The effect of mindfulness-based interventions on enhancing attention control efficiency among twice-exceptional students in Saudi Arabia

IntroductionMindfulness is one of the potential alternative interventions for children with attention-deficit hyperactivity disorder (ADHD). Some evidence suggests that mindfulness is related to changes in brain regions associated with ADHD....

BackgroundAttention-Deficit-Hyperactivity-Disorder (ADHD) is, with a prevalence of 5 %, a highly common childhood disorder, and has severe impact on the lives of youngsters and their families. Medication is often the treatment of choice, as it currently is most effective. However, medication has only short-term effects, treatment adherence is often low and most importantly; medication has serious side effects. Therefore, there is a need for other interventions for youngsters with ADHD. Mindfulness training is emerging as a potentially effective training for children and adolescents with ADHD. The aim of this study is to compare the (cost) effectiveness of mindfulness training to the (cost) effectiveness of methylphenidate in children with ADHD on measures of attention and hyperactivity/impulsivity.Methods/designA multicenter randomized controlled trial with 2 follow-up measurements will be used to measure the effects of mindfulness training versus the effects of methylphenidate. Participants will be youngsters (aged 9 to 18) of both sexes diagnosed with ADHD, referred to urban and rural mental healthcare centers. We aim to include 120 families. The mindfulness training, using the MYmind protocol, will be conducted in small groups, and consists of 8 weekly 1.5-h sessions. Youngsters learn to focus and enhance their attention, awareness, and self-control by doing mindfulness exercises. Parents will follow a parallel mindful parenting training in which they learn to be fully present in the here and now with their child in a non-judgmental way, to take care of themselves, and to respond rather than react to difficult behavior of their child. Short-acting methylphenidate will be administered individually and monitored by a child psychiatrist. Assessments will take place at pre-test, post-test, and at follow-up 1 and 2 (respectively 4 and 10 months after the start of treatment). Informants are parents, children, teachers, and researchers.DiscussionThis study will inform mental health care professionals and health insurance companies about the clinical and cost effectiveness of mindfulness training for children and adolescents with ADHD and their parents compared to the effectiveness of methylphenidate. Limitations and several types of bias that are anticipated for this study are discussed.Trial registrationDutch Trial Register: NTR4206. Registered 11 October 2013.

(1) Objectives: Mindfulness-based interventions have been receiving more attention in research for children with attention deficit hyperactivity disorder (ADHD). This systematic review and meta-analysis was conducted to synthesize the findings of randomized controlled trials of mindfulness-based interventions for children with ADHD. (2) Methods: A systematic review and meta-analysis of studies published in PsycINFO, PubMed, and Google Scholar was completed from the earliest available date until August 2022. (3) Results: The systematic review included 12 studies that met the inclusion criteria, and the meta-analysis included 11 studies. The overall effect sizes were g = 0.77 for ADHD symptoms, g = 0.03 for externalizing behavior problem, g = 0.13 for internalizing behavior problem, g = 0.43 for mindfulness, and g = 0.40 for parental stress for children with ADHD. (4) Conclusion: The results of this systematic review highlight the possible benefits of mindfulness-based interventions for children with ADHD.

ObjectivesResearch demonstrates that meditation interventions tend to positively influence social well-being. Yet, prior research has exclusively examined meditation in relation to average levels of social outcomes (e.g., social connectedness), despite other work demonstrating variability or fluctuations in social functioning play a distinct role in contributing to well-being. This study examined the hypothesis that training in mindfulness meditation and loving-kindness meditation would predict lower variability in social connectedness, even accounting for their positive influence on average levels of social connectedness. Moreover, this study also examined the hypothesis that lower variability in positive and negative emotions would mediate the link between training in meditation and reduced variability in social connectedness.MethodsThese hypotheses were tested using a randomized study of 224 mid-life adults. Participants received training in either mindfulness or loving-kindness meditation for 6 weeks. They reported their daily social connectedness and emotions for 2 weeks prior to the training, 6 weeks during the training, and 3 weeks after the training.ResultsConsistent with hypotheses, results demonstrated that participants in both meditation groups reported lower variability in social connectedness across the course of the intervention, even accounting for average levels of connectedness. Moreover, lower positive and negative affective variability partially mediated the association between time (training in meditation) and reduced variability in social connectedness.ConclusionsThese results suggest that (a) meditation may help to smooth social ups and downs across time and that (b) it may do so via its association with reduced affective variability.

Little is known about the academic motivation of twice-exceptional students, although it represents a protective factor for academic success. Guided by Self-Determination Theory, this study investigated academic motivation among gifted-only and twice-exceptional students with Attention Deficit/Hyperactivity Disorder (ADHD) or a specific learning disorder (SLD), considering parent and student perspectives as well as student gender. Participants were 214 Canadian parents ( M age = 41.09; 93.50% mothers) of gifted-only and twice-exceptional elementary school students, and 103 of those students ( M age = 9.50; 62.10% boys) who completed online questionnaires. Twice-exceptional students reported lower levels of intrinsic motivation, integrated regulation, and self-efficacy than gifted-only students. Twice-exceptional girls showed higher levels of intrinsic motivation and identified regulation and lower levels of amotivation than twice-exceptional boys. These findings highlight the presence of a gender-masking effect on academic motivation among twice-exceptional students with ADHD or SLD, emphasizing the necessity of examining academic motivation through a gender-specific perspective within this population.

Objective Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent disorders in childhood, which may pose risks in later life such as academic underachievement and anti-social behaviour. It has been suggested that mindfulness-based interventions (MBI) may contribute to positive outcomes with child and adult populations. In this article, we aim to systematically review the literature regarding the effectiveness of MBI on both children with ADHD and their parents. Method Seven databases were searched using the PRISMA criteria and included peer-reviewed journals and grey literature. Results Ten studies met the inclusion criteria. Findings suggested that MBI had positive results in addressing attention deficits in children with ADHD, but in terms of hyperactivity, the evidence was conflicting. MBI interventions also appear to effectively address parental stress and family functioning. However, the rating from the quality assessment showed several methodological limitations. Discussion The current evidence on the impact of MBI on ADHD symptoms is non-conclusive. However, promising data indicated the potential for MBI in addressing parental stress and family functioning. Further research is recommended to overcome the current methodological limitations.

This study examines the effect of mindfulness training on improving executive functions—especially working memory and attention—among gifted students with special educational needs in learning English. The sample consisted of 46 gifted students with special educational needs, who were randomly divided into an experimental group and a control group. The study included an experimental phase during which a training program based on mindfulness strategies was implemented over 8 weeks. The results show that training children in mindfulness practices contributes to increased focus and reduced symptoms associated with Attention Deficit Hyperactivity Disorder (ADHD), such as impulsivity and hyperactivity. Moreover, the results revealed a significant improvement in working memory capacities, which play a central role in behaviour regulation and learning. Additionally, the study indicates that mindfulness interventions not only enhance cognitive performance but also help reduce stress and anxiety levels among students, thereby improving their overall mental health. The study highlights that regular mindfulness training helps children acquire skills to recognise and manage their emotions, thereby supporting the improvement of social relationships and daily task performance. The study emphasises the integration of these programs into comprehensive treatment plans that include psychological and behavioural support to ensure optimal outcomes. In conclusion, the study affirms that mindfulness represents a promising and beneficial approach as part of treatment strategies for attention deficit hyperactivity disorder, contributing to enhanced executive functioning, improved mental health, and strengthened academic and social performance in children and adolescents with the disorder.

Attention deficit disorder/hyperactivity: a scientific overview

Mindfulness-based interventions (MBIs) are increasingly used in adults with attention-deficit hyperactivity disorder (ADHD). The aim of the current study was to conduct a meta-analysis of the available studies on the effects of MBIs on ADHD symptoms, depression, and executive functioning in adults diagnosed with ADHD. Screening and selection of peer-reviewed literature using PRISMA-P guidelines on PsycINFO, PubMed, SCOPUS, and ERIC databases from inception to July 2019 A total of 14 studies were included in the meta-analysis, for an aggregated sample of 834 adults with ADHD. Overall, the results showed that MBIs are effective to treat ADHD symptoms in adults, as well as to reduce depression and dysexecutive problems post-intervention. MBIs are useful to improve ADHD symptoms, negative affect, and cognition in adult ADHD. The results contribute to better understanding and encourage the use of non-pharmacological treatments in ADHD.

Secular Mindfulness-Based Interventions: Efficacy and Neurobiology.

Background: Attention deficit hyperactivity disorder affecting both children and their parents. This study aimed to evaluate the effect of mindful parenting training for parents with children having attention deficit hyperactivity disorder on parenting stress. Quasi-experimental pre-test–post-test control group design has been implemented. A purposive sample has been used to select 100 parents (mothers or fathers) of children with attention deficit hyperactivity disorder. This study has been carried out at the psychiatric outpatient clinic of Menoufia University Hospital at Shebin El-kom District, Menoufia Governorate, Egypt. Three tools were used to gather the data; A structured interviewing questionnaire to assess socio-demographic characteristics of the parents and children characteristics, Parenting Stress Index – Short Form, and Interpersonal mindfulness in parenting scale. The results revealed that there was a highly statistically significant reduction in the total mean score of parenting stress among the study group after the intervention compared to the control group where p value (p = 0.001), and there was a statistical significant improvement in the level of mindfulness in parenting of the study group after the intervention compared to the control group. It was concluded that the mindful parenting training had statistically significant positive effect on reducing parenting stress and improving level of mindfulness of parents with children having attention deficit hyperactivity disorder. Recommendation: mindful parenting training should be incorporated into current treatment guidelines as a psychosocial option for families with attention deficit hyperactivity disorder

As part of inclusive education, teachers are likely to see two other categories of students with special needs that do not specifically fit into one of the 13 disability categories under IDEA: (a) students diagnosed with attention-deficit disorder (ADD)/attention-deficit/hyperactivity disorder (ADHD), and (b) twice-exceptional students. Both of these categories of students warrant individual attention in the discussion of inclusive education. Thus, this chapter provides an overview of ADD/ADHD and twice-exceptional students, discusses how these categories connect with IDEA, and presents important information for teachers working with ADD/ADHD and twice-exceptional students in inclusive classrooms. Specific research-based strategies that general education teachers can use to educate these students as well as resources for gaining further information are included.

FORMAL PRACTICES OF MINDFULNESS TRAINING AND THEIR BUDDHIST CONTEXT The aim of this monograph is to distinguish the main formal meditation practices present in mindfulness trainings and to show their place and function in the original Buddhist context. In the fi rst chapter, we analyze the four most popular and best known mindfulness trainings in Poland, i.e. MBSR, MBCT, MBLC and P. Gilbert and Choden’s mindful compassion training, presenting their genesis, structure and distinguishing the central formal practices. In the last point of this chapter, we divide formal meditation practices into four categories: based on concentration, open awareness practices, analytical/insight practices and practices based on working with imagination. Then we present the results of contemporary research on the eff ectiveness of specifi c practices. As the research shows, the greatest positive eff ectiveness in terms of psychology is characterized by open awareness/open monitoring practices, followed by practices based on concentration. The development of research on mindfulness trainings, related to the use of achievements in neuroscience and psychology, also leads to important observations, emphasizing the need for greater personalization of the meditation techniques used. In the second chapter, we present selected formal practices of mindfulness training in the context of Theravada Buddhism, the most widespread form of Buddhism in Southeast Asia. In the fi rst section, we outline the historical background of the development of Theravada, and in the second section, we present the main doctrinal ideas, i.e. the four noble truths, the idea of non-self, the chain of dependent origination, and the basic meditation practices according to classical sources such as the Satipaṭṭhāna Sutta (MN.010), which describes the establishments of mindfulness, the Sallekha Sutta (MN.008), which discusses the four meditative absorptions (Pāli jhāna), and Buddhagosha’s treatise Visuddhimagga, which clearly separates practices based on concentration (San. śamatha, Pāli samatha) from insight meditation (San. vipaśyanā; Pāli vipassanā). In the third point of this chapter, we show what place and function the practices of sitting meditation and walking meditation have within the framework of a 30-day retreat in the spirit of Theravada, led by J. Goldstein, and how mindfulness of breathing and body scanning are embedded in S.N. Goenka’s 10-day course of insight meditation. Chapter three is devoted to Japanese Zen Buddhism, as the most widespread representative of Mahayana Buddhism. Here, too, we begin by presenting the traditional history of Chan Buddhism in China and its transmission to Japan as Zen. Then we discuss the main doctrinal ideas such as the bodhisattva ideal, the concept of the Buddha nature present in all sentient beings, and the doctrine of emptiness, and we note the presence of Taozi infl uences. As the main meditation practices in Zen Buddhism, we present zazen with an object of concentration on the breath, shikantaza, and zazen with a koan. In the third section, we focus on analyzing the place and function of mindfulness of breathing, open monitoring, and mindful walking in the context of an intensive Zen retreat called sesshin. In the fourth chapter, we discuss Tibetan Buddhism. Similarly to the two previous chapters, we present an outline of this branch of Buddhism and its main doctrines and practices. In discussing doctrinal aspects, we focus particularly on showing the importance of tantra in Vajrayana Buddhism, as Tibetan Buddhism is also called, and the dzogchen teachings of the Nyingma school. Due to the fact that in this branch of Buddhism there is a huge number of meditation practices, largely based on visualization and transmitted in an individualized way by the guru/lama to a specifi c disciple, we have discussed the so-called preliminary practices, called nyndro, i.e. prostrations and taking refuge, Vajrasattva meditation, mandala off ering, and guru yoga. In the third section, we present the formal practices of creating a safe place, compassionate imagination, compassion for the self, and tong-len and their relationship to Tibetan Buddhism. We focus in particular on the role of visualization and imagination within Vajrayana practices and mindfulness and compassion trainings. We also show the similarities and diff erences between some Dzogchen practices and open monitoring as a practice developing mindfulness. The last chapter is devoted to the assessment of the mindfulness movement from a Buddhist perspective. We narrow this perspective to the voices expressed by representatives of Zen Buddhism on mindfulness training. The starting point for the considerations in this section was an essay by a Zen master of the secular Empty Cloud Line, Aleksander Poraj-Żakiej, entitled Zen and the practice of mindfulness, published on the blog wszystkoJEDNO.org. The fi rst clear diff erence between Zen Buddhism and mindfulness training concerns the purposefulness and benefi ts associated with these two paths of development. In this context, we address the problem of the degree of secularization and adaptation of Zen Buddhism to the Western mentality and the problem of the secularity of mindfulness. In the case of the mindfulness movement, this is related to the discussion on the development of the so-called second-generation mindfulness-based interventions (SG-MBIs), emphasizing the need to take greater account of the Buddhist roots of this trend without giving up secularity. The second area that diff erentiates Buddhism from mindfulness training is the role and signifi cance of the subject/observer. In the context of this remark, we show that the understanding of the subject is closely linked in Buddhism to a broader doctrinal background, assuming a specifi c ontology and anthropology. We also discuss the signifi cance of the master in Zen Buddhism also asking about the competence of mindfulness teachers in this matter. The last area of diff erence indicated by Aleksander Poraj-Żakiej is the role of breathing, and thus the role of formal meditation techniques. The considerations and analyses carried out in fi ve chapters allow us to answer the research problems posed in the introduction, resulting from the proposed topic of the issue. First, in all branches of Buddhism we can note a clearly soteriological orientation of all meditation practices. Of course, this soteriological goal is described using diff erent concepts, taking into account the specifi city of individual branches of Buddhism. Secondly, the individual meditation practices that have become the source basis for formal secular mindfulness training practices are integrally connected to the entire doctrinal system of a given branch of Buddhism, including its ontology, anthropology and psychology. Through the process of extracting individual meditation practices from their Buddhist world and placing them in a new, secular and scientifi c context, it has inevitably led to the need to develop new theoretical frameworks or paradigms in which they now function. An example of this type of new paradigm is, for example, the scientifi c verifi cation of the eff ectiveness and benefi ts of mindfulness training practices based on the tools of psychology and neuroscience. Third, in the context of recommended meditation practices and evaluation of their eff ectiveness, the roles of a mindfulness teacher/instructor and a Buddhist master/teacher are completely diff erent. A mindfulness training teacher basically follows the structure of the program. Their task is to organize and conduct group sessions, convey content related to a given stage of the program, accompany and support students. Apart from programs such as MBCT, completing psychology studies is not required. Courses for individual mindfulness training instructors contain modules related to teaching and working with students, which allow them to acquire suffi cient competences to conduct them. In any crisis or diffi cult situations related to the mental health of participants, the teacher should recommend consultation with a psychologist, therapist or psychiatrist. On the other hand, a Buddhist teacher has defi nitely diff erent competences. This diff erence in roles was clearly visible in chapters two, three and four. First, obtaining the title of teacher is associated with practicing a given form of Buddhism for many years. In Thai Theravada Buddhism, to obtain the title of teacher, i.e. ajahn, one must live in a monastic community for 10 years. To become a Zen master in the Rinzai school, one must have an experience of awakening confi rmed by one’s own master, undergo koan training, and integrate this experience into many years of training after awakening. In Tibetan Buddhism, both one’s own experience of insight into the nature of mind and the entire path of a given tradition are also of key importance. This process also takes many years and requires receiving confirmation from one’s own guru/lama. Secondly, since the practice of meditation in a given tradition of Buddhism is not limited to a specifi c period of time, such as 8 weeks in many mindfulness courses, the master accompanies and supports the student for many years. It is the authentic master who is able to assess the student’s state of advancement, the experiences they have had, or their actual awakening. If a mindfulness practitioner has a deeper experience, the instructor has a real problem of assessing this phenomenon. He or she does not have the tools and procedures to verify the experience of insight or the experience of some states that may falsely pass for insight (makyo in Zen Buddhism). It seems very likely that this state of aff airs is a consequence of placing Buddhist practices in a secular, scientifi c paradigm. This paradigm is characterized by a systematic naturalistic approach to reality, in which concepts such as “insight into the nature of things” or “awakening” may not fully fi t, due to their religious, ontological provenance. Of course, such a person can be referred to a psychologist or psychiatrist, but even there it is not possible to really verify the experience of insight. Hence, it seems very useful for mindfulness teachers to have some knowledge about Buddhism and the Buddhist sources of mindfulness training so that they can at least to some extent recognize what types of experience they may be dealing with during their courses. In addition, it is also benefi cial for participants of mindfulness programs to obtain a certain amount of knowledge about the connections between mindfulness and Buddhism. The mindfulness movement will continue to develop and gain popularity. The development of psychology and especially neuroscience will enable, and already does enable, increasingly personalized selection of specifi c meditation practices to a given psychological profi le of a person developing mindfulness. There will probably be more new programs. However, as the discussion related to SG-MBIs shows, the mindfulness movement cannot and should not forget its Buddhist roots. While maintaining its secular and scientifi c character, it should continue to enter into dialogue with Buddhism, searching for its own ethical foundations and protecting itself from the constant temptation of commercialization and instrumentalization.

Mindfulness meditation training has been shown to reduce stress and improve short-term memory for military personnel. However, no studies have investigated the effects of in-person and virtual world (VW) mindfulness training on Post-Traumatic Stress Disorder (PTSD) or Attention Deficit Hyperactivity Disorder (ADHD) symptoms. In this study, U.S. military active duty service members and veterans were pseudo-randomized into two mindfulness training groups: in-person (IP) and online via a VW, and a wait-list control group. Volunteers answered a demographic questionnaire, and completed the PTSD Checklist-Military Version (PCL-M) and ADHD Current Symptoms Scale before and after training. The results showed practical and clinically relevant reductions in PTSD symptoms, particular for the IP group, but did not show statistical relevance with hypothesis testing. Results also showed post-training reductions in ADHD symptoms for both IP and VW groups, but no change for the control group. To investigate the effects of initial ADHD symptoms, IP and VW groups were combined into a single Mindfulness Training group. Those with high-initial ADHD symptoms attending training showed improvements, but the control group did not. These results expand research on the mindfulness training, and suggest that IP mindfulness training, rather than VW training, may be of greater benefit for those with PTSD symptoms, while either delivery system appears adequate for reducing attentional symptoms.

BackgroundAttention deficit hyperactivity disorder (ADHD) is associated with poor educational outcomes that can have long-term negative effects on the mental health, wellbeing, and socio-economic outcomes of university students. Mental health provision for university students with ADHD is often inadequate due to long waiting times for access to diagnosis and treatment in specialist National Health Service (NHS) clinics. ADHD is a hidden and marginalised disability, and within higher education in the UK, the categorisation of ADHD as a specific learning difference (or difficulty) may be contributing to this.AimsThis consensus aims to provide an informed understanding of the impact of ADHD on the educational (or academic) outcomes of university students and highlight an urgent need for timely access to treatment and management.MethodsThe UK Adult ADHD Network (UKAAN) convened a meeting of practitioners and experts from England, Wales, and Scotland, to discuss issues that university students with ADHD can experience or present with during their programme of studies and how best to address them. A report on the collective analysis, evaluation, and opinions of the expert panel and published literature about the impact of ADHD on the educational outcomes of university students is presented.ResultsA consensus was reached that offers expert advice, practical guidance, and recommendations to support the medical, education, and disability practitioners working with university students with ADHD.ConclusionsPractical advice, guidance, and recommendations based on expert consensus can inform the identification of ADHD in university students, personalised interventions, and educational support, as well as contribute to existing research in this topic area. There is a need to move away from prevailing notions within higher education about ADHD being a specific learning difference (or difficulty) and attend to the urgent need for university students with ADHD to have timely access to treatment and support. A multimodal approach can be adapted to support university students with ADHD. This approach would view timely access to treatment, including reasonable adjustments and educational support, as having a positive impact on the academic performance and achievement of university students with ADHD.