Children and youth coming from disadvantaged socio-economic backgrounds are at risk of developing behavioural problems. This study examined the efficacy of a yoga program implemented in a low socio-economic status school, for the prevention of depression, anxiety, and aggression. After-school workshops were delivered twice a week during 12 weeks to 125 students in 5th, 8th, and 9th grades, enrolled in a school in BogotÃ¡, Colombia.
Participants were randomly assigned to an intervention and to a control group. Children's anxiety, depression, aggression, and some socio-emotional competencies (specifically empathy, anger management, and pro-sociality) were quantitatively assessed before and after the intervention, by means of self-and peer-reported questionnaires. Qualitative data were also collected to assess children's perceived benefits from the workshops. Results suggested a potential of the program to reduce children's anxiety problems, in particular. Results are discussed in terms of recommended improvements to the program and its future evaluation.
Keywords: Yoga; intervention; prevention programmes; depression; anxiety; aggression; socio-emotional competencies.
Children and youth raised in lower socio-economic contexts face many challenges that demand abilities for coping with stressful situations. These situations often put them at risk of developing mental and behavioural problems. In fact, research has shown that perceived chronic stress is related to anxiety, depression, and aggression (Suldo, Shaunessy, & Hardesty, 2008). Anxiety and depression can lead to maladaptive development given that children who exhibit these problems are more prone to be victimized by their peers (Kochenderfer & Ladd, 1996; Perry, Hodges, & Egan, 2001), which puts them at risk of psychopathology (Widom, 2000).
On the other hand, research on aggression shows that children who are repeatedly aggressive in school have a higher risk of getting involved in violence and criminality later in life (Farrington, 1993; Huesmann, Eron, Lefkowitz, & Walder, 1984). Given the consequences and relative stability of these problems across life, especially when the onset occurs in childhood and adolescence (Fombonne, Wostear, Cooper, Harrington, & Rutter, 2001; Weissman et al., 1999), researchers and educational practitioners have looked for intervention alternatives to prevent them early in life (Shonkoff, Boyce, & McEwen, 2009). Helping children to develop coping strategies to deal with stressful contexts can be an effective way to prevent depression, anxiety, and aggression.
According to Harper (2010), yoga might give children a â€œframe work for processing and handling their emotions, helping to defuse anger and stress (p. 101). In light of this, the pre sent study explored the potential benefits of a school-based yoga program for the prevention of anxiety, depression, and aggression, in low socio-economic status (SES) children and youth.
One of the main concerns for children's development has to do with school violence. This problem affects between 9% and 54% of children and youth worldwide (Vanderbilt & Augustyn, 2010). In Bogotá¡, Colombia, a survey study conducted by the Secretary of Education of BogotÃ¡ (Chaux, 2013) revealed that around 35% of students in Grades 5 to 9 reported being victims of physical aggression, and around 25% reported being victims of exclusion in their schools.
Previous research has shown that aggression can be attributed to the exposure to stressful environments, for example, community violence, family maltreatment, and aggressive peers (Saldarriaga, VelÃ¡squez, Bruce-Santo, Bukowski, & Chaux, 2009), which are more characteristic of public schools (Chaux, 2013). This could be related to the fact that, in BogotÃ¡, 66% of public schools are below the mid-level of socio-economic conditions (Secretaría de Educación del Distrito, 2013).
In addition to these contextual factors, aggression has also been associated with a lack of socio-emotional competencies such as empathy and anger regulation (Chaux, 2012). Empathy refers to the cognitive and emotional capacity to experience feelings that are congruent to the situation of another person (Hoffman, 2000), and anger regulation refers to the capacity to modulate the degree of emotional reactivity (in this case, anger) to cope with the demands of the environment (Saarni, Campos, Camras, & Witherington, 2006). This has led to the development and implementation of interventions aimed at preventing school violence through the promotion of socio-emotional competencies (Chaux, 2012).
Another concern for children's development is depression and anxiety, given that children who exhibit these problems also experience social withdrawal (Rubin, Coplan, & Bowker, 2009), peer rejection (Harrist, Zaia, Bates, Dodge, & Pettit, 1997), and victimization (Kochenderfer & Ladd, 1996; Perry et al., 2001), all of which impair their social development. In BogotÃ¡, a survey study showed that 52% of school-age children report moderate to high levels of social anxiety related to school activities (Chaux & Veláquez, 2008). Another study conducted by the first author in the same city with 1,346 elementary school students showed that 78% of children reported having experienced depressive feelings, from sometimes to always, in a period of 2 weeks.
Taking into account the association between these problems and chronic stress (Suldo et al., 2008), one way to prevent these problems in school-aged children is to provide them with tools to cope with and reduce stress. One promising alternative for the prevention of violence and the promotion of psychological wellbeing is yoga training (Lamb, 2004).
Yoga is defined as a â€œholistic system of multiple mind-body practices for mental and physical health that include physical postures and exercises, breathing techniques, deep relaxation practices, cultivation of awareness/mindfulness, and meditation (Khalsa, Hickey-Schultz, Cohen, Steiner, & Cope, 2012). The practice of yoga is considered to benefit individuals in different ways, exerting a positive influence on the individual's physiological and psychological systems. It has been explained that yoga influences the nervous system by triggering the parasympathetic nervous system, which inhibits the sympathetic nervous system responsible for causing the stress response (Lamb, 2004; Vempati & Telles, 2002).
In line with this, Steiner, Sidhu, Pop, Frenette, and Perrin (2013) state that, through calm breathing, postures, and meditation, yoga might help to regulate the autonomic nervous system, to calm down, and to focus the mind. Based on this, yoga may have an effect of reducing depression and anxiety by enhancing adaptation through the improvement of self-regulatory capacities (Skinner & Zimmer-Gembeck, 2007) and by acting on the neural circuitry associated with stress reactivity function (Davidson et al., 2003). Also, yoga training may be an effective method to reduce aggression (Steiner et al., 2013) by helping children and youth to develop abilities such as emotional regulation and empathy (Khalsa et al., 2012; Serwacki & Cook-Cottone, 2012). Steiner et al. (2013) pose that improvement in these skills may be achieved by yoga training insofar as it increases the individual's cognitive capacities such as attention, concentration, and awareness of one's emotional states.
Studies on the beneficial effects of yoga have suggested that it has a positive impact on individuals' well being(for a review, see Silva, Ravindran, & Ravindran, 2009). For example, research findings have shown an effect of yoga training on the reduction of anxiety (Kirkwood, Rampes, Tuffrey, Richardson, & Pilkington, 2005; Li & Goldsmith, 2012), depression (Shapiro et al., 2007), physical aggression (Berger, Silver, & Stein, 2009), anger control (Khalsa et al., 2012; Yoshihara, Hiramoto, Sudo, & Kubo, 2011), and perceived stress (Bayne, Aten, Smith, Greer, & Francisco, 2007; Granath, Ingvarsson, von Thiele, & Lundberg, 2006). However, most of these studies have been conducted in adult populations. Given the importance of preventing problems early in life, more attention needs to be paid to intervention programs during childhood and adolescence.
For this purpose, school settings become efficient contexts to intervene. On the one hand, the school is one of the settings where most of children's and adolescents' social life takes place; therefore, within this setting, they face challenging experiences, deal with stress, and manage anger. On the other hand, the school system and its organization provide adequate facilities for the implementation of prevention programs. Therefore, this study sets out to examine the beneficial effects of yoga interventions in school-aged children from low-income families. Some studies have already explored the efficacy of yoga training on children's school behaviour.
For example, a recent study showed that yoga reduced trauma-related distress in children (Culver, Whetten, Boyd, & O'Donnell, 2015). A meta-analysis conducted by Serwacki and Cook-Cottone (2012) showed that although participation in yoga training may have beneficial effects on emotional regulation, attention, anxiety reduction, reactivity, and physical aggression for children in school settings, there are several methodological limitations that need to be addressed such as randomization, greater samples, and statistical clarity.
A few studies, however, can be used as good models of rigorous research. One, conducted by White (2012), examined the effect of an 8-week yoga program, where 155 fourth- and fifth-grade children attending public schools were randomly distributed in experimental and control groups. Results showed improvements in self-esteem and self-regulation for children in both groups, but those in the experimental group reported having better coping strategies for stress, compared to the control group.
Another study, conducted on seventh-grade students by Khalsa et al. (2012), evidenced positive results of yoga training for the improvement of anger control. In this study, 121 participants were randomly assigned to physical education classes and yoga classes during 11 weeks. At the end of the intervention, the students that took yoga classes showed statistically significant differences when compared to the students who attended regular physical education classes.