Methylphenidate or Family Mindfulness? Effects on Internalizing, Externalizing and Social Problems in Children with Attention Deficit Hyperactivity Disorder
Brett Kosterman Zoller, Susan M. 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.
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
Cited by 3
- The effects of an online mindfulness-based intervention for parents of children with attention deficit/hyperactivity disorder. Journal of Affective Disorders October 20, 2026
- Cost-Effectiveness of a Child and Parent Mindfulness-Based Training Versus Medication for Childhood ADHD. Journal of Attention Disorders August 24, 2026
- Mechanisms of Change in Mindfulness-Based Family Intervention (MYmind) Versus Methylphenidate for Childhood ADHD: A Randomized Controlled Trial Children March 23, 2026
Cites 13
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- Mindfulness-Based Program for Children with Autism Spectrum Disorder and Their Parents: Direct and Long-Term Improvements Mindfulness October 5, 2017
- Does mindfulness-based cognitive therapy with tapering support reduce risk of relapse/recurrence in major depressive disorder by enhancing positive affect? A secondary analysis of the PREVENT trial. Journal of Consulting and Clinical Psychology September 1, 2024
- Child and Parent Mindfulness-Based Training Versus Medication for Childhood ADHD: A Randomised Clinical Trial Mindfulness February 1, 2024
and 8 more in the library