The World Health Organisation defines adolescence as the stage between 10 and 19 years of age where significant physical and cognitive changes occur that may determine life forces or increase social vulnerability conditions and health risks (WHO, 2024). These risks, although preventable, may persist into adulthood and interfere with educational achievement and work productivity.
Epidemiological studies suggest the global importance of adolescent health. In Europe, according to UNICEF (2021), the prevalence of psychiatric disorders in adolescents is 16.3%, which means 9 million adolescents live with a mental disorder. The rate in the UK is of 16.2% (1,237,430 people); Girls 15.9%; Boys 16.4%. Spain has the highest rate in all of Europe, around 20.80% (21.40% girls; 20.40% boys), with anxiety disorders and depression being the most prevalent. In addition, emotional and behavioral deregulation amplifies many of these social and emotional risks.
In an ever-changing world, educators, parents and caregivers face unprecedented challenges to equip adolescents with the knowledge and skills they need to succeed in school and in life.
In agreement with Engel (1977), health and disease in humans depend on biological, psychological and social factors. In adolescence, these factors become particularly important as young people face multiple threats to their physical and emotional well-being. These include disengagement from school, concern for body image, peer influence, pressure to engage in sexual or risk activities, and exposure to social media, that they can shape behaviors in contradiction to family and social values.
High levels of school stress associated with homework, exams, performance expectations, interactions with teachers and time pressures are also reported in adolescence. To successfully meet these challenges requires considerable social and emotional competence.
Social and emotional skills are essential, and increasingly recognised, to manage one’s life effectively. This encompasses:
- flexible decision making,
- resistance to stress,
- maintaining prosperity and civility,
- knowing how to channel attention,
- maintaining motivation,
- working cooperatively,
- coping with frustration,
- responding to challenges in an appropriate manner and
- avoiding risky behaviors.
Decades of research have demonstrated that prevention programs, such as mindfulness-based programs, can reduce conduct problems while building skills for mental health, interpersonal relationships, and academic achievement.
Neurobiological changes of adolescence
Scientific evidence is growing that adolescence is a sensitive period for stress as a result of puberty-related changes in hormones and dramatic plasticity in the structure and function of the brain. In addition, this is a period of particular vulnerability to the social and emotional environment.
Adolescents process emotional information differently from the way prepubertal children and adults do, that is, the adolescent brain is particularly reactive to emotional information and especially to threat.
Brain development that occurs during adolescence primarily involves changes in the frontal and parietal cortices. These areas play a role in
- judgment,
- impulse control,
- planning, and
- emotion regulation.
As in childhood, experience-dependent learning also plays a part in the sculpting of the brain at adolescence
Effects of stress in adolescence
While the human stress response is adaptive in short bursts enhancing memory and helping to mobilise energy reserves for goal-directed purposes, prolonged stress or dysregulated responsiveness can have a negative effect on health, learning, and productivity. Evidence suggests that the ability to effectively direct attention and solve problems is disrupted by high emotional stress, particularly when perceived lack of control over stressors.
Given the potentially harmful consequences of the chronically overactivated stress system, it is extremely important to consider the effects of stress on adolescents’ developing brains. Overexpression of and increased sensitivity to cortisol, the main stress hormone, during this period may signal a window of vulnerability for the development of psychopathology.
Perceived stress, mental anticipation of a stressor, and memories about past stressors and peer rejection have particularly strong associations with cardiac and cortisol reactivity among adolescents. In fact, the most salient, well-researched and problematic behaviors of adolescence are all related to emotions. Depression, anxiety, aggression, risk-taking, sexual behavior, suicide, interpersonal conflicts, self-harm, and passionate interests in the arts, sports, and relationships with peers all result from emotional processes.
The importance of emotion regulation
Emotion regulation involves strategies for managing distress in order to achieve certain goals, such as those involved in learning, and is a basis for well-being, academic achievement, and positive adjustment throughout the life span.
Emotion regulation processes also include:
- identifying and accepting emotional experiences,
- managing distress,
- modulating arousal,
- sustaining motivation,
- prioritising among competing goals, and
- adaptive adjustment of behavioral responses.
Difficulties in emotion regulation are a core feature of many adolescent-onset emotional and behavioral problems, such as those seen above.
Heightened emotional distress predicts behavior problems and academic failure. Adolescents with low distress tolerance are significantly more susceptible to engage in harmful risk-taking behavior than those with greater capacity for distress tolerance despite similar risk taking propensity. Emotional distress disrupts the learning process through several mechanisms, including the reduction of self-regulatory efficacy and academic motivation and the amplification of experiential avoidance.
If adolescence is a stress-sensitive period of development, then emotional distress may be a risk factor for emotional and behavioral problems for all adolescents. Therefore, we need to prioritise effective universal prevention programs that teach emotion regulation (distress tolerance) skills to all adolescents, not just to those at increased risk of problems, as part of comprehensive social and emotional language programming. We propose that a mindfulness-based approach may be uniquely suited to this task.
The contribution of mindfulness for training attention and emotion regulation
Mindfulness is a term used to describe a particular kind of attention that is characterised by intentionality, present moment focus, and nonevaluative observation of experience.
Behaviors such as aggression and procrastination may become impulsive automatic responses to emotional distress (for example, anger or anxiety) or perceptions of unpleasantness (for example, boredom). Mindfulness is particularly suited to addressing these tendencies to respond in automatic, nonconscious ways to triggers, sometimes referred to as automatic pilot. The practice of an attentive and nonreactive attitude toward one’s impulses may “increase the gap between impulse and action” and lead to problem solving in a more conscious way.
Although research with adolescents is more limited, some studies have documented improvements in attention skills; social skills in students with learning difficulties; quality of sleep; well-being and reductions in anxiety symptoms, depression, somatic and externalising symptoms (related to impulse control, aggressiveness, etc.) in adolescents with clinical derivations.
While more research with rigorous experimental designs is needed to assess the effects of mindfulness-based approaches on young people, available research on child and youth mindfulness is promising. For adolescents, mindfulness appears to strengthen fundamental skills in self-regulation, support the cognitive skills needed for learning, and expand the capacity to tolerate suffering. Other studies show the feasibility of sustaining mindfulness-based treatments as a valuable and promising contribution, with links between mindfulness interventions and reduced levels of anxiety and depression, among others.
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