Taming the Wandering Mind: Mindful Awareness Meditation and Adult ADHD Makelya I. Hayes
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ttention-deficit hyperactivity disorder (ADHD) is the most common learning and neurodevelopmental disorder among Americans, afflicting between 5 to 10% of children and approximately 3 to 5 % of adults (Wender & Tomb, 2017). Once considered a childhood disorder, ADHD is now estimated to continue into adulthood for 40 to 60% of those diagnosed during childhood (Volkow & Swanson, 2013). It has been estimated that as many as eight million adults have ADHD in the United States (Targum & Adler, 2014). The tendency to have a problematically wandering mind is not confined to childhood. Beyond the problems it presents for school achievement, we now know from experiential sampling studies that mind-wandering also produces unhappiness (Killingsworth & Gilbert, 2010). Still, much remains unknown about adult ADHD relative to what is known about children and adolescents. Although adults and children may experience ADHD differently, the treatment they receive typically involves stimulant medication and may not be ideal for long-term use (Volkow & Swanson, 2013). Short-acting stimulant drugs have a higher chance of being abused, leading to addictive effects like cocaine (Kooij, 2013). Treatment practice is ineffective for long-acting and shortacting stimulant drugs because patients forget to take their medication (Kooij, 2013). Clinical results for stimulants have revealed that adjustments for dosage are necessary for maximizing symptom control while minimizing adverse effects (Volkow & Swanson, 2013). Too few randomized trials have investigated the long-term (i.e., six months or more) effects of ADHD medications (Volkow & Swanson, 2013). There seems to be a continuing need for a solution that challenges the standard of treating mental health disorders. Mindfulness & Mindfulness-Based Interventions (MBIs) Recent research suggests that mindfulness and other forms of mental training may provide viable alternatives or companion treatment. Rooted in Buddhism and eastern traditions and philosophy,
mindfulness is defined as paying attention to the present experience without judgment. In practicing mindfulness, one seeks to change one’s response to thoughts, rather than changing the content of the thoughts themselves, similar to some forms of cognitive-behavioral therapy (Househam & Solanto, 2016). In the 1970s, Jon Kabat-Zinn introduced mindfulness-based interventions (MBIs) to primarily treat stress that contributes to mental illness in adults (Househam & Solanto, 2016). Two of the most utilized MBIs are mindfulnessbased cognitive therapy (MBCT) and mindfulnessbased stress reduction (MBSR). According to two recent systematic reviews, the results for both interventions showed a reduction in symptoms involving a lack of attention, executive functioning, and emotional regulation in adults (ages 18-65). More specifically, Lee and colleagues (2017) found that half of the studies examined demonstrated improvement in attention in adults. Poissant et al. (2019) reported that all the studies reviewed presented significant improvements in ADHD symptoms (i.e., inattention and hyperactivity), as well as cognitive task performance postintervention, in which the reduction was maintained at follow-up (i.e., three to six months after the intervention concluded). Most of the participants were medicated (e.g., methylphenidate). Five out of thirteen studies included participants with comorbid disorders (i.e., anxiety disorder or symptoms, bipolar disorder, eating disorder, etc.). Another meta-analysis of eleven studies (Poissant et al., 2020) found a combined effect size [Hedge’s g = – 0.591, 95% CI = – 0.858 to – 0.324, p < 0.0001] that showed an improvement in ADHD symptoms. This analysis also investigated treatment outcomes of MBIs on executive functioning. Nine studies revealed improved dysexecutive problems; seven studies with comparison groups and two pre to post studies had significant improvement based on combined effect size (Poissant et al., 2020). Another recent mixed-method pilot study on MBCT for adults with ADHD exhibited a significant reduction of ADHD symptoms (i.e., inattention, hyperactive-impulsive, and executive functioning symptoms). Twenty-six percent of patients had a clinically relevant reduction in ADHD symptoms,
