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Lee YC, Chen CR, Lin KC. Effects of Mindfulness-Based Interventions in Children and Adolescents with ADHD: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15198. [PMID: 36429915 PMCID: PMC9690476 DOI: 10.3390/ijerph192215198] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
(1) Objectives: Mindfulness-based interventions have been receiving more attention in research for children with attention deficit hyperactivity disorder (ADHD). This systematic review and meta-analysis was conducted to synthesize the findings of randomized controlled trials of mindfulness-based interventions for children with ADHD. (2) Methods: A systematic review and meta-analysis of studies published in PsycINFO, PubMed, and Google Scholar was completed from the earliest available date until August 2022. (3) Results: The systematic review included 12 studies that met the inclusion criteria, and the meta-analysis included 11 studies. The overall effect sizes were g = 0.77 for ADHD symptoms, g = 0.03 for externalizing behavior problem, g = 0.13 for internalizing behavior problem, g = 0.43 for mindfulness, and g = 0.40 for parental stress for children with ADHD. (4) Conclusion: The results of this systematic review highlight the possible benefits of mindfulness-based interventions for children with ADHD.
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Affiliation(s)
- Yi-Chen Lee
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Chyi-Rong Chen
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei 100, Taiwan
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Keh-Chung Lin
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei 100, Taiwan
- Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei 100, Taiwan
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2
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Ručević S. Parental psychopathic traits and its interaction with children's psychopathy features as predictors of perceived parenting behavior five years later. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2022.111512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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3
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Lee CS, Ng KH, Chan PC, Peng X. Effectiveness of mindfulness parent training on parenting stress and children’s ADHD-related behaviors: A systematic review and meta-analysis. Hong Kong J Occup Ther 2022; 35:3-24. [PMID: 35847187 PMCID: PMC9279872 DOI: 10.1177/15691861211073826] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/29/2021] [Indexed: 11/18/2022] Open
Abstract
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.
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Affiliation(s)
- Clara S.C. Lee
- Departemnt of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Ka-hin Ng
- Departemnt of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Phyllis C.K. Chan
- Departemnt of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Xianwei Peng
- Departemnt of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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4
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Green CD, Langberg JM. A Review of Predictors of Psychosocial Service Utilization in Youth with Attention-Deficit/Hyperactivity Disorder. Clin Child Fam Psychol Rev 2021; 25:356-375. [PMID: 34498154 DOI: 10.1007/s10567-021-00368-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2021] [Indexed: 11/29/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common childhood disorders. Professional practice guidelines recommend combined treatment, psychopharmacological and psychosocial, for youth with ADHD. There have been multiple reviews of pharmacological prescription practices and utilization, however, less is known about predictors of ADHD psychosocial service utilization. Given the importance of accessing psychosocial treatment in relation to improving functional impairment, this review synthesizes evidence on predictors of ADHD psychosocial intervention utilization in clinic, community, and school settings. Eighteen studies were identified and included in the review. Findings are summarized across informant profile factors, predisposing characteristics, and barriers and facilitators. The most robust findings were for the impact of symptom severity/impairment, the presence of comorbidities, and age on ADHD psychosocial service utilization. Race/ethnicity, sex, parental knowledge of the disorder and insurance coverage were also identified as key factors. Future avenues of research are provided, and clinical and policy implications targeted at reducing psychosocial treatment disparities in youth with ADHD are discussed.
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Affiliation(s)
- Cathrin D Green
- Virginia Commonwealth University, 806 W. Franklin St, Box 842018, Richmond, VA, 23284, USA
| | - Joshua M Langberg
- Virginia Commonwealth University, 806 W. Franklin St, Box 842018, Richmond, VA, 23284, USA.
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Belo-Tomic S, Quinlan E, Read E. Young Adult’s Perception of Their Relationship with an ADHD Parent: A Qualitative Study. CONTEMPORARY FAMILY THERAPY 2021. [DOI: 10.1007/s10591-021-09566-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fossati M, Negri L, Fianco A, Cocchi MG, Molteni M, Delle Fave A. Resilience as a moderator between Objective and Subjective Burden among parents of children with ADHD. Arch Psychiatr Nurs 2020; 34:53-63. [PMID: 32035590 DOI: 10.1016/j.apnu.2019.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 10/30/2019] [Accepted: 11/09/2019] [Indexed: 12/30/2022]
Affiliation(s)
| | - Luca Negri
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Andrea Fianco
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | | | - Massimo Molteni
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Antonella Delle Fave
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy; Department of Pathophysiology and Transplantation, University of Milano, Milano, Italy
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Smith ZR, Langberg JM. Review of the Evidence for Motivation Deficits in Youth with ADHD and Their Association with Functional Outcomes. Clin Child Fam Psychol Rev 2019; 21:500-526. [PMID: 30141121 DOI: 10.1007/s10567-018-0268-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Preeminent theories of attention-deficit/hyperactivity disorder (ADHD) suggest that motivation deficits are core underlying features of the disorder. However, it is currently unclear whether empirical evidence supports the assertion that significant group (ADHD v. comparison) differences in motivation exist or that problems with motivation contribute to the functional impairments that youth with ADHD experience. Accordingly, this review focused on evaluating and summarizing the empirical literature on the presence of motivation deficits and their association with functional outcomes in samples of youth with ADHD. Twenty studies met the review inclusion criteria. Results support the assertion that youth with ADHD have lower academic-related motivation in comparison to their peers and that motivation plays an important role in academic outcomes, with the strongest evidence to date for reading achievement. However, the available evidence is limited, and few existing studies are aligned with the much larger theoretical and empirical motivation literature in typically developing youth. Given preliminary evidence that motivation plays a role in the academic impairments of youth with ADHD, the review concludes with a discussion of whether current ADHD interventions adequately target motivation and highlights important future directions.
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Affiliation(s)
- Zoe R Smith
- Virginia Commonwealth University, 806 W. Franklin St., Box 842018, Richmond, VA, 23284, USA
| | - Joshua M Langberg
- Virginia Commonwealth University, 806 W. Franklin St., Box 842018, Richmond, VA, 23284, USA.
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Siebelink NM, Bögels SM, Boerboom LM, de Waal N, Buitelaar JK, Speckens AE, Greven CU. Mindfulness for children with ADHD and Mindful Parenting (MindChamp): Protocol of a randomised controlled trial comparing a family Mindfulness-Based Intervention as an add-on to care-as-usual with care-as-usual only. BMC Psychiatry 2018; 18:237. [PMID: 30045714 PMCID: PMC6060473 DOI: 10.1186/s12888-018-1811-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 07/09/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Self-control in childhood has been linked to long-term and cascading effects on health, academic, criminality, wealth and parenting outcomes. Hence it is important to target self-control deficits early in life. Self-control deficits are a hallmark of Attention Deficit/Hyperactivity Disorder (ADHD). Even after receiving care-as-usual (CAU) for ADHD, impaired self-control often remains. Pharmacotherapy can be hampered by side-effects, low adherence and short-term effectiveness. Other limitations of CAU are decreased effectiveness when parents have ADHD and little effect on parental well-being. Mindfulness-Based Interventions (MBIs) are an emerging non-pharmacological approach with potential to improve self-control and well-being in both children and parents. However, there is a lack of sufficiently powered randomised controlled trials (RCTs) to establish their effects in families with ADHD. This study protocol describes an RCT to investigate the effectiveness of a family MBI as an add-on to CAU in treatment of youth with ADHD, and is described in accordance with Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT). METHODS/DESIGN An RCT will be conducted in N = 100 children (aged 8-16 years) with ADHD and their parents. The experimental condition will consist of a family MBI (MYmind): 8-week group-based MBI for youth combined with parallel group-based Mindful Parenting for their parents, as an add-on to CAU. The control condition will consist of CAU-only. Assessments will take place at baseline, end of treatment (3 months later), 2 and 6 months' follow-up. Primary outcome measure will be an ecologically valid assessment of child self-control with the parent-rated Behaviour Rating Inventory of Executive Function (BRIEF). Secondary child outcome measures will be teacher-rated BRIEF, computerised self-control tasks and questionnaires on psychological symptoms (e.g. ADHD, symptoms of autism), well-being and mindfulness. For parental outcomes, secondary measures will be self-rated BRIEF, computerised self-control tasks and questionnaires on psychological symptoms, well-being and mindful parenting. DISCUSSION The proposed RCT will take account of methodological limitations of previous studies on MBIs in child ADHD populations. The current study will provide valuable information on family MBI as a potential effective intervention in targeting self-control deficits for youth with ADHD and their parents. TRIAL REGISTRATION ClinicalTrials.gov NCT03220308 . Retrospectively registered 18 July 2017.
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Affiliation(s)
- Nienke M. Siebelink
- 0000 0004 0444 9382grid.10417.33Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands ,Karakter Child and Adolescent Psychiatry, University Center, Reinier Postlaan 12, Nijmegen, 6525 GC The Netherlands
| | - Susan M. Bögels
- 0000000084992262grid.7177.6Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands
| | - Lisanne M. Boerboom
- Karakter Child and Adolescent Psychiatry, University Center, Reinier Postlaan 12, Nijmegen, 6525 GC The Netherlands
| | - Noor de Waal
- Karakter Child and Adolescent Psychiatry, University Center, Reinier Postlaan 12, Nijmegen, 6525 GC The Netherlands
| | - Jan K. Buitelaar
- 0000 0004 0444 9382grid.10417.33Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands ,Karakter Child and Adolescent Psychiatry, University Center, Reinier Postlaan 12, Nijmegen, 6525 GC The Netherlands
| | - Anne E. Speckens
- 0000 0004 0444 9382grid.10417.33Department of Psychiatry, Radboudumc Centre for Mindfulness, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Corina U. Greven
- 0000 0004 0444 9382grid.10417.33Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands ,Karakter Child and Adolescent Psychiatry, University Center, Reinier Postlaan 12, Nijmegen, 6525 GC The Netherlands ,0000 0001 2322 6764grid.13097.3cKing’s College London, Social, Genetic and Developmental Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Modesto-Lowe V, Charbonneau V, Farahmand P. Psychotherapy for Adolescents With Attention-Deficit Hyperactivity Disorder: A Pediatrician's Guide. Clin Pediatr (Phila) 2017; 56:667-674. [PMID: 27895149 DOI: 10.1177/0009922816673308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Attention-deficit hyperactivity disorder (ADHD) presents with high levels of inattention, impulsiveness, and hyperactivity. ADHD starts in childhood and results in impairments that continue into adulthood. ADHD symptoms lead to decreased functionality in various life domains and result in poor academics, behavioral challenges, delayed independence, and strained relationships. Despite advances in diagnosis and treatment, persistent residual symptoms are common, highlighting the need for novel treatment strategies. This article aims to provide a review of the psychotherapeutic interventions available for teens that receive pharmacotherapy but continue to struggle with the residual symptoms of ADHD that interfere with academic function, relationship formation, and psychological development.
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Affiliation(s)
- Vania Modesto-Lowe
- 1 Connecticut Valley Hospital, Middletown, CT, USA.,2 University of Connecticut School of Medicine, Farmington, CT, USA.,3 Quinnipiac University, Hamden, CT, USA
| | | | - Pantea Farahmand
- 4 New York-Presbyterian Hospital/Columbia-Cornell, Child and Adolescent Psychiatry, New York, NY, USA
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Alvarado C, Modesto-Lowe V. Improving Treatment in Minority Children With Attention Deficit/Hyperactivity Disorder. Clin Pediatr (Phila) 2017; 56:171-176. [PMID: 27113035 DOI: 10.1177/0009922816645517] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Studies have shown that African American, Caucasian, and Hispanic children all have the same prevalence of attention deficit/hyperactivity disorder (ADHD) symptoms and respond similarly to treatment. However, the number of African American and Hispanic children actually diagnosed with ADHD is significantly lower than that of the Caucasian population. Consequently, the numbers of African American and Hispanic children receiving ADHD treatment is also low. This article investigates the barriers to diagnosis and treatment of ADHD in African American and Hispanic populations, which include financial limitations, differing parental views, and cultural norms. It then discusses potential solutions to help address those barriers with the hope of providing culturally sensitive care among African American and Hispanic communities.
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Affiliation(s)
- Camille Alvarado
- 1 University of Connecticut School of Medicine, Farmington. CT, USA
| | - Vania Modesto-Lowe
- 1 University of Connecticut School of Medicine, Farmington. CT, USA.,2 Connecticut Valley Hospital, Middletown, CT, USA.,3 Quinnipiac University, Hamden, CT, USA
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Associations between Inadequate Parenting Practices and Behavioral Problems in Children and Adolescents with Attention Deficit Hyperactivity Disorder. ScientificWorldJournal 2015; 2015:683062. [PMID: 26844292 PMCID: PMC4710942 DOI: 10.1155/2015/683062] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 12/17/2015] [Indexed: 11/19/2022] Open
Abstract
Children and adolescents with ADHD present behaviors such as impulsiveness, inattention, and difficulties with personal organization that represent an overload for parents. Moreover, it also increases their level of stress and leads them to resort to inadequate educational strategies. The present study verifies associations between inadequate parenting practices and behavioral profiles of children and adolescents with ADHD. The sample was composed of 22 children with ADHD (age range 6–16 years) and their mothers. Spearman correlation analyses were made with the scores of Parenting Style Inventory (PSI) and Child Behavior Checklist for ages 6–18 (CBCL/6–18). Results indicate statistically significant associations between behavioral problems and the use of punishment practices and negligence. When assessing a child with ADHD, it is important to verify the predominant types of parenting practices that can influence both immediate interventions and the prognosis of the disorder.
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Regalla MA, Guilherme P, Aguilera P, Serra-Pinheiro MA, Mattos P. Attention deficit hyperactivity disorder is an independent risk factor for lower resilience in adolescents: a pilot study. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2015; 37:157-60. [DOI: 10.1590/2237-6089-2015-0010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 06/02/2015] [Indexed: 11/21/2022]
Abstract
Objective: Attention deficit hyperactivity disorder (ADHD) is associated with impaired daily functioning in a wide range of domains. Resilience, the ability to overcome and recover from challenges, has been scarcely investigated in ADHD and could potentially provide novel strategies for treatment. However, since ADHD is often comorbid with other clinical conditions, it is necessary to better understand if it impairs resilience levels when controlled for other variables. This pilot study is the first to investigate the correlation between quantitative measures of resilience and ADHD using strict diagnostic criteria by controlling this correlation for comorbid conditions.Methods:Twelve adolescents diagnosed with ADHD via semi-structured interview using Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) were compared to 12 adolescents exhibiting typical development, regarding resilience, in an analysis controlled for anxiety and depression levels, socioeconomic status, and intelligence quotient (IQ).Results: The ADHD group was less resilient than the control group (p < 0.01). Importantly, resilience in the ADHD group was not correlated with depression or anxiety, age, intelligence level, and socioeconomic status.Conclusions:ADHD seems to be associated with lower resilience, which cannot be explained by depression, anxiety, intelligence level, age, or socioeconomic status.
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