Note to teens: Just breathe

A team led by Dara Ghahremani, an assistant researcher in the department of psychiatry at UCLA's Semel Institute for Neuroscience and Human Behavior conducted a study on the Youth Empowerment Seminar, or YES!, a workshop for adolescents that teaches them to manage stress, regulate their emotions, resolve conflicts and control impulsive behavior. Impulsive behavior, in particular -- including acting out in class, engaging in drug or alcohol abuse, and risky sexual behaviors -- is something that gets adolescents in trouble.

The YES! program, run by the nonprofit International Association for Human Values, includes yoga-based breathing practices, among other techniques, and the research findings show that a little bit of breathing can go a long way. The scientists report that students who went through the four-week YES! for Schools program felt less impulsive, while students in a control group that didn't participate in the program showed no change.

The study appears in the July issue of the Journal of Adolescent Health.

"The program helps teens to gain greater control over their actions by giving them tools to respond to challenging situations in constructive and mindful ways, rather than impulsively," said Ghahremani, who conducted the study at the UCLA Center for Addictive Behaviors and UCLA's Laboratory for Molecular Neuroimaging. "The program uses a variety of techniques, ranging from a powerful yoga-based breathing program called Sudarshan Kriya to decision-making and leadership skills that are taught via interactive group games. We found it to be a simple yet powerful approach that could potentially reduce impulsive behavior."

Ghahremani noted that teens are often just as stressed as adults.

"There are home and family issues, academic pressures and, of course, social pressures," he said. "With the immediacy and wide reach of communication technology, like Facebook, peer pressure and bullying has risen to a whole new level. Without the tools to handle such pressures, teens can often resort to impulsive acts that include violence towards others or themselves."

Impulsive behavior, or a lack of self-control, in adolescence is a key predictor of risky behavior, Ghahremani said.

"Substance abuse and various mental health problems that begin in adolescence are often very difficult to shake in adulthood -- there is a need for interventions that bring impulsive behavior under control in this group," he said. "Our research is the first scientific study of the YES! program to show that it can significantly reduce impulsive behavior."

For the study, students between the ages of 14 and 18 from three Los Angeles-area high schools were invited to participate, between spring 2010 and fall 2011. In total, 788 students participated -- 524 in the YES! program and 264 in the control group. The program was taught during the students' physical education courses for four consecutive weeks. Students were asked to fill out questionnaires to rate statements about their impulsive behavior -- for example, "I act without thinking" and "I feel self-control most of the time" -- directly before and directly after the program. The students who did not go through the program also completed the questionnaires.

The YES! program is composed of three modules focused on healthy body, healthy mind and healthy lifestyle. The healthy body module consists of physical activity that includes yoga stretches, mindful eating processes and interactive discussions about food and nutrition. The healthy mind module includes stress-management and relaxation techniques, including yoga-based breathing practices, yoga postures and meditation to relax the nervous system, bring awareness to the moment and enhance concentration. Group processes promote personal responsibility, respect, honesty and service to others. In the healthy lifestyle module, students learn strategies for handling challenging emotional and social situations, especially peer pressure. Mindful decision-making and leadership skills are taught via interactive games. Students also create a group community-service project, applying their newly learned skills toward that goal.

"There is a need for simple, engaging interventions that bring impulsive behavior under control in adolescents," said Ghahremani. "This is important to the public because impulsive behavior in adolescents is associated with many mental health problems and, when left unchecked, can result in violent acts, such as those resulting in tragedies recently observed on school campuses.

"The advantage of this program over approaches that center around psychiatric medications is that it develops a sense of responsibility and empowerment in teens, allowing them to clarify and pursue their goals while fostering a sense of connection to their community. Although some medications can help control impulsive behavior, they often come with unpleasant side effects and the risk of medication abuse. Moreover, approaches that rely on them don't necessarily focus on empowering kids to take control of their lives. "

Non-pharmacologically-based programs like YES! for Schools that increase self-control are important to explore since they offer concrete tools that students can actively apply to their everyday lives with noticeable results, Ghahremani said.

To follow up on results from this study, the National Institute on Drug Abuse has awarded Ghahremani and his colleagues a grant to examine the effects of the YES! program by using functional magnetic resonance imaging (fMRI) to study the brain circuitry that is important for self-control and emotion regulation. The project also aims to examine how the YES! program can reduce cravings among teen smokers.

Other authors of the study included Eugene Y. Oh, Andrew C. Dean, Kristina Mouzakis, Kristen D. Wilson and senior author Edythe D. London, all of UCLA. Funding for the study was provided by an endowment from the Thomas P. and Katherine K. Pike Chair in Addiction Studies and a gift from the Marjorie M. Greene Trust.