to collect sleep-related data

Inclusion Criteria:

• Age 18-24

• Reside in the US

• Experiences of psychosocial forms of early life adversity, defined as saying yes to at least one of these following questions:

  1. Did you ever miss school due to fear of being bullied?
  2. Were you ever injured or threatened with a weapon or otherwise assaulted by a peer at school?
  3. Were you ever physically attacked, hit, hurt, or injured by a parent, primary caregiver, or guardian?
  4. Were you ever touched sexually against your wishes or forced to touch someone else sexually?
  5. Were you ever forced to engage in sexual intercourse?
  6. Were you ever forced to have sex or were you ever sexually abused (e.g., being touched or fondled by an adult?)

• Experience more than minimal symptoms of anxiety (GAD-7 score of 5 or higher) and/or mild to moderately severe depression symptoms (PHQ-9 score between 5-19)

• Not currently in mental health treatment

• Being willing to answer 3-4 short surveys daily, each 2-5 mins

• Being willing to engage in recommended daily mindfulness practices for 4-6 weeks

• Have not been extensively exposed to mindfulness, defined as meditation retreat experience, consistent mindfulness practice (> once/week) within the past 6 months, or prior participation in a mindfulness course/program

Exclusion Criteria:

• At imminent risk of suicide
• Have a current diagnosis of Major Depressive Disorder
• Meet the criteria for Major Depressive Episode based on the MINI-Major Depressive Episode module at screening
• Score 20 or higher on Alcohol Use Disorders Identification Test (AUDIT) at screening
• Score 25 or higher on Drug Use Disorders Identification Test (DUDIT) at screening
• Have a history of psychotic disorder (e.g., schizophrenia) or psychotic episode
• Have ever been diagnosed with bipolar disorder