Efficacy of mindfulness-based interventions for children and adolescents with attention deficit hyperactivity disorder: a systematic review and meta-analysis

Background and objectiveAttention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in childhood. Although mindfulness-based interventions (MBIs) have been proposed as promising non-pharmacological treatments, evidence regarding their efficacy in children and adolescents with ADHD remains inconsistent.MethodsA systematic search of PubMed, Embase, the Cochrane Library, Scopus, and Web of Science was conducted up to December 31, 2025, supplemented by manual screening of reference lists. Eligible studies were randomized controlled trials (RCTs) in which mindfulness-based intervention was the primary treatment for children or adolescents with ADHD, even alongside other therapies. Study selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed using the Cochrane RoB 1.0 tool. Meta-analyses employed random-effects or fixed-effects models based on heterogeneity.ResultsFourteen randomized controlled trials were included in the meta-analysis. The results demonstrated that MBIs significantly alleviated core ADHD symptoms in children (standardized mean difference (SMD) = -1.30; 95% confidence interval (95% CI) [-2.14, -0.45]; p = 0.003). However, the heterogeneity was considerably high (I² = 91%), and publication bias could not be excluded (as suggested by funnel plot/Egger’s test, if available). Regarding neurocognitive functions, MBIs showed potential benefits in improving attention network function (SMD = 0.44; 95% CI [0.01, 0.87]; p = 0.04; I² = 88%) and executive function (SMD = 0.45; 95% CI [0.02, 0.88]; p = 0.04; I² = 84%), though the high heterogeneity (I² > 75%) and possible publication bias warrant cautious interpretation. No significant effects were observed on emotional problems, social problems, externalizing behavioral problems (including oppositional defiant, disruptive, and aggressive behaviors), or mindfulness skills.ConclusionsThis systematic review suggests that MBIs may improve core ADHD symptoms and neurocognitive functions (including attention and executive functions) in children and adolescents. Yet, effects on emotional health, social relationships, externalizing behaviors, and mindfulness skills remain inconclusive. While suggesting that MBIs hold promise as a potential adjunctive intervention alongside standard treatments, significant heterogeneity underscores the need for further high-quality research to confirm these therapeutic benefits.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251171407, identifier CRD420251171407.

An Evidence-Based AI Virtual Assistant for Young People With Attention Deficit Hyperactivity Disorder: Co-Design and Prototype Development

<strong>Background:</strong> Though attention deficit hyperactivity disorder (ADHD) is thought to be the most prevalent neurodevelopmental disorder in young people worldwide, there are inequalities in access to psychoeducation and health care support. One way to improve access, potentially increase engagement, reduce health care inequalities, and enhance care is by co-developing digital responsive interventions. These have the potential to support long-term condition management and to act as an adjunct to usual care. Virtual assistants that use large language models can provide information in response to questions and learn to tailor communication to suit an individual user’s needs. This can be especially valuable for people with ADHD who often struggle to regulate attention and can experience communication challenges. Involving people with lived experience in the co-design process is crucial for the development of effective digital interventions. Therefore, this article explores the views and preferences of young people with ADHD and their supporters from the United Kingdom who collaborated with researchers to co-design a prototype chatbot. <strong>Objective:</strong> This study aimed to co-develop an evidence-based chatbot prototype, intended to help young people with ADHD thrive through improved access to health care information, psychoeducation, and self-management strategies. <strong>Methods:</strong> An interdisciplinary team was established, including researchers, software developers, clinicians, and lived experience collaborators. Research advisory and working groups were set up in ways that facilitated flexible involvement. Following the person-based approach, guiding principles were established, and workshops were held with young people with ADHD and supporters of young people with ADHD to co-develop an early prototype. Feedback was sought via think-aloud interviews with lived experience collaborators. <strong>Results:</strong> In total, 9 experts by lived experience and 3 health care professionals chose to engage in workshops, and this feedback informed the development of a SmartADHD chatbot prototype. An off-the-shelf chatbot (GPT-4o hosted on Convai) was trained using resources from the National Health Service (NHS). Overall, 6 experts by lived experience engaged with think-aloud interviews, providing feedback on the prototype conversational flow and feel, the avatar, the text-to-speech, the chatbox feature, and the content of the messages. Seven recommendations are made for future development, which will inform the SmartADHD program of work. <strong>Conclusions:</strong> These findings provide rich data on the preferences of people with ADHD. Specific recommendations for a chatbot for young adults with ADHD have not been investigated before with young people, making this study a novel contribution to the field. These findings provide an excellent foundation for chatbot development for this group and may be relevant for those developing digital tools for people with ADHD across the lifespan and other neurodevelopmental conditions. Further work is required to elucidate the views of health care professionals and identify the limits of the technology before subsequent evaluation. <strong>Trial Registration:</strong>

Rapid Entrainment and Signal-guided Neuromodulation for Behavioral Health

Conditions: Anxiety; PTSD; ADHD; Depression Disorders; Post-traumatic Stress; Substance Use; Executive Function; Sleep Disturbance

Interventions: Behavioral: AIP-Informed Integrative Psychotherapy; Device: Transcutaneous Auricular Vagus Nerve Stimulation; Behavioral: Regulated Breathing and Autonomic Regulation; Device: Audiovisual Entrainment; Device: Vibroacoustic Stimulation; Behavioral: Breathwork-Based Auditory Driving Entropy Module (BADEM); Device: Transcranial Electrical Stimulation

Sponsors: Tactical Mind Research Coalition, Inc.

Active, not recruiting

Resting-state functional connectivity of the sensorimotor network in medication-naïve Chinese children with ADHD: cross-sectional associations with hyperactivity/impulsivity and executive function

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder, often—but not always—characterized by inattention, hyperactivity/impulsivity, and deficits in executive functions (EFs); some individuals may also exhibit sensorimotor dysfunction. While SMN dysfunction has been implicated in ADHD, the patterns of SMN functional connectivity (FC) and their relationships with clinical symptoms and EFs remain inconsistent, partly due to methodological heterogeneity.MethodsThe study included 62 medication-naïve patients with ADHD (aged 6–15 years) and 46 healthy controls matched for age, sex, and IQ. Clinical symptoms and EFs were assessed using CPRS, IVA-CPT, and Stroop tests. Resting-state fMRI data were acquired, and ROIs within SMN, SN, DMN, and FPN were selected from the Dosenbach atlas. FC was analyzed using Network-Based Statistics (NBS). Partial correlations explored FC–behavior relationships in the ADHD group, controlling for age, sex, and IQ.ResultsThe ADHD group showed significantly higher CPRS hyperactivity/impulsivity scores and poorer IVA-CPT and Stroop performance. Compared to controls, ADHD showed increased FC within SMN (right posterior insula to left precentral gyrus/parietal lobe), between SMN–DMN (precentral gyrus, dorsal frontal cortex, temporal lobe, angular gyrus, posterior cingulate cortex, and precuneus), and SMN–SN (middle insula, superior parietal lobule, superior temporal gyrus, basal ganglia, and fusiform gyrus). Enhanced intra-SMN FC was negatively correlated with impulsivity/hyperactivity and hyperactivity index scores. Enhanced SMN–DMN FC was negatively correlated with hyperactivity symptoms and positively correlated with control quotients in IVA-CPT. Enhanced SMN–SN FC was negatively correlated with Stroop correct responses and positively correlated with omission errors.ConclusionsIn this medication-naïve pediatric sample, distinct SMN connectivity patterns differentially related to ADHD symptoms and executive function. However, given the cross-sectional design and modest sample size, these associations cannot establish causality; they require replication in longitudinal studies and larger cohorts to clarify whether they reflect developmental variation, neurobiological subtypes, or epiphenomena.

Clinical Outcomes and Predictors of Improvement With Virtual Behavioral Health Care for Gambling Disorder: Retrospective Cohort Study

<strong>Background:</strong> Gambling disorder is associated with substantial psychiatric and functional burden, yet few individuals receive treatment. Limited real-world evidence exists evaluating outcomes of virtually delivered behavioral health care for gambling disorder, particularly among clinically complex patients. <strong>Objective:</strong> The purpose of this study was to evaluate gambling symptom severity outcomes among adults with gambling disorder receiving care from Birches Health. We aimed to (1) characterize the clinical profile of adults seeking treatment for gambling disorder; (2) quantify changes in gambling symptom severity over the initial 12 weeks of treatment and examine whether baseline clinical complexity, such as gambling symptom severity, depression severity, and psychiatric comorbidities, was associated with differences in gambling symptom severity improvement over time; and (3) estimate the timing and likelihood of achieving clinically meaningful improvement in gambling symptom severity. <strong>Methods:</strong> This retrospective cohort study included 1305 adults receiving virtual behavioral health treatment for gambling disorder through Birches Health between June 2024 and April 2026. Gambling symptom severity was assessed using the Gambling Symptom Assessment Scale (G-SAS) weekly. Linear mixed-effects models evaluated changes in gambling symptom severity over 12 weeks and associations with baseline clinical characteristics. Clinically meaningful improvement was defined as a reduction of 4 or more points in the G-SAS score. <strong>Results:</strong> Participants had a mean age of 41.5 (SD 13.1) years, 65.2% (851/1305) were male, and baseline gambling symptom severity was moderate (mean G-SAS score 20.5, SD 11.83). Over half (730/1305, 56%) of participants presented with at least one psychiatric comorbidity, most commonly anxiety disorder (351/1305, 26.9%) and depressive disorder (276/1305, 21.1%). Gambling symptom severity declined significantly over the first 12 weeks of treatment, with G-SAS scores decreasing by approximately 0.099 points per day (<i>P</i>&lt;.001), corresponding to an estimated 8.3-point reduction over 12 weeks. Higher baseline depressive symptom severity was associated with faster improvement in gambling symptoms (<i>P</i>=.01), whereas depressive disorder (<i>P</i>=.03) and attention-deficit/hyperactivity disorder (<i>P</i>=.008) diagnoses were associated with slower improvement trajectories. Among patients with routine follow-up assessments recorded during the initial 12 weeks of treatment (1071/1305, 82.1%), 71.7% (935/1305) achieved clinically meaningful improvement in gambling symptom severity, with a median time to improvement of 14 days. <strong>Conclusions:</strong> A clinically complex population of adults receiving care through a national virtual behavioral health care provider demonstrated rapid and clinically meaningful reductions in gambling symptom severity. These findings highlight the potential of specialized virtual care models to expand access to gambling treatment and support symptom improvement in routine care settings. Future research should evaluate longer-term recovery trajectories and identify factors associated with sustained improvement and ongoing engagement in care.