Kosterman Zoller Brett, Bögels Susan M, Meppelink Renee, de Bruin Esther I
Research Institute of Child Development and Education (RICDE), University of Amsterdam, 1018 WS Amsterdam, The Netherlands.
Developmental Psychology, University of Amsterdam, 1018 WB Amsterdam, The Netherlands.
Children (Basel). 2025 May 26;12(6):681. doi: 10.3390/children12060681.
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.
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).
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.
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.
外化问题、内化问题和社交问题是多动症儿童常见的共病情况。本研究探讨了哌甲酯与儿童及家长并行正念训练项目（MYmind）对儿童内化问题、外化问题和社交问题的影响。数据来自我们的随机对照试验，该试验调查了对儿童多动症症状这一主要结局的治疗效果。
儿童按照分配的治疗方案接受治疗4个月：46名儿童在正念训练组，42名儿童在药物治疗组。多水平模型分析了四位信息提供者（母亲、父亲、儿童和教师）在三个随访时间点（短期，2个月；中期，4个月；长期，10个月）的反应。
两个治疗组在所有结局上均较基线有所改善。在任何时间点，儿童报告的正念觉察改善情况在两组之间均未发现差异。在短期随访中，与正念训练组相比，药物治疗组儿童在母亲观察到的内化问题、外化问题（母亲；父亲）和社交问题（母亲；教师）方面减少得更多。在中期随访中，父亲观察到药物治疗组儿童在外化问题上的减少幅度仍然更大，但在所有其他结局上，信息提供者的报告在两组之间没有差异。在长期随访中，没有信息提供者报告治疗组在对内化、外化或社交问题的影响上存在任何差异。
鉴于在短期、中期和长期观察到类似的改善情况，对于寻求药物替代方法以减少共病的外化、内化和/或社交问题的多动症儿童家庭而言，正念训练可能是一种可行的选择。
