Interventions Based on Mind-Body Therapies for the Improvement of Attention-Deficit/Hyperactivity Disorder Symptoms in Youth: A Systematic Review

Assessing willingness and preference for body scan practices in ADHD: a survey study

BACKGROUND

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition, but current treatment options are limited. Although medication is widely used, it does not fully address all challenges and can result in considerable side effects. One approach showing promise in alleviating symptoms is mindfulness. However, typical mindfulness-based stress reduction programmes require a significant time commitment, resulting in high attrition. Researchers have therefore started to focus on discrete components on mindfulness, including the body scan meditation.

METHODS

Before embarking on large-scale trials, it is helpful to understand the willingness and preferences for body scan practice. Using an online survey, we examined current mindfulness exercises and preferences, willingness, belief that it was feasible to engage in body scan practices in 157 individuals with ADHD.

RESULTS

We found that most were not currently practising mindfulness but were willing to do so and believed that it was feasible. Symptom severity and available space were predictors of willingness. Preferences were shown for professional classes and 1-2 body scan practices per week. These data indicate people with ADHD are willing to engage with body scan practices, supporting the implementation of large-scale studies.

CONCLUSIONS

The result provides insights to support the co-development of an intervention based on body scan meditation to manage the difficulties and the design of future studies to investigate its efficacy.

Assessing the impact of mindfulness programs on attention-deficit/ hyperactivity disorder in children and adolescents: a systematic review

BACKGROUND

Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder which poses challenges for the individuals with the disorder and their families. While stimulant medications are effective, a comprehensive approach, including psychosocial and behavioral interventions, is recommended. There is a growing body of research exploring the potential benefits of mindfulness-based interventions for children with ADHD. Our study aims to assess the effectiveness of mindfulness interventions in reducing ADHD symptoms in children and adolescents through a systematic review of relevant studies.

METHODS

Following PRISMA guidelines, our systematic review searched PubMed, Cochrane library, Psycinfo, and Scopus from January 2000 to August 2022. We included studies focusing on mindfulness for pediatric ADHD, comprising various study designs with a minimum 8-week duration. Descriptive statistics summarized results, while risk of bias was assessed using Cochrane RoB and ROBANS tools. The quality of RCTs was further evaluated using the Correlation of Quality Measures tool.

RESULTS

In the initial search, 450 records were identified, and after removing duplicates, 339 underwent screening. Forty-one studies underwent full text assessment for eligibility, with 11 studies meeting inclusion criteria, including seven RCTs, two Quasi RCTs, and three cohort studies. These studies, conducted in five countries, involved participants aged 7 to 18 years. Six studies showed improvement in hyperactivity/inattentive symptoms, and five studies showed improvement in impulsivity.

CONCLUSIONS

This systematic review demonstrates the potential benefits of mindfulness programs on ADHD symptoms in children and adolescents. This study emphasizes the need for high-quality research to explore mindfulness-based interventions for ADHD management in younger populations. PROSPERO registration number: IDCRD42024520800.

Movement Awareness Therapies in Eating Disorders: A Systematic Review and Meta-Analysis

Given the rising prevalence and complexity of eating disorders, a comprehensive multidisciplinary holistic approach is necessary. This work aimed to assess the effectiveness of body and movement awareness therapies in patients with eating disorders. Search strategy was undertaken using several scientific health databases. Articles were eligible if they were randomized controlled trials analyzing the effects of movement and body awareness therapies in eating disorders. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement for systematic reviews was followed and the risk of bias was assessed using the "Cochrane Collaboration Tool to assess the risk of bias." 11 articles met the inclusion criteria, including 437 patients. No high-quality randomized controlled trials were found. Forest plot analysis of the Eating Disorder Examination scale showed a difference favors to body awareness therapies but not significantly neither homogeneous. The interventions analyzed included yoga, body awareness therapy, dance, and psychomotor therapy. Body awareness therapies provide some additional benefits for eating disorder symptoms, such as emotion regulation, self-criticism, self-confidence, self-compassion, anxiety, body attitude, eating disorder symptoms, and quality of life.

Experiences of Second-Grade Primary School Children and Their Teachers in a Mind-Body Activity Program: A Descriptive Qualitative Study

OBJECTIVES

This study explored the experiences of second-grade children and their teachers who participated in a mind-body program to understand its impact on their development.

METHODS

A qualitative descriptive study was conducted. Student data were collected through seven focus groups, and semi-structured interviews were conducted with tutors in December 2021. Data analysis was performed following COREQ guidelines.

RESULTS

Three themes were generated: (1) competitiveness and restlessness in children: something needs to be done; (2) seeds sown and fruits harvested; and (3) it is necessary to advance from the occasional to the structural. Participants reported positive changes in areas of their development such as self-regulation, relaxation, attention capacity, and stress reduction. Improvements in interpersonal relationships and social skills were also observed.

CONCLUSIONS

These improvements in emotional well-being and social skills highlight the importance of this type of intervention in the school environment.

Conduct problems, hyperactivity, and screen time among community youth: can mindfulness help? an exploratory study

Background

The influence of mindfulness-based intervention (MBI) programs on behavioural problems among community youth is largely understudied. While technology continues to evolve and the prevalence of screen-based activities is rising, limited studies have accounted for screen time when examining the efficacy of an MBI. Accordingly, this study investigated the impact of MBI on conduct problems and hyperactivity among community youth, accounting for sociodemographic characteristics and four types of screen time.

Method

Linear regression models were used to investigate 1) the association between four types of screen time and behavioural problems (i.e., conduct problems and hyperactivity) and 2) the efficacy of online mindfulness programs in reducing behavioural problems among community youth. The data were collected at baseline, intervention completion and 1-month follow-up (Spring 2021 to Spring 2022) in Ontario, Canada (n=117, mean age=16.82, male=22%, non-White=21%).

Results

The average score for conduct problems was within the normal range, while the average score for hyperactivity was considered borderline at baseline. Accounting for other types of screen time, time spent playing video games was significantly associated with increased conduct problems (β= 1.75, p=.03), albeit rendering non-significant after correcting for multiple comparisons. The online mindfulness program was significantly associated with reduced hyperactivity, controlling for baseline mental health, age, sex and screen time.

Conclusion

The current findings suggest a 12-week online mindfulness program may play a positive role in reducing hyperactivity even when accounting for screen time. Our findings advocate the evidence base on the efficacy of MBI in managing hyperactivity.

[Sports and Physical Exercise Therapy in the Treatment of Mental Health Issues in Children and Adolescents]

Sports and Physical Exercise Therapy in the Treatment of Mental Health Issues in Children and Adolescents Abstract: Mental disorders are among the most common chronic diseases in childhood and adolescence in Germany and worldwide. The health benefits of a physically active lifestyle during adolescence are well documented. Furthermore, a growing body of evidence suggests a positive impact of physical activity on mental health and emotional well-being. Longitudinal studies also show an association between physical activity and reduced risk of developing a mental disorder. Therefore, therapeutic exercise plays an important role in child and adolescent psychiatry. High-quality randomized-controlled trials are needed to substantiate the described effects.

The Effects of Mindfulness for Youth (MYmind) versus Group Cognitive Behavioral Therapy in Improving Attention and Reducing Behavioral Problems among Children with Attention-Deficit Hyperactivity Disorder and Their Parents: A Randomized Controlled Trial

INTRODUCTION

There is a lack of studies evaluating mindfulness-based interventions for children with attention-deficit hyperactivity disorder (ADHD) compared with an evidence-based control. This randomized controlled trial (RCT) evaluated the effects of mindfulness for youth (MYmind) in improving children's attention, behavior, and parent-related outcomes versus cognitive behavioral therapy (CBT).

METHODS

A total of 138 families of children with ADHD aged 8-12 years were recruited from the community with 69 randomized to MYmind and 69 to CBT. Participants were assessed at baseline, immediately after intervention, at 3 months and 6 months. The primary outcome was the attention score of the Sky Search subtest of the Test of Everyday Attention for Children (TEA-Ch). Secondary outcomes were child behavior and parent-related assessments. Linear mixed models were used to assess the efficacy of MYmind compared with CBT.

RESULTS

Both MYmind and CBT significantly improved children's attention score at 6 months (MYmind: β = 1.48, p = 0.013, Cohen's d = 0.32; CBT: β = 1.46, p = 0.008, d = 0.27). There were significant within-group improvements in most secondary outcomes. No significant difference was shown for both primary or secondary outcomes between the two arms at any time point.

CONCLUSIONS

Both MYmind and CBT appeared to improve children's attention and behavior outcomes, although no difference was found between these two interventions. This is the largest RCT so far comparing MYmind and CBT although there was loss of follow-up assessments during the pandemic. Further RCTs adopting a non-inferiority design are needed to validate the results.

A systematic meta-review of systematic reviews on attention deficit hyperactivity disorder

BACKGROUND

There are now hundreds of systematic reviews on attention deficit hyperactivity disorder (ADHD) of variable quality. To help navigate this literature, we have reviewed systematic reviews on any topic on ADHD.

METHODS

We searched MEDLINE, PubMed, PsycINFO, Cochrane Library, and Web of Science and performed quality assessment according to the Joanna Briggs Institute Manual for Evidence Synthesis. A total of 231 systematic reviews and meta-analyses met the eligibility criteria.

RESULTS

The prevalence of ADHD was 7.2% for children and adolescents and 2.5% for adults, though with major uncertainty due to methodological variation in the existing literature. There is evidence for both biological and social risk factors for ADHD, but this evidence is mostly correlational rather than causal due to confounding and reverse causality. There is strong evidence for the efficacy of pharmacological treatment on symptom reduction in the short-term, particularly for stimulants. However, there is limited evidence for the efficacy of pharmacotherapy in mitigating adverse life trajectories such as educational attainment, employment, substance abuse, injuries, suicides, crime, and comorbid mental and somatic conditions. Pharmacotherapy is linked with side effects like disturbed sleep, reduced appetite, and increased blood pressure, but less is known about potential adverse effects after long-term use. Evidence of the efficacy of nonpharmacological treatments is mixed.

CONCLUSIONS

Despite hundreds of systematic reviews on ADHD, key questions are still unanswered. Evidence gaps remain as to a more accurate prevalence of ADHD, whether documented risk factors are causal, the efficacy of nonpharmacological treatments on any outcomes, and pharmacotherapy in mitigating the adverse outcomes associated with ADHD.

A Systematic Review of Yoga and Meditation for Attention-Deficit/Hyperactivity Disorder in Children

With attention-deficit/hyperactivity disorder (ADHD) being a prevalent disorder in childhood, it is essential to acknowledge the different adverse effects the disorder can have on the quality of life in children. Therefore, this systematic review focuses mainly on children. Medical therapy, especially stimulants, can have many side effects. Our systematic review aims to evaluate the potential of other non-medical treatment options for ADHD, such as yoga or meditation. We used PubMed and Google Scholar as databases for this systematic review. Using different combinations of medical subheadings (MeSH) and key terms, followed by the application of several inclusion/exclusion criteria and filters to narrow down our search. From an initial 51,675 articles, we selected 10 papers that passed our screening process and quality check to analyze in depth. Yoga and meditation positively affect various symptoms in children with ADHD, including attention, hyperactivity, and impulsive behavior. If done in family group sessions, it also benefited the parents and family dynamics, suggesting a potential option for family therapy. Furthermore, other psychological symptoms, such as anxiety or low self-esteem, appeared to be positively impacted by these interventions. Although yoga and meditation positively influenced children with ADHD, a more in-depth research is necessary with a more significant number of participants and over a more extended period of time. The results of the included studies suggest a substantial benefit. Nonetheless, as the number of studies is limited, at present yoga and meditation could be beneficial as supplemental therapy rather than being used alone as a therapy for ADHD.

Mindfulness Interventions for Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-Analysis

Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition impacting children and adults. Current treatments are limited and there is increasing interest in the use of mindfulness, which is growing in popularity. Previous systematic reviews have typically focused on specific ages, outcome measures or interventions. The current review aimed to take a more comprehensive approach. Title and abstract searches were performed in five databases for randomized and non-randomized controlled trials or pre-post studies with participants with an ADHD diagnosis or a score above a clinically relevant cut-off on a validated ADHD measure. Studies had to measure symptoms of ADHD, global or social functioning. Extraction of key information including participant status (i.e., diagnosis, scale scores, comorbidities, medication use), study design, and outcome measures was conducted. Effect sizes (Hedge’s g) were calculated and where a measure had been used in at least three studies with the same population, meta-analyses were considered. Twenty-nine studies were initially identified, with seven deemed poor quality and removed from further analysis leaving, 22 studies containing data from 1237 children and adults with ADHD along with data from 525 family members. The data indicate possible benefits of mindfulness on self-compassion, quality of life, wellbeing, depression, and anxiety. The findings also suggest that mindfulness may also improve ADHD symptoms, executive function, problematic behaviours, and emotional dysregulation, although results vary by age of patient and measures used. Parent stress and parenting style have received limited attention, highlighting the need for more studies in these areas. Whilst the data presented suggest that mindfulness may be beneficial, the evidence base is not as strong as the popularity of the approach. Many of the studies lacked blind assessment, adequate randomization, or suitable control conditions. As such high-quality controlled studies considering medication, other psychosocial interventions, use of active and in active controls and comorbidity as well as longer follow-up periods, are needed to confirm this.

Mind-body therapies for older adults with dementia: a systematic review and meta-analysis

PURPOSE

This systematic review of randomised controlled trials (RCTs) aimed to determine the effects of mind-body therapies (MBTs) among older adults with dementia.

METHODS

We searched five electronic databases (PubMed, PsycINFO, Web of Science, EMBASE, and the Cochrane Library) for publications investigating the effect of MBTs until July 14th, 2020. We included published peer-reviewed RCTs among participants with a mean age of 60 and above and a diagnosis of any dementia. Eligible studies included measurements for all types of health outcomes, including cognitive function, neuropsychiatric inventory, depressive syndromes, agitation, psychosocial status, and other health outcomes. Two investigators extracted data, the risk of bias for each study was evaluated through Review Manager, and statistical meta-analysis was performed using Stata.

RESULTS

A total of nine studies met the eligibility criteria, with full-text available for systematic review. Five of them, with 338 participants, were included in the meta-analysis. For most included RCTs of the review, the methodological quality was moderate. The meta-analysis showed that Tai Chi had a mild effect on global cognitive function (Mini-Mental State Examination, SMD = 0.40, 95% CI 0.10-0.70). Yoga and aromatherapy may also be beneficial for depression, and these three MBTs improved quality of life.

CONCLUSION

The current review suggested that MBTs may act as potential non-pharmaceutical approaches to improve certain health outcomes among older populations with dementia. Systematic review and meta-analysis registration: PROSPERO CRD42021198514.

Mind-Body Physical Activity Interventions and Stress-Related Physiological Markers in Educational Settings: A Systematic Review and Meta-Analysis

Mind–Body Physical Activity (MBPA) in educational settings is one possible preventive strategy for ameliorating stress-related physiological health parameters. The objectives of this study were to conduct a systematic review of the literature with meta-analyses on the effects of MBPA on stress-related physiological health markers in primary, secondary, and higher education students. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the search for peer-reviewed articles published in English was conducted in PubMed, EBSCOhost, PsychInfo, Scopus, and Cochrane Library databases. Criteria for inclusion consisted of empirical studies targeting the student population (primary, secondary, higher education), studies examining the effectiveness of an MBPA intervention, studies including a control or comparison group (pre-test/post-test studies excluded), studies targeting physiological marker outcomes such as heart rate, blood glucose, cortisol, and blood pressure, and finally, studies examining interventions implemented within educational settings. Twenty-six interventions were eligible for the review and quantitative synthesis, which comprised a total of 1625 participants, with 783 students serving within the control/comparison group. There were statistically significant and large pooled effects for MBPA effectiveness for lowering heart rate (Hedges’ g = −1.71, 95% Confidence Interval (CI): −2.43, −0.98), cortisol (Hedges’ g = −1.32, 95% CI: −2.50, −0.16), and systolic and diastolic blood pressure (Hedges’ g = −1.04, 95% CI: −1.53, −0.58). These effects tended to be stronger in older students compared to younger students. Most analyses were characterized as having high heterogeneity and only 10 of the 26 studies were characterized as good quality (38.4%). MBPA interventions may have a positive impact on specific physiological health markers in students, especially in students within higher education. However, higher-quality research is needed in this area.

A Randomized Study on the Effects of Minds in Motion and Yoga on Motor Proficiency and Academic Skills Among Elementary School Children

BACKGROUND

Physical activity is critical for the healthy development and well-being of children. Specifically, physical activity is associated with improvements in coordination, balance, attention, and behavior among elementary school-aged children. However, for many children, particularly those belonging to minority groups, opportunities to engage in quality physical activity programs outside school settings are limited. The purpose of this study was to examine the whether a physical activity program called Minds in Motion (MiM) The Maze before school, as compared with yoga, meets the criteria of the Comprehensive School Physical Activity Program framework as a before-school program to improve overall physical activity and academic performance among elementary school-age students.

METHODS

A total of 48 children attending an urban public school with large minority representation in the Midwest were randomly assigned to MiM-The Maze or yoga. Participants were assessed on motor proficiency, behavior, balance, and academic skills before and after training. Training consisted of either yoga or MiM-The Maze 30 minutes per day before school, 5 times per week for 12 weeks.

RESULTS

MiM-The Maze and yoga group students showed significant improvements in academic skills.

CONCLUSIONS

MiM-The Maze is feasible and affordable before-school program to promote students' classroom behavior in elementary school students.