The Effectiveness of Mindfulness Training on Behavioral Problems and Attentional Functioning in Adolescents with ADHD

Novel Smartphone App and Supportive Accountability for the Treatment of Childhood Disruptive Behavior Problems: Protocol for a Randomized Controlled Trial

BACKGROUND

Although evidence-based treatments have been developed for childhood behavior problems, many families encounter barriers to treatment access and completion (eg, local availability of services, transportation, cost, and perceived stigma). Smartphone apps offer a cost-efficient method to deliver content to families.

OBJECTIVE

The aim of this study is to evaluate the effectiveness of the UseIt! mobile health system as both stand-alone and coach-assisted interventions via a randomized controlled trial. The UseIt! System is designed to reduce disruptive behaviors in young children.

METHODS

A nationwide sample of parents of children aged 5 years to 8 years with disruptive behaviors (N=324 dyads) are randomly assigned to the stand-alone app (UseIt!; n=108), the coach-assisted app (UseIt! plus supportive accountability; n=108), or the control app (mindfulness app; n=108). The UseIt! App provides parents with tools and troubleshooting to address disruptive behaviors, along with a behavior diary to track behaviors and strategies over time. The coach-assisted condition includes a bachelor's level paraprofessional who provides weekly phone calls to promote engagement with the app. The control condition is composed of a mindfulness app. The web-based, self-assessed outcome measures (post treatment and 6-month follow-up) include measures of app usage, parenting knowledge (eg, knowledge of parent management training and cognitive behavioral therapy skills), and strategies (use of evidence-based parenting strategies), symptom reduction (eg, behavior problems), and parent mental health (eg, anxiety, stress, and depression). We hypothesize that both intervention conditions will show greater parent knowledge and use of skills along with greater symptom reduction relative to the control condition. Further, we hypothesize that those assigned to the coach assisted condition will report greater knowledge, skill use, and symptom reduction than the stand-alone app. We will use intent-to-treat analyses to regress outcomes on study conditions to evaluate for differences across conditions.

RESULTS

Recruitment of study participants began in December of 2022 and is ongoing. We have recruited over half of our intended sample of 324 parent-child dyads (n=214) as of December 2024. These dyads have been randomly allocated to each of the intervention conditions, with 71 assigned to the coach-assisted condition, 72 assigned to the stand-alone app, and 71 assigned to the control app condition. Data collection is projected to be completed by late 2026.

CONCLUSIONS

The current study aims to address a gap in the literature regarding the feasibility, effectiveness, and utility of a smartphone app that includes a coach-assisted arm. Digital therapeutics have the potential to enhance the reach and scalability of skills-based psychosocial interventions. Findings from this study will advance scientific knowledge and have implications for clinical practice.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05647772; https://clinicaltrials.gov/study/NCT05647772.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/67051.

The Effect of The Mindfulness-Based Relaxation, Aromatherapy, and Prayer (RADO) Intervention on Anxiety and Quality of Life Among Children With Cancer

Purpose

This study evaluates the effectiveness of a novel mindfulness-based intervention called RADO (Relaxation, Aromatherapy, and Prayer) for reducing anxiety and improving the quality of life in children with cancer.

Patients and Methods

A quasi-experimental pre- and post-control group design was used. Participants included 66 children with cancer aged 10-17 years, diagnosed with cancer for at least 3 months, currently undergoing treatment, and able to communicate verbally, and recruited from three hospitals in Bandung, Indonesia. The study used consecutive sampling. The intervention group received a seven-day RADO program involving mindfulness-based relaxation, aromatherapy, and prayer. Anxiety and QoL were measured using the Hamilton Rating Scale for Anxiety (HRS-A) and Pediatric Quality of Life Inventory (PEDQL 3.0), respectively. Data were collected at baseline (T0), day three (T1), and day seven (T3). Statistical analysis included repeated ANOVA and independent t-tests.

Results

By day seven (T3), the intervention group showed a significant reduction in anxiety (p < 0.001) and improved QoL (p = 0.001) compared to the control group. Repeated ANOVA revealed significant within-group changes in the intervention group across time points, while no significant changes were observed in the control group. Following the intervention, males and a diagnosis of ALL demonstrated slightly higher anxiety scores and quality of life scores than female and those with other cancer types. Additionally, individuals who underwent fewer chemotherapy cycles (<10) showed better outcomes in anxiety and quality of life than those with 10 or more cycles.

Conclusion

The RADO intervention significantly reduced anxiety and enhanced QoL among pediatric cancer patients, demonstrating its potential as a culturally tailored MBI for children undergoing cancer treatment. Further research is needed to explore long-term effects and cross-cultural adaptability.

Assessing the impact of mindfulness programs on attention-deficit/ hyperactivity disorder in children and adolescents: a systematic review

BACKGROUND

Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder which poses challenges for the individuals with the disorder and their families. While stimulant medications are effective, a comprehensive approach, including psychosocial and behavioral interventions, is recommended. There is a growing body of research exploring the potential benefits of mindfulness-based interventions for children with ADHD. Our study aims to assess the effectiveness of mindfulness interventions in reducing ADHD symptoms in children and adolescents through a systematic review of relevant studies.

METHODS

Following PRISMA guidelines, our systematic review searched PubMed, Cochrane library, Psycinfo, and Scopus from January 2000 to August 2022. We included studies focusing on mindfulness for pediatric ADHD, comprising various study designs with a minimum 8-week duration. Descriptive statistics summarized results, while risk of bias was assessed using Cochrane RoB and ROBANS tools. The quality of RCTs was further evaluated using the Correlation of Quality Measures tool.

RESULTS

In the initial search, 450 records were identified, and after removing duplicates, 339 underwent screening. Forty-one studies underwent full text assessment for eligibility, with 11 studies meeting inclusion criteria, including seven RCTs, two Quasi RCTs, and three cohort studies. These studies, conducted in five countries, involved participants aged 7 to 18 years. Six studies showed improvement in hyperactivity/inattentive symptoms, and five studies showed improvement in impulsivity.

CONCLUSIONS

This systematic review demonstrates the potential benefits of mindfulness programs on ADHD symptoms in children and adolescents. This study emphasizes the need for high-quality research to explore mindfulness-based interventions for ADHD management in younger populations. PROSPERO registration number: IDCRD42024520800.

Mindful Awareness Practices (MAPs) in Adolescents With ADHD and Cognitive Disengagement Syndrome (CDS): A Pilot Open Trial

Objective: Very few studies have investigated intervention approaches that may be efficacious for youth with ADHD and co-occurring cognitive disengagement syndrome (CDS) symptoms. This study examined the feasibility, acceptability, and preliminary efficacy of a mindfulness-based intervention for adolescents with ADHD and co-occurring CDS symptoms. Methods: Fourteen adolescents ages 13 to 17 years (35.71% female; 64.29% White, 7.14% Black, 28.57% Multiracial) with ADHD and elevated CDS symptoms completed the 8-week group-based Mindful Awareness Practices (MAPs) program developed for individuals with ADHD. We collected measures of CDS, ADHD, mind-wandering, mindfulness, and other difficulties and functioning at baseline, 1-month post-intervention, and 3-month post-intervention to examine preliminary efficacy. We measured participant session attendance, session engagement, at-home practice adherence, and satisfaction of adolescents and caregivers at 1-month post-intervention to examine feasibility and acceptability. We also collected qualitative feedback from adolescents and caregivers at 1-month post-intervention. Results: The intervention was overall feasible to administer, and caregivers and adolescents reported satisfaction with the intervention despite some difficulties with attendance and engagement. We observed improvements to both caregiver- and adolescent-reported CDS symptoms and ADHD-inattentive symptoms from pre-intervention to post-intervention time points, though findings across 1- and 3-month follow-up differed based on informant. We also observed improvements to some indices of adolescent-reported mind-wandering, mindfulness, brooding rumination, and academic functioning. For caregiver report, the only other noted improvement was for executive functioning. No improvements were reported by teachers. Conclusions: Findings support the initial feasibility, acceptability, and preliminary efficacy of MAPs for adolescents with ADHD and co-occurring CDS symptoms on a range of outcomes. Larger trials with a randomized design are warranted to further examine mindfulness-based interventions for adolescents with ADHD and co-occurring CDS symptoms.

The effectiveness of a mindfulness-based intervention on improving executive functions and reducing the symptoms of attention deficit hyperactivity disorder in young children

The aim was to investigate the effectiveness of a mindfulness-based intervention on improving executive functions and reducing the symptoms of attention deficit hyperactivity disorder in young children. This study employed a quantitative approach using a quasi-experimental, pretest and post-test and follow up design. 56 children between 5 and 7 years of age(M = 6.9, SD= 1.7) with ADHD or with symptoms of inattention and hyperactivity are being recruited to participate in the mindfulness-based intervention. To determine whether there are any significant differences between the two independent (unrelated) groups on executive functions and symptoms of attention deficit hyperactivity disorder, pre-post-follow up test and multiple comparisons are used. Pretest assessments were conducted for both the control and training groups. Following the pretest, a four-weeks of training commenced for the intervention group only. T-test results for the differences in post- test mean scores between the two groups in EF and in ADHD symptoms showed that the training group outperformed the control group. There were statistical differences in EF and in ADHD symptoms between pre and post measures in favor of post test, and between pre and follow up measures in favor of follow up test, but no statistical differences between post and follow up test. This study demonstrates that it is possible to enhance EF skills using mindfulness-based intervention in which young with ADHD are engaged in a series of group play based activities.

Addressing co-occurring conditions in behavioural therapy for tic disorders: a review and guideline

Co-occurring psychiatric conditions are very common in tic disorders and Tourette syndrome. These additional symptoms are often detrimental to quality of life and may impact upon the implementation and efficacy of evidence-based behavioural therapies (BT) for tics. Combining a review of the available literature, relevant theory, and expert clinical practice, we present a guideline for implementing behavioural and psychosocial interventions when common comorbidities are present. These include attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety, disruptive behaviour, autism spectrum disorder (ASD) and depression. Practical recommendations are provided for assessment, formulation and management of specific and multiple comorbidities in BT for both children and adults. Despite comorbidities being common in tic disorders, few studies have comprehensively addressed how they may influence the efficacy or implementation of existing therapies or how such treatments may need to be modified or sequenced. We outline recommendations for future research, including randomised control trials of BT for those with specific or multiple comorbidities, as well as adequately powered sub-group analyses within larger scale trials or naturalistic study designs. Transdiagnostic models of psychiatric disorders and treatment, including modular cross-diagnostic therapies, which recognise the dimensionality of psychiatric disorders are also highlighted as an important focus in treatment development in tic disorders.

Parental Reflective Capacities: A Scoping Review of Mindful Parenting and Parental Reflective Functioning

Objectives

Two key parental reflective capacities-mindful parenting (MP) and parental reflective functioning (PRF) - have been shown to promote healthy parent-child relationships through parents' increased sensitivity and responsiveness to their children's needs in spite of parenting stressors. Despite the theoretical overlap between these two constructs, researchers have continued to examine them independently. Therefore, the purpose of this scoping review was to review the overlapping and distinctive outcomes and correlates in the empirical MP and PRF literatures.

Method

A comprehensive literature search across the MP and PRF literature for studies published from 2005 through early 2020 (pre-COVID-19 pandemic) was conducted.

Results

A review of 301 articles (n = 180 MP and n = 121 PRF) revealed overlapping study outcomes and correlates, including improvement in parent and child well-being, parenting behaviors, and attachment. Both MP and PRF literatures suggest MP and PRF are amenable to intervention-induced changes, although mostly documented in White mothers, which results may not be generalizable to diverse populations.

Conclusions

Researchers should consider the impact MP and PRF have on positive family relationships. Results suggest that scholars should consider investigating and intervening on MP and PRF simultaneously. Specifically, results identified MP and PRF convergent associations and perhaps synergistic impacts on positive parenting behaviors. Limitations and future directions are discussed.

Preregistration

This review was not preregistered.

Impact of a mindfulness-based intervention on neurobehavioral functioning and its association with large-scale brain networks in preterm young adolescents

AIM

Adolescents born very preterm (VPT; <32 weeks of gestation) face an elevated risk of executive, behavioral, and socioemotional difficulties. Evidence suggests beneficial effects of mindfulness-based intervention (MBI) on these abilities. This study seeks to investigate the association between the effects of MBI on executive, behavioral, and socioemotional functioning and reliable changes in large-scale brain networks dynamics during rest in VPT young adolescents who completed an 8-week MBI program.

METHODS

Neurobehavioral assessments and resting-state functional magnetic resonance imaging were performed before and after MBI in 32 VPT young adolescents. Neurobehavioral abilities in VPT participants were compared with full-term controls. In the VPT group, dynamic functional connectivity was extracted by using the innovation-driven coactivation patterns framework. The reliable change index was used to quantify change after MBI. A multivariate data-driven approach was used to explore associations between MBI-related changes on neurobehavioral measures and temporal brain dynamics.

RESULTS

Compared with term-born controls, VPT adolescents showed reduced executive and socioemotional functioning before MBI. After MBI, a significant improvement was observed for all measures that were previously reduced in the VPT group. The increase in executive functioning, only, was associated with reliable changes in the duration of activation of large-scale brain networks, including frontolimbic, amygdala-hippocampus, dorsolateral prefrontal, and visual networks.

CONCLUSION

The improvement in executive functioning after an MBI was associated with reliable changes in large-scale brain network dynamics during rest. These changes encompassed frontolimbic, amygdala-hippocampus, dorsolateral prefrontal, and visual networks that are related to different executive processes including self-regulation, attentional control, and attentional awareness of relevant sensory stimuli.

MiNa scale: Assessing mindfulness in nature and its impact on the mental health, wellbeing and holistic development of young children

OBJECTIVE

. Aim: The aim of this study was to design, validate, and assess the effectiveness of the MiNa scale in measuring mindfulness and its impact on young students' mental health and holistic development, with a focus on diverse educational needs.

PATIENTS AND METHODS

Materials and Methods: This study utilized a mixed-methods approach to validate the MiNa Questionnaire. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were conducted on a sample of 224 students from Greece and Cyprus, who completed the questionnaire. Psychometric properties, including reliability and validity, were also assessed using standard statistical methods.

RESULTS

Results: EFA revealed a three-factor structure explaining 53% of the variance, with strong factor loadings and reliability (Cronbach's α > 0.7). CFA further confirmed the model fit, with RMSEA = 0.03, CFI = 0.97, and SRMR = 0.08. The results indicated significant improvements in students that attended mindfulness interventional programs, especially on their emotional regulation, and cognitive focus. It is important to note that positive results were predominantly observed among the sample of students characterized by vulnerability.

CONCLUSION

Conclusions: The MiNa Questionnaire has proven to be a reliable and valid tool for assessing mindfulness in students from diverse educational backgrounds. Its adaptability for students with disabilities, combined with its cultural inclusivity, makes it a valuable resource for educators seeking to implement mindfulness programs in varied educational contexts.

A randomized controlled trial of mindfulness-based cognitive therapy for body dysmorphic disorder: Impact on core symptoms, emotion dysregulation, and executive functioning

BACKGROUND AND OBJECTIVES

Mindfulness-based cognitive therapy (MBCT) is garnering increasing empirical interest as an intervention for Body Dysmorphic Disorder (BDD), although no studies of mindfulness as a standalone treatment have included a sample composed entirely of patients with BDD or a comparison group. The aim of this study was to investigate the improvement of MBCT intervention on the core symptoms, emotional dysfunction, and executive function of BDD patients, as well as the feasibility and acceptability of MBCT training.

METHOD

Patients with BDD were randomized into an 8-week MBCT group (n = 58) or treatment-as-usual (TAU) control group (n = 58) and were assessed at pre-treatment, post-treatment, and 3-month follow-up.

RESULTS

Participants who received MBCT showed greater improvement on self-reported and clinician ratings of BDD symptoms, self-reported emotion dysregulation symptoms and executive function compared with TAU participants. Improvement for executive function tasks was partially supported. In addition, feasibility and acceptability of MBCT training were positive.

LIMITATIONS

There is no systematic assessment of the severity of key potential outcome variables associated with BDD.

CONCLUSION

MBCT may be a useful intervention for patients with BDD, improving patients' BDD symptoms, emotion dysregulation, and executive functioning.

Digital Cognitive Training for Children with Attention Deficit Hyperactivity Disorder

The present article used a pilot study to determine the effectiveness of digital cognitive mindfulness training developed based on dialectical behavioral therapy (DBT) in reducing attention deficit hyperactivity disorder (ADHD) symptoms in children. The sample consisted of 90 children (8-10 years old) diagnosed with ADHD. The participants were randomized into two groups: an experimental group (n = 45) and a control group (n = 45). Results were assessed at three time points: before, after the study, and one month after the end of the study. Regarding ADHD symptoms, the ANCOVA results showed that there were no statistically significant differences between the study groups for inattention and hyperactivity/impulsivity after testing. One month after completion of the program, there was a significant alleviation in symptoms of inattention, executive functioning, learning problems, aggression, and peer relationships. Hyperactivity was the only variable that showed a decrease both post-test and during follow-up. These results suggest that a DBT-based mindfulness program is a promising method of reducing ADHD symptoms in children.

Effortful and effortless training of executive functions improve brain multiple demand system activities differently: an activation likelihood estimation meta-analysis of functional neuroimaging studies

Both effortful and effortless training have been shown to be effective in enhancing individuals' executive functions. Effortful training improves domain-specific EFs, while effortless training improves domain-general EFs. Furthermore, effortful training has significantly higher training effects on EFs than effortless training. The neural mechanism underlying these different effects remained unclear. The present study conducted meta-analysis on neuroimaging studies to explore the changes of brain activations induced by effortful and effortless training. The results showed that effortful training induced greater activation in superior frontal gyrus, while effortless training induced greater activation in middle frontal gyrus, precuneus and cuneus. The brain regions of MD system enhanced by effortful training were more associated with core cognitive functions underlying EFs, while those enhanced by effortless training were more correlated with language functions. In addition, the significant clusters induced by effortful training had more overlaps with the MD system than effortless training. These results provided us with possibility to discuss the different behavioral results brought by effortful and effortless training.

Mindfulness training modifies attentional bias to facial emotion and emotional symptoms

BACKGROUND

Mindfulness training has been shown to improve emotional symptoms such as anxiety and depressive symptoms. However, its cognitive-behavioral mechanism is still unclear. The present study aimed to investigate the effect of mindfulness training on attention to emotional faces and its role in the improvement in emotional symptoms.

METHODS

Eighty participants were recruited and randomly divided into a training group (n = 40) that received eight weeks of mindfulness training and a control group (n = 40) that attended a mindfulness lecture. Before training (T1), immediately after training (T2), and three months after training (T3), all participants were asked to complete the Self-Rating Depression Scale (SDS) and the Self-Rating Anxiety Scale (SAS) to assess their emotional symptoms and a modified dot-probe task to measure their attention to emotional faces.

RESULTS

Mindfulness training significantly reduced anxiety and depressive symptoms at both T2 and T3. After training, the attentional bias toward happy faces increased, while the attentional bias toward sad faces decreased in the training group compared with the control group. Mediation analysis showed that the improvement in attentional bias toward sad faces partially mediated the effect of mindfulness training on depression at T2.

LIMITATIONS

Our participants were not a clinical sample (i.e., were not diagnosed with emotional disorders), and the time course of attention components was difficult to examine in the present study.

CONCLUSIONS

Mindfulness training can stably reduce anxious and depressive symptoms. However, it may have a temporary effect on attentional bias toward facial emotions, which plays a limited role in improving emotional symptoms.

Tübinger Training for Autism Spectrum Disorders (TüTASS): a structured group intervention on self-perception and social skills of children with autism spectrum disorder (ASD)

In autism spectrum disorders (ASD), social communication and stereotypical behaviour patterns affect all areas of life, and can result in a decrease of its quality. Previous research has shown promising results for the social skills of groups of children with ASD. Furthermore, a pilot study of the Tübingen Group Training for Autism Spectrum Disorders (TüTASS) has demonstrated that mindfulness-based elements achieve additional positive effects. To build on these findings, the TüTASS training was adapted and expanded. Indeed, the TüTASS currently includes 20 90-min appointments starting with the basic skills of emotions, body, and communication, which are then transferred to personal, family, peer, and school spheres. The appointments have a fixed, consistent structure and each includes a body awareness exercise. In this study, we evaluated the TÜTASS with 27 children with ASD. The results showed improvements in pre-post comparison in behaviours associated with autism, as well as in externalising and internalising behaviours as assessed by parent reports, participant self-reports, and independent raters in participating children. Furthermore, the perceived parent burden in relation to their children decreased, whereas the participants' self-rated quality of life increased. Overall, both the participants and their parents rated the TüTASS very positively in rating sheets and in free feedback. If replicated in larger controlled trials, TÜTASS training might be a useful treatment tool for groups of children with ASD.

Rolling out a mindfulness-based stress reduction intervention for parents of children with ADHD: a feasibility study

BACKGROUND

Attention-deficit/Hyperactivity Disorder (ADHD) is the single most frequent reason for attendance at Child and Adolescent Mental Health Services (CAMHS) in Ireland. Research has suggested that parents of children with ADHD experience more parenting stress than parents of non-clinical controls, yet routine treatment for ADHD rarely addresses parental well-being. Mindfulness-based interventions (MBIs) have been found to result in a reduction in parental stress.

METHOD

An adapted Mindfulness-Based Stress Reduction (MBSR) intervention was delivered to parents (n = 23) of children with ADHD recruited from CAMHS and ADHD Ireland.

RESULTS

Following the intervention a significant improvement was documented within the social relationships domain of quality of life (WHOQOL-BREF) and a significant reduction on the child hyperactivity scale of the Strengths and Difficulties (SDQ) questionnaire.

CONCLUSION

This pilot study suggests that an MBSR intervention is both feasible and effective for parents whose children have ADHD. Larger scale studies need to be conducted before inclusion in routine CAMHS.

The efficacy of mindfulness-based intervention in ameliorating externalizing behaviors and attentional concerns among college students

Objective: The purpose of this study was to investigate the efficacy of a mindfulness-based intervention among college students with externalizing behaviors and attentional problems. Participants: Three students attending their first year in college received mindfulness-based stress reduction (MBSR) intervention and data were collected pre-intervention, during the intervention, post-intervention, and follow-up. Methods: The study utilized a single-case design (SCD). Data were collected via the Conners continuous performance test, Third Edition (CPT-3), the Conners Continuous Auditory Test of Attention (CATA), the Behavioral Assessment Scale for Children, Flex Monitor, Third Edition (BASC-3 FM), and the Mindfulness Attention Awareness Scale (MAAS). Results: Data were analyzed by calculating standard error of the difference, reliable change index, non-overlap of all pairs (NAP), and Tau-U. Conclusions: The results of this study strongly suggest that mindfulness may be an effective intervention for addressing externalizing behaviors and attentional problems among first-year college students.

Mindfulness Interventions for Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-Analysis

Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition impacting children and adults. Current treatments are limited and there is increasing interest in the use of mindfulness, which is growing in popularity. Previous systematic reviews have typically focused on specific ages, outcome measures or interventions. The current review aimed to take a more comprehensive approach. Title and abstract searches were performed in five databases for randomized and non-randomized controlled trials or pre-post studies with participants with an ADHD diagnosis or a score above a clinically relevant cut-off on a validated ADHD measure. Studies had to measure symptoms of ADHD, global or social functioning. Extraction of key information including participant status (i.e., diagnosis, scale scores, comorbidities, medication use), study design, and outcome measures was conducted. Effect sizes (Hedge’s g) were calculated and where a measure had been used in at least three studies with the same population, meta-analyses were considered. Twenty-nine studies were initially identified, with seven deemed poor quality and removed from further analysis leaving, 22 studies containing data from 1237 children and adults with ADHD along with data from 525 family members. The data indicate possible benefits of mindfulness on self-compassion, quality of life, wellbeing, depression, and anxiety. The findings also suggest that mindfulness may also improve ADHD symptoms, executive function, problematic behaviours, and emotional dysregulation, although results vary by age of patient and measures used. Parent stress and parenting style have received limited attention, highlighting the need for more studies in these areas. Whilst the data presented suggest that mindfulness may be beneficial, the evidence base is not as strong as the popularity of the approach. Many of the studies lacked blind assessment, adequate randomization, or suitable control conditions. As such high-quality controlled studies considering medication, other psychosocial interventions, use of active and in active controls and comorbidity as well as longer follow-up periods, are needed to confirm this.

Adverse Childhood Experiences, Mindfulness, and Grit in College Students in China

This study investigated the effect of ACEs and COVID-19 on grit and whether this effect is mediated by mindfulness. Although current scholarship has found that adverse childhood experiences (ACEs) have harmful consequences to individuals across the life span, less is known about the relationship between ACEs and grit. Grit is predictive of educational success and subjective wellbeing. A cross-sectional online survey administered to junior and senior students from 12 universities spread across China was conducted from September 20, 2020 to October 5, 2020. The universities were selected from geographically diverse regions of China to ensure a diverse sample. We received 1,871 completed responses from 2,229 invited students. The survey response rate was 83.9%. The results indicated that ACEs had significantly negative effects on grit, while mindfulness had significantly positive effects on grit. Once controlling for level of mindfulness, the effects of ACEs on grit largely reduced and became insignificant. The findings of this research indicate that mindfulness has a significant mediational effect on the relation between ACEs and grit and call for mindfulness-based interventions for enhancing grit for the population at risks.

Listen to the Children: Elementary School Students' Perspectives on a Mindfulness Intervention

In recent years, mindfulness-based practices in grade schools have been associated with students' improved cognitive skills and general classroom behavior. In the majority of studies, however, only teacher and parent feedback are elicited, omitting a considerably significant voice - that of the students. Our study aims to fill this gap by exploring student opinions and perceptions regarding the implementation of a classroom-based mindfulness program. Elementary school students (N = 51) took part in teacher-facilitated mindfulness activities which were incorporated into their daily classroom routines. Over the course of the 8-week intervention period, students participated in focus groups about their perceptions of the program. Through qualitative content analysis, two major findings emerged from the focus group data: student opinions about the mindfulness program varied substantially and the mindfulness activities were not always liked and enjoyed. Critically, if students do not enjoy classroom-based mindfulness programs, they may be less motivated to engage in mindful activities and in turn may not experience the benefits that mindfulness has to offer. To maximize student engagement with mindfulness while addressing their concerns, the following recommendations are made: A balance between the entertaining and educational aspects of the program, flexible program delivery, and encouraging students to pursue mindful living outside of the classroom. This research is important to educational and clinical practitioners as student insight will benefit the development and modification of classroom-based mindfulness programs to ensure that students are better able to engage with and benefit from these programs.

The impact of session-introducing mindfulness and relaxation interventions in individual psychotherapy for children and adolescents: a randomized controlled trial (MARS-CA)

Background

The investigation of mindfulness-based interventions (MBIs) in cognitive-behavioral therapy has greatly increased over the past years. However, most MBI research with youth focuses on structured, manualized group programs, conducted in school settings. Knowledge about the implementation and effects of MBIs in individual psychotherapy with children and adolescents is scarce. To fill this research gap, the “Mindfulness and Relaxation Study – Children and Adolescents” (MARS-CA) is designed. It aims to assess the effects of short session-introducing interventions with mindfulness elements on juvenile patients’ symptomatic outcome and therapeutic alliance in individual child and adolescent psychotherapy.

Methods

MARS-CA is conducted at a university outpatient training center for cognitive-behavior therapy. Short session-introducing interventions with mindfulness elements will be compared to short session-introducing relaxation interventions and no session-introducing intervention to explore their effects on symptomatic outcome and therapeutic alliance. The session-introducing interventions will take place at the beginning of 24 subsequent therapy sessions. We hypothesize that patients’ symptomatic outcome and therapeutic alliance improve more strongly in the mindfulness condition than in the other two conditions and that the mindfulness condition moderates the relationship between therapeutic alliance and symptomatic outcome. Patients and their trainee therapists will be randomized to one of the three treatment arms. Participants aged between 11 and 19 years and having a primary diagnosis of either a depressive disorder, an anxiety disorder, or a hyperkinetic disorder will be included. Therapeutic alliance will be assessed after every therapy session (therapy session 1 to therapy session 24), symptomatic outcome will be assessed before the start of treatment (pre), after the 3rd, the 10th, and the 17th therapy sessions, at the end of treatment (24th therapy session, post), and at a 6-month follow-up. Additionally, mindfulness and mindfulness-related measures as well as demographic data, adherence, allegiance, and therapeutic techniques will be assessed. It is our aim to assess a sample of 135 patients. We will conduct multilevel modeling to address the nested data structure.

Discussion

The study can provide information about how add-on MBIs, conducted by trainee therapists, influence therapeutic alliance and symptomatic outcome in individual psychotherapy in children and adolescents.

Trial registration

ClinicalTrials.gov NCT04034576. Registered on July 17, 2019

Effectiveness of mindfulness parent training on parenting stress and children’s ADHD-related behaviors: A systematic review and meta-analysis

Background/Objective

Literature shows that there is a circular relationship between children’s ADHD-related behaviors and parenting stress. This systematic review and meta-analysis aimed to understand if mindfulness parent trainings have benefits for both parenting stress and the problem behaviors in children with ADHD.

Methods

Five databases, CINAHL, Embase, PsycINFO, PubMED, and Web of Science, were searched. Within-group effects at post-treatment and follow-up assessment, and between-group effects at post-treatment were analyzed. Effect sizes (Hedges’ g) were also calculated.

Results

Ten studies (5 RCTs and 5 non-RCTs) met the selection criteria and were selected for systematic review, and nine of them were included for meta-analysis. Among these 10 studies, five studies involved mindfulness training for both parents and children, while the other five studies involved mindfulness training for parents only. Within-group effects at post-treatment were small-to-large for all outcomes. Hedges’ g ranged between −0.17 [95% CI (−0.98, 0.64)] and 4.70 [95% CI (3.59, 5.81)] for parenting stress; 0.17 [95% CI (−0.03, 0.37)] and 4.03 [95% CI (2.97, 5.09)] for children’s problem behaviors; and 0.20 [95% CI (−0.10, 0.50)] and 2.98 [95% CI (2.16, 3.80)] for children’s ADHD symptoms. Between-group comparisons showed mindfulness parent training was superior to other active controls on all outcomes.

Conclusion

Findings suggest that mindfulness parent training may be beneficial for parenting stress and children’s ADHD-related behaviors, and due to the small number of studies reviewed, cautions should be taken when interpreting the results.

Mindfulness Training for Children with ADHD and Their Parents: A Randomized Control Trial

OBJECTIVE

The aim of this randomized control trial is to analyze the efficacy of a Mindfulness-based program (MYmind) in improving ADHD symptoms, associated problems, executive functions, and family functioning.

METHOD

The sample was composed of 30 children (9-14 years old) with an ADHD diagnosis and their parents. Participants were randomized into two groups, the MYmind group (n = 15) and a wait-list group (n = 15). Participants were assessed in three time periods: pre-, post-intervention, and at 6-month follow-up.

RESULTS

After the program, parents reported a decrease in parenting stress and improvements in parenting styles. Six months after the intervention, parents reported significant improvements in children's inattention symptoms, executive functions, learning problems, aggression, and peer relations. Overreactivity was the only variable that showed a decrease in both the post-test and follow-up periods.

CONCLUSION

These results suggest that the MYmind program is a promising treatment for children with ADHD and their parents.

A structured group intervention (TüTASS) with focus on self-perception and mindfulness for children with autism spectrum disorder, ASD. A pilot study

Autism spectrum disorders (ASD) represent a set of long-lasting severe neurodevelopmental conditions and effective therapeutic interventions are needed. Recent research points to the importance of including mindfulness-based elements to improve emotion and body perception in the psychotherapy of patients with ASD. Therefore, we developed a structured group psychotherapy program The Tübinger Training for Autism Spectrum Disorders (Tübinger Training für Autismus-Spektrum-Störungen; TüTASS) which focuses on mindfulness-based training elements. This pilot study accompanying the TüTASS reports the first results on the feasibility of the program with a pre-post comparison of 25 treated children with ASD. The psychometric assessment comprised five standardized questionnaires/ scales evaluating on the basis of parents and patients self-reports the child's social responsiveness, behavior, strengths and difficulties, quality of life, and depressive symptoms before and after training completion. The results indicated that upon training completion, symptoms with respect to emotional and social problems, externalizing behavior, and attentional and schizoid-compulsive behavior substantially declined. In a questionnaire assessing feasibility and quality of the group training, patients and parents found the therapy highly beneficial, especially as to the focus on emotions and body, and strengths and failures. This training program was developed to bridge the gap of lacking mindfulness-based interventions with the aim to optimize the course of ASD, especially with respect to behavioral disturbances and social-emotional problems.

A randomised controlled trial (MindChamp) of a mindfulness-based intervention for children with ADHD and their parents

BACKGROUND

Family mindfulness-based intervention (MBI) for child attention-deficit/hyperactivity disorder (ADHD) targets child self-control, parenting and parental mental health, but its effectiveness is still unclear.

METHODS

MindChamp is a pre-registered randomised controlled trial comparing an 8-week family MBI (called 'MYmind') in addition to care-as-usual (CAU) (n = 55) with CAU-only (n = 48). Children aged 8-16 years with remaining ADHD symptoms after CAU were enrolled together with a parent. Primary outcome was post-treatment parent-rated child self-control deficits (BRIEF); post hoc, Reliable Change Indexes were explored. Secondary child outcomes included ADHD symptoms (parent/teacher-rated Conners' and SWAN; teacher-rated BRIEF), other psychological symptoms (parent/teacher-rated), well-being (parent-rated) and mindfulness (self-rated). Secondary parent outcomes included self-ratings of ADHD symptoms, other psychological symptoms, well-being, self-compassion and mindful parenting. Assessments were conducted at post-treatment, 2- and 6-month follow-up.

RESULTS

Relative to CAU-only, MBI+CAU resulted in a small, statistically non-significant post-treatment improvement on the BRIEF (intention-to-treat: d = 0.27, p = .18; per protocol: d = 0.33, p = .11). Significantly more children showed reliable post-treatment improvement following MBI+CAU versus CAU-only (32% versus 11%, p < .05, Number-Needed-to-Treat = 4.7). ADHD symptoms significantly reduced post-treatment according to parent (Conners' and SWAN) and teacher ratings (BRIEF) per protocol. Only parent-rated hyperactivity impulsivity (SWAN) remained significantly reduced at 6-month follow-up. Post-treatment group differences on other secondary child outcomes were consistently favour of MBI+CAU, but mostly non-significant; no significant differences were found at follow-ups. Regarding parent outcomes, significant post-treatment improvements were found for their own ADHD symptoms, well-being and mindful parenting. At follow-ups, some significant effects remained (ADHD symptoms, mindful parenting), some additional significant effects appeared (other psychological symptoms, self-compassion) and others disappeared/remained non-significant.

CONCLUSIONS

Family MBI+CAU did not outperform CAU-only in reducing child self-control deficits on a group level but more children reliably improved. Effects on parents were larger and more durable. When CAU for ADHD is insufficient, family MBI could be a valuable addition.

Mindful Parenting and Parent Technology Use: Examining the Intersections and Outlining Future Research Directions

Popular media attention and scientific research in both mindful parenting and technology use in the context of parenting has expanded in the 21st century; however, these two streams of research have largely evolved separately from one another. Thus, in this conceptual paper, we integrate the research on mindful parenting with that on parents’ technology use and parenting to examine how parent technology use may impact or be linked with aspects of mindful parenting. Mindful parenting theory outlines five key components: listening with full attention, self-regulation in the parent–child relationship, emotional awareness of self and child, nonjudgmental acceptance of self and child, and compassion for self and child. Parent technology use, in particular the use of mobile devices, has the potential to impact all five elements of mindful parenting. However, the relationship between mindful parenting and technology is complex, and there can be both positive and negative implications of parent technology use on mindful parenting. On the positive side, technology use might help parents regulate their emotions; access support; and develop more empathy, acceptance, and compassion for themselves and their children. Yet, parent technology use also has the potential to create distractions and disrupt parent–child interactions, which may make it more difficult for parents to listen with full attention, maintain awareness of their own and their child’s emotions, and calmly respond to child behaviors with intentionality. Technology use may also create more opportunities for social comparisons and judgement, making it more difficult for parents to accept their children nonjudgmentally and have compassion for their children as they are. Future research is needed to understand the conditions under which technology use can hinder or promote mindful parenting and how interventions can promote mindful parenting skills and a positive uses of technology.

Mindfulness-Based Strategies for Improving Sleep in People with Psychiatric Disorders

PURPOSE OF THE REVIEW

To review the recent literature on mindfulness-based strategies for improving self-report and objective measures of sleep, in individuals with psychiatric disorders.

RECENT FINDINGS

Currently, research provides some support for the use of mindfulness-based interventions to improve sleep amongst individuals with psychiatric comorbidities. The strongest evidence was for the use of standardized programs, particularly for improving sleep in anxiety and depressive disorders. There is a paucity of well-controlled studies using validated subjective or objective measures of sleep. As these interventions were not specifically designed to target sleep, observed improvements may be an indirect consequence of reduced psychiatric symptoms. There is insufficient research into the application of mindfulness-based strategies to improve sleep or treat sleep disorders in people with psychiatric disorders. Well-controlled studies using standardized, mindfulness-based interventions developed to target sleep, such as mindfulness-based therapy for insomnia, may optimize the potential benefits of mindfulness for sleep in psychiatric populations.

Persistent Deficits in Self-Regulation as a Mediator between Childhood Attention-Deficit/Hyperactivity Disorder Symptoms and Substance Use Disorders

The link between attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) has been largely demonstrated. Some scholars have hypothesized that self-regulation mechanisms might play a key role in explaining this association. Objective(s): The current study tested the hypothesis that retrospective childhood ADHD symptoms might lead to more severe SUDs and this association should be mediated by current self-ratings of behavioral disinhibition, inattention, and emotional dysregulation among 204 treatment-seeking adults (male: 67.3%; female: 32.7%) with a primary diagnosis of alcohol use disorder and other SUDs. Methods: The mediational model was estimated through self-report measures of childhood ADHD symptoms (independent variable; WURS), current self-regulation mechanisms (mediators)-behavioral disinhibition (BIS-11 motor subscale), difficulties with attention regulation (MAAS) and emotion regulation (DERS)-and severity of SUDs (dependent variable; SPQ alcohol, illicit and prescribed drugs). Results: The analysis showed that alterations in the self-regulation system fully mediated the association between the severity of childhood ADHD symptoms and SUDs in adulthood. Behavioral disinhibition and difficulties in attention regulation were the most representative alterations in self-regulation processes that explained this association. Conclusions: These findings suggest it is useful to implement several therapeutic approaches (e.g. behavioral, mindfulness-based, and pharmacological) to increase the self-regulation abilities of children and adolescents with ADHD in order to reduce the probability of SUD onset in adulthood. However, future longitudinal neuroimaging and neuropsychological studies are needed to further support the role of self-regulation mechanisms in explaining the prospective association between childhood ADHD symptoms and SUDs in adulthood.

Multimodal intervention improves core symptoms in preschool children with attention-deficit/hyperactivity disorder

I tested the effect of a psychobehavioral intervention combined with electroencephalographic (EEG) biofeedback on the core symptoms of preschool children with attention-deficit/hyperactivity disorder (ADHD). Participants were 42 preschool children with attention-deficit, hyperactive-impulsive, or compound-type ADHD. They were randomly divided into the control group, a psychobehavioral intervention group, an EEG biofeedback intervention group, or a psychobehavioral + EEG biofeedback intervention group (i. e., comprehensive). After 4 months of intervention, I assessed (a) attention concentration time and (b) impulsivity and hyperactivity scores using Conners Parent Symptom Questionnaire. Results show that the multimodal intervention significantly improved participants' concentration time and behavioral hyperactive-impulsive symptoms. The multimodal (vs. single-modal) intervention was more effective in improving core symptoms. My results provide a reference for related research and practical application.

Mindfulness and Attention Deficit Hyperactivity Disorder: A Neuropsychological Perspective

ABSTRACT

Understanding the underlying mechanisms of mindfulness has been a hot topic in recent years, not only in clinical fields but also in neuroscience. Most neuroimaging findings demonstrate that critical brain regions involved in mindfulness are responsible for cognitive functions and mental states. However, the brain is a complex system operating via multiple circuits and networks, rather than isolated brain regions solely responsible for specific functions. Mindfulness-based treatments for attention deficit hyperactivity disorder (ADHD) have emerged as promising adjunctive or alternative intervention approaches. We focus on four key brain circuits associated with mindfulness practices and effects on symptoms of ADHD and its cognitive dysfunction, including executive attention circuit, sustained attention circuit, impulsivity circuit, and hyperactivity circuit. We also expand our discussion to identify three key brain networks associated with mindfulness practices, including central executive network, default mode network, and salience network. We conclude by suggesting that more research efforts need to be devoted into identifying putative neuropsychological mechanisms of mindfulness on how it alleviates ADHD symptoms.

Adverse childhood experiences, mindfulness and happiness in Chinese college students during the COVID-19 pandemic

The rise of literature on adverse childhood experiences (ACEs) has indicated a strong relationship between ACEs and negative life outcomes, leading to important implications for services to the population. However, less is known about the effects of ACEs on happiness and the role of mindfulness in this relation. This study examined the relationships between ACEs and happiness and whether mindfulness mediated the effects of ACEs on happiness in a sample of Chinese college students. The data were collected from 1871 college students from 12 colleges across China in September 2020. The findings of this study show that ACEs had significant negative effects on students' happiness and that mindfulness helped to substantially reduce the negative effects of ACEs on happiness. Students who experienced emotional neglect and abuse in childhood were affected the most. By contrast, this group is not the primary focus of mindfulness-based interventions in existing literature; thus, this study calls for specific mindfulness-based interventions for this vulnerable population.

Mindfulness for Children With ADHD and Mindful Parenting (MindChamp): A Qualitative Study on Feasibility and Effects

Objective: We describe qualitative results on facilitators and barriers to participating in a family mindfulness-based intervention (MBI) for youth with ADHD and their parents and perceived effects on child and parent. Method: Sixty-nine families started the 8-week protocolized group-based MBI called "MYmind." After the MBI, individual semi-structured interviews were conducted with a purposive sample of parents (n = 20), children (n = 17, ages 9-16 years), and mindfulness teachers (n = 3). Interviews were analyzed using Grounded Theory. Results: Facilitators and barriers regarding contextual factors (e.g., time investment), MBI characteristics (e.g., parallel parent-child training), and participant characteristics (e.g., ADHD-symptoms) are described. Perceived effects were heterogeneous: no/adverse effects, awareness/insight, acceptance, emotion regulation/reactivity, cognitive functioning, calmness/relaxation, relational changes, generalization. Conclusion: MYmind can lead to a variety of transferable positively perceived effects beyond child ADHD-symptom decrease. Recommendations on MYmind participant inclusion, program characteristics, mindfulness teachers, and evaluating treatment efficacy are provided.

The effect of a mindfulness-based intervention on executive, behavioural and socio-emotional competencies in very preterm young adolescents

Very preterm (VPT) children and adolescents show executive, behavioural and socio-emotional difficulties that persists into adulthood. This study aims to assess the effectiveness of a mindfulness-based intervention (MBI) in improving these competencies in VPT young adolescents using a randomised controlled trial design. 56 young adolescents aged 10–14 years, born before 32 gestational weeks, were randomly assigned to an “intervention” or a “waiting” group and completed an 8-week MBI in a cross-over design. Executive, behavioural and socio-emotional competencies were assessed at three different time points via parent and self-reported questionnaires, neuropsychological testing and computerised tasks. The data were analysed using an intention-to-treat approach with linear regression modelling. Our findings show a beneficial effect of MBI on executive, behavioural and socio-emotional competencies in VPT young adolescents measured by parent questionnaires. Increased executive competencies were also observed on computerised task with enhanced speed of processing after MBI. Two subgroups of participants were created based on measures of prematurity, which revealed increased long-term benefits in the moderate-risk that were not observed in the high-risk subgroups of VPT young adolescents. MBI seems a valuable tool for reducing detrimental consequences of prematurity in young adolescents, especially regarding executive, behavioural and socio-emotional difficulties.

Clinical Trial Registration ClinicalTrials, NCT04638101. Registered 20 November 2020—Retrospectively registered, https://clinicaltrials.gov/show/NCT04638101.

Improving executive, behavioural and socio-emotional competences in very preterm young adolescents through a mindfulness-based intervention: Study protocol and feasibility

BACKGROUND

Very preterm (VPT) children and adolescents show executive, behavioural and socio-emotional difficulties that persist into adulthood. Despite the promising role of mindfulness-based intervention (MBI) in improving theses competences in children and adolescents, the effectiveness of an MBI has not been assessed in a VPT population so far.

AIMS

To describe the protocol and to evaluate the feasibility and acceptability of a clinical trial on an 8-week MBI program to enhance executive and socio-emotional competences in a cohort of VPT young adolescents.

STUDY DESIGN

A randomised controlled trial (RCT) and a pre-post intervention designs.

PARTICIPANTS

164 VPT young adolescents from 10 to 14 years old, born before 32 gestational weeks, without major intellectual, sensory or physical impairments, and attending mainstream school, were invited to participate in an 8-week MBI program.

OUTCOME MEASURES

Completion rate of the study was recorded. Acceptability, satisfaction and attendance measures of the MBI were collected using self-reported questionnaires and registration of attendance.

RESULTS

Of the 63 participants who were enrolled in the study (38.2% of families invited to participate), 52 (82.5%) completed all assessments. Acceptability was high as shown by the high attendance rate in the sessions and the feedback evaluation questionnaire.

CONCLUSIONS

Our findings suggest that an MBI is feasible to implement and show a high acceptability among participants. The use of an RCT design in our study constitutes the gold standard for testing the efficacy of such intervention in VPT young adolescents. If effective, the MBI program could potentially be a valuable tool for improving executive and socio-emotional competences in the vulnerable VPT population.

TRIAL REGISTRATION

ClinicalTrials, NCT04638101. Registered 19 November 2020 - retrospectively registered, https://clinicaltrials.gov/show/NCT04638101.

The efficacy of mindfulness-based interventions in attention-deficit/hyperactivity disorder beyond core symptoms: A systematic review, meta-analysis, and meta-regression

BACKGROUND

Mindfulness-Based Interventions (MBIs) have been increasingly proposed as treatment in patients with Attention-Deficit/Hyperactivity Disorder (ADHD), showing promising results on different proposed outcomes, in both children and adults.

OBJECTIVES

To systematically review and meta-analyse studies concerning the effects of MBIs on either ADHD and associated features, associated clinical conditions, neurocognitive impairments, mindfulness skills, global functioning and quality of life.

METHODS

Searches were conducted on five databases, including controlled and observational studies on both adults and children populations. The review process was compliant to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Meta-analyses and meta-regression models were conducted.

RESULTS

Thirty-one full-texts were included. In both adults and children, MBIs showed to be more effective than waiting lists in improving ADHD symptoms and some other outcomes. In adults, a medium pooled effect size was shown by meta-analysis for ADHD symptoms but in some cases a publication bias was detected. Subgroup analysis and meta-regression confirmed the gap detected by our systematic review between the medium/large effect size of inactive-controlled studies and the low/negligible one of active-controlled studies. In children, no active-controlled studies have been conducted. Mindfulness Awareness Practice (MAP) and Mindfulness Based Cognitive Therapy (MBCT) were the most used protocols in adult studies, whereas a combination of MBCT and Mindfulness Based Stress Reduction (MBSR) was more preferred for children and adolescent patients.

CONCLUSIONS

Even if further studies with a better methodology are needed, we can suggest the MBIs may be useful as complementation and not as replacement of other active interventions.

A review of mindful parenting

The benefits of mindfulness are widely recognized, and it has received increasing research attention. Recently, researchers have extended the concept and practice of mindfulness to the parent–child relationship and proposed the construct of mindful parenting, that is, parenting with mindfulness. However, mindful parenting is a relatively new concept in the field of family studies, and the contents, psychometrically robust measures, outcomes, and cultivation methods of mindful parenting warrant in-depth exploration. This article presents a systematic review of mindful parenting. We first conceptualized mindful parenting by consolidating the existence of this construct. Then, we summarized various measurements to assess this construct, and reviewed theoretical models and empirical research on the roles of mindful parenting. We also illustrated the ways to enhance mindful parenting and provided current evidence regarding these methods. Further, we discussed the limitations in this field and proposed future research directions.

The Differential Impact of Acute Exercise and Mindfulness Meditation on Executive Functioning and Psycho-Emotional Well-Being in Children and Youth With ADHD

This study investigated how acute exercise and mindfulness meditation impacts executive functioning and psycho-emotional well-being in 16 children and youth with ADHD aged 10-14 (male = 11; White = 80%). Participants completed three interventions: 10 min of exercise, 10 min of mindfulness meditation, and 10 min of reading (control). Before and after each intervention, executive functioning (inhibitory control, working memory, task-switching) and psycho-emotional well-being (mood, self-efficacy) were assessed. Mindfulness meditation increased performance on all executive functioning tasks whereas the other interventions did not (d = 0.55-0.86). Exercise enhanced positive mood and self-efficacy whereas the other interventions did not (d = 0.22-0.35). This work provides preliminary evidence for how acute exercise and mindfulness meditation can support differential aspects of executive and psycho-emotional functioning among children and youth with ADHD.

The efficacy of mindful parenting interventions: A systematic review and meta-analysis

BACKGROUND

Mindful parenting is the process of bringing awareness and attention intentionally in a non-reactive and non-judgemental way to a child at any present moment. Parenting mindfulness is believed to influence parenting factors and parental psychological outcomes, child's emotional and behavioural outcomes, and family relationships. However, the efficacy of such interventions on interpersonal mindfulness in parenting and parenting behaviours has received minimal empirical attention.

OBJECTIVE

This meta-analysis aims to quantitatively evaluate the efficacy of mindful parenting interventions on parenting mindfulness and parenting behaviours. Parenting stress, parents' psychological wellbeing, interpersonal relationships, and child behavioural outcomes were examined secondarily. When meta-analysis was not possible (due to insufficient data in the included studies), the narrative approach was taken to present the findings.

DESIGN

A systematic review, meta-analysis, and narrative summary.

METHODS

Six electronic databases (PubMed, Embase, PsycINFO, CINAHL, Scopus, and ProQuest Dissertations and Theses) were systematically searched for articles in the English language from their respective dates of inception to December 2020. Studies involving clinical and non-clinical samples of parents with children or youths aged 24 years and below were included. Only randomised controlled trials were included. Studies were excluded if the mindfulness intervention did not focus on parenting skills training; that is, it focused on childbirth, stress reduction or incorporated other forms of therapy (e.g. cognitive behavioural therapy). Data was synthesised using a random-effects model in RevMan 5.4. The outcomes of primary interest were parenting mindfulness and parenting behaviours. The secondary outcomes were parenting stress, parents' psychological wellbeing, interpersonal relationships, and child behavioural outcomes.

RESULTS

Eleven studies representing 1,340 parents from six countries were included in the review. No evidence of intervention effect was found for overall parenting mindfulness and overall parenting stress. However, mindful parenting interventions demonstrated a moderate effect size when examining parenting mindfulness scores (standardised mean differences (d)=0.62, 95% CI: 0.11, 1.13, p = 0.02) of parents with non-clinical samples of children. No intervention effect was found for overall parenting stress. Due to insufficient studies and data, findings on parenting behaviours, psychological wellbeing, relationships, and child behaviour were presented narratively.

CONCLUSION

Mindful parenting interventions are associated with higher parenting mindfulness scores for parents of typically developing children when compared with a control group. The limited studies and mixed results on positive parenting behaviours, parental psychological wellbeing, parental relationship with child and partner, and child behavioural outcomes serve as an impetus for further research.

Adverse Childhood Experiences and Psychological Well-Being in Chinese College Students: Mediation Effect of Mindfulness

Literature on the antecedents of psychological well-being (PWB) has found that adverse childhood experiences (ACEs) and mindfulness are associated with PWB; less is known, however, about the role of mindfulness, a type of emotional and self-regulation, in the pathway between ACEs and PWB. This study used data from 1871 college students across China to examine the relation between ACEs and PWB, and whether the relation was mediated by mindfulness. The findings from structural equation modelling indicate a statistically significant negative association between ACEs and PWB, while mindfulness was strongly and positively associated with PWB. The effect of ACEs on PWB was reduced once mindfulness was controlled for in the analysis. This provides evidence that mindfulness was able to partially mediate the effects of negative life experiences on psychological well-being. This calls for mindfulness interventions targeted toward students with a history of ACEs to buffer the effects of ACEs on PWB.

Adverse Childhood Experiences and Mindfulness in Chinese College Students During the COVID-19 Pandemic

Mindfulness has been found to have many positive effects on life outcomes, including mental health and educational achievement. However, less is known about the antecedents of mindfulness, particularly in Chinese college students. This study examines the effect of adverse childhood experiences (ACEs) on mindfulness among Chinese college students in September 2020, during the COVID-19 pandemic. We hypothesized that ACEs negatively affected students' mindfulness. The data were collected from 1,871 college students from 12 colleges across China. The results aligned with our hypothesis that ACEs was negatively associated with mindfulness. In particular, emotional abuse and neglect in childhood appear to have the most negative effects on mindfulness compared to other dimensions of ACEs such as physical abuse and household challenges.

Effects and Moderators of Computer-Based Training on Children's Executive Functions: A Systematic Review and Meta-Analysis

Computer-based training has attracted increasing attention from researchers in recent years. Several studies have found that computer-based training resulted in improved executive functions (EFs) in adults. However, it remains controversial whether children can benefit from computer-based training and what moderator could influence the training effects. The focus of the present meta-analysis was to examine the effects of computer-based training on EFs in children: working memory, cognitive flexibility, and inhibitory control. A thorough search of published work yielded a sample of 36 studies with 216 effect sizes. The results indicated that computer-based training showed moderate training effects on improving EFs in children (g = 0.35, k = 36, p < 0.001), while training effects of working memory were significantly higher. Furthermore, we found near-transfer effects were marginally significantly higher than far-transfer effects. The standard training method was significantly more effective than training with game elements. In computer-based training, typically developing children had significantly better training effects than atypically developing children. Some additional factors, such as the number of training sessions and age, also modulated the training effects. In conclusion, the present study investigated the effects and moderators of computer-based training for children's EFs. The results provided evidence that computer-based training (especially standard training) may serve as an efficient way to improve EFs in children (especially typically developing individuals). We also discussed some directions for future computer-based training studies.

Clinical Application of Mindfulness-Oriented Meditation: A Preliminary Study in Children with ADHD

Mindfulness-oriented meditation (MOM) is a self-regulatory training used for attentional and behavioral problems. With its focus on attention, MOM is a promising form of training that is gaining empirical support as a complementary or alternative intervention for attention deficit/hyperactivity disorder (ADHD). In this study, we tested the preliminary efficacy of MOM training in children with ADHD, by comparing its efficacy with an active control condition (Emotion Education Program, EEP). Twenty-five children with ADHD aged 7–11 years participated in MOM training (n = 15) or EEP (n = 10) 3 times per week for 8 weeks. Neuropsychological and academic measures and behavioral, emotional, and mindfulness ratings were collected before and after the two programs. On average, MOM training had positive effects on neuropsychological measures, as evidenced by a significant mean improvement in all outcome measures after training. Moreover, positive effects on ADHD symptoms were found only in the MOM group. Although they are preliminary, our results documented that MOM training promotes changes in neuropsychological measures and in certain behavioral symptoms, suggesting it as a promising tool for ameliorating cognitive and clinical manifestations of ADHD.

Moderate-to-vigorous physical activity and behavioral outcomes in adolescents with attention deficit and hyperactivity disorder: The role of sleep

BACKGROUND

Attention deficit and hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has a worldwide prevalence of 7.2%. Individuals with ADHD often have sleep and behavioral problems.

OBJECTIVE

This cross-sectional survey aims to investigate the relationships between moderate-to-vigorous physical activity (MVPA), sleep, bullying, and school engagement in adolescents with ADHD.

METHODS

Data were obtained from the 2011-2012 National Survey of Children's Health. A subsample (n = 272) that fit the inclusion criteria was included. Path analysis was used to test the hypothesized model (i.e., MVPA → sleep → bullying/school engagement).

RESULTS

The proposed model fit the data well. MVPA was found to be associated with sleep, bullying, and school engagement. In addition, sleep mediated the relationship between MVPA and bullying/school engagement.

CONCLUSIONS

MVPA and sleep play an important role in understanding behavioral outcomes in adolescents with ADHD. Longitudinal or intervention studies are needed to support the present findings.

[Mindfulness in Trainee Psychotherapies with Children and Adolescents]

Mindfulness in Trainee Psychotherapies with Children and Adolescents The implementation of mindfulness-based interventions (MBIs) in cognitive-behavioral therapy has greatly increased over the past few years. However, there is little research about the implementation of MBIs in individual child and adolescent psychotherapy. The present paper gives an overview of current MBIs and their efficacy in children and adolescents. A depiction of the implementation of MBIs in individual therapy and a description of the "Mindfulness and Relaxation Study - Children and Adolescents" (MARS-CA) is given. The study aims to examine the effects of short session-introducing interventions with mindfulness elements on juvenile patients' psychopathological symptomatology and therapeutic alliance. For this reason, the authors compare session-introducing interventions with mindfulness elements with session-introducing relaxation interventions and no session-introducing intervention. Qualitative results of the pre-study show that both interventions with mindfulness elements and relaxation interventions work well with juvenile patients.

The mental welfare effect of creativity: how does creativity make people happy?

There is an emerging interest in the positive influence of creativity on individuals' psychological well-being (PWB). Considering most studies focused on the relationship between divergent thinking and PWB, only several studies have dealt with the role of convergent thinking in PWB, which should be just as important, if not more so. To deepen the knowledge on the association between convergent thinking and PWB, 423 undergraduates were invited to complete the Mindful Attention Awareness Scale, the PWB Scale and the Remote Associates test. As expected, results showed a positive association between PWB and convergent thinking. Also, mindfulness was found to partially mediate the relationship between creativity and PWB. Potential implications and future research directions are proposed.