The effectiveness of a single session of mindfulness-based cognitive training on cardiac vagal control and core symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD): a preliminary randomized controlled trial

Abstract

This study examined the effectiveness of a mindfulness-based intervention (MBI) on Conners’ continuous performance test scores (CPTs), cardiac vagal control (CVC) assessed by vagally mediated heart rate variability (HRV), and mood in children and adolescents with ADHD. We conducted a randomized controlled trial (RCT) recruiting 70 children and adolescents (M age 11.03, SD 2.78) with a clinical diagnosis of ADHD, which were allocated to either 1 session of mindfulness cognitive training, or an active control condition and were examined at baseline, post-treatment and 4-week follow-up. See clinicaltrials.gov: NCT04316832. There was a significant main effect of time on the primary outcomes measured by CPT scores of attention-related problems (omission errors, reaction time) and hyperactivity–impulsivity (commission errors). However, time-by-group interaction did not achieve statistical significance for commission errors and hit RT, indicating that the changes over time in these outcomes were not significantly different between the MBI and Control conditions. In addition, there was a significant time-by-group interaction for omission errors. Relative to control, MBI resulted in a small ( d = 0.011) non-statistically significant reduction in omission errors post-treatment. Furthermore, there were no significant differences in detectability. Secondary outcomes were CVC and mood. A small treatment effect on CVC ( d = 0.37) was observed; there was a slight increase in vagally mediated HRV measure post-treatment. There were no significant differences in mood improvement over time between conditions. One brief session of MBI effectively enhances CVC but does not significantly improve CPT scores of attention-related problems and hyperactivity–impulsivity or mood in children with ADHD. Clinicaltrials.gov: NCT04316832.

Effects of Mindfulness-Based Interventions in Children and Adolescents with ADHD: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Study authors spanned a number of countries or regions, including Iran [ 28 , 29 ], Spain [ 30 , 31 ], Italy [ 32 , 33 , 34 ], the United States [ 27 , 35 ], Australia [ 36 ], Romania [ 37 ], and Hong Kong [ 38 ]. All studies except one [ 36 ] were published in or after 2017.…”

“…As detailed in Table 1 , the age varied across the studies. Two studies recruited adolescents [ 28 , 29 ], whereas the others recruited children aged between 5 and 12 years [ 27 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. Most studies recruited significantly higher percentages of boys with ADHD than girls [ 27 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ], whereas two studies recruited all female adolescents with ADHD as participants [ 28 , 29 ].…”

“…Three types of mindfulness-based intervention were identified: yoga intervention [ 27 , 36 ], mindfulness-based psychological intervention [ 28 , 29 , 30 , 31 , 32 , 35 , 36 , 37 , 38 , 39 ], and meditation training [ 33 , 34 ]. Five studies provided mindfulness-based training to both children or adolescents with ADHD and to their parents [ 30 , 31 , 32 , 38 , 39 ].…”

“…Two studies used treatment as usual [ 39 ] or standard care [ 30 ] as control groups. Four studies used an active control group, such as a listening task [ 37 ], behavioral therapy [ 35 ], cooperative activities [ 36 ], or an emotional education program [ 33 , 34 ].…”

“…Children’s internalizing problems and externalizing problems were measured in nine studies with the Child Behavior Checklist [ 30 , 38 ], the Conners’ Parent Rating Scale-Revised [ 33 , 36 ], the Conners’ Teacher Rating Scale-Revised [ 36 ], the Difficulties in Emotion Regulation Scale [ 29 ], the Present Functioning Visual Analogue Scale [ 37 ], the Modified Overt Aggression Scale [ 32 ], the Strengths and Difficulties Questionnaire [ 32 ], and Conners-3rd Edition [ 31 ].…”