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The effects of mindfulness and cognitive strategy interventions on core symptoms in children with ADHD: A randomized controlled trial.

Xueke Wang, Li Chen, Tingyong Feng

Journal of Affective Disorders October 1, 2025 DOI: 10.1016/j.jad.2025.120513 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Peer reviewed
Sample size 70
Population Children with ADHD aged 6-12
Duration 12-week intervention; 1- and 4-month follow-ups
Topics Meditation
Key findings Both mindfulness-plus-cognitive-behavioral and cognitive-behavioral-plus-mindfulness 12-week interventions reduced parent-rated ADHD symptoms in children compared with usual care (effect sizes 0.68 and 0.55), with effects maintained at 1- and 4-month follow-ups. Reliable improvement was more common in intervention groups (63.6% and 52.2%) than controls (8.0%), and improvements in inhibitory control predicted symptom reduction. The mindfulness-first group showed greater reductions in hyperactivity-impulsivity and executive function deficits.

Abstract

Psychological interventions based on mindfulness and cognition have shown promise for treating ADHD, yet their application in children remains understudied. This study aimed to investigate the effectiveness and sustainability of mindfulness and cognitive strategy interventions in reducing core symptoms of ADHD in children. A randomized controlled trial (RCT) was conducted involving 70 children with ADHD aged 6-12, who were randomly assigned to one of three groups: a mindfulness-based cognitive intervention group (M + CB, n = 22), a cognitive-based mindfulness intervention group (C + MB, n = 23), both of which consisted of a 12-week intervention involving mindfulness and cognitive-behavioral strategy training, or a control group (n = 25) that followed care-as-usual without psychological intervention. Both M + CB and C + MB groups showed significant reductions in parent-rated ADHD symptoms [M + CB: d = 0.68, p < 0.01; C + MB: d = 0.55, p < 0.01] at post-treatment compared to the control group. These effects were consistently maintained at 1- and 4-months follow-ups. A higher proportion of children showed reliable post-treatment improvements in the intervention groups versus the control group (63.6 % vs. 52.2 % vs. 8.0 %, p < 0.01), with those having more severe baseline symptoms benefiting more from the intervention. Significant improvements were also observed in child-measured inhibitory control, with these changes predicting the degree of improvement in core symptoms. Additionally, the M + CB group exhibited greater reductions in parent-rated hyperactivity-impulsivity symptoms and executive function deficits, as well as enhanced performance in child-measured executive function. This study provides evidence supporting the effectiveness of interventions combining mindfulness and cognitive-behavioral strategies for children with ADHD, which may be valuable treatment options for reducing symptoms and enhancing executive functions.