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Übersicht

Metaanalyse zur Wirksamkeit achtsamkeitsbasierter Interventionen bei ADHS im Kindes- und Jugendalter

Published Online:February 27, 2019https://doi.org/10.1026/0942-5403/a000278

Abstract

Zusammenfassung. Die vorliegende Metaanalyse berechnet die Wirksamkeit achtsamkeitsbasierter Interventionen bei Kindern und Jugendlichen mit ADHS gemäß empirischer Studien aus den Jahren 2008 – 2018. Als abhängige Maße werden die ADHS-Symptomatik, kognitive Leistungen (Aufmerksamkeitsleistungen in standardisierten Tests) sowie ADHS-spezifische Komorbiditäten berücksichtigt. Insgesamt wurden 16 Studien einbezogen. Im Ergebnis zeigt sich hinsichtlich der Reduktion der gesamten ADHS-Symptomatik eine große Effektstärke von d = 1.08. Zudem konnten eine Verringerung der Unaufmerksamkeitssymptomatik (d = 0.47), mittlere Effekte auf Hyperaktivität / Impulsivität sowie moderate bis große Effekte auf komorbide internalisierende Störungen (Depressionen, Angststörungen) festgestellt werden. Die Metaanalyse liefert Hinweise darauf, dass achtsamkeitsbasierte Interventionen bei Kindern und Jugendlichen mit ADHS wirksam sind. Jedoch bestehen auf Ebene der Einzelstudien beträchtliche methodische Limitationen.


Meta-Analysis of the Efficacy of Mindfulness-Based Interventions in Children and Adolescents With ADHD

Abstract. A rising number of clinical and school-related empirical studies report a good efficacy of mindfulness-based interventions relating to attention deficit hyperactivity disorder (ADHD) symptom reduction. However, no systematic meta-analysis has been performed to synthesize the findings of school-related and clinical studies in the period 2008 – 2018. The current meta-analysis considers the impact of mindfulness-based interventions on ADHD symptomatology, cognitive functioning (inattention in standardized tests), and ADHD-specific comorbidities (anxiety, depression, and dissocial behavior). Studies from the Psychology and Behavioral Science Collection, Psyndex, PsycINFO, and Google Scholar were taken into account. The effect size analysis of randomized controlled trials (RCTs) was based on Klauer’s averaged and weighted effect size, which also controls pretest differences between experimental groups and controls. Studies measuring dependent variables before and after mindfulness-based interventions were also included using weighted Cohen’s d effect sizes. As a result, 16 studies met the inclusion criteria. Based on five experimental studies, an ADHD total symptom reduction was found when comparing both the pretest–posttest measurements of the ADHD groups (1.02) and the differences between experimental groups and controls (1.08). Eight studies found reduced inattention symptoms amounting to an average effect size of 0.47 (pre–post), while in three experimental studies the average effect was 0.32. Pretest–posttest improvements of accuracy (0.45) and reaction speed (0.83) in standardized attention tests were reported. These effects were also shown in five experimental studies. Some studies found moderate and middle effects relating to hyperactivity/impulsiveness symptoms. ADHD comorbidities such as depressive (0.41 pretest–posttest, 0.29 RCT) and anxiety symptoms (0.48 pretest–posttest, 0.38 RCT) were significantly reduced. In six studies with pretest–posttest measurements, a large effect on dissocial behavior was reported (1.00), whereas this effect was not evident in three RCTs that considered dissocial ADHD comorbidities (0.23). In the overall picture, indications were found of a medium-to-good efficacy of mindfulness-based interventions on ADHD, but the results can only be generalized to a limited extent owing to the small number of methodologically sufficiently good studies and the inhomogeneity of the effects. With regard to inattentiveness, there are indications of a marked variance in the ADHD self-assessment scales. This implies the necessity to consider multiple diagnostic sources of information when recording attention processes. Further studies representative of the ADHD population, especially experimental studies, are required, which also consider implementation aspects and differential effects (e. g., different effects of individual therapy components). The possibly high relevance of mindfulness competence for subjective well-being and thus the quality of life of children and adolescents with ADHD could be further investigated with prospective longitudinal studies.

Literatur* In die Metaanalyse einbezogene Studien.

  • *Abadi, M. S., Madgaonkar, J. & Venkatesan, S. (2008). Effect of yoga on children with attention deficit/hyperactivity disorder. Psychological Studies, 53, 54 – 159. First citation in articleGoogle Scholar

  • *Abdolahzadeh, Z., Mashhadi, A. & Tabibi, Z. (2017). Effectiveness of mindfulness-based therapy on the rate of symptoms and mindfulness in adolescents with attention-deficit hyperactivity disorder. Journal of Fundamentals of Mental Health, 19, 30 – 37. First citation in articleGoogle Scholar

  • Black, D. S., Milam, J. & Sussman, S. (2009). Sitting meditation interventions among youth: A review of treatment efficacy. Pediatrics, 124, 532 – 541. First citation in articleCrossref, Google Scholar

  • Borenstein, M., Higgins, J. T., Hedges, L. V. & Rothstein, H. R. (2017). Basics of meta‐analysis: I2 is not an absolute measure of heterogeneity. Research Synthesis Methods, 8, 5 – 18. First citation in articleCrossref, Google Scholar

  • Cairncross, M. & Miller, C. J. (2016). The effectiveness of mindfulness-based therapies for ADHD: A meta-analytic review. Journal of Attention Disorders, 20, 1 – 16. First citation in articleGoogle Scholar

  • *Chou, C. & Huang, C. (2017). Effects of an 8-week yoga program on sustained attention and discrimination function in children with attention deficit hyperactivity disorder. PeerJ, 5, 1 – 17. First citation in articleCrossref, Google Scholar

  • *Cohen, S. C. L., Harvey, D. J., Shields, R. H., Shields, G. S., Rashedi, R. N., Tancredi, D. J. et al. (2018). Effects of yoga on attention, impulsivity, and hyperactivity in preschool-aged children with attention-deficit hyperactivity disorder symptoms. Journal of Developmental and Behavioral Pediatrics, 39, 200 – 209. First citation in articleCrossref, Google Scholar

  • De Los Reyes, A., Augenstein, T. M., Wang, M., Thomas, S. A., Drabick, D. G., Burgers, D. E. & Rabinowitz, J. (2015). The validity of the multi-informant approach to assessing child and adolescent mental health. Psychological Bulletin, 141, 858 – 900. First citation in articleCrossref, Google Scholar

  • Evans, S., Ling, M., Hill, B., Rinehart, N., Austin, D. & Sciberras, E. (2018). Systematic review of meditation-based interventions for children with ADHD. European Child & Adolescent Psychiatry, 27, 9 – 27. First citation in articleCrossref, Google Scholar

  • *Gu, Y., Xu, G. & Zhu, Y. (2018). A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for College Students with ADHD. Journal of Attention Disorders, 22, 388 – 399. First citation in articleCrossref, Google Scholar

  • Hampel, P., Petermann, F. & Desman, C. (2009). Exekutive Funktionen bei Jungen mit Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung im Kindesalter. Kindheit und Entwicklung, 18, 144 – 152. First citation in articleLink, Google Scholar

  • *Haydicky, J., Wiener, J., Badali, P., Milligan, K. & Ducharme, J. M. (2012). Evaluation of a mindfulness-based intervention for adolescents with learning disabilities and co-occurring ADHD and anxiety. Mindfulness, 3, 151 – 164. First citation in articleCrossref, Google Scholar

  • *Huguet, A., Miguel-Ruiz, D., Haro, J. M. & Alda, J. A. (2017). A pilot study of the efficacy of a mindfulness program for children newly diagnosed with Attention-Deficit Hyperactivity Disorder: Impact on core symptoms and executive functions. International Journal of Psychology and Psychological Therapy, 17, 305 – 316. First citation in articleGoogle Scholar

  • Irving, J. A., Farb, N. A. S. & Segal, Z. V. (2015). Mindfulness-based cognitive therapy for chronic depression. In K. W. BrowJ. D. CreswellR. M. Ryan (Eds.), Handbook of mindfulness: Theory, research, and practice (pp. 348 – 366). New York, NY: Guilford Press. First citation in articleGoogle Scholar

  • Jansen, P., Schulz, A. & Nottberg, C. (2016). Einfluss von achtsamkeitsbasierten Interventionen auf Exekutive Funktionen im Kindesalter: Ein systematisches Review. Zeitschrift für Entwicklungspsychologie und Pädagogische Psychologie, 48, 206 – 216. First citation in articleLink, Google Scholar

  • Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delacorte. First citation in articleGoogle Scholar

  • *Kiani, B., Hadianfard, H. & Mitchell, J. T. (2016). The impact of mindfulness meditation training on executive functions and emotion dysregulation in an Iranian sample of female adolescents with elevated attention-deficit/hyperactivity disorder symptoms. Australian Journal of Psychology, 69, 273 – 282. First citation in articleCrossref, Google Scholar

  • Klauer, K. (1993). Denktraining für Jugendliche. Ein Programm zur intellektuellen Förderung. Handanweisung. Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Klauer, K. J. (2001). Handbuch kognitives Training. Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Klingbeil, D. A., Fischer, A. J., Renshaw, T. L., Bloomfield, B. S., Polakoff, B., Willenbrink, J. B. & Chan, K. T. (2017). Effects of mindfulness-based interventions on disruptive behavior: A meta-analysis of single-case research. Psychology in the Schools, 54, 70 – 87. First citation in articleCrossref, Google Scholar

  • Klingbeil, D. A., Renshaw, T. L., Willenbrink, J. B., Copek, R. A., Chan, K. T., Haddock, A. et al. (2017). Mindfulness-based intervention with youth: A comprehensive meta-analysis. Journal of School Psychology, 63, 77 – 103. First citation in articleCrossref, Google Scholar

  • Linderkamp, F. (2018). Achtsamkeit. In G.W. LauthF. Linderkamp (Hrsg.), Verhaltenstherapie mit Kindern und Jugendlichen (4. Aufl., S. 753 – 769). Weinheim: Beltz. First citation in articleGoogle Scholar

  • Linderkamp (im Druck). Die Effektivität achtsamkeitsbasierter Therapieverfahren bei Kindern und Jugendlichen mit ADHS – ein systematisches Review. Lernen und Lernstörungen. First citation in articleGoogle Scholar

  • *Lo, H. H. M., Wong, S. W. L., Wong, J. Y. H., Yeung, J. W. K., Snel, E. & Wong, S. Y. S. (2017). The effects of family-based mindfulness intervention on ADHD symptomology in young children and their parents: A randomized control trial. Journal of Attention Disorders, 21, 1 – 14. First citation in articleGoogle Scholar

  • Lüdeke, S. & Linderkamp, F. (im Druck). Beurteilerdiskrepanzen als Indikatoren für Schulstress. Eine Studie zu Einschätzungen internalisierender und externalisierender Verhaltensprobleme aus Sicht von Jugendlichen und Lehrpersonen. Empirische Sonderpädagogik. First citation in articleGoogle Scholar

  • *Malboeuf-Hurtubise, C., Lacourse, E., Taylor, G., Joussemet, M. & Amor, L. B. (2017). A mindfulness-based intervention pilot feasibility study for elementary school students with severe learning difficulties: Effects on internalized and externalized symptoms from an emotional regulation perspective. Journal of Evidence-Based Complementary & Alternative Medicine, 22, 473 – 481. First citation in articleCrossref, Google Scholar

  • Markel, C. (2016). Child-focused psychosocial interventions for children and adolescents with attention-deficit hyperactivity disorder (ADHD): A systematic review and meta-analysis. Retrieved from https://tspace.library.utoronto.ca/bitstream/1807/76568/3/Markel_Clarisa_201611_PhD_thesis.pdf First citation in articleGoogle Scholar

  • *Naseh, A., Heydarinasab, L. & Shairi, M. R. (2016). The efficacy of mindfulness-based intervention on adolescents with attention deficit/hyperactivity symptoms and externalizing problems on reducing mother–adolescent conflict. International Journal of Applied Behavioral Science, 3, 15 – 22. First citation in articleGoogle Scholar

  • *Oord, S. van der, Bögels, S. M. & Peijnenburg, D. (2012). The effectiveness of mindfulness training for children with ADHD and mindful parenting for their parents. Journal of Child and Family Studies, 21, 139 – 147. First citation in articleCrossref, Google Scholar

  • Peasgood, T., Bhardwaj, A., Biggs, K., Brazier, J. E., Coghill, D., Cooper, C. L et al. (2016). The impact of ADHD on the health and well-being of ADHD children and their siblings. European Child & Adolescent Psychiatry, 25, 1217 – 1231. First citation in articleCrossref, Google Scholar

  • Rustenbach, S. J. (2003). Metaanalyse: Eine anwendungsorientierte Einführung. Bern: Huber. First citation in articleGoogle Scholar

  • Scahill, L., Carroll, D. & Burke, K. (2004). Methylphenidate: Mechanism of action and clinical update. Journal of Child and Adolescent Psychiatric Nursing, 17, 85 – 86. First citation in articleCrossref, Google Scholar

  • Schmertz, S. K., Anderson, P. L. & Robins, D. L. (2009). The relation between self-report mindfulness and performance on tasks of sustained attention. Journal of Psychopathology and Behavioral Assessment, 31, 60 – 66. First citation in articleCrossref, Google Scholar

  • Schmidt, S. & Petermann, F. (2008). Entwicklungspsychopathologie der ADHS. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 56, 265 – 274. First citation in articleLink, Google Scholar

  • *Sibalis, A., Milligan, K., Pun, C., McKeough, T., Schmidt, L. A. & Segalowitz, S. J. (2017). An EEG investigation of the attention-related impact of mindfulness training in youth with ADHD: Outcomes and methodological considerations. Journal of Attention Disorders, 21, 1 – 11. First citation in articleGoogle Scholar

  • *Singh, S. (2016). Effects of mindfulness based therapy in managing aggression and conduct problem in adolescents with ADHD symptoms. Indian Journal of Health and Wellbeing, 7, 483 – 487. First citation in articleGoogle Scholar

  • Smalley, S. L., Loo., S. K., Shrestha, A., McGough, J., Flook, L. & Reise, S. (2009). Mindfulness and attention deficit hyperactivity disorder. Journal of Clinical Psychology, 65, 1087 – 98. First citation in articleCrossref, Google Scholar

  • *Weijer-Bergsma, E. van de, Formsma, A. R., Bruin, E. I. & Bögels, S. M. (2012). The effectiveness of mindfulness training on behavioral problems and attentional functioning in adolescents with ADHD. Journal of Child and Family Studies, 21, 775 – 787. First citation in articleCrossref, Google Scholar

  • *Zhang, D., Chan, S. K. C., Lo, H. H. M., Chan, C. Y. H., Chan, J. C. Y., Ting, K. T. et al. (2017). Mindfulness-based intervention for chinese children with ADHD and their parents: A pilot mixed-method study. Mindfulness, 8, 859 – 872. First citation in articleCrossref, Google Scholar