Comparing the Effectiveness of Mindfulness-Based Cognitive Therapy and Neurofeedback on Executive Functions in Children with Attention-Deficit/ Hyperactivity Disorder

Attention–Deficit/Hyperactivity Disorder (ADHD) is a mental disorder marked by an ongoing pattern of inattention and hyperactivity–impulsivity that interferes with functioning or development. Inattention and hyperactivity/impulsivity are the key symptoms of ADHD. ADHD is among the most prevalent childhood psychiatric disorders that could lead to irreversible complications and injuries if not given proper treatment. In terms of the etiology of ADHD, various issues have been discussed based on damage to executive functions. Among the most critical executive functions, working memory and planning ability could be mentioned. Mindfulness–Based Cognitive Therapy (MBCT) is a combination of cognitive–behavioral therapy and mindfulness therapy, and one of the methods of teaching sustained attention. Mindfulness could be defined as directing attention in a specific, purpose–oriented way in the present and without judgment. Neurofeedback (NF) is another non–pharmacological treatment option, which has recently gained significant experimental support concerning the improvement of the symptoms of ADHD. NF attempts to teach the subject a self–regulation strategy by recording the brainchr('39')s electrical waves and providing feedback. Feedback is usually given to the person through sound or image, which helps to determine if it has made a significant change in their brainwave activity. The present study aimed to compare the effects of MBCT and NF on executive functions (working memory & planning ability) in children with ADHD. 

This was a quasi–experimental study with a pretest–posttest and a control group design. The population of this study included all children aged 9–12 years, referring to counseling and psychology clinics in Tabriz City, Iran. After observing the inclusion and exclusion criteria of the research and implementing the Child Symptom Inventory–4 (CSI–4), Child Behavior Checklist (CBCL), Integrated Visual and Auditory (IVA) scale, and diagnosis by a child psychologist, 45 ADHD children were selected. The study subjects were randomly divided into three groups, as follows: MBCT, NF, and the controls. All subjects completed the Wechsler Memory Scale, Fourth Edition (WMS–IV), and the Tower of London test before and after conducting the treatment. The reliability of the WMS–IV has been reported from 0.65 to 0.95. The validity of this test was also reported from 0.66 to 0.92 (Abedi, Sadeghi, and Rabiei, 2011). The reliability of the Tower of London test was reported equal to 0.80. The researchers also reported the validity of this test as 0.79 (Lezak, Howieson & Loring, 2004). The members of the MBCT group received treatment in 15 sessions, and those of the NF group received 25 sessions of intervention; however, the control group received no treatment. The collected data were analyzed by SPSS–24 using Multivariate Analysis of Covariance (ANCOVA) and Bonferroni posthoc test.

The obtained data indicated that MBCT and NF affected the executive functions (working memory & planning ability) in children with ADHD. Findings also revealed that MBCT had a more significant effect on executive functions (working memory & planning ability) in the studied children with ADHD in the posttest phase, compared to the NF group (p<0.001).

Considering the effectiveness of MBCT on executive functions (working memory & planning ability) in children with ADHD, this study highlighted the importance of using this method, along with other approaches to reduce the ADHD symptoms.