Mindfulness Intervention Reduced Executive Dysfunction, Delay Aversion, and ADHD Symptoms: A Randomized Controlled Trial Based on the Dual Pathway Model.
Man-Ying Kang, Yves Cho Ho Cheung, D. F. K. Wong
The Behavior Therapist 2026 DOI: 10.1016/j.beth.2026.01.002 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 120 |
| Population | Adults with elevated ADHD symptoms |
| Intervention | Mindfulness-based intervention |
| Duration | 8-week intervention |
| Topics | Meditation |
| Key findings | The mindfulness-based intervention reduced ADHD symptoms, executive dysfunction, and delay aversion, and increased trait mindfulness relative to a waitlist control. Changes in trait mindfulness and executive dysfunction sequentially mediated the ADHD symptom reduction, and trait mindfulness changes mediated delay aversion reduction. Delay aversion reduction was not associated with ADHD symptom reduction when executive dysfunction and trait mindfulness were included, suggesting that improved trait mindfulness and subsequent executive dysfunction are possible therapeutic mechanisms. |
Abstract
In the dual pathway model, executive dysfunction (EDF) and delay aversion (DEL) are key mechanisms underlying ADHD. This study aimed to develop and evaluate a pathway model to elucidate the mediating roles of trait mindfulness (TM), EDF, and DEL in mindfulness-based interventions' (MBIs) impact on ADHD symptoms. 120 adults (Mage = 25.11, SDage = 5.33) exhibiting elevated ADHD symptoms were randomized into either an 8-week MBI group (n = 60) or a waitlist control group (n = 60). ADHD symptoms, EDF, DEL, and TM were assessed. Structural equation modeling was used to examine a theoretical pathway model and construct a data-driven model. Compared with the control group, the intervention group exhibited significant reductions in EDF, DEL, and ADHD symptoms and increased TM. Changes in TM and EDF sequentially mediated the effect of MBI on ADHD symptom reduction. Additionally, changes in TM mediated the impact of MBI on DEL reduction. However, DEL reduction did not link to changes in ADHD symptoms when EDF and TM were considered. It empirically indicated that improvement in TM and, subsequently, improvement in EDF are possible therapeutic mechanisms of MBIs on adult ADHD symptoms. While increased TM was associated with DEL reductions, this pathway was insignificantly related to ADHD symptom reduction.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cites 18
- Using Self-Report Assessment Methods to Explore Facets of Mindfulness Assessment January 27, 2006
- Positive Psychological States in the Arc from Mindfulness to Self-Transcendence: Extensions of the Mindfulness-to-Meaning Theory and Applications to Addiction and Chronic Pain Treatment Current Opinion in Psychology January 14, 2019
- Self-Regulation Without Force: Can Awareness Leverage Reward to Drive Behavior Change? Perspectives on Psychological Science August 28, 2020
- Mindfulness and Attention Deficit Hyperactivity Disorder The Journal of Nervous and Mental Disease July 21, 2021
- The efficacy of mindfulness-based interventions in attention-deficit/hyperactivity disorder beyond core symptoms: A systematic review, meta-analysis, and meta-regression. Journal of Affective Disorders September 1, 2021
and 13 more in the library