正念冥想对成年ADD注意力缺陷患者的改善作用

DBT技能训练用于ADHD. 在临床实践中，许多患有注意缺陷多动障碍(ADHD)的患者需要在药物治疗之外进行额外的心理治疗干预。Hesslinger等人[35]对ADHD患者进行团体DBT训练 ...

正念训练可以通过减少个体的消极情绪和保持较高水平的积极情绪来改善工作记忆，并有助于预防在高应激情况下出现认知功能障碍，特别是工作记忆的损伤[14]。所以，通过正念 ...

正念认知疗法主要是通过正念打断负性思维的循环,减少个体感知幸福感的干扰源.通过正念练习改变对消极想法的看法,减少其对情绪的掌控,增加不愉快体验的允许,节省心理能量.

Attention-deficit/hyperactivity disorder (ADHD) is a recognized serious mental disorder that often persists into adulthood. The symptoms and impairments associated with ADHD often cause significant mental suffering in affected individuals. ADHD has been associated with abnormal neuronal activity in various neuronal circuits, such as the dorsofrontostriatal, orbitofrontostriatal, and frontocerebellar circuits. Psychopharmacological treatment with methylphenidate hydrochloride is recommended as the first-line treatment for ADHD. It is assumed that medication ameliorates ADHD symptoms by improving the functioning of the brain areas affected in the condition. However, side effects, contraindications, or non-response can limit the effectiveness of a psychopharmacological treatment for ADHD. It is therefore necessary to develop non-pharmacological interventions that target neuronal mechanisms associated with the condition in the same way as pharmacological treatment. We think that mindfulness meditation employed as a neuropsychotherapeutic intervention could help patients with ADHD to regulate impaired brain functioning and thereby reduce ADHD symptoms. In this paper, we highlight the mechanisms of such mindfulness meditation, and thus provide a rationale for further research and treatment development from a neuropsychotherapeutic perspective. We conclude that mindfulness meditation employed as a neuropsychotherapeutic intervention in therapy is a promising treatment approach in ADHD.

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Background Attention regulation is crucial for mindfulness practice; however, the influence of baseline attention ability on mindfulness training outcomes remains underexplored. This study examined the effects of a brief mindfulness intervention on attention and investigated whether baseline inattention symptoms moderated these effects in meditation-naïve university students. Methods This study employed a pretest-posttest, between-groups experimental design. Meditation-naïve university students (n = 121, aged 18–31, 69% women) were randomly assigned to either a mindfulness group, which engaged in 10 min of guided mindful breathing, or a control group, which listened to a talk on green living. Baseline attention was assessed using the Adult ADHD Self-Report Scale (ASRS), and attentional changes were measured via EEG recorded during a visual novelty oddball task. Results Both groups showed increased post-intervention P3b amplitudes, an electrophysiological indicator of attention. However, the mindfulness group exhibited a significantly greater increase compared to the control group. Importantly, inattention symptoms moderated this effect: participants with higher inattention symptoms in the mindfulness group showed a greater increase in P3b amplitude, while those in the control group showed a decrease. Conclusion These findings highlight the importance of considering individual attentional profiles when designing mindfulness-based interventions. Tailoring mindfulness training based on baseline attention levels may enhance its cognitive benefits. Future research should explore additional potential moderators of mindfulness training outcomes and clinical conditions (e.g., anxiety or depression) that may influence attentional functioning and responsiveness to mindfulness practice.

College students are vulnerable to diverse mental health disorders. We aimed to investigate whether a meditation class would be an effective means to address students' mental health challenges. Among the college students who registered for the meditation course, 256 participants were enrolled. The meditation course was a 15-week program incorporating mindfulness meditation and Ganhwa Seon (a traditional Buddhist meditation). A questionnaire was administered twice, on the first and last class of the course, collecting information on personal characteristics and six mental health indicators. A paired t-test was used to examine whether the meditation course conferred benefit on the mental health indicators, and logistic regression analyses were run to identify factors associated with mental health outcomes. After completing the meditation course, there were significant improvements for the adult ADHD score (p < 0.01) and ego identity (p = 0.02) but not for the other outcomes. Among college students, meditation practice may have positive effects on the adult ADHD score and ego identity.

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Objective. Adults with attention deficit hyperactivity disorder (ADHD) display affective problems and impaired attention. Mood in ADHD can be improved by mindful awareness practices (MAP), but results are mixed regarding the enhancement of attentional performance. Here we evaluated MAP-induced changes in quality of life (QoL), mood, and attention in adult ADHD patients and controls using more measures of attention than prior studies. Methods. Twenty-one ADHD patients and 8 healthy controls underwent 8 weekly MAP sessions; 22 similar patients and 9 controls did not undergo the intervention. Mood and QoL were assessed using validated questionnaires, and attention was evaluated using the Attentional Network Test (ANT) and the Conners Continuous Performance Test (CPT II), before and after intervention. Results. MAP enhanced sustained attention (ANT) and detectability (CPT II) and improved mood and QoL of patients and controls. Conclusion. MAP is a complementary intervention that improves affect and attention of adults with ADHD and controls.

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Adult attention-deficit/hyperactivity disorder (ADHD) is a serious mental disorder associated with impaired neurocognitive performance related to working memory function. Recent clinical trials have suggested that mindfulness is a promising intervention in adults with ADHD. We performed a randomised controlled clinical trial to investigate working memory (WM) with an n-back task in adults with ADHD during fMRI before and after an 8-week mindfulness intervention (MAP) compared with psychoeducation (PE). ADHD symptoms were assessed using the self- and observer-rated Conners Adult ADHD Rating Scales (CAARS). The complete pre-post data of 21 MAP and 19 PE participants were analysed. We found no group difference in ADHD symptoms or task performance at the pre-measurement, but there was a significant decrease in ADHD symptoms and significant improvement in task performance in both groups at the post-measurement. Furthermore, we found a significant increase in task-related activation in the right parietal lobe, with no difference between groups. Exploratory two-sample paired t-tests revealed significant increased brain activation after MAP in the bilateral inferior parietal lobule, right posterior insula and right precuneus. A decrease in self-rated 'Inattention/Memory Problems' after MAP compared to baseline was associated with stronger activation in parts of the left putamen, globus pallidus and thalamus.

Adult attention-deficit/hyperactivity disorder (ADHD) is estimated to affect 2.5–5% of adults globally. Although medication remains a first-line treatment, many individuals experience only partial benefit, unwanted side effects or discontinue use over time. This review examines current evidence on four major non-pharmacological interventions—cognitive-behavioural therapy (CBT), mindfulness-based approaches, psychoeducation, and cognitive training—and discusses their effectiveness and clinical relevance. Findings from randomized controlled trials and meta-analyses show consistent clinician-rated improvements across all four interventions. CBT shows the most consistent effects, leading to reductions in symptoms and improvements in daily functioning. Mindfulness-based interventions are particularly effective in enhancing attention and emotional regulation, while psychoeducation improves participants’ understanding of ADHD and their self-management skills. Cognitive training yields modest gains in cognitive performance, though its transfer to real-world functioning appeared limited. Top-down approaches such as CBT and psychoeducation, and bottom-up methods like mindfulness and cognitive training, represent complementary therapeutic pathways. Combining these evidence-based strategies within individualized, multimodal treatment plans may improve outcomes for adults with ADHD beyond what medication alone can achieve.

This study explored the effects of a Mindfulness-Based Stress Reduction (MBSR) intervention on reading, attention, and psychological well-being among people with developmental dyslexia and/or attention deficits. Various types of dyslexia exist, characterized by different error types. We examined a question that has not been tested so far: which types of errors (and dyslexias) are affected by MBSR training. To do so, we tested, using an extensive battery of reading tests, whether each participant had dyslexia, and which errors types s/he makes, and then compared the rate of each error type before and after the MBSR workshop. We used a similar approach to attention disorders: we evaluated the participants’ sustained, selective, executive, and orienting of attention to assess whether they had attention-disorders, and if so, which functions were impaired. We then evaluated the effect of MBSR on each of the attention functions. Psychological measures including mindfulness, stress, reflection and rumination, lifesatisfaction, depression, anxiety, and sleep-disturbances were also evaluated. Nineteen Hebrew-readers completed a 2-month mindfulness workshop. The results showed that whereas reading errors of letter-migrations within and between words and vowelletter errors did not decrease following the workshop, most participants made fewer reading errors in general following the workshop, with a significant reduction of 19% from their original number of errors. This decrease mainly resulted from a decrease in errors that occur due to reading via the sublexical rather than the lexical route. It seems, therefore, that mindfulness helped reading by keeping the readers on the lexical route. This improvement in reading probably resulted from improved sustained attention: the reduction in sublexical reading was significant for the dyslexic participants who also had attention deficits, and there were significant correlations between reduced reading errors and decreases in impulsivity. Following the meditation workshop, the rate of commission errors decreased, indicating decreased impulsivity, and the variation in RTs in the CPT task decreased, indicating improved sustained attention. Significant improvements were obtained in participants’ mindfulness, perceived-stress, rumination, depression, state-anxiety, and sleep-disturbances. Correlations were also obtained between reading improvement and increased mindfulness following the workshop. Thus, whereas mindfulness training did not affect specific types of errors and did not improve dyslexia, it did affect the reading of adults with developmental dyslexia and ADHD, by helping them to stay on the straight path of the lexical route while reading. Thus, the reading improvement induced by mindfulness sheds light on the intricate relation between attention and reading. Mindfulness reduced impulsivity and improved sustained attention, and this, in turn, improved reading of adults with developmental dyslexia and ADHD, by helping them to read via the straight path of the lexical route.

Objective: This study aims to perform a systematic review and meta-analysis of the effect of MBIs (Mindfulness, Tai Chi, Yoga, and Qigong) on symptoms and executive function (EF) in ADHD. Method: PubMed, Web of Science, the Cochrane Library, PsycINFO, CINAHL, Embase, and CNKI databases were searched to collect randomized controlled trials (RCTs) on the effects of MBIs on symptoms and EF in ADHD. Data extraction and methodological quality evaluation were conducted by two researchers, and a meta-analysis was conducted by Stata SE. Results: The pooled meta-analyses of MBIs revealed a positive and small effect on inattention (g = −0.26), hyperactivity/impulsivity (g = −0.19), and EF (g = −0.35). Conclusion: Results suggest that MBIs have a significant improvement relative to the control condition. Although some results show that symptoms are affected by age, interventions, and total time of moderators, while EF is not affected by age and measurement, it needs to be supported by more research evidence. (J. of Att. Dis. XXXX; XX(X) XX-XX)

BACKGROUND Persistent mind-wandering processes are associated with negative emotions; however, mindful states exhibit an anticorrelation with mind-wandering patterns. The aim of this study is to investigate the mediating role of excessive mind wandering (EMW), rumination, and trait mindfulness between attention-deficit hyperactivity disorder (ADHD) symptoms and the severity of anxiety/depression in adults with ADHD. METHODS Medication-free 159 adults diagnosed with ADHD completed a test battery that included a sociodemographic form as well as the Adult ADHD Severity Rating Scale, Hospital Anxiety Depression Scale, Mind Excessively Wandering Scale, Ruminative Response Scale, and Freiburg Mindfulness Inventory after the diagnostic examination according to the Structured Clinical Interview for DSM-5-Clinician Version (SCID-5). RESULTS ADHD symptoms exhibited an indirect, but not a direct, association with the severity of anxiety and depression, mediated by increased excessive mind wandering and rumination, as well as decreased trait mindfulness. LIMITATIONS This study was carried out within a clinical population using a cross-sectional design. While diagnostic assessments were conducted using SCID-5, psychiatric symptoms were evaluated through self-report measures. CONCLUSIONS Coping with EMW and rumination and promoting mindfulness ability may be promising targets in treating comorbid conditions in adults with ADHD. These findings have highlighted the effects of mentation processes on depression and anxiety, which are common comorbidities with ADHD in adults; however, longitudinal studies are needed.

Background Control over the tendency to make or withhold responses guided by contextual Pavlovian information plays a key role in understanding impulsivity and hyperactivity. Here we set out to assess (1) the understudied relation between contextual Pavlovian inhibitory control and hyperactivity/impulsivity in adults with ADHD and (2) whether this inhibition can be enhanced by mindfulness based cognitive therapy (MBCT). Methods Within the framework of a randomized controlled trial 50 Adult ADHD patients were assessed before and after 8 weeks of treatment as usual (TAU) with (n = 24) or without (n = 26) MBCT. We employed a well-established behavioral Pavlovian-to-instrumental transfer task that quantifies Pavlovian inhibitory control over instrumental behavior. Results Task results revealed (1) less aversive Pavlovian inhibition in ADHD patients with clinically relevant hyperactivity/impulsivity than in those without; and (2) enhanced Pavlovian inhibition across all ADHD patients after TAU+MBCT compared with TAU. Conclusion These findings offer new insights in the neurocognitive mechanisms of hyperactivity/impulsivity in ADHD and its treatment: We reveal a role for Pavlovian inhibitory mechanisms in understanding hyperactive/impulsive behaviors in ADHD and point toward MBCT as an intervention that might influence these mechanisms.

Introduction Mindfulness-based cognitive therapy (MBCT) is one of the promising treatments with no known side effects for neuropsychiatric conditions such as Attention-deficit/hyperactivity disorder (ADHD). However, the mechanism of action underlying MBCT is not clearly understood. Here, we applied resting-state EEG microstate analysis and machine learning modeling to characterize brain network dynamics in adults with ADHD exposed to MBCT. Methods Sixty-one participants were randomized to a 12-week MBCT intervention or waitlist control (WL), with clinical assessments and EEG recordings collected pre-to-post trial. We analyzed the microstate dynamics of EEG data in different frequency bands, comparing four microstate classes (A-D), and the cross-correlation of microstate dynamics with clinical measures. Furthermore, machine learning computational techniques were applied to predict which patients can benefit more from the MBCT intervention based on their brain dynamics pre-treatment. Results Microstate analyses revealed significant MBCT-related alterations in temporal dynamics, including increased coverage and duration of microstates A and B, as well as changes in individual explained variance in microstate A (theta band) and microstate D (alpha band). Coverage and explained variance for microstate B also showed significant changes across the full spectrum. These changes were strongly correlated with improvements in ADHD symptomatology, mindfulness skills, quality of life, and executive function across seven clinical domains. Critically, machine learning models predicted individual treatment responses with 83% accuracy using microstate dynamics. Discussion These findings demonstrate that MBCT systematically reshapes resting-state neural microstates in ADHD, including microstate classes A, B, and D, and suggest that computational EEG biomarkers may inform precision approaches to mindfulness-based interventions.

Objective: The present study evaluated the near (attention) and far (reading, ADHD symptoms, learning, and quality of life) transfer effects of a Computerized Progressive Attention Training (CPAT) versus Mindfulness Based Stress Reduction (MBSR) practice among adults with ADHD compared to a passive group. Method: Fifty-four adults participated in a non-fully randomized controlled trial. Participants in the intervention groups completed eight 2-hr weekly training sessions. Outcomes were assessed before, immediately after, and 4 months post-intervention, using objective tools: attention tests, eye-tracker, and subjective questionnaires. Results: Both interventions showed near-transfer to various attention functions. The CPAT produced far-transfer effects to reading, ADHD symptoms, and learning while the MBSR improved the self-perceived quality of life. At follow-up, all improvements except for ADHD symptoms were preserved in the CPAT group. The MBSR group showed mixed preservations. Conclusion: Both interventions have beneficial effects, however only the CPAT group exhibited improvements compared to the passive group.

Purpose Little is known about the effects of yoga training in adults with ADHD symptoms. This pilot study sought to determine the feasibility and selected psychological effects of 6 weeks of yoga training in women screening positive for adult ADHD compared to a wait-list control group. Methods A randomized trial was conducted with 32 adult women (18–24 years) who volunteered after screening positive for adult ADHD as assessed by the Adult ADHD Self-Report Scale (ASRS). Participants were randomized to 6 weeks of Bikram yoga training or to a wait-list control group. The yoga intervention consisted of two 90-min classes per week. Multilevel models were used to test hypothesized interactions of yoga-induced improvements compared to controls across time (baseline, 3 weeks, and 6 weeks). The primary outcomes assessed inhibitory control, cognitive flexibility and working memory using the NIH Toolbox. Separate models with trait mindfulness, trait anxiety and expectations for change in either attention or working memory as covariates tested whether these variables mediated the changes in the three measures of executive function. Secondary outcomes included mood, perceived functional impairment and motivation for, and hyperactivity during, the cognitive tests. Results No adverse events were observed. Attendance averaged 91.7% among the 69% of the sample that did not dropout. No significant Group X Time interactions were found for any of the psychological outcomes and the null executive function findings were unchanged when including the covariates. Conclusion Six-weeks of yoga training twice per week is potentially feasible for women experiencing ADHD symptoms, but an exercise stimulus of this duration and magnitude yields no beneficial cognitive or mood outcomes.

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Adult attention‐deficit/hyperactivity disorder (ADHD) is associated with substantial impairments in well‐being and quality of life. In addition to cognitive and behavioral symptoms, emotional dysregulation characterizes the disorder. This study investigated habitual worry in the context of cognitive control and heart rate variability (HRV) in adult ADHD. Groups with high and low ADHD symptoms (n = 51 per group) were selected from a large participant pool (n = 1020) using the Adult ADHD Self‐Report Scale. HRV was recorded during a breathing focus task assessing cognitive control. The task included two phases during which participants' ability to concentrate on their breathing was recorded before and after an instructed worry phase. While groups did not differ in HRV, participants with high ADHD symptoms reported greater habitual worry, more negative affect, and less positive affect than those with low ADHD symptoms. They exhibited less ability to concentrate on breathing, more frequent positive, neutral, and negative thought intrusions, and greater distress during instructed worry. In the total sample, habitual worry correlated negatively with breathing focus ability and positively with intrusive thoughts. HRV correlated positively with breathing focus ability and negatively with thought intrusions. Moreover, HRV correlated negatively with distress during instructed worry. Impaired cognitive control may contribute to exaggerated worry and negative emotional states related to ADHD symptoms. The lack of association between HRV and ADHD symptoms accords with previous studies. The correlations seen for HRV implicate prefrontal cortex function and vagal cardiac control in emotional regulation and inhibition of intrusive thoughts.

Recent literature suggests that ADHD is a risk factor for the development of antisocial behavior that is more severe and persistent than in community and other psychiatric populations. The combination of stimulant medication and psychotherapy (particularly cognitive behavioral therapy, CBT) is considered an evidence-based intervention for adults with ADHD. In contrast, few studies have evaluated the efficacy of medication in adult prisoners with ADHD, and the literature on the efficacy of psychotherapy is virtually nonexistent. Therefore, this article presents the protocol of a trial that will assess the efficacy of a formulation-based CBT program for inmates with ADHD. The study has a multicenter randomized controlled trial design. After screening and recruitment, participants will be randomly assigned to the CBT intervention, a general offender treatment program, or a waitlist. Pre- and post-treatment self-report and clinician-report assessments, as well as 6- and 12-month follow-up assessments will be conducted. These will include both clinical (e.g., ADHD symptoms, depression and anxiety symptoms, self-esteem, alcohol/drug abuse, treatment adherence, quality of life) and criminological (e.g., recidivism and risk of recidivism) measures. Linear mixed models will be used to assess differences between groups. This study may be the first to evaluate the efficacy of a psychotherapy intervention in adult inmates with ADHD. It is expected that addressing the specific needs of ADHD would not only result in the previously reported clinical improvements (e.g., reduction in ADHD and comorbidity symptoms), but also reduce the risk and rate of recidivism compared to the general intervention or no intervention. However, the design may be limited by the difficulties inherent in the prison setting and in following up the sample after release. ClinicalTrials.gov NCT06080373. Registered on October 12, 2023.

This study investigated whether treatment naïve adults with Attention Deficit Hyperactivity Disorder (ADHD; n = 33; 19 female) differed from healthy controls (n = 31; 17 female) in behavioral performance, event-related potential (ERP) indices of preparatory attention (CueP3 and late CNV), and reactive response control (Go P3, NoGo N2, and NoGo P3) derived from a visual cued Go/NoGo task. On several critical measures, Cue P3, late CNV, and NoGo N2, there were no significant differences between the groups. This indicated normal preparatory processes and conflict monitoring in ADHD patients. However, the patients had attenuated Go P3 and NoGoP3 amplitudes relative to controls, suggesting reduced allocation of attentional resources to processes involved in response control. The patients also had a higher rate of Go signal omission errors, but no other performance decrements compared with controls. Reduced Go P3 and NoGo P3 amplitudes were associated with poorer task performance, particularly in the ADHD group. Notably, the ERPs were not associated with self-reported mood or anxiety. The results provide electrophysiological evidence for reduced effortful engagement of attentional resources to both Go and NoGo signals when reactive response control is needed. The absence of group differences in ERP components indexing proactive control points to impairments in specific aspects of cognitive processes in an untreated adult ADHD cohort. The associations between ERPs and task performance provided additional support for the altered electrophysiological responses.

[This corrects the article DOI: 10.1371/journal.pone.0159833.].

Abstract Access to evidence-based psychosocial interventions for adults with attention-deficit/hyperactivity disorder (ADHD) remains limited, despite strong patient demand for nonpharmacological options such as cognitive behavioral therapy (CBT). Digital interventions may offer a scalable, low-threshold solution to meet this need and complement existing care. This pragmatic randomized controlled trial evaluated the effectiveness of attexis, a fully self-guided digital intervention based on CBT and mindfulness principles, as an adjunct to treatment as usual (TAU). A total of 337 adults with confirmed ADHD were randomized to either attexis + TAU or TAU alone. The primary outcome was ADHD symptom severity (Adult ADHD Self-Report Scale total score) at 3 months post-randomization (T1). Secondary outcomes included functional impairment, depressive symptoms, self-esteem, and health-related quality of life. Follow-up was conducted at 6 months (T2). Intent-to-treat analyses showed significantly lower ADHD symptom severity in the intervention group at T1 (baseline-adjusted mean difference = −5.0 points; d = 0.85, p < .001). Significant improvements were also observed across all secondary outcomes, and effects remained stable at T2. Responder analyses confirmed the clinical relevance of the findings. Subgroup analyses demonstrated consistent effects across sex, medication use, psychotherapy status, and treatment changes. No adverse events related to attexis were reported. attexis was effective in reducing ADHD symptoms and improving a broad range of functional and psychosocial outcomes. As a safe, low-threshold, fully self-guided intervention, it may serve as a valuable adjunct to routine care and help address existing gaps in access to psychosocial treatment for adults with ADHD.

Background Many clinical studies reported deficits in basic and complex cognitive functions in adults with Attention-Deficit/Hyperactivity Disorder (ADHD). However, the extent in which deficits in basic functions (i.e., processing speed and distractibility) contribute to complex cognitive impairments (i.e., working memory, planning, cognitive flexibility, memory functions) in adults with ADHD is not well-studied. So far, literature show only one study, revealing that basic functions explain 27–74% of executive dysfunctions. Yet, the authors reported that findings could be affected by the selection of neuropsychological tests. The goal of the present research is to replicate such a finding using a different sample and a different set of neuropsychological tests. Methods Forty-eight adult patients with ADHD were compared with 48 healthy controls in basic cognitive functions, namely processing speed and distractibility and more complex cognitive functions, namely selective attention, cognitive flexibility, planning, working memory, verbal fluency, and verbal memory. Basic and complex cognitive functions were assessed using the Vigilance and Sustained Attention, Selective Attention, N-Back, Tower of London, Trail Making Test, Word Fluency, and Verbal Learning and Memory. Results and conclusion Logistic regression analyses showed that impairments in complex cognitive functions explained 25% of the variance in ADHD diagnosis. The explained variance dropped from 25% to 9% after considering basic functions of processing speed and distractibility. This 64% reduction highlights the importance of basic functions for impairments in complex functions in patients with ADHD.

Objective: There is an updated conceptualization of whole-lifespan attention-deficit hyperactivity disorder (ADHD), promoted by awareness of probable persistence of impairment into adulthood. We investigated cognition trajectories from adolescence to mid-adulthood in ADHD. Method: Data of 240 patients with ADHD and 244 healthy controls (HCs) were obtained; clinical symptoms and neuropsychological functions were assessed using the various tests. Results: Compared to HCs, patients with ADHD except 35 to 44 age interval showed lower full scale intelligence quotient. They showed decreased verbal comprehensive scores except in the 35 to 44 age interval and working memory scores in all intervals. In the Comprehensive Attention Test, patients with ADHD showed increased working memory error frequencies except in the 15 to 17 age interval and divided attention omission error in all intervals. Conclusion: Adults with ADHD showed deficits not in simple attention but in complex attention, including divided attention and working memory.

Objective: This study examined the contribution of the temporal dynamics of two cognitive control mechanisms—inhibitory control (IC) and working memory (WM)—to emotion dysregulation (ED) in attention-deficit/hyperactivity disorder (ADHD) in ecological settings. Method: One hundred twenty-two participants (age 18–33 years; 60 with ADHD) reported their ED at baseline, followed by a 5-day ecological momentary assessment (EMA) study, with short behavioral IC and WM tasks performed five times/day. Results: For IC, mean and lability of performance over EMA significantly accounted for differences in ED but not baseline performance. For WM, both baseline and mean of EMA, but not EMA lability, accounted for ED variance. ADHD status further contributed to the explained variance of ED. Conclusions: Our results support the contribution of dynamic IC processes to ED in ADHD, in addition to WM performance level, and highlight the importance of dynamic and ecological investigation of different cognitive control components.

Smartphone use is nearly ubiquitous, with 93% of adults among economically developed countries, including the United States, Canada, Israel, and South Korea owning a smartphone (Taylor & Silver, 2019). Multiple studies have demonstrated the distracting effects of smartphone notifications on behavioral measures of cognition. Fewer studies have examined the effects of notifications on neural activity underlying higher-level cognitive processes or behavioral inductions to reduce smartphone-related distraction. Using EEG spectral frequency power densities, we assessed the effects of smartphone notifications (vs. control trials) on engagement of attentional shifting processes involved in cognitive control during a Navon Letter visual oddball task. Participants were randomly assigned to a brief mindfulness induction (N = 44) or a neutral narration control condition (N = 43). Overall, participants had lower theta-band power, but higher alpha- and beta-band power densities on target letter trials preceded by smartphone notifications. Additionally, participants in the mindfulness (vs. control) condition had a larger attention shifting oddball assessed via theta power density, theta/beta ratio (TBR) values-reflecting increased engagement of cognitive control-particularly for smartphone notification (vs. control) trials. Together, these results provide evidence supporting the idea that smartphone notifications can decrease activity of neural correlates of cognitive control, and for the promise of brief mindfulness inductions to buffer against the effects of smartphone notifications on cognitive control. The findings indicate a need for further research of mindfulness to reduce distractibility by smartphones.

Introduction Attention-Deficit Hyperactivity Disorder (ADHD) in adults is common and characterized by difficulties in regulation of attention, activity and goal directed behaviors. These challenges are especially associated with inattentive symptoms, why high levels of inattention imply severe impairment in everyday life. CBT for ADHD-inattentive presentation, (CADDI), is designed to treat inattention and incorporates skills training in organization, behavioral activation, and mindfulness. The aim of this study was to compare the effectiveness of CADDI with regular CBT treatment for ADHD. Methods A multicenter, pragmatic, two-arm, parallel, randomized controlled trial compared CADDI to Hesslinger’s dialectical behavior therapy protocol. The study included 108 participants from six psychiatric outpatient clinics in Stockholm. Self-reported scales were used to assess outcome measures of behavioral activation, procrastination, symptoms of ADHD, depression, quality of life and functional impairment. Data were analyzed for between and within-group effects using multilevel modeling. Results Between-group analysis showed that participants in the CADDI group had significantly greater improvement on the primary outcome measure of activation at post assessment (p = .045, d = 0.49). No significant between-group effect was found on the other measures. However, within-group analysis showed larger effect sizes in the CADDI condition relative to the control condition on several measures. Adherence was good and attrition 21.3% despite effects of the pandemic. Participants and therapists reported higher satisfaction with CADDI as compared to the control group. Discussion This trial demonstrated that CADDI was more effective regarding behavioral activation and suggests a potential advantage of an intervention specifically targeting ADHD-I over generic CBT for ADHD. However, the trial was underpowered and failed to prove between-group effects in spite of large differences in effect sizes on several measures. Future research with larger samples and long-term follow-ups is recommended to validate and expand upon these results.

The ability to focus one's attention underlies success in many everyday tasks, but voluntary attention cannot be sustained for a long period of time. Several studies indicate that attention training using computer-based exercises can lead to improved attention in children and adults. a major goal of recent research is to create a short (10 minutes) and effective VR Mindfulness meditation particularly designed for regaining or improving sustained attention. In this study, we have created a custom virtually relaxing environment including an archery game with multiple targets. In the experiment, the attention span of 12 adults are tested before and after the virtual reality session by a non-action video game ([19]) score and Muse headband EEG-signals. After the 10-minute virtual reality session participants' game scores increased (according to game experience): for the beginner by 275%, for intermediate by 107%, and for an expert by 17%. For Muse headband data, calm points increased by 250% irrespective of the participants gaming experiences. After the experiment, all participants reported feeling recharged to continue their daily activities.

Fast and efficient strategies for modulation of attention have been extensively studied recently. The present study has attempted to observe the effect of brief meditation practices on executive control of the attention system. The study recruits cognitive control by introducing conflict using Stroop task in twenty-six novice participants. Behavioral responses indicate a positive effect on response time and accuracy at Stroop task after ten minutes of meditation intervention. Neurophysiological findings suggest more efficient allocation of attentional resources. An increase in positive ERP components (P200, P300) and expected decrease in the inhibitory or negative component (N200) after intervention shows positive results. The findings suggest a positive impact of meditation intervention on attention even for brief periods in non-meditating population.

College students with ADHD respond positively to simple socially assistive robots (SARs) that monitor attention and provide non-verbal feedback, but studies have been done only in brief in-lab sessions. We present an initial design and evaluation of an in-dorm SAR study companion for college students with ADHD. This work represents the introductory stages of an ongoing user-centered, participatory design process. In a three-week within-subjects user study, university students (N=11) with self-reported symptoms of adult ADHD had a SAR study companion in their dorm room for two weeks and a computer-based system for one week. Toward developing SARs for long-term, in-dorm use, we focus on 1) evaluating the usability and desire for SAR study companions by college students with ADHD and 2) collecting participant feedback about the SAR design and functionality. Participants responded positively to the robot; after one week of regular use, 91% (10 of 11) chose to continue using the robot voluntarily in the second week.

Mindfulness is the state of paying attention to the present moment on purpose and meditation is the technique to obtain this state. This study aims to develop a robot assistant that facilitates mindfulness training by means of a Brain Computer Interface (BCI) system. To achieve this goal, we collected EEG signals from two groups of subjects engaging in a meditative vs. nonmeditative human robot interaction (HRI) and evaluated cerebral hemispheric asymmetry, which is recognized as a well defined indicator of emotional states. Moreover, using self reported affective states, we strived to explain asymmetry changes based on pre and post experiment mood alterations. We found that unlike earlier meditation studies, the frontocentral activations in alpha and theta frequency bands were not influenced by robot guided mindfulness practice, however there was a significantly greater right sided activity in the occipital gamma band of Meditation group, which is attributed to increased sensory awareness and open monitoring. In addition, there was a significant main effect of Time on participants self reported affect, indicating an improved mood after interaction with the robot regardless of the interaction type. Our results suggest that EEG responses during robot-guided meditation hold promise in realtime detection and neurofeedback of mindful state to the user, however the experienced neurophysiological changes may differ based on the meditation practice and recruited tools. This study is the first to report EEG changes during mindfulness practice with a robot. We believe that our findings driven from an ecologically valid setting, can be used in development of future BCI systems that are integrated with social robots for health applications.

In this paper, we present the preliminary findings from a qualitative study (i.e., semi-structured interviews) on how a Mindfulness-Based Stress Reduction (MBSR) program, carried out in the Software Development (SD) working context, is perceived by the software developers of a multinational company who participated in the MBSR program and by the instructor who led it. MBSR is a deeply personal and experiential practice in helping individuals manage stress, particularly in high-pressure environments such as workplaces, healthcare settings, education, and other demanding professional or personal situations. Although MBSR has been experimented in different working contexts; surprisingly, it has never been studied in the SD working context where there are several stress factors that developers experience (e.g., time pressure and uncertainty about the content of a particular task and its outcome). In this respect, qualitative research can generate valuable insights into the application of MBSR in the SD working context that cannot be captured by standardized quantitative measures. Being MBSR instructors and software developers the key stakeholders in delivering an MBSR program in the SD working context, understanding their first-hand experiences can provide a more detailed picture of the investigated phenomenon. The most important takeaway result of our research can be summarized as follows: despite initial skepticism, the developers recognized personal improvements due to the MBSR practice, though the integration of MBSR techniques in the working context remained challenging.

Attention Deficit Disorder with or without Hyperactivity (ADHD is a neurodevelopmental disorder which affects the day-to-day functioning of children and adults with this condition. Pharmacological treatment can reduce the symptoms associated with ADHD, but it has some limitations. The objective of this symposium is to determine the effects of non-pharmacological approaches on ADHD symptoms. Results indicate that the following intervention are promising approaches: cognitive behavioral therapy (CBT), mindfulness-based interventions (MBI), yoga, cognitive and metacognitive intervention, neurofeedback and parental training programs. Current research advocates multimodal approaches in conjunction with school or work accommodations integrating innovative technologies.

The comparative benefits and harms of available interventions for ADHD in adults remain unclear. We aimed to address these important knowledge gaps. In this systematic review and component network meta-analysis (NMA), we searched multiple databases for published and unpublished randomised controlled trials (RCTs) investigating pharmacological and non-pharmacological interventions for ADHD in adults from database inception to Sept 6, 2023. We included aggregate data from RCTs comparing interventions against controls or any other eligible active intervention for the treatment of symptoms in adults (ages ≥18 years) with a formal diagnosis of ADHD. Pharmacological therapies were included only if their maximum planned doses were considered eligible according to international guidelines. We included RCTs of at least 1-week duration for medications, of at least four sessions for psychological therapies, and of any length deemed appropriate for neurostimulation. For RCTs of medications, cognitive training, or neurostimulation alone, we included only double-blind RCTs. At least two authors independently screened the identified records and extracted data from eligible RCTs. Our primary outcomes were efficacy (change in ADHD core symptom severity on self-rated and clinician-rated scales at timepoints closest to 12 weeks) and acceptability (all-cause discontinuation). We estimated standardised mean differences (SMDs) and odds ratios (ORs) using random effects pairwise and component NMA, dismantling interventions into specific therapeutic components. This study was registered with PROSPERO (CRD42021265576). People with relevant lived experience were involved in the conduct of the research and writing process. Of 32 416 records, 113 unique RCTs encompassing 14 887 participants were eligible for analysis (6787 [45·6%] females, 7638 [51·3%] males, 462 [3·1%] sex not reported). The RCTs encompassed pharmacological therapies (63 [55·8%] of 113 RCTs; 6875 participants), psychological therapies (28 [24·8%] of 113 RCTs; 1116 participants), neurostimulatory therapy and neurofeedback (ten [8·8%] of 113 RCTs; 194 participants), and control conditions (97 [85·8%] of 113 RCTs; 5770 participants). For reduction of ADHD core symptoms at 12 weeks on both self-reported and clinician-reported rating scales, atomoxetine (self-reported scale SMD -0·38, 95% CI -0·56 to -0·21; clinician-reported scale -0·51, -0·64 to -0·37) and stimulants (0·39, -0·52 to -0·26; -0·61, -0·71 to -0·51) had higher efficacy than placebo (Confidence in Network Meta-Analysis [CINeMA] ranging between very low and moderate). Cognitive behavioural therapy (-0·76, -1·26 to -0·26), cognitive remediation (-1·35, -2·42 to -0·27), mindfulness (-0·79, -1·29 to -0·29), psychoeducation (-0·77, -1·35 to -0·18), and transcranial direct current stimulation (-0·78; -1·13 to -0·43) were better than placebo only on clinician-reported measures. Regarding acceptability, all therapeutic components were similar to placebo other than atomoxetine (OR 1·43, 95% CI 1·14 to 1·80; CINeMA moderate) and guanfacine (3·70, 1·22 to 11·19; high), which had lower acceptability compared with placebo. Baseline severity of self-reported ADHD core symptoms, year of publication, percentage of male individuals, and percentage of individuals with ADHD and another mental health condition did not explain the heterogeneity observed in unadjusted non-component models of self-reported ADHD core symptoms. Treatment length had little effect on heterogeneity. Stimulants and atomoxetine were the only interventions with evidence of beneficial effects in terms of reducing ADHD core symptoms in the short term, supported by both self-reported and clinician-reported ratings. However, atomoxetine was less acceptable than placebo. Medications for ADHD were not efficacious on additional relevant outcomes, such as quality of life, and evidence in the longer term is underinvestigated. The effects of non-pharmacological strategies were inconsistent across different raters. Our network meta-analysis represents the most comprehensive synthesis of available evidence to inform future guidelines in the field. UK National Institute for Health and Care Research.

To assess the effects of and related evidence certainty of interventions for attention deficit/hyperactivity disorder (ADHD) across an individual's lifespan, and to develop a continuously updated web platform for people with lived experience of ADHD as a method to disseminate living evidence synthesis for shared decision making. Umbrella review and platform for shared decision making. Six databases from inception to 19 January 2025. Study authors were contacted for additional information when necessary. Systematic reviews that used meta-analyses of randomised controlled trials were eligible if they compared a drug or non-drug intervention with a passive control in individuals with a diagnosis of ADHD. Primary outcomes were severity of ADHD symptoms, analysed by rater type (clinician-rated, parent-rated, teacher-rated, or self-rated) and time point (short term (12 weeks, or study endpoint), medium term (26 weeks), and long term (52 weeks)),acceptability (participants dropping out for any reason), and tolerability (participants dropping out owing to any side effects). Secondary outcomes included daily functioning, quality of life, comorbid symptoms, and key side effects (decreased sleep and appetite). Eligible meta-analyses were re-estimated with a standardised statistical approach. Methodological quality was assessed using AMSTAR-2. Evidence certainty was evaluated using an algorithmic version of the GRADE framework, adapted for drug and non-drug interventions. 115 of 414 full text articles were deemed eligible and 299 were excluded; the eligible articles comprised 221 unique combinations of participants, interventions, comparators, and outcomes. For each combination, the most recent and methodologically robust meta-analysis was selected for re-estimation, which gave 221 re-estimated meta-analyses in total, derived from 47 meta-analytic reports. In the short term, alpha-2 agonists, amphetamines, atomoxetine, methylphenidate, and viloxazine showed medium to large effect sizes in reducing the severity of ADHD symptoms in children and adolescents, with moderate to high certainty evidence. Methylphenidate showed consistent benefits across raters (standardised mean difference >0.75, 95% confidence interval (CI) 0.56 to 1.03; moderate or high certainty evidence). These interventions showed lower tolerability than the placebo, but this effect was not significant for methylphenidate and atomoxetine. In adults, atomoxetine, cognitive behavioural therapy, methylphenidate (and, when restricting analyses to high quality trials, amphetamines) showed at least moderate certainty evidence of efficacy on ADHD symptoms, with medium effect sizes. Methylphenidate, amphetamines, and atomoxetine had worse tolerability than placebo (methylphenidate, risk ratio 0.50, 95% CI 0.36 to 0.69; amphetamines, 0.40, 0.22 to 0.72; atomoxetine, 0.45, 0.35 to 0.58). Some non-drug interventions (acupuncture and cognitive behavioural therapy in children and adolescents, and mindfulness in adults) showed large effect sizes for ADHD symptoms, but with low certainty evidence. No high certainty, long term evidence was found for any intervention. An online platform showing effects and evidence certainty of each intervention across age groups, time points, and outcomes (https://ebiadhd-database.org/) was developed. This review provides updated evidence to inform patients, practitioners, and guideline developers how best to manage ADHD symptoms. The online platform should facilitate the implementation of shared decision making in daily practice. Open Science Framework https://osf.io/ugqy6/.

This review presents an overview of the present knowledge of the effectiveness of mindfulness interventions (MI) for patients with ADHD. A search was performed in four databases, and 15 papers were found. In adults, the effect of MI was significant on ADHD symptoms but unclear on other outcomes. For children and adolescents, results were uncertain but point toward improved planning, cognitive flexibility and better interactions in the families. No studies have compared the efficacy of MI to pharmacological treatment. Evidence in the field is still sparse due to small sample sizes and differences in study designs.

ADHD is a childhood-onset psychiatric condition that often continues into adulthood. Stimulant medications are the mainstay of treatment; however, additional approaches are frequently desired. In recent years, mindfulness meditation has been proposed to improve attention, reduce stress, and improve mood. This study tests the feasibility of an 8-week mindfulness training program for adults and adolescents with ADHD. Twenty-four adults and eight adolescents with ADHD enrolled in a feasibility study of an 8-week mindfulness training program. The majority of participants completed the training and reported high satisfaction with the training. Pre-post improvements in self-reported ADHD symptoms and test performance on tasks measuring attention and cognitive inhibition were noted. Improvements in anxiety and depressive symptoms were also observed. Mindfulness training is a feasible intervention in a subset of ADHD adults and adolescents and may improve behavioral and neurocognitive impairments. A controlled clinical study is warranted.

Attention-deficit/hyperactivity disorder (ADHD) frequently persists into adulthood and is associated with impairments in attention, emotional regulation, executive functioning, and quality of life. Although mindfulness-based interventions (MBIs) have been proposed as promising non-pharmacological treatments, the evidence regarding their efficacy in adults with ADHD remains inconsistent. A systematic search was conducted using the MEDLine, CINAHL, and PsycINFO databases to identify controlled trials published up to 2023. Studies were included if they evaluated the effects of MBIs in adults with ADHD using a control group, regardless of randomization. Only studies in which mindfulness was the primary therapeutic modality were included, even if limited psychoeducational or behavioral components were present. Ten studies met the inclusion criteria. Outcomes were categorized into 6 domains: self-reported and observer-rated ADHD symptoms, negative and positive affect, mindfulness skills, and functional outcomes. Meta-analyses were performed using standardized mean differences (SMDs) or mean differences with 95% confidence intervals (CIs). Risk of bias and publication bias were assessed using Cochrane tools and funnel plots, respectively. Statistically significant improvements were observed in self-reported ADHD symptoms (SMD = 0.48, 95% CI [0.19, 0.76]), observer-rated ADHD symptoms (SMD = 0.32, 95% CI [0.09, 0.56]), and functional outcomes (SMD = 0.56, 95% CI [0.22, 0.90]). However, there were no significant effects on mindfulness skills (SMD = -0.20, 95% CI [-0.47, 0.08]), negative affect (SMD = 0.31, 95% CI [-0.06, 0.67]), or positive affect (SMD = -0.21, 95% CI [-0.58, 0.16]). MBIs may be effective in improving core ADHD symptoms and overall functioning in adults with ADHD. However, their effects on emotional well-being and mindfulness skills remain inconclusive. These findings support the utility of MBIs as complementary interventions for ADHD while highlighting the need for further high-quality studies to clarify their long-term effects and mechanisms of action.

Individuals with ADHD face significant neurodevelopmental hurdles with inattention and/or hyperactive/impulsive behavior through their life span. Mindfulness training may be one self-regulatory method for strengthening attentional processes (orienting, alerting, and executive attention). This review's goals are to (a) argue for the use of mindfulness training as an adjunct to evidence-based treatment for ADHD and (b) call for improving psychosocial intervention for ADHD within families by integrating mindfulness training with behavioral parent training. EBSCOhost was utilized to search 29 psychology-related research databases through Athabasca University. Mindfulness training should be incorporated into current treatment guidelines as a psychosocial option for families with ADHD. Preliminary findings suggest significant improvements in attentional processes, and prominent mindfulness-based approaches have been successfully adapted for ADHD.

Attention deficit hyperactivity disorder (ADHD) manifests by high levels of inattention, impulsiveness and hyperactivity. ADHD starts in childhood and results in impairments that continue into adulthood. While hyperactivity declines over time, inattention and executive function difficulties persist, leading to functional deficits. Adolescents and adults with ADHD have pervasive impairment in interpersonal and family relationships. They may develop addiction, delinquent behavior and comorbid psychiatric disorders. Despite advances in diagnosis and treatment, persistent residual symptoms are common, highlighting the need for novel treatment strategies. Mindfulness training, derived from Eastern meditation practices, may improve self-regulation of attention. It may also be a useful strategy to augment standard ADHD treatments and may be used as a potential tool to reduce impairments in patients with residual symptoms of ADHD. Clinically, this would manifest by an increased ability to suppress task-unrelated thoughts and distractions resulting in improved attention, completion of tasks and potential improvement in occupational and social function.

Mindfulness-based intervention has received more clinical interest and empirical support for individuals with ADHD especially to improve attention. However, no systematic review has been done to analyze and compare the effectiveness of mindfulness-based intervention on individuals with ADHD in different age groups. This review examined its effectiveness for individuals (children, adolescents and adults) with ADHD to improve attention. In 7 databases, totally of 152 studies were identified; 9 met the inclusion and exclusion criteria and were reviewed. Five of the studies recruited adults as the participants, two recruited adolescents as the participants, one recruited both adults and adolescents as the participants and one recruited children as the participants. It was found that mindfulness-based intervention was comparatively more popularly used in adults with ADHD to improve attention, and the improvement was significant. It is still unclear whether mindfulness-based intervention is effective for children and adolescence with ADHD due to limited studies available and the limitations of the study design in the reviewed studies. Therefore, more research in the future is required to answer the question.

Although earlier work has shown a link between mind-wandering and ADHD symptoms, this relationship has not been further investigated by taking into account recent advances in mind-wandering research. The present study provides a comprehensive assessment of the relationship between mind-wandering and ADHD symptomatology in an adult community sample ( N = 105, 71 females, M age = 23.1) using laboratory measures and experience sampling during daily life. Mind-wandering and detrimental mind-wandering were positively associated with ADHD symptoms. Meta-awareness of mind-wandering mediated the relationship between ADHD symptomatology and detrimental mind-wandering, suggesting that some of the negative consequences can be ameliorated by strategies that facilitate meta-awareness. Interestingly, participants with low ADHD scores showed a positive relationship between detrimental mind-wandering and useful mind-wandering; however, participants with high ADHD scores failed to engage in this type of "strategic" mind-wandering. These results provide new insights into the relationship between ADHD symptomatology and mind-wandering that could have important clinical implications.

Microdosing (MD), repeatedly taking psychedelics in small, non-hallucinogenic amounts, has been practiced by individuals to relieve attention deficit hyperactivity disorder (ADHD) symptoms. Generally, adults diagnosed with ADHD have lower levels of mindfulness and differ in personality structure from non-ADHD adults. How MD affects mindfulness and personality in adults with ADHD remains unexplored. This study aimed to investigate the effects of 4 weeks of MD on mindfulness and personality traits in adults diagnosed with ADHD and those experiencing severe ADHD symptoms. It was expected that mindfulness and the personality traits conscientiousness, extraversion, agreeableness, and openness would increase and neuroticism would decrease after 4 weeks of MD compared to baseline. It was explored if using conventional ADHD medication alongside MD and/or having comorbidities influenced MD-induced effects. An online prospective naturalistic design was used to measure participants before MD initiation and 2 and 4 weeks later. Validated self-report measures were used assessing mindfulness (15-item Five Facet Mindfulness Questionnaire) and personality traits (10-item version of the Big Five Inventory) at three time points. The sample included MD induced changes in otherwise stable traits. Future placebo-controlled studies are warranted to confirm whether these changes occur in a controlled setting.

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The current study aims to examine the efficacy of an add-on dialectical behavior therapy skills training (DBT-ST) on adult attention-deficit/hyperactivity disorder (ADHD). The DBT-ST was applied online under the pandemic conditions that occurred after the study had started. The current randomized controlled trial consists of an intervention group to whom the DBT-ST was applied in online setting and a waitlist control group who received treatment as usual (TAU). Data were collected pre-, post-, and mid-treatment. ADHD symptoms (with the sub-dimensions of inattention and hyperactivity), impulsivity, mindfulness, difficulty with emotion regulation, interpersonal effectiveness, distress tolerance, life satisfaction, functionality in daily life, and general psychological symptom levels were measured with self-report scales. The data were analyzed using mixed-design ANOVA. The global ADHD, inattention, and hyperactivity symptoms of the DBT-ST group significantly decreased more than those in the TAU control group. The DBT-ST group also showed a significant decrease regarding difficulty with emotion regulation and increases in life satisfaction and functionality, though the group × time effect was not significant. DBT-ST was found effective against the participants' ADHD symptoms. The treatment was additionally found to improve their emotion regulation and quality of life. Further investigation is needed to investigate DBT-ST in an online setting.

Between 2% and 8% of college students meet criteria for ADHD, with increased incidence in recent decades. There are very few clinical trials conducted on the meaningful intervention of ADHD in college. Mindfulness-based cognitive therapy (MBCT) effectively treats college students with ADHD and could be more feasibly applied in college mental health clinics. Fifty-four undergraduates with ADHD between ages 19 and 24 were randomized to receive either MBCT or wait-list (WL) during a 6-week intervention phase. ADHD symptoms, neuropsychological performance, and related outcomes were assessed at pre-treatment, post-treatment, and 3-month follow-up. Participants receiving MBCT group showed greater treatment response rates (57%-71% vs. 23%-31%) and experience less anxiety and depression, and greater levels of mindfulness; MBCT participants show greater improvement on neuropsychological performance. MBCT may be a useful intervention for college students with ADHD, improving participants' ADHD symptoms, mindfulness, and sustained attention.

Attention deficit hyperactivity disorder (ADHD) is a disorder characterized by attentional difficulties. Mindfulness is a receptive attention to present experience. Both ADHD and mindfulness are associated with attention and personality. This study tests whether individuals with ADHD have lower mindfulness scores than controls and, if true, whether personality contributes to these differences. One hundred and five adults (half with ADHD) were assessed for mindfulness, using the Kentucky Inventory of Mindfulness Skills, and personality, using the Tridimensional Character Inventory. Individuals with ADHD report themselves as less mindful than non-ADHD controls and more novelty-seeking, less self-directed, and more self-transcendent. Mindfulness is negatively associated with ADHD and positively associated with self-directedness and self-transcendence. Analyses of subscales of mindfulness suggest that ADHD is associated most with the "Acting in Awareness" dimension, perhaps because of shared items reflecting attentional variability. The current findings support that a large portion of variability in trait mindfulness can be explained by ADHD status and personality traits of self-directedness and self-transcendence. It further suggests that interventions that increase mindfulness might improve symptoms of ADHD and increase self-directedness and/or self-transcendence.

Mindfulness-meditation has a variety of benefits on well-being. However, individuals with primary attentional impairments (e.g. attention deficit disorder) or attentional symptoms secondary to anxiety, depression or addiction, may be less likely to benefit, and require additional mindfulness-augmenting strategies. To determine whether a single dose of the cognitive enhancer, modafinil, acutely increases subjective and behavioural indices of mindfulness, and augments brief mindfulness training. A randomised, double-blind, placebo-controlled, 2 (drug: placebo, modafinil) × 2 (strategy: mindfulness, relaxation control) experiment was conducted. Seventy-nine meditation-naïve participants were assigned to: placebo-relaxation, placebo-mindfulness, modafinil-relaxation or modafinil-mindfulness. Pre-drug, post-drug and post-strategy state mindfulness, affect and autonomic activity, along with post-strategy sustained attention and mind-wandering were assessed within a single lab session. After the session, participants were instructed to practice their assigned behavioural strategy daily for one week, with no further drug administration, after which, follow-up measures were taken. As predicted, modafinil acutely increased state mindfulness and improved sustained attention. Differential acute strategy effects were found following mindfulness on autonomic activity but not state mindfulness. There were no strategy or drug effects on mind-wandering. However, exploratory analyses indicated that participants receiving modafinil engaged in more strategy practice across strategy conditions during follow-up. Modafinil acutely mimicked the effects of brief mindfulness training on state mindfulness but did not enhance the effects of this training. Limitations of the current study, and recommendations for future research examining modafinil as an adjunct to mindfulness- (or relaxation-) based treatments are discussed.

In clinical practice many adult patients with attention deficit hyperactivity disorder (ADHD) ask for an additional psychotherapeutic intervention besides the medical therapy. In this paper we present a structured skill training program particularly tailored for adult patients with ADHD. The program is based on the principles of cognitive-behavioral treatment for borderline personality disorder developed by M. Linehan. It was modified to suit the special needs of adult patients with ADHD. In this exploratory pilot study we tested this program in a group setting. The following elements were presented: neurobiology of ADHD, mindfulness, chaos and control, behavior analysis, emotion regulation, depression, medication in ADHD, impulse control, stress management, dependency, ADHD in relationship and self respect. In an open study design patients were assessed clinically using psychometric scales (Attention Deficit Hyperactivity Disorder Checklist according to DSM-IV, 16 items of the SCL-90-R, Beck-Depression Inventory, visual analogue scale) prior to and following group therapy. This treatment resulted in positive outcomes in that patients improved on all psychometric scales.

Attention deficit hyperactivity disorder (ADHD) is associated with marked impairments in familial, social, and professional functioning. Although stimulant treatments can be effective in adult ADHD, some patients will respond poorly or not at all to medication. Previous studies demonstrated that cognitive behavioural therapy- (CBT) and dialectical behavior therapy- (DBT) oriented interventions are effective in reducing the burden of the disease, which is mainly marked by depression, interpersonal difficulties, low self-esteem, and low quality of life. In order to determine the effectiveness of this intervention, we assessed the benefits of a CBT/DBT programme to reduce residual symptoms and help patients improve their quality of life. 49 ADHD-patients, poor responders to medication, were enrolled in a one-year programme where they received individual therapy, associated with weekly sessions of group therapy with different modules: Mindfulness, Emotion Regulation, Interpersonal Effectiveness and Distress Tolerance, Impulsivity/Hyperactivity and Attention. Each subject was assessed at baseline, at months 3 and 6, and at the end of the treatment for ADHD severity (ASRS v1.1), depression severity (BDI-II), hopelessness (BHS), mindfulness skills (KIMS), anger expression and control (STAXI), impulsivity (BIS-11), quality of life (WHOQOL-BREF), and social functioning (QFS). The 49 ADHD patients were compared with 13 ADHD subjects on a waiting list. Linear mixed models were used to measure response to treatment. Overall, the psychotherapeutic treatment was associated with significant improvements in almost all dimensions. The most significant changes were observed for BDI-II (b=-0.30; p<0.0001), ASRS total score (b=-0.16; p<0.0001), and KIMS AwA (b=0.21; p<0.0001), with moderate to large effect sizes. Compared with the waiting list controls, ADHD patients showed a better, albeit non-significant, pattern of response. Individual and structured psycho-educational DBT/CBT groups support existing data suggesting that a structured psychotherapeutic approach is useful for patients who respond partially or not at all to drug therapy.

Many young adults are affected by attention deficit hyperactivity disorder (ADHD) and often desire non-pharmacological treatment options. Mind-body techniques might serve as complementary therapies to first-line stimulant medications, but studies are limited. Tai Chi is an increasingly popular practice that integrates movement with cognitive skills relevant to ADHD. We performed a feasibility trial of Tai Chi training in undergraduates to inform the design of a fully powered randomized controlled trial (RCT). Undergraduates with ADHD were recruited, screened, enrolled, and assessed at baseline. They were assigned to three parallel seven-week intervention arms, Tai Chi, Active Control (cardio-aerobic fitness), and Inactive Control (no contact), with follow-up assessments. Feasibility of a larger clinical trial was evaluated, especially with respect to enrollment and retention. Additionally, potential clinical outcome measures were examined for practicality and reliability. 21 participants were assessed at baseline and 19 at follow-up (90 % retention). The primary clinical outcome measure, self-reported inattention symptoms (Conners' CAARS-S:L DSM-IV Inattentive Symptoms subscale), exhibited good test-retest reliability in controls (r = 0.87, n = 10) and correlated with reduced mindfulness (FFMQ acting with awareness subscale) at baseline (r = -0.74, n = 20). Class attendance and self-reported daily practice time were variable. Randomization to group classes was hindered by the college students' restricted schedules. The high retention rate and good data quality suggest that an RCT of Tai Chi for ADHD is feasible. Further measures are identified to improve enrollment rates, adherence, and randomization procedures. Future work might extend to other young adult populations and high school students.

Attention deficit hyperactivity disorder (ADHD) is a serious mental disorder that often persists in adulthood. In a pilot study, a structured skills training group program for adult ADHD led to significant symptomatic improvements. The present study evaluated the program's effectiveness, feasibility, and patient acceptability in a multicenter setting. Seventy-two adult ADHD patients were assigned to 13 two-hour weekly sessions at 4 different therapy sites. The therapy was well tolerated and led to significant improvements of ADHD, depressive symptoms, and personal health status (p < 0.001). The factors treatment site and medication did not contribute to the overall improvement. Patients regarded the program topics "behavioral analyses," "mindfulness," and "emotion regulation" as the most helpful. In this multicenter study, the therapy program showed therapist-independent effects and seemed to be disorder-specific. This warrants the effort of organizing further controlled studies.