Mindfulness-Based Interventions May Be Comparable to Cognitive Behavioural Therapy At Improving ADHD-related Symptoms

1. MYmind (a mindfulness-based therapy program) is comparable to cognitive behavioural therapy in improving attention scores in youths.

2. There were small to moderate improvements in behaviour, executive function, and overall well-being within treatment groups.

Evidence Rating Level: 1 (Excellent)

Attention deficit hyperactivity disorder (ADHD) is one of the most common disorders affecting school-aged children with a prevalence of 9-15%. The mainstay management for ADHD may involve both pharmacotherapy and behavioural therapy. However, mindfulness therapies have not been adequately compared to evidence-based therapies in the management of ADHD. The purpose of this study was to fill in this specific gap.

This randomized control trial (RCT) compared MYmind to cognitive behavioural therapy (CBT) to improve ADHD symptoms in children aged 8-12 in Hong Kong. MYmind is an 8-week mindfulness-based therapy program. In this RCT, 69 youths were randomized to the MYmind group and 69 youths were randomized to the CBT group. Children aged 8-12 with a confirmed diagnosis of ADHD based on DSM-5 criteria, who had a normal cognitive function, and who were either on no pharmacotherapy or on the same medication for 3 months were included. Children who could not speak Cantonese, who had previously participated in a mindfulness-based therapy, or who had a severe conduct disorder, other behavioural disorders, or another psychiatric or medical illness that prevented them from participating in the study were excluded. Participants were assessed before treatment, immediately after treatment, 3 months post-treatment, and finally 6 months post-treatment. Attention was assessed using the Sky Search subtest of the Test of Everyday Attention for Children (TEA-Ch). Behaviour, executive function, mindfulness, and overall well-being were also assessed using various recognized inventories. The primary outcome measured was the attention score based on TEA-ch. The secondary outcomes measured improvement in behaviour, executive function, and overall well-being.

The results found MYmind to be comparable to CBT in improving attention scores in youths with ADHD. Within-group data showed significant improvement in secondary outcomes, however MYmind was not shown to be superior to CBT concerning these outcomes either. A limitation of this study is that the study was carried out during the peak of the COVID-19 lockdowns and social unrest. This affected thorough follow-up and required the researchers to carry out some interventions over Zoom. However, this is the largest RCT carried out comparing mindfulness therapy to an evidence-based technique. The future of this research may involve performing a larger non-inferiority study, with longer post-treatment follow-up to assess the stability of outcomes post-intervention. Depending on future findings, mindfulness-based techniques may prove to be an adjunct or alternative therapy in the management of ADHD in youths.

Click here to read this study in Psychotherapy and Psychosomatics.

Image: PD

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