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Hawkey EJ, Williams AI, Chung S, Owens EB, Pfiffner LJ. Emotion Regulation and Organizational Skills in Children With ADHD Symptoms Are Associated With Behavioral Parent Training Adherence. J Atten Disord 2024; 28:1320-1330. [PMID: 38726593 DOI: 10.1177/10870547241251725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVE Behavioral parent training (BPT) is a well-established treatment for ADHD; however, treatment response is variable. Consistency in parent skill use during BPT is known to influence child outcomes post-treatment, while less research has focused on specific child factors that may be impacting parent skill utilization during treatment. The current study examined associations between child organizational skills and emotion dysregulation (ED) with parent treatment adherence during BPT and post-treatment child impairment. METHOD Parents of 72 children (Mage = 8.31) with ADHD symptoms and impairment participated in BPT which was embedded in a 12-week, multicomponent, school-based intervention for children delivered by school mental health clinicians. Outcomes included parent treatment adherence and child improvements in global impairment post-treatment. RESULTS Greater pre-treatment child organizational problems were associated with less parent treatment adherence regardless of ADHD symptom severity. Worse pre-treatment child ED was associated with more impairment post-treatment regardless of ADHD symptom severity whereas the effects of child ED on parent treatment adherence were moderated by child ADHD symptom severity. CONCLUSION The current study suggests that pre-treatment child ED and organizational difficulties impact parent treatment adherence to behavioral interventions targeting ADHD symptoms, potentially in unique ways, and should be considered in future BPT treatment studies.
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Affiliation(s)
| | | | - Sara Chung
- University of California, San Francisco, CA, USA
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2
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McGuire A, Amaro CM, Singh MN, Brown S. Targeting Caregiver Psychopathology in Parent Management Training for Adolescents: A Scoping Review of Commercially Available Treatment Resources. CHILD & YOUTH CARE FORUM 2024; 53:269-291. [PMID: 38601299 PMCID: PMC11003757 DOI: 10.1007/s10566-023-09754-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2023] [Indexed: 04/12/2024]
Abstract
Background While parent management training (PMT) has been shown to be an effective treatment for adolescents with externalizing concerns, evidence suggests that effectiveness is not equitable across all types of families. Research suggests that caregiver psychopathology may adversely affect PMT success for adolescents. However, it remains unclear whether research on caregiver psychopathology is integrated within adolescent PMT resources (e.g., treatment manuals). Objective A scoping review of commercially available, clinician focused PMT resources was conducted to assess for information on caregiver psychopathology and clinical guidance for addressing caregiver psychopathology. Methods A search for commercially available resources was conducted among national treatment databases and book resource websites. Information on caregiver psychopathology was extracted from individual sessions of the PMT resources. Results Seven treatment resources met inclusion criteria. The majority of the treatment resources made at least one explicit comment that caregiver psychopathology may impact the course of treatment. There was very limited mention of caregiver psychopathology in skill building sections of the resources. Conclusions While most resources mentioned caregiver psychopathology, these comments lacked breadth and depth in providing clinicians with recommendations on how to tailor treatment to caregivers' needs. Recommendations are provided for how PMT programs might be improved in the future to support clinicians when faced with caregiver psychopathology by recognizing inequities and lack of diversity in resource development, using a transdiagnostic perspective (including a transdiagnostic approach to assessment of care-giver psychopathology), and integrating caregiver skill development.
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Affiliation(s)
- Austen McGuire
- Clinical Child Psychology Program, 2015 Dole Human Development Center, University of Kansas, 1000 Sunnyside Avenue, Lawrence, KS 66045-7556, USA
| | - Christina M. Amaro
- Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave, Boston, MA 02215, USA
- Division of Behavioral Health and Center for Healthcare Delivery Science, Nemours Children’s Hospital, 1600 Rockland Road, Delaware, Wilmington, DE 19803, USA
| | - Mehar N. Singh
- Clinical Child Psychology Program, 2015 Dole Human Development Center, University of Kansas, 1000 Sunnyside Avenue, Lawrence, KS 66045-7556, USA
| | - Shaquanna Brown
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Box G-BH, Providence, RI 02912, USA
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Avenue, Providence, RI 02906, USA
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3
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Ponomarev R, Sklyar S, Krasilnikova V, Savina T. Digital Cognitive Training for Children with Attention Deficit Hyperactivity Disorder. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2023; 52:2303-2319. [PMID: 37544957 DOI: 10.1007/s10936-023-10003-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/08/2023]
Abstract
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.
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Affiliation(s)
- Roman Ponomarev
- Department of Special Pedagogy, Abai Kazakh National Pedagogical University, Almaty, Kazakhstan.
| | - Sergey Sklyar
- General and Applied Psychology Department, Faculty of Philosophy and Political Science, Al-Farabi KazNU, Almaty, Kazakhstan
| | - Varvara Krasilnikova
- Institute of Linguistics and Intercultural Communication, Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Tamara Savina
- Department of Polyclinic Therapy, Sechenov First Moscow State Medical University, Moscow, Russian Federation
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Sökmen Z, Karaca S. The effect of Self-Regulation Based Cognitive Psychoeducation Program on emotion regulation and self-efficacy in children diagnosed with attention deficit hyperactivity disorder. Arch Psychiatr Nurs 2023; 44:122-128. [PMID: 37197856 DOI: 10.1016/j.apnu.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 02/18/2023] [Accepted: 04/17/2023] [Indexed: 05/19/2023]
Abstract
AIM This study aimed to determine the effect of Self-Regulation Based Cognitive Psychoeducation Program on emotion regulation and self-efficacy in children diagnosed with attention deficit hyperactivity disorder (ADHD) and receiving medication. METHOD The sample of this study with control group and pre-test, post-test and follow-up randomized experimental design consisted of children followed in the child and adolescent mental health outpatient clinic of a state hospital. The data were evaluated by parametric and non-parametric analyses. RESULTS A statistically significant increase was determined in the internal functional emotion regulation mean scores of children, who participated in the Self-Regulation Based Cognitive Psychoeducation Program, measured before, immediately after, and 6 months after the intervention (p < 0.05). A statistically significant increase was also found in their external functional emotion regulation mean scores measured before and 6 months after the intervention (p < 0.05). In addition, a statistically significant difference was found between their internal dysfunctional and external dysfunctional emotion regulation mean scores measured before and 6 months after the intervention; however the mean scores of those in the control group 6 months after the intervention were higher than those in the intervention group (p < 0.05). Furthermore, there was a statistically significant increase in their self-efficacy mean scores measured before and 6 months after the intervention (p < 0.05). CONCLUSION The Self-Regulation Based Cognitive Psychoeducation Program was found be effective in increasing the levels of emotion regulation and self-efficacy in children with ADHD.
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Affiliation(s)
- Zeynep Sökmen
- Marmara University, Institute of Health Science, Department of Psychiatric Nursing, Istanbul, Turkey.
| | - Semra Karaca
- Marmara University, Institute of Health Science, Department of Psychiatric Nursing, Istanbul, Turkey
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5
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Rabinowitz JA, Reboussin BA, Thrul J, Drabick DAG, Kahn G, Green KM, Ialongo NS, Huhn AS, Maher BS. Early Childhood Behavioral and Academic Antecedents of Lifetime Opioid Misuse among Urban Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:864-876. [PMID: 33688771 PMCID: PMC8977050 DOI: 10.1080/15374416.2021.1875324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Opioid misuse has become an epidemic in the United States. In the present study, we examine potential malleable early childhood predictors of opioid misuse including whether childhood achievement, aggressive behavior, attention problems, and peer social preference/likability in first grade predicted opioid misuse and whether these relationships differed depending on participant sex. METHOD Data are drawn from three cohorts of participants (N = 1,585; 46.7% male) recruited in first grade as part of a series of elementary school-based, universal preventive interventions conducted in a Mid-Atlantic region of the US. In first grade, participants completed standardized achievement tests, teachers reported on attention problems, and peers nominated their classmates with respect to their aggressive behavior and social preference/likability. At approximately age 20, participants reported on their misuse of opioids defined as lifetime use of heroin or misuse of prescription opioids. RESULTS Higher levels of peer nominations for aggressive behavior in first grade predicted a greater likelihood of opioid misuse. An interaction between participant sex and attention problems was observed such that females higher in attention problems were more likely to misuse opioids, particularly prescription opioids, than females lower in attention problems. An interaction was also found between participant sex and peer likability such that males lower in peer-nominated likability were more likely to misuse opioids relative to males higher in likability. CONCLUSION Given the malleable nature of attention problems, aggression, and social skills in early childhood, prevention programs that target these behaviors during this developmental period may attenuate risk for opioid misuse.
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Affiliation(s)
- Jill A Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine
| | - Johannes Thrul
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | | | - Geoffrey Kahn
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | | | - Nicholas S Ialongo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Andrew S Huhn
- Department of Psychiatry and Behavioral Services, Johns Hopkins Bloomberg School of Public Health
| | - Brion S Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
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6
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Gu Y, Zhu Y, Brown KW. Mindfulness and Attention Deficit Hyperactivity Disorder: A Neuropsychological Perspective. J Nerv Ment Dis 2021; 209:796-801. [PMID: 34292276 DOI: 10.1097/nmd.0000000000001388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
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.
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Affiliation(s)
- Yingqi Gu
- Department of Psychology, Zhejiang Sci-Tech University, Hangzhou
| | | | - Kirk Warren Brown
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
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7
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Mah JWT, Murray C, Locke J, Carbert N. Mindfulness-Enhanced Behavioral Parent Training for Clinic-Referred Families of Children With ADHD: A Randomized Controlled Trial. J Atten Disord 2021; 25:1765-1777. [PMID: 32532175 DOI: 10.1177/1087054720925882] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective: This study evaluated the efficacy of a mindfulness-enhanced behavioral parent training (BPT) group program compared to standard BPT in families of children with ADHD. Method: Parents (N = 63) of children (aged 6-11) diagnosed with ADHD were randomly assigned to either mindful or standard BPT, and participated in 12 weekly 2-hr group sessions. Parents completed a series of questionnaires assessing mindful parenting, parenting stress, harsh discipline practices, behavioral dysregulation, and child ADHD symptoms, before and after completing the group intervention. Results: Parents in the mindful group had decreased harsh discipline practices and improved self-regulation compared to parents in the standard group. Both groups improved in parenting sense of competence and child ADHD symptoms. No significant group differences were found in mindful parenting or parenting stress. Conclusion: There are some important parental benefits to enhancing BPT with mindfulness.
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Affiliation(s)
- Janet W T Mah
- BC Children's Hospital, Vancouver, Canada.,The University of British Columbia, Vancouver, Canada
| | - Candice Murray
- BC Children's Hospital, Vancouver, Canada.,The University of British Columbia, Vancouver, Canada
| | - Jake Locke
- BC Children's Hospital, Vancouver, Canada.,The University of British Columbia, Vancouver, Canada
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8
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Lo HHM, Wong SWL, Wong JYH, Yeung JWK, Snel E, Wong SYS. The Effects of Family-Based Mindfulness Intervention on ADHD Symptomology in Young Children and Their Parents: A Randomized Control Trial. J Atten Disord 2020; 24:667-680. [PMID: 29185375 DOI: 10.1177/1087054717743330] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: The aim of the study is to investigate the feasibility of a family-based mindfulness intervention in improving children with inattention and hyperactivity symptoms. Method: A total of 100 children aged 5 to 7 years with ADHD symptoms and their parents were randomly assigned to a family-based mindfulness intervention (n = 50) or a wait-list control group (n = 50). Results: Families from intervention group had greater improvements in children's ADHD symptoms, with medium effect sizes of -0.60 for inattention and -0.59 for hyperactivity; overall behaviors; and parenting stress and well-being than those in wait-list control group. Conclusion: The positive results on the child primary outcome measures have provided initial evidence of the family-based mindfulness intervention as a treatment option to ADHD. The reduction of parental stress and increase in psychological well-being has demonstrated the value of mindfulness in enhancing parent's self-management.
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Affiliation(s)
| | | | | | | | - Eline Snel
- The Academy of Mindful Teaching, Leusden, The Netherlands
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9
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Dosman CF, Andrews D, Gallagher S, Goulden KJ. Anticipatory guidance for behaviour concerns: School age children. Paediatr Child Health 2019; 24:e78-e87. [PMID: 30996611 DOI: 10.1093/pch/pxy080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Parenting powerfully influences children's cognitive and social-emotional development. Parents often have behaviour concerns and seek advice from their clinician. This paper is an evidence-based clinic tool to empower clinicians to promote pro-social behaviour through developmentally-targeted strategies that parents can use to decrease problem behaviour. Typical scenarios are provided for noncompliance, aggression, attention, and bedtime worries. Parenting principles Authoritative parenting is essential for healthy outcomes. It combines warmth and structure to foster emotional regulation, attachment, and perspective-taking and problem-solving skills. A framework for developmentally-targeted parenting strategies We present a framework for parenting strategies which integrates The Incredible Years Parenting Pyramid® and Antecedent-Behaviour-Consequence model, to guide parents on prevention of problem behaviour. The framework emphasizes daily relationship time and using empathy to the child to help him/her calm, become aware of his/her own emotions, and be receptive to the parent's instructions. It also teaches skills to replace the behaviour, providing physical needs, and explaining reasons for rules. When parents focus most of their time on the foundational skills of the pyramid, problem behaviour decreases, and consequences are rarely needed. Managing behaviour concerns Managing behaviour concerns also requires screening for developmental and behavioural disorders, and following up to determine whether referrals are needed. Conclusion Anticipatory guidance for behaviour concerns prioritizes children's rights to respect and dignity.
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Affiliation(s)
- Cara F Dosman
- Division of Developmental Pediatrics, Department of Pediatrics, University of Alberta, Edmonton, Alberta
| | - Debbi Andrews
- Division of Developmental Pediatrics, Department of Pediatrics, University of Alberta, Edmonton, Alberta
| | - Sheila Gallagher
- Division of Developmental Pediatrics, Department of Pediatrics, University of Alberta, Edmonton, Alberta
| | - Keith J Goulden
- Division of Developmental Pediatrics, Department of Pediatrics, University of Alberta, Edmonton, Alberta
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10
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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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11
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Fortuna LR, Porche MV, Padilla A. A treatment development study of a cognitive and mindfulness-based therapy for adolescents with co-occurring post-traumatic stress and substance use disorder. Psychol Psychother 2018; 91:42-62. [PMID: 28815876 DOI: 10.1111/papt.12143] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 07/13/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Substance use is common among adolescents with post-traumatic stress disorder (PTSD). We aimed to develop and study an integrated treatment for adolescents with co-occurring disorders. DESIGN This is a therapy development and open pilot trial study of a manualized therapy for adolescents with post-traumatic stress, depression, and substance use that uses a combination of cognitive therapy (CT) and mindfulness. METHODS Descriptive statistics and paired sample t-tests were calculated to assess for changes in PTSD symptoms, depression, and substance use frequency from baseline to end of treatment using standardized measures and validated by urine drug screens. We also examined for safety, predictors of clinical outcomes, and treatment retention. RESULTS Thirty-seven adolescents participated in the study; 62% were study completers as defined by retention for at least 6 weeks of treatment. There were significant improvements in PTSD and depression symptoms from baseline to end of treatment, reflecting medium effect sizes, and which was associated with changes in trauma-associated cognitions. There was a reduction in cannabis use, which was the most commonly used substance. CONCLUSIONS Preliminary results suggest feasibility, safety, and potential clinical effectiveness of an integrated therapy for adolescents with PTSD, depression, and substance use. Retention was comparable to other therapy clinical trial studies of adolescents despite the high risk for poor treatment retention and poor clinical outcomes among adolescents with PTSD and co-occurring disorders. We discuss the rationale for continued research of this mindfulness-based CT for adolescents with co-occurring disorders. PRACTITIONER POINTS Adolescents with co-occurring PTSD and substance use achieved meaningful improvement in PTSD and depression symptom severity after receiving a CT and mindfulness dual diagnosis approach. An integrated manualized therapy for dual diagnosis shows promise for reducing cannabis use in adolescents with PTSD. Changes in trauma-related cognitions have the potential to improve PTSD and depression symptoms in adolescents with substance use problems.
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Affiliation(s)
- Lisa R Fortuna
- Boston Medical Center, Boston University School of Medicine, Massachusetts, USA
| | | | - Auralyd Padilla
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
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12
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Gu Y, Xu G, Zhu Y. A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for College Students With ADHD. J Atten Disord 2018; 22:388-399. [PMID: 28038496 DOI: 10.1177/1087054716686183] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Between 2% and 8% of college students meet criteria for ADHD, with increased incidence in recent decades. There are very few clinical trials conducted on the meaningful intervention of ADHD in college. Mindfulness-based cognitive therapy (MBCT) effectively treats college students with ADHD and could be more feasibly applied in college mental health clinics. METHOD Fifty-four undergraduates with ADHD between ages 19 and 24 were randomized to receive either MBCT or wait-list (WL) during a 6-week intervention phase. ADHD symptoms, neuropsychological performance, and related outcomes were assessed at pre-treatment, post-treatment, and 3-month follow-up. RESULTS Participants receiving MBCT group showed greater treatment response rates (57%-71% vs. 23%-31%) and experience less anxiety and depression, and greater levels of mindfulness; MBCT participants show greater improvement on neuropsychological performance. CONCLUSION MBCT may be a useful intervention for college students with ADHD, improving participants' ADHD symptoms, mindfulness, and sustained attention.
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Affiliation(s)
- Yingqi Gu
- 1 East China Normal University, Shanghai, China.,2 Hainan Medical University, Haikou, China
| | | | - Yi Zhu
- 2 Hainan Medical University, Haikou, China
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13
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Miller CJ, Brooker B. Mindfulness programming for parents and teachers of children with ADHD. Complement Ther Clin Pract 2017; 28:108-115. [PMID: 28779917 DOI: 10.1016/j.ctcp.2017.05.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 05/23/2017] [Accepted: 05/25/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Parents and teachers of children with attention-deficit/hyperactivity disorder (ADHD) are at-risk for a range of suboptimal psychosocial outcomes, including mental health difficulties and heightened stress, problems perhaps ameliorated through mindfulness-based programming. OBJECTIVE To show pilot data from an investigation of the outcomes of a purpose-built mindfulness training for parents and teachers of children with ADHD (N = 26). METHODS The program represents a purpose-driven modification of the Mindfulness-Based Stress Reduction (MBSR) curriculum. Namely, we reduced participant time commitment and added psychoeducation about ADHD with brief parent training. The measurement protocol included measures of stress, anxiety, depression, and mindfulness. RESULTS Following the 8-week program, parents and teachers reported reduced perceived stress, reduced self-reported anxiety, and improvements in some facets of mindfulness. CONCLUSION The work highlights the promise of specialized mindfulness-based interventions in promoting positive psychosocial outcomes in specific at-risk groups, such as the carers of children with ADHD.
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14
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Aadil M, Cosme RM, Chernaik J. Mindfulness-Based Cognitive Behavioral Therapy as an Adjunct Treatment of Attention Deficit Hyperactivity Disorder in Young Adults: A Literature Review. Cureus 2017; 9:e1269. [PMID: 28775916 PMCID: PMC5526699 DOI: 10.7759/cureus.1269] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 05/23/2017] [Indexed: 11/18/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurological disorder that often continues into adult age. Stimulants medication are the mainstay of treatment, however, in the recent years, there has been a lot of studies conducted to understand the effectiveness and feasibility of mindfulness-based cognitive behavioral therapy for treatment of attention deficit hyperactivity disorder in children and adults. In this article, we have reviewed 17 articles to look for the beneficial effects of such therapy in adults. Overall, we found that there is a clear beneficial effect of such therapies, especially when used in adjunct with stimulant medication and may increase overall compliance. For better understanding, we suggest that large, well-designed studies should be conducted with robust strategies, allowing more comparison studies with the better analytical outcome.
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Affiliation(s)
- Muhammad Aadil
- Department of Psychiatry and Mental Health, Rush University Medical Center
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Petcharat M, Liehr P. Mindfulness training for parents of children with special needs: Guidance for nurses in mental health practice. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2017; 30:35-46. [PMID: 28449389 DOI: 10.1111/jcap.12169] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 04/01/2017] [Accepted: 04/04/2017] [Indexed: 11/27/2022]
Abstract
PROBLEM Parents of children with special needs encounter specific challenges in carrying out their caregiving roles. They experience difficulty accepting their children due to unrealistically high expectations. Mindfulness training (MT) may increase parental psychological well-being and acceptance. OBJECTIVE The purpose of this article is to examine the evidence-base for the effectiveness of MT in enhancing psychological well-being for parents of children with special needs as a foundation for guidance for nurses in mental health practice. METHODS A literature review of relevant research studies was undertaken using specific inclusion criteria. The literature was derived from three databases that identified 56 articles narrowed to 5, which met inclusion criteria. FINDINGS The studies indicated that cultivating a more mindful way of parenting is associated with reduced stress, anxiety, and depression. Parents experienced increased mindful awareness and improved psychological well-being, and they were more accepting of their children. Their children also had fewer behavior problems and enhanced positive interaction with their parents. Because mindfulness interventions fall within the scope of independent nursing practice, nurses can play a significant role in applying mindfulness to promote psychological well-being in parents who have children with special needs.
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Affiliation(s)
- Manika Petcharat
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Patricia Liehr
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
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Abstract
Individuals with attention-deficit/hyperactivity disorder (ADHD) experience impairments in a number of functional domains. Although current evidence-based treatments for ADHD reduce symptoms and improve academic and behavioral functioning, they have minimal impact on social functioning or on risky behaviors (see Evans et al. in J Clin Child Adolesc Psychol, 43:527-551, 2014 for review). Preliminary evidence indicates that emotion dysregulation (ED) is associated with impairments across the developmental spectrum, such as social impairment and risky behaviors, and that its relative absence/presence is differentially associated with treatment response. It thus stands to reason that by incorporating a focus on ED in interventions targeting social impairment and risky behaviors, we may be able to increase the number of youth who respond to such interventions and decrease the prevalence or degree of these impairments and behaviors among youth and adults with ADHD. However, a number of questions remain unaddressed about the association between ADHD and ED, such as the portion of individuals with ADHD who experience ED, the extent to which ED is associated with the above impairments and behaviors, and whether or not ED is malleable. To begin addressing these questions, we summarize and critically evaluate the literature on the association between ADHD and ED and make recommendations for future basic, translational, and treatment outcome research.
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Keith JR, Blackwood ME, Mathew RT, Lecci LB. Self-Reported Mindful Attention and Awareness, Go/No-Go Response-Time Variability, and Attention-Deficit Hyperactivity Disorder. Mindfulness (N Y) 2016; 8:765-774. [PMID: 28458727 DOI: 10.1007/s12671-016-0655-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The abilities to stabilize the focus of attention, notice attention lapses, and return attention to an intended object following lapses are precursors for mindfulness. Individuals diagnosed with attention-deficit hyperactivity disorder (ADHD) are deficient in the attentional and self-control skills that characterize mindfulness. The present study assessed the relationship between mindfulness and ADHD in young adults using the Mindful Attention and Awareness Scale (MAAS), a computerized Go/No-Go task (the Test of Variables of Attention (TOVA)), the World Health Organization Adult Self-Report Scale (ASRS), a tool used as an adult ADHD screen, the Beck Anxiety Inventory (BAI), and the Beck Depression Inventory-II (BDI-II). We recruited 151 adult volunteers (ages 18 to 40); 100 with confirmed ADHD diagnoses and 51 control participants. Overall, participants with prior diagnoses of ADHD scored lower on the MAAS than controls and ASRS scores were strongly negatively correlated MAAS scores. Attention performance index, response time, and response-time variability subscales of the TOVA were positively correlated with MAAS scores and negatively correlated with ASRS scores. Intrasubject response-time variability on the TOVA, a parameter associated with attention lapses, was also strongly negatively correlated with MAAS scores. Overall, participants' self-reported mindfulness, as measured by the MAAS, was strongly related to self-reports on a clinical measure of attention disorders, anxiety, depression, and multiple indices of concentration and mind wandering on a standardized Go/No-Go task, the TOVA.
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Affiliation(s)
- Julian R Keith
- Department of Psychology, University of North Carolina, Wilmington, 601 South College Road, Wilmington, NC 28403-5612, USA
| | - Mallory E Blackwood
- Department of Psychology, University of North Carolina, Wilmington, 601 South College Road, Wilmington, NC 28403-5612, USA
| | - Rano T Mathew
- Department of Psychology, University of North Carolina, Wilmington, 601 South College Road, Wilmington, NC 28403-5612, USA
| | - Len B Lecci
- Department of Psychology, University of North Carolina, Wilmington, 601 South College Road, Wilmington, NC 28403-5612, USA
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The Self-Enhancement Bias in Attention Deficit/Hyperactivity Disorder: Origin, Nature, and Consequences. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2016. [DOI: 10.1007/s40474-016-0073-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Colzato LS, van der Wel P, Sellaro R, Hommel B. A single bout of meditation biases cognitive control but not attentional focusing: Evidence from the global–local task. Conscious Cogn 2016; 39:1-7. [DOI: 10.1016/j.concog.2015.11.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 11/05/2015] [Accepted: 11/08/2015] [Indexed: 11/26/2022]
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Modesto-Lowe V, Farahmand P, Chaplin M, Sarro L. Does mindfulness meditation improve attention in attention deficit hyperactivity disorder? World J Psychiatry 2015; 5:397-403. [PMID: 26740931 PMCID: PMC4694553 DOI: 10.5498/wjp.v5.i4.397] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/08/2015] [Accepted: 10/19/2015] [Indexed: 02/05/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) manifests by high levels of inattention, impulsiveness and hyperactivity. ADHD starts in childhood and results in impairments that continue into adulthood. While hyperactivity declines over time, inattention and executive function difficulties persist, leading to functional deficits. Adolescents and adults with ADHD have pervasive impairment in interpersonal and family relationships. They may develop addiction, delinquent behavior and comorbid psychiatric disorders. Despite advances in diagnosis and treatment, persistent residual symptoms are common, highlighting the need for novel treatment strategies. Mindfulness training, derived from Eastern meditation practices, may improve self-regulation of attention. It may also be a useful strategy to augment standard ADHD treatments and may be used as a potential tool to reduce impairments in patients with residual symptoms of ADHD. Clinically, this would manifest by an increased ability to suppress task-unrelated thoughts and distractions resulting in improved attention, completion of tasks and potential improvement in occupational and social function.
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Cardoso-Moreno MJ, Tomás-Aragonés L, Rodríguez-Ledo C. Socio-emotional intervention in attention deficit hyperactive disorder. EUROPEAN JOURNAL OF EDUCATION AND PSYCHOLOGY 2015. [DOI: 10.1016/j.ejeps.2015.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Mindfulness Meditation Improves Mood, Quality of Life, and Attention in Adults with Attention Deficit Hyperactivity Disorder. BIOMED RESEARCH INTERNATIONAL 2015; 2015:962857. [PMID: 26137496 PMCID: PMC4475526 DOI: 10.1155/2015/962857] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 11/17/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Adults with attention deficit hyperactivity disorder (ADHD) display affective problems and impaired attention. Mood in ADHD can be improved by mindful awareness practices (MAP), but results are mixed regarding the enhancement of attentional performance. Here we evaluated MAP-induced changes in quality of life (QoL), mood, and attention in adult ADHD patients and controls using more measures of attention than prior studies. METHODS Twenty-one ADHD patients and 8 healthy controls underwent 8 weekly MAP sessions; 22 similar patients and 9 controls did not undergo the intervention. Mood and QoL were assessed using validated questionnaires, and attention was evaluated using the Attentional Network Test (ANT) and the Conners Continuous Performance Test (CPT II), before and after intervention. RESULTS MAP enhanced sustained attention (ANT) and detectability (CPT II) and improved mood and QoL of patients and controls. CONCLUSION MAP is a complementary intervention that improves affect and attention of adults with ADHD and controls.
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