Mindfulnessis the practice of purposefully paying attention to the present moment without judgment. It involves meditation techniques that train awareness and attention.
Research shows mindfulness can help people better regulate behavior, emotions, and thought patterns.
By focusing the mind, it allows individuals to consciously respond to maladaptive impulses contributing to conditions like depression, anxiety, chronic pain, and ADHD. Practiced regularly, mindfulness skills enable people to calmly face daily stresses.
Mindfulness can help people with ADHD improve their ability to focus, regulate their emotions and behaviors, and manage the symptoms that are often detrimental in work, school, and relationships.
Key Points
Rationale
It impacts children and adults and is associated with difficult relationships, poor school performance, increased injuries, illegal drug use, risky sexual behaviors, and unemployment.
Treatmentshave limitations – medications have considerable side effects, and psychosocial interventions require extensive trained staff. Alternative approaches, like mindfulness, are of interest as they are less staff-dependent and easier to integrate into daily life (Roberts & Neece, 2015).
Mindfulness has been proposed to target deficits seen in ADHD. Whilst reviews have examined mindfulness in ADHD, most focus on core symptoms or single ages (Barranco-Ruizet al.,2019; Poissantet al.,2019).
This review aimed to provide a comprehensive analysis of mindfulness interventions for ADHD, considering a broad range of outcomes across children and adults.
Method
The authorssystematically searched5 databases using PRISMA guidelines. They includedrandomized controlled trials (RCTs), non-randomized controlled trials, and pre-post studies with participants who had an ADHD diagnosis or elevated symptoms.
Outcomes had to include scale or cognitive/behavioral measures of core symptoms, global/social functioning, or quality of life.
Study quality was assessed using NIH tools. Effect sizes (Hedge’s g) were calculated, andmeta-analyseswere conducted.
In total 22 studies were included containing data from 1237 individuals with ADHD (age range 7-65 years) and 525 parents. Diagnoses were made using DSM or ICD criteria, besides 2 studies.
Common comorbidities were permitted, but psychosis, bipolar disorder, and substance dependence were typically exclusion criteria. Most allowed stable medication use alongside mindfulness interventions.
Results
Evidence suggests mindfulness interventions may provide benefits across outcomes.
Considering core symptoms, scale measures indicated reduced inattentive symptoms in adults and children, with larger effects when parents provided ratings of children.
Some objective tests, like the continuous performance test, revealed decreased commission errors, indicating reduced impulsivity.
For other tasks, results varied. Executive function scales showed improvements in adults, but findings were inconsistent in children. Emotional regulation also seemed to benefit based on scale measures.
Wider health impacts were also indicated with improved quality of life and self-compassion in adults with ADHD, reduced anxiety and depressive symptoms in adults, and increased well-being in children and parents after mindfulness interventions. However, many studies also saw effects in control groups.
Insight
This comprehensive systematic review provides extensive insight into the effects of mindfulness interventions for ADHD across cognitive and health-related outcomes.
The review emphasizes that whilst popular, mindfulness interventions do not yet have an extensive evidence base and lack high-quality trials.
The authors identified issues around small samples, failure to consider comorbidities and use of control groups that make it difficult to attribute effects specifically to mindfulness.
They provide guidance for improving research quality through appropriate controlled trials and stress the need for further work, especially around long-term impacts. This will inform whether mindfulness should be more routinely recommended alongside standard ADHD care.
Strengths
This review had several key methodological strengths:
Limitations
However, there were also several limitations that restrict the implications of this review:
Implications
These results indicate mindfulness could provide a range of benefits for those with ADHD across cognitive, emotional, and behavioral domains. This is encouraging, given limitations around side effects and the availability of standardADHD treatments.
However, better trials are imperative before clinical recommendations can be made, especially for child populations where less evidence currently exists.
Researchers should build on these findings using methodologically rigorous designs – randomized, double-blind controlled trials with active and non-active controls, concealed allocation, blind outcome assessment, and appropriate follow-ups spanning at least 6 months.
Comparing mindfulness to gold-standard treatments would also inform whether it should be an adjunct or alternative option. Replication with larger, more diverse samples is needed, along with better characterization of medication status and comorbidities.
References
Primary reference
Kretschmer, C.R., Göz Tebrizcik, B., & Dommett, E.J. (2022). Mindfulness interventions for attention deficit hyperactivity disorder: A systematic review and meta-analysis.Psychiatry International, 3(4), 363-399.https://doi.org/10.3390/psychiatryint3040031
Other references
Barranco-Ruiz, Y., Esturo Etxabe, B., Ramírez-Vélez, R., & Villa-González, E. (2019). Interventions based on Mind–Body therapies for the improvement of Attention-Deficit/Hyperactivity Disorder symptoms in youth: A systematic review.Medicina,55(7), 325.https://doi.org/10.3390/medicina55070325
Poissant, H., Mendrek, A., Talbot, N., Khoury, B., & Nolan, J. (2019). Behavioral and cognitive impacts of mindfulness-based interventions on adults with attention-deficit hyperactivity disorder: A systematic review.Behavioural neurology,2019.https://doi.org/10.1155/2019/5682050
Roberts, L. R., & Neece, C. L. (2015). Feasibility of mindfulness-based stress reduction intervention for parents of children with developmental delays.Issues in mental health nursing,36(8), 592-602.
Keep Learning
Here are some suggested Socratic questions for students to critically analyze and discuss this research paper further:
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
