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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：
10197772
负责人：
Hedy Kober
金额：
$ 25.13万
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 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10197772
关键词：
3-Dimensional Achievement Adolescent Adult Adverse effects Affect Aftercare Age American Anxiety Anxiety Disorders 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 acceptability and feasibility 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 underserved area 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/概要注意力缺陷/多动障碍（ADHD）影响11%的儿童，并导致不良后果[1，2]。这些包括受损的心理社会，教育和神经心理学发展，跨领域的成就水平较低，以及痛苦，通常持续到成年[3-7]。药物，虽然往往有效地减少某些ADHD症状，有许多缺点，包括误用和副作用[8-15]。行为干预没有这些不良影响，但它们并不有效[9，10]。正念一直是越来越多的学术和临床关注的主题[16]。近年来，它已在成人人群中研究了各种医疗和精神疾病，并且已知它对包括ADHD在内的疾病有效[17-34]。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[35，36]。然而，在儿童和青少年中的调查远不常见[37-40]。据我们所知，正念作为小学儿童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ADHD儿童治疗（MBAT-C）的可行性和可接受性，MBAT-C是一种针对小学儿童的新型神经科学干预措施。 MBAT-C是专为儿童在正是年龄时，多动症相关的神经认知系统正在发展和临床症状开始出现。有理由相信这种创新的治疗方法将成功地治疗ADHD，因为正念发挥其作用的神经科学机制与ADHD的神经生物学之间存在重叠[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ADHD小学儿童注意力调节能力受损的治疗方案可能是有效的。将从位于康涅狄格州布里奇波特的西南社区健康中心招募45名儿童参加这项随机对照可行性试验，该试验将比较MBAT-C和药物治疗。目标1是最后完成MBAT-C手册。目的2是评估MBAT-C的可行性指标的招聘，随机化，出勤率，服药依从性，参与，保留，家庭作业完成，接受和教师的忠诚度。目的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，后和后续措施。根据国家补充和整合医学中心开发身心干预措施的框架，本可行性研究的数据将用于随后的基于机制的多中心可行性和多中心疗效研究，这些研究将分别由R61/R33、U 01、UG 3/UH 3 +U24赠款以及K23培训赠款资助。最终目标是开发一种对ADHD儿童具有药物治疗效果，但没有其副作用的非药物干预方法。