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Übersichtsarbeit

Die Effektivität achtsamkeitsbasierter Therapieverfahren bei Kindern und Jugendlichen mit ADHS – ein systematisches Review

Published Online:March 28, 2019https://doi.org/10.1024/2235-0977/a000265

Abstract

Zusammenfassung. Kinder und Jugendliche mit Aufmerksamkeitsdefizit-/Hyperaktivitätsstörungen (ADHS, Falkai & Wittchen, 2015) sind immer häufiger Zielgruppe achtsamkeitsbasierter Verfahren. Aufmerksamkeitsregulierung ist ein zentraler Bestandteil von Achtsamkeitsübungen wie auch Aufmerksamkeitsfokussierung, Aufmerksamkeitswechsel und -flexibilität, Meta-Kognition, Inhibition, Arbeitsgedächtnis, Selbst-Regulation u.a.m., was auf die Überschneidung der Achtsamkeit mit Aufmerksamkeitsprozessen hinweist. Die Wirksamkeit achtsamkeitsbasierter Therapie bei Kindern und Jugendlichen mit ADHS wird in einer zuletzt stetig wachsenden Zahl von Therapiestudien dokumentiert, die in Meta-Analysen zusammengefasst wurden. Für den vorliegenden Review wurden aktuelle Metaanalysen in diesem Feld recherchiert, analysiert und interpretiert. Insgesamt konnten auf diesem Weg 4 Metaanalysen gefunden werden, die dezidierten Einschlusskriterien (Publikationszeitraum 2016–2018, Publikationen in englischer oder deutscher Sprache, Publikationen der einbezogenen Einzelstudien in Peer reviewed Journals, keine Einzelfallstudien, zumindest Teilstichproben der Studien müssen aus klinisch diagnostizierten oder per klinischen Ratings klassifizierten Kindern oder Jugendlichen mit ADHS bestehen) genügten. Die einbezogenen Metaanalysen belegen insgesamt gute bis sehr gute Effekte in den Bereichen des Verhaltens und der Aufmerksamkeitsleistungen der Kinder und Jugendlichen. So zeigen sich durchgehend signifikante Reduktionen im Bereich der ADHS-Symptomatik mit hohen Effektstärken (d = 0.8 bis d = 1.23). Ähnliches zeigt sich im Bereich der Reduktion externalisierender und internalisierender komorbider Störungen (d = 0.9 bis d = 1.02) sowie im Bereich der Aufmerksamkeitsleistungen (d = 0.62, bis d = 2.29). Zudem wurden übergreifende positive Effekt auf das Selbstwertgefühl und die Peerbeziehungen ermittelt. Therapeutische und weitere inhaltliche sowie forschungsmethodische Implikationen werden diskutiert.


The effectiveness of mindfulness based interventions with children and adolescents with ADHD – a systematic review

Abstract. Children and adolescents with attention deficit/hyperactivity disorder (ADHD, Falkai & Wittchen, 2015) are increasingly being treated with mindfulness based interventions. Attention regulation as well as concentration, attentional changes and flexibility, meta cognition, inhibition, working memory, self-regulation etc. are central parts of mindfulness based interventions which represents the conceptual overlap between mindfulness and attention processes. Currently, the effectiveness of such mindfulness-based therapies in children and adolescents with ADHD are being documented in a growing number of therapy studies, which have been summarized in several meta-analytic studies. For this review current meta analytic studies were collected, analyzed and discussed. In total, 4 meta-analyses could be found that fulfilled the specific search criteria, which included: publication span between 2016–2018, publication in English or German, publication of the included studies in peer reviewed journals, no single case studies, at least parts of the samples had to consist of children and adolescents that had been clinically diagnosed or assessed by standardized rating scales with ADHD. The included meta-analyses reveal overall medium and high effect sizes in the fields of behavior and attentional achievements. Overall, there was a significant reduction of ADHS-symptoms (effect sizes d = 0.8 until d = 1.23). Similar results could also be found in the reduction of externalized and internalized comorbid disorders (d = 0.9 until d = 1.02) and also with respect to attentional achievements (d = 0.62, until d = 2.29). Additionally, further positive effects on self-esteem and peer relationships could be observed. Therapeutical and further substantive, as well as methodological implications are discussed.

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