Mindfulness-Based ADHD Treatment for Children: a Feasibility Study

基于正念的儿童多动症治疗：可行性研究

基本信息

批准号：
9977970
负责人：
Hedy Kober
金额：
$ 33.5万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-07-15 至 2022-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9977970
关键词：
3-Dimensional Achievement Adolescent Adult Adverse effects Affect Aftercare Age American Anxiety Anxiety Disorders Area Attention Attention deficit hyperactivity disorder Behavior Behavior Therapy Behavioral Borderline Personality Disorder Brain Caucasians Child Clinical Cognitive Complementary Medicine Data Development Disadvantaged Disease Distress Eating Disorders Economic Burden Effectiveness Exercise Feasibility Studies Focus Groups Funding Goals Gold Grant Guidelines Headache Impairment Integrative Medicine Intervention Interview Investigation Length Location Logistics Manuals Measures Medical Meditation Mental Depression Mental disorders Mind-Body Intervention Neighborhood Health Center Neurobiology Neurocognitive Neurocognitive Deficit Neurodevelopmental Disorder Neuropsychology Neurosciences Outcome Pain intensity Parents Participant Patients Persons Pharmaceutical Preparations Pharmacology Pharmacotherapy Population Procedures Protocols documentation Provider Randomized Regulation Reporting Rest Series Severities Short-Term Memory Site Sleeplessness Social Phobia Source Standardization Stress Students Substance Use Disorder Symptoms System Testing Time Training Work adverse outcome appetite loss base chronic pain patient comorbidity design effective therapy efficacy study efficacy trial elementary school emotion regulation executive function externalizing behavior feasibility trial follow-up impaired capacity improved indexing innovation medication compliance mindfulness mindfulness intervention mindfulness-based stress reduction minority communities novel preference prospective psychosocial recruit scale up side effect standard care substance misuse symptomatic improvement teacher treatment group treatment program willingness

项目摘要

Abstract/Summary Attention-Deficit/Hyperactivity Disorder (ADHD) affects 11% of children and leads to adverse outcomes[1,2]. These include impaired psychosocial, educational, and neuropsychological development, lower achievement levels across domains, and distress, often continuing into adulthood[3–7]. Medications, while often effective in reducing certain ADHD symptoms, have many disadvantages, including misuse and side effects[8–15]. Behavioral interventions do not have these adverse effects, but they are not as effective[9,10]. Mindfulness has been the subject of increasing academic and clinical attention[16]. In recent years, it has been studied in adult populations for a variety of medical and psychiatric conditions, and it is known to be effective across disorders, including ADHD[17–34]. Moreover, we and others have shown that it improves attention and emotion regulation, and alters resting state brain activity and connectivity[35,36]. However, investigations in children and adolescents are far less common[37–40]. To our knowledge, mindfulness as an intervention for ADHD in elementary school children has not been systematically and rigorously studied. We propose to evaluate the feasibility and acceptability of Mindfulness-Based ADHD Treatment for Children (MBAT-C), a novel neuroscience-informed intervention for elementary school children, in an underserved area. MBAT-C is designed for children at precisely the age when ADHD-relevant neurocognitive systems are developing and clinical symptoms begin to appear. There is reason to believe that this innovative treatment will succeed in treating ADHD, given the overlap between neuroscientific mechanisms by which mindfulness exerts its effects and the neurobiology of ADHD[41–44]. Proposed mechanisms of mindfulness include modulation of subsystems of attention, suggesting that a treatment program that targets the attention regulation capacities impaired in elementary school children with ADHD may be efficacious. Forty-five children from Southwest Community Health Center in Bridgeport, CT will be recruited to participate in this randomized- controlled feasibility trial that will compare MBAT-C and medication. Aim 1 is to finalize the MBAT-C manual. Aim 2 is to evaluate the feasibility of MBAT-C on indices of recruitment, randomization, attendance, medication adherence, participation, retention, homework completion, acceptance, and teacher fidelity. Aim 3 is to preliminarily evaluate (within group) pre-, post-, and follow-up measures of ADHD severity, behavior, attention, executive function, working memory, and mindfulness. In accordance with the National Center for Complementary and Integrative Medicine’s framework for developing mind and body interventions, data from this feasibility study will be used in subsequent mechanism- based, multi-site feasibility, and multi-site efficacy studies that will be funded by R61/R33, U01, UG3/UH3+U24 grants, respectively, as well as a K23 training grant. The ultimate goal is to develop a non-pharmacologic intervention for children with ADHD with the efficacy of pharmacotherapy, but without its side effects.

摘要/总结注意力缺陷/多动障碍 (ADHD) 影响 11% 的儿童，并导致不良后果[1,2]，其中包括社会心理、教育和神经心理发展受损、各领域的成就水平较低以及痛苦，通常会持续到成年期[1,2]。 3-7] 药物虽然通常可以有效减轻某些 ADHD 症状，但也有许多缺点，包括误用和副作用[8-15]。有效[9,10]。近年来，正念已成为学术和临床关注的焦点[16]，它在成年人群中针对各种医学和精神疾病进行了研究，并且众所周知它在各种疾病中都有效。此外，我们和其他人已经证明它可以改善注意力和情绪调节，并改变静息状态下的大脑活动和连接性[35,36]。据我们所知，正念作为小学生多动症的干预措施尚未得到系统和严格的研究，我们建议评估基于正念的儿童多动症治疗（MBAT-C）的可行性和可接受性。是一种针对服务匮乏地区小学生的新颖的神经科学干预措施。 MBAT-C 专为 ADHD 相关神经认知系统正在发育且临床症状开始出现的年龄的儿童而设计。鉴于正念的神经科学机制之间的重叠，我们有理由相信这种创新疗法将成功治疗 ADHD。发挥其影响和 ADHD 的神经生物学[41-44] 提出的正念机制包括注意力子系统的调节，这表明针对患有 ADHD 的小学生注意力调节能力受损的治疗方案可能会。来自康涅狄格州布里奇波特西南社区健康中心的 45 名儿童将被招募参加这项随机对照可行性试验，该试验将比较 MBAT-C 和药物，目标 1 是最终确定 MBAT-C 手册。目标 3 是初步评估（组内）。 ADHD 严重程度、行为、注意力、执行功能、工作记忆和正念的前、后和后续测量。根据国家补充和综合医学中心制定身心干预措施的框架，本可行性研究的数据将用于后续基于机制的多中心可行性和多中心疗效研究，这些研究将由 R61 资助/R33、U01、UG3/UH3+U24 补助金，以及 K23 培训补助金最终目标是为 ADHD 儿童开发一种具有药物治疗功效的非药物干预措施，但没有副作用。