Mindfulness-based cognitive therapy for perceived stress and psychosomatic symptoms in Chinese adolescent girls: a mixed-methods school-based study of parent and teacher perceptions.

Abstract

Mindfulness-Based Cognitive Therapy (MBCT) integrates mindfulness practices with cognitive strategies to alleviate perceived stress and its associated symptoms. While well studied in adults, evidence for school-based MBCT among adolescents with psychosomatic complaints-particularly in China-remains limited. We conducted a quasi-experimental, mixed-methods study in three public secondary schools in DaZhou (Sichuan, China). Female students aged 14-16 were screened (N = 1,200) using the Psychosomatic Complaints Scale (PCS; cutoff > 45) and DSM-5-informed clinical interviews; 60 eligible students were randomly allocated to MBCT (8 weekly 75-minute sessions) or school-as-usual control. To mitigate non-specific effects, controls received attention-balanced administrative contacts (weekly neutral check-ins without psychological content). Outcome assessors and the data analyst were blinded to allocation. The primary outcomes were the Perceived Stress Scale (PSS; α = 0.85) and the PCS (α = 0.86), both of which were adapted for Chinese adolescents. Parent (n = 6) and teacher (n = 5) interviews were analyzed thematically (Braun & Clarke). Compared with controls, the MBCT group showed greater reductions in perceived stress and psychosomatic symptoms at post-test and two-month follow-up (Group×Time, p < .001; partial η²≈0.32-0.63). Mean reductions exceeded a conventional 0.5 SD benchmark, supporting applied relevance alongside statistical significance. Qualitative analysis yielded six themes that contextualized change: (1) reduced stress reactivity, (2) improved emotion regulation and self-awareness, (3) strengthened coping, (4) enhanced peer/family communication, (5) better classroom engagement, and (6) conditions for maintenance (practice dose, prompts, family/teacher supports). School-delivered MBCT was associated with sustained improvements in perceived stress and psychosomatic complaints among 14-16-year-old girls, with convergent qualitative evidence from parents and teachers. Interpretation remains cautious given the passive control, short follow-up, and bounded generalizability. Future work should test MBCT against attention-matched/active comparators, extend follow-up to 6-12 months, and examine mechanisms (e.g., decentering, rumination) and cultural/implementation outcomes to inform scaling in diverse Chinese school contexts.