Mindfulness Meditation Help Adults & Teens with ADHD

In recent years, mindfulness meditation has a new approach for stress reduction and has been incorporated into the treatment for a variety of psychiatric disorders, including depression, anxiety, and substance abuse. Of special relevance to the treatment of ADHD are findings that meditation has the potential to regulate brain functioning and attention. For example, research has demonstrated that mindfulness meditation can modify attentional networks, modulate EEG patterns, alter dopamine levels, and change neural activity.

Mindfulness Training -

Mindfulness meditation is described as involving 3 basic steps:

  1. bringing attention to an "attentional anchor" such as breathing
  2. noting that distraction occurs and letting go of the distraction
  3. refocusing back to the "attentional anchor"

Measures -

Pre- and posttest assessments included individual self-report scales of ADHD, depression, and anxiety as well as several cognitive tests that were administered when participants were off medication. Attention was assessed using a computerized assessment called the Attention Network Test that measures 3 aspects of attention: alerting (maintaining a vigilant state of preparedness), orienting (selecting a stimulus among multiple inputs), and conflict (prioritizing among competing tasks). Neuropsychological tests that assessed working memory and the ability to shift attention sets (Trails A and B) were also included. At the end of the training, participants were also asked to rate their overall satisfaction with the training.

Results -

Seventy-eight percent of participants (25 of 33) completed the study. On average, participants attended 7 of the 8 weekly training sessions. Adults reported an average of 90 minutes and 4.6 sessions per week of at-home meditation practice; adolescents averaged 43 minutes and 4 sessions of weekly at-home practice. Both adolescents and adults who completed the program reported high levels of satisfaction with it - average scores above 9 on a 1 to 10 satisfaction scale.

Seventy-eight percent of participants reported a reduction in total ADHD symptoms, with 30% reporting at least a 30% symptom reduction (a 30% reduction in symptoms is often used to identify clinically significant improvement in ADHD medication trials). Because the majority of participants were receiving medication treatment, for many these declines represent improvement above and beyond what benefits were already being provided by medication.

On neurocognitive test performance, significant improvements were found on the measure of attentional conflict and on several other neuropsychological tests (i.e., Stroop color-word test and Trails A and B) but not for measures of working memory.

For adults, significant reductions in depressive and anxiety symptoms were reported. Comparable reductions in these symptoms were not evident in adolescents.

Summary and Implications -

Results from this study indicate that mindfulness meditation training may be a beneficial complementary treatment approach for adolescents and adults with ADHD. Positive findings include:

  1. the absence of any reported adverse events;
  2. highly favorable ratings of the treatment by participants;
  3. reductions in self-reported ADHD symptoms reported by over three quarters of participants, even though the majority were already being treated with medication;
  4. significant improvement on several of the neuropsychological measures;
  5. reductions in depressive and anxiety symptoms for the adults.

The authors are appropriately cautious in discussing their findings and suggest that the study supports the "...feasibility and potential utility of mindfulness meditation in at least a subset of adults and adolescents with ADHD." They are careful to note, however, that this was a pilot study with a small sample, and that the reported pre-post changes in behavioral and neurocognitive measures should be "...considered exploratory given the absence of a control group and reliance on self-report measures of psychiatric symptoms."

Given the promising results obtained in this pilot study, there is a clear need for a more extensive research on mindfulness meditation training as an intervention for ADHD. In the meantime, although mindfulness meditation could not be considered a scientifically supported treatment for ADHD, it may have benefits as a complementary treatment and is highly unlikely to have any adverse effects.

I find it both encouraging and exciting that there seems to be growing interest among ADHD researchers to explore the scientific support for complementary approaches such as mindfulness meditation training and to subject a wider range of treatments subjected to rigorous scientific research. This has not always been the case and it would be wonderful if this trend were to continue. I hope that the authors of this study are already in the midst of the controlled trial that they call for and will certainly continue to cover these kinds of interesting investigations in Attention Research Update as they appear in the literature.

Dr. David Rabiner is a child clinical psychologist and Director of Undergraduate Studies in the Department of Psychology and Neuroscience at Duke University. His research focuses on various issues related to ADHD, the impact of attention problems on academic achievement, and attention training. He also publishes Attention Research Update, a complimentary online newsletter that helps parents, professionals, and educators keep up with the latest research on ADHD.

Mindfulness Meditation Training in Adults and Adolescents With ADHD -- A Feasibility Study

Lidia Zylowska
University of California-Los Angeles
Deborah L. Ackerman
University of California-Los Angeles
May H. Yang
University of California-Los Angeles
Julie L. Futrell
University of California-Los Angeles
Nancy L. Horton
University of California-Los Angeles
T. Sigi Hale
University of California-Los Angeles
Caroly Pataki
University of Southern California
Susan L. Smalley
University of California-Los Angeles

Objective: ADHD is a childhood-onset psychiatric condition that often continues into adulthood. Stimulant medications are the mainstay of treatment; however, additional approaches are frequently desired. In recent years, mindfulness meditation has been proposed to improve attention, reduce stress, and improve mood. This study tests the feasibility of an 8-week mindfulness training program for adults and adolescents with ADHD.

Method: Twenty-four adults and eight adolescents with ADHD enrolled in a feasibility study of an 8-week mindfulness training program.

Results: The majority of participants completed the training and reported high satisfaction with the training. Pre—post improvements in self-reported ADHD symptoms and test performance on tasks measuring attention and cognitive inhibition were noted. Improvements in anxiety and depressive symptoms were also observed.

Conclusion: Mindfulness training is a feasible intervention in a subset of ADHD adults and adolescents and may improve behavioral and neurocognitive impairments. A controlled clinical study is warranted. (J. of Att. Dis. 2008; 11(6) 737-746)

How can mindfulness help people with AD/HD?

It improves your ability to control your attention. In other words, it teaches you to pay attention to paying attention. Mindful awareness can also make people more aware of their emotional state, so they won't react impulsively. That's often a real problem for people with AD/HD.

Researchers have talked about using mindfulness for AD/HD for some time, but the question was always whether people with AD/HD could really do it, especially if they're hyperactive.
-- UCLA Mindful Awareness Research Center (MARC)

"Mindfulness" Can Help Calm Stress

Today's pressure-cooker society takes a toll on everyone, but practicing "mindfulness" can help people cope with the stresses of daily life. At UCLA, the Mindful Awareness Research Center (MARC) helps individuals learn how to better deal with stress, improve their attention span and gain an overall sense of well-being.

"We live in a very attention-deficit culture, with little time to really focus on any one thing," says Susan Smalley, Ph.D., founder and director of MARC in the UCLA Semel Institute of Neuroscience and Human Behavior. "But these practices of mindful awareness, or mindfulness, really do open up time and give a person the perception and feeling that they have more time."

The result, Dr. Smalley says, is not only a greater sense of self-awareness and inner peace, but also a greater connection to others and to community. "It is a natural outgrowth of becoming more 'present' in your daily life that you enjoy the company of others," she says. In addition to providing benefits in one's daily life, researchers have verified the positive effects of mindfulness in a number of settings, points out Michael Irwin, M.D., director of the Cousins Center for Psychoneuroimmunology in the UCLA Semel Institute.

Studies have found, for example, that such practices can play a significant role inimproving a person's immune response following cancer, heart disease or arthritis. Mindfulness practice has been used to help treat a variety of behavioral and psychiatric disorders, such as attention deficit hyperactivity disorder, obsessive-compulsive disorder, depression and anxiety