Attention-Deficit-Hyperactivity-Disorder (ADHD) and Mind-Body Alternatives:
Protocol for a meta-analysis and preliminary data
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1
Universite du Quebec a Montreal, Canada
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2
Bishops University, Psychology, Canada
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3
Universite de Sherbrooke, Radiology, Canada
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4
Universite de Sherbrooke, Computer Sciences, Canada
Background : Attention Deficit Hyperactivity Disorder (ADHD) is a very common childhood disorder with potentially severe impact on affected youngsters and their families. Students with ADHD often do not actively engage in academic instruction because they have difficulty in attending to task demands resulting in deteriorated academic outcomes. Although pharmacotheraphy is often the treatment of choice, it has typically short-term effects, is associated with various side effects and poor adherence. Therefore, there is a need for other interventions for youngsters with ADHD. Mind-body training is emerging as a potentially effective intervention for the ADHD treatment. Typically, these trainings are conducted in small groups were participants learn to focus and enhance their attention, awareness, and self-control, as well as learn to be fully present in the here and now in a non-judgmental way. The present meta-analysis provides an overview of the literature regarding mind-body-based interventions for the treatment of ADHD.
Method : We limit the meta-analysis to peer-reviewed empirical studies that examined effects of meditation or mindfulness on symptoms of ADHD. We searched in PsycINFO, PubMed and SCOPUS data bases. Additionally, we plan to thoroughly examine reference lists of previous meta-analyses. The search terms « ADHD AND meditation OR mindfulness » and their derivatives terms (e.g. impulsivity, inattention, hyperactivity, samatha, yoga, etc.) are considered for inclusion. Impact of mind-body treatment in ADHD is extended to cognition and relative domains such as executive function and brain structures alterations. Eligible control conditions are placebo, wait-list, no treatment and usual care. Along with Krisanaprakornkit et al. (2010) and Cochrane’s guidelines, we consider relevant randomized trials (RCT), comparative studies, clinical trials, prospective or follow-up studies, and single or double blind studies for inclusion.
The search was performed from the first available date up to December 2016. The literature search produced 157 studies : PsycINFO (n=68), PubMed (n=67) SCOPUS (n=22). Upon first evaluation by two independent reviewers, 53 duplicates (+2 conferences, 1 erratum) were eliminated. After reviewing the abstracts of the 101 remaining studies, 68 studies were eliminated. From the remaining 33 studies, 10 corresponds to the Cairncross and Miller (2016) meta-analysis.
Results : Preliminary results from Cairncross et Miller (2016) meta-analysis.
The data were synthesized to compare difference between pre- and post-intervention scores divided by the population standard deviation (Cohen’s d). The analyses focused on the overall effects of meditation or mindfulness on ADHD symptoms. Effects based on more than one informant was combined to obtain a single effect-size estimate. The variance for the composite effect size was computed taking into account both the individual informant variance and the correlation between informant reports (fixed at 0.7). The composite Cohen’s d and its associated variance were computed for each individual study and each outcome of interest: inattention and hyperactivity symptoms. 1- For inattention, the random effect model and Cohen’s d indicate an effect size of 0,680, SE= 0,150. The Cochran’s Q indicates that the effect size varies according to studies (Q (dl=9) = 30,137; p < 0,05) so there is heterogeneity (Higgins and Thompson’s I2 = 76,67 %). 2- For hyperactivity, the random effect model and Cohen’s d indicate an effect size of 0,523, SE= 0,105. The Cochran’s Q also indicates that the effect size varies according to studies (Q (dl=8) = 17,154; p < 0,05) so there is heterogeneity (Higgins and Thompson’s I2 = 51,81 %). See forest plot on figure 1. Meta regression analyses with potential moderated variables (gender, age, medication and number of weeks of intervention) did not reveal any significant results (figures 1a-b).
Conclusion and future studies : Along with the meta-analysis of Cairncross and Miller (2016), we found a positive effect of mind-body treatment alternatives on ADHD symptoms. However, we also found moderate to high heterogeneity between studies, mostly for the inattention symptoms. Meta regression analysis rule out the possibility of an effect of age, gender, duration of treatment and médication on that heterogeneity. In future studies, we will need to address more closely this issue. In the next months, we plan to increase our pool of studies in order to extend the present preliminary data and update Cairncross’s findings.
Acknowledgements
The authors would like to aknowledge the Fonds Quebecois de Recherche Societe et Culture.
References
Cairncross, M., Miller, C. J. (2016). The effectiveness of Mindfulnes-Based Therapies for ADHD: A Meta-Analytic Review. Journal of Attention Disorders, 1-17.
Krisanaprakornkit, T., Ngamjarus, C., Witoonchart, C., & Piyavhatkul, N. (2010). Meditation therapies for attention‐deficit/hyperactivity disorder (ADHD). The Cochrane Library.
Keywords:
meta analysis,
Attention Deficit Disorder with Hyperactivity,
Mind-Body Therapies,
Child,
Adult,
Young Adult
Conference:
2nd International Conference on Educational Neuroscience, Abu Dhabi, United Arab Emirates, 5 Mar - 6 Mar, 2017.
Presentation Type:
Poster Presentation
Topic:
Educational Neuroscience
Citation:
Poissant
H,
Raiche
G,
Mendrek
A,
Whittingstall
K and
Descoteaux
M
(2017). Attention-Deficit-Hyperactivity-Disorder (ADHD) and Mind-Body Alternatives:
Protocol for a meta-analysis and preliminary data.
Conference Abstract:
2nd International Conference on Educational Neuroscience.
doi: 10.3389/conf.fnhum.2017.222.00014
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Received:
16 Jan 2017;
Published Online:
11 Dec 2017.
*
Correspondence:
Prof. Helene Poissant, Universite du Quebec a Montreal, Montreal, Canada, helenepoissant@gmail.com