Behavioral and Cognitive Impacts of Mindfulness-Based Interventions on Adults with Attention-Deficit Hyperactivity Disorder: A Systematic Review

Abstract

Mindfulness-based interventions (MBIs) are becoming increasingly popular as treatments for physical and psychological problems. Recently, several studies have suggested that MBIs may also be effective in reducing symptoms of attention-deficit hyperactivity disorder (ADHD). Most studies have examined the effectiveness in children, but there are now a sufficient number of individual treatment trials to consider a systematic review in adults. Majority of existing systematic reviews and meta-analyses only consider ADHD symptoms as an outcome, and most of them do not fully report potential biases of included studies, thus limiting considerably their conclusions. This is an important facet because some studies could be found ineligible to be included in future analysis due to their low quality. In this systematic review, we followed the PRISMA/PICO criteria and we thoroughly assessed the risks of bias for each of the selected studies according to Cochrane guidelines. We searched the available literature concerning MBIs in adult participants with ADHD using PsycINFO, PubMed, Scopus, and ERIC databases. In total, 13 studies conducted with 753 adults (mean age of 35.1 years) were identified as eligible. Potential moderators such as participants’ age, ADHD subtypes, medication status, comorbidity, intervention length, mindfulness techniques, homework amount, and training of therapists were carefully described. Aside from measuring the symptoms of ADHD, outcome measures were categorized into executive/cognitive functioning, emotional disturbances, quality of life, mindfulness, and grade point average at school. According to presented descriptive results, all the studies (100%) showed improvement of ADHD symptoms. In addition, mindfulness meditation training improves some aspects of executive function and emotion dysregulation. Although these are promising findings to support treatment efficacy of MBIs for ADHD, various biases such as absence of randomization and lack of a control group may affect the actual clinical value and implications of the studies. Moreover, the relatively low quality of selection and performance criteria in several studies, as well as relatively high attrition bias across studies, call for caution before considering conducting further analysis.

Effects of short‐term mindfulness‐based training on executive function: Divergent but promising

“…For example, one prospective cohort study found that chronically ill older adults with high EFs had lower mortality rates at their 10‐year follow‐ups (Hall, Crossley, & D'Arcy, 2010). Nonetheless, many clinical studies have resulted in promising findings: The resting‐state functional connectivity among brain regions associated with EF was increased by a mindfulness intervention in individuals with high levels of psychological distress (Taren et al, 2017); for adults with ADHD, some aspects of EF were improved after mindfulness meditation training (Poissant, Mendrek, Talbot, Khoury, & Nolan, 2019).…”

Test–Retest Reliability and Reliable Change Estimates for Four Mobile Cognitive Tests Administered Virtually in Community-Dwelling Adults

“…Research opportunities incorporating MCTs include delivering compensatory cognitive training in a telehealth format (e.g., Lawson et al, 2020 ), assessing the cognitive impact of pharmacotherapy for epilepsy (e.g., Eddy et al, 2011 ; Adams et al, 2017 ), measuring cognitive improvement following mindfulness-based treatment for ADHD ( Poissant et al, 2019 ), and measuring long-term cognitive trajectories after mild traumatic brain injury and concussion ( McAllister and McCrea, 2017 ), among others. In each of these cases, replacing traditional paper–pencil neuropsychological tests with remotely delivered MCTs would greatly reduce the time burden and overall cost associated with running the study.…”

Biological mechanism study of meditation and its application in mental disorders

“…Up to now, the efficacy of meditation intervention in adult patients diagnosed with ADHD is relatively manifest, prevailingly using MBIs. 59 Mindfulness intervention can considerably improve attention in adults with ADHD, 60–63 with additional improvements in executive functioning, 63 working memory 60 and anxiety and depressive emotions. 61 Improved attention may be associated with increased activation of the left putamen, globus pallidus and thalamus.…”