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      Mindfulness based cognitive therapy versus treatment as usual in adults with attention deficit hyperactivity disorder (ADHD)

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          Abstract

          Background

          Adults with attention deficit hyperactivity disorder (ADHD) often present with a lifelong pattern of core symptoms that is associated with impairments of functioning in daily life. This has a substantial personal and economic impact. In clinical practice there is a high need for additional or alternative interventions for existing treatments, usually consisting of pharmacotherapy and/or psycho-education. Although previous studies show preliminary evidence for the effectiveness of mindfulness-based interventions in reducing ADHD symptoms and improving executive functioning, these studies have methodological limitations. This study will take account of these limitations and will examine the effectiveness of Mindfulness Based Cognitive Therapy (MBCT) in further detail.

          Methods/design

          A multi-centre, parallel-group, randomised controlled trial will be conducted in N = 120 adults with ADHD. Patients will be randomised to MBCT in addition to treatment as usual (TAU) or TAU alone. Assessments will take place at baseline and at three, six and nine months after baseline. Primary outcome measure will be severity of ADHD symptoms rated by a blinded clinician. Secondary outcome measures will be self-reported ADHD symptoms, executive functioning, mindfulness skills, self-compassion, positive mental health and general functioning. In addition, a cost-effectiveness analysis will be conducted.

          Discussion

          This trial will offer valuable information about the clinical and cost-effectiveness of MBCT in addition to TAU compared to TAU alone in adults swith ADHD.

          Trial registration

          ClinicalTrials.gov NCT02463396. Registered 8 June 2015.

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          Most cited references34

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          Construction and factorial validation of a short form of the Self-Compassion Scale.

          The objective of the present study was to construct and validate a short-form version of the Self-Compassion Scale (SCS). Two Dutch samples were used to construct and cross-validate the factorial structure of a 12-item Self-Compassion Scale-Short Form (SCS-SF). The SCS-SF was then validated in a third, English sample. The SCS-SF demonstrated adequate internal consistency (Cronbach's alpha ≥ 0.86 in all samples) and a near-perfect correlation with the long form SCS (r ≥ 0.97 all samples). Confirmatory factor analysis on the SCS-SF supported the same six-factor structure as found in the long form, as well as a single higher-order factor of self-compassion. The SCS-SF thus represents a reliable and valid alternative to the long-form SCS, especially when looking at overall self-compassion scores. Copyright © 2010 John Wiley & Sons, Ltd.
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            The neuroscience of mindfulness meditation.

            Research over the past two decades broadly supports the claim that mindfulness meditation - practiced widely for the reduction of stress and promotion of health - exerts beneficial effects on physical and mental health, and cognitive performance. Recent neuroimaging studies have begun to uncover the brain areas and networks that mediate these positive effects. However, the underlying neural mechanisms remain unclear, and it is apparent that more methodologically rigorous studies are required if we are to gain a full understanding of the neuronal and molecular bases of the changes in the brain that accompany mindfulness meditation.
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              Prevalence and correlates of adult attention-deficit hyperactivity disorder: meta-analysis.

              In spite of the growing literature about adult attention-deficit hyperactivity disorder (ADHD), relatively little is known about the prevalence and correlates of this disorder. To estimate the prevalence of adult ADHD and to identify its demographic correlates using meta-regression analysis. We used the MEDLINE, PsycLit and EMBASE databases as well as hand-searching to find relevant publications. The pooled prevalence of adult ADHD was 2.5% (95% CI 2.1-3.1). Gender and mean age, interacting with each other, were significantly related to prevalence of ADHD. Meta-regression analysis indicated that the proportion of participants with ADHD decreased with age when men and women were equally represented in the sample. Prevalence of ADHD in adults declines with age in the general population. We think, however, that the unclear validity of DSM-IV diagnostic criteria for this condition can lead to reduced prevalence rates by underestimation of the prevalence of adult ADHD.
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                Author and article information

                Contributors
                Lotte.Janssen@radboudumc.nl
                Cees.Kan@radboudumc.nl
                P.Carpentier@rvagroep.nl
                B.Sizoo@dimence.nl
                Sevket.Hepark@radboudumc.nl
                Janneke.Grutters@radboudumc.nl
                Rogier.Donders@radboudumc.nl
                Jan.Buitelaar@radboudumc.nl
                Anne.Speckens@radboudumc.nl
                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central (London )
                1471-244X
                15 September 2015
                15 September 2015
                2015
                : 15
                : 216
                Affiliations
                [ ]Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
                [ ]Reinier van Arkel groep, ‘s-Hertogenbosch, The Netherlands
                [ ]Dimence, Deventer, The Netherlands
                [ ]Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
                [ ]Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
                Author information
                http://orcid.org/0000-0003-1967-8068
                Article
                591
                10.1186/s12888-015-0591-x
                4572448
                26373634
                2f31e966-8e34-4f07-a646-93b8cfce7fe1
                © Janssen et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 20 July 2015
                : 19 August 2015
                Categories
                Study Protocol
                Custom metadata
                © The Author(s) 2015

                Clinical Psychology & Psychiatry
                Clinical Psychology & Psychiatry

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