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Methylphenidate or Family Mindfulness? Effects on Internalizing, Externalizing and Social Problems in Children with Attention Deficit Hyperactivity Disorder

Brett Kosterman Zoller, S. Bögels, Renée Meppelink, E. D. de Bruin

Children May 26, 2025 DOI: 10.3390/children12060681 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Peer reviewed
Sample size 88
Population Children with ADHD
Interventions Methylphenidate Mindfulness program (MYmind)
Duration 4-month treatment, with follow-up at 2, 4, and 10 months
Topics Meditation
Key findings Both methylphenidate and the MYmind mindfulness program were associated with improvements in children's internalizing, externalizing, and social problems from baseline. Medication showed greater short-term reductions on several outcomes, but by the 10-month follow-up no informant reported differences between groups. The authors conclude mindfulness might be a viable alternative to medication for families seeking to reduce comorbid problems.

Abstract

Background: Externalizing, internalizing and social problems are frequent comorbidities for children with ADHD. This study explored the effects of methylphenidate versus a child and parents’ parallel mindfulness program (MYmind) on children’s internalizing, externalizing and social problems. Data came from our RCT investigating treatment effects on the primary outcome of children’s ADHD symptoms.

Methods: Children followed their ascribed course of treatment for 4 months: 46 children were in the mindfulness group and 42 in the medication group. Multilevel modeling analyzed the responses of four informants (mothers, fathers, children and teachers) across three follow-up points: short-term (2 months), medium-term (4 months) and long-term (10 months).

Results: Both treatment groups improved from the baseline across all outcomes. No differences were found between groups on improvement of mindful awareness as reported by children at any time point. At the short-term follow-up, children in the medication group showed greater reductions as compared to those in the mindfulness group on internalizing problems (as observed by mothers), externalizing problems (mothers; fathers) and social problems (mothers; teachers). At the medium-term follow-up, children in the medication group still showed larger reductions in externalizing problems as observed by fathers, but on all other outcomes, informants’ reports did not differ between groups. At the long-term follow-up, none of the informants reported any differences between treatment groups in effects on internalizing, externalizing or social problems.

Conclusions: Given the observations of similar improvements at short-, medium- and long-term, mindfulness might be a viable option for families of children with ADHD who are seeking an alternative to medication to reduce comorbid externalizing, internalizing and/or social problems.