Mentalization-based treatment for adults with attention-deficit/hyperactivity disorder: a pilot study

Abstract

Recent literature suggests that, in addition to its core cognitive and behavioural symptoms, socioemotional difficulties represent key characteristics of adult attention-deficit/hyperactivity disorder (ADHD). Importantly, these deficits not only contribute negatively to the low social functioning and poorer professional achievements of ADHD patients relative to healthy individuals, they also respond poorly to medication and are not specifically addressed by current evidence-based psychological treatments. Mentalization-based treatment (MBT) is a psychological intervention focused on promoting the imaginative capacity to understand human behaviour as being driven by mental states. MBT has been shown to be effective in patients with chronic emotional dysregulation; it may therefore represent a valuable approach to address sociocognitive deficits and shape adaptive functioning in ADHD. In this study, we tailored the timelimited MBT program developed for borderline personality disorder to the specific clinical needs of individuals with ADHD. We report on the first eight patients with ADHD included in our programme at the Geneva University Hospitals. Preliminary results support the feasibility and relevance of the MBT model for ADHD. We discuss conceptual and clinical implications of the current data.

Evidence of emotion dysregulation as a core symptom of adult ADHD: A systematic review

“…Concerning intervention programs to improve ED in people with ADHD, preliminary data points to the effectiveness of Mindfulness training as an effective intervention for this purpose [71]. However, the results of the mentalization-based intervention are not significant, despite appreciating a trend towards improvement in symptoms [72]. More studies of treatments that consider emotional variables are needed.…”

“…When the criteria were not clear, the inclusion or exclusion of the article was decided among all three authors. S1 Table shows the bibliometric properties of the included articles [13,[51][52][53][54][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74], which are marked with � in the references section.…”

“…Significant differences before-after treatment compared to the control group were found on the DERS Impulse Control Difficulties and Limited Access to Emotion Regulation Strategies subscales, both experiencing a significant reduction [p = 0.002, d = 1.60, and p = 0.007, d = 1.38, respectively]. However, Badoud et al [72] did not obtain significant changes in any measure after a mentalization-based intervention without a control group, observing lower scores on the ASRSv1.1 and Emotion Reactivity Scale (ERS) subscales, which would indicate a reduction in symptoms, with small effect sizes.…”

Emotion dysregulation in adults suffering from attention deficit hyperactivity disorder (ADHD), a comparison with borderline personality disorder (BPD)

“…These poorer capacities are related to difficulties in perceiving contextual information possibly linked to deficits in directing attention on emotional signals, to deficits in reflexive functioning, and to deficits in emotional face recognition [9,14,23]. Thus targeting empathy, either directly or indirectly, in ADHD during treatment might help decrease ED and subsequently the severity of the disorder [56,57]. Indeed, improving mentalizing capacities -defined as linking one's own and other people's actions to mental states which are thus closely related to empathyis promising for improving emotion regulation in adults suffering from ADHD [57].…”

“…Thus targeting empathy, either directly or indirectly, in ADHD during treatment might help decrease ED and subsequently the severity of the disorder [56,57]. Indeed, improving mentalizing capacities -defined as linking one's own and other people's actions to mental states which are thus closely related to empathyis promising for improving emotion regulation in adults suffering from ADHD [57].…”