A Mindfulness Intervention for ADHD in Adulthood

Dr. John Mitchell, Ph.D. is an Assistant Professor of Psychiatry and Behavioral Sciences at Duke University School of Medicine and the Duke ADHD Program. He will be presenting at the 2017 APSARD Annual Meeting on “A Mindfulness Intervention for ADHD in Adulthood Workshop”

Mindfulness-based interventions, or MBIs, involve the teaching of mindfulness meditation practices. The practice of mindfulness meditation has received widespread attention in the popular press. Further, there are numerous books and online resources available to people looking to add mindfulness meditation practices to their own daily routine (e.g., see https://health.ucsd.edu/specialties/mindfulness/programs/mbsr/Pages/audio.aspx as one of many resources freely available). However, is there a scientific basis for all the buzz around mindfulness? The short answer: yes. There’s over 4,000 peer-reviewed publications devoted to the topic of mindfulness (https://goamra.org/resources/). In fact, MBIs have now been actively studied among various medical, psychiatric, and non-clinical populations. To date, many of these studies have demonstrated improvements among individuals with depression, anxiety, and substance use, just to name a few (e.g., see the special issue of American Psychologist devoted entirely to MBIs http://psycnet.apa.org/journals/amp/70/7/ for a thorough review of where the field is at currently). These interventions involve teaching both formal meditation exercises, such as focusing on your breath, and informal exercises to apply mindfulness in everyday life, such as mindfully eating.

Although MBIs on the surface might seem counterintuitive for individuals with ADHD—for example, think about asking someone who struggles with distractibility and restlessness to close their eyes, sit still, and focus on their breath—there’s actually a strong case to be made for that application of mindfulness meditation practice for ADHD. MBIs are thought to have a beneficial impact through different mechanisms, such as improving attentional functioning and emotion regulation. Over the years as the mechanistic research has developed, researchers have increasingly identified individuals with ADHD as a population that may be particularly responsive to MBIs. After all, ADHD is a disorder characterized by difficulty with both attention and emotion regulation. Further, other behavioral characteristics that mindfulness has been demonstrated to improve are typically implicated as problematic in ADHD as well, such as mind wandering.

Since 2008 when the first pilot trial of mindfulness for ADHD was published by Dr. Lidia Zylowska and colleagues (https://www.ncbi.nlm.nih.gov/pubmed/18025249), this has been a topic of increasing scientific interest among ADHD researchers. There are now reviews that establish the empirical status of MBIs for individuals with ADHD (http://guilfordjournals.com/doi/abs/10.1521/adhd.2016.24.2.1, https://www.ncbi.nlm.nih.gov/pubmed/25908900, https://www.ncbi.nlm.nih.gov/pubmed/26740931). One recent meta-analysis indicated that MBIs particularly appear to have a particularly beneficial impact among adults with the disorder (https://www.ncbi.nlm.nih.gov/pubmed/26838555)

At the annual APSARD conference, we’ll discuss what MBIs are, why they are applicable to adults with ADHD, and establish the current evidence-base of MBIs for adults with ADHD. In addition, although self-help materials for adults with ADHD have been published (http://www.shambhala.com/the-mindfulness-prescription-for-adult-adhd.html), there are currently no clinician materials to guide practitioners in administering a MBI for adults diagnosed with ADHD. Therefore, those attending this workshop will also learn about a MBI adapted for adults with ADHD called the Mindful Awareness Practices (MAPs) for ADHD Program. This particular intervention has been tested in open-label and randomized trials. Attendees will be exposed to a session-by-session description of the MAPs for ADHD Program.

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