关键词: 注意力缺陷多动障碍儿童 正念冥想 干预 心理机制 脑机制

Abstract: Attention deficit hyperactivity disorder (ADHD) is characterized by symptoms that include the inability to keep one’s attention focused on a task, trouble organizing tasks, avoiding things that take effort, and follow-through. ADHD may also include problems with hyperactivity and impulsivity. Mindfulness meditation is the increased awareness that arises when we pay attention to the present experience, non-judgmentally. Recently, mindfulness meditation has been introduced as a promising intervention approach for improving the mental and physical health of children with ADHD. Several aspects of the mindfulness-based intervention for adults have been adapted for children with ADHD. First, the duration of each lesson or each exercise is shortened, and the varieties of activities are improved, along with making it enjoyable. Second, a target reward system is established, in which children are rewarded for their homework and active participation in the class. Third, using metaphors helps children understand the implication of mindfulness, and master the essentials of the practice; these metaphors are advised to be based on children's daily experiences. Besides, considering the importance of parents in children’s lives, the intervention practices usually involve them. Research, including case studies, quasi-experimental studies, and randomized controlled trials, has shown that mindfulness training significantly improves the core symptoms of ADHD in children. Preliminary studies have shown that mindfulness meditation can improve attention in children with ADHD. Previous studies have also shown that mindfulness-based psychological intervention techniques can improve the hyperactive/impulsive behaviors of children with ADHD to some extent. Mindfulness meditation can also reduce anxiety and depression in children with ADHD, and can improve the symptoms of externalization, such as conduct disorder and oppositional defiant disorder. The advantages of mindfulness intervention for parenting are also evident. For example, by participating in mindfulness training, parents learned to pay attention to what their children talked about, to be more aware of how their children felt, and became more empathetic. Mindfulness also works in improving parent-child bonding, by promoting positive interactions, reducing negative reactions, and decreasing the feeling that their parents are being over-controlling. With respect to psychological mechanisms, mindfulness meditation is effective in improving executive functions and decentering. Executive functions are a set of cognitive processes for behavioral control, including selecting and monitoring behaviors for the purpose of achieving chosen goals. Children with ADHD have problems with executive functions, which can be improved through mindfulness training. Mindfulness interventions also enable children with ADHD to observe their moment-to-moment experiences more objectively, and this decentered mindset may be helpful for mental well-being. In addition, changes in brain activation patterns and structures may be the neural basis of the effectiveness of mindfulness-based interventions in children with ADHD. Mindfulness practice improves activity and functional connectivity in the prefrontal cortex. Studies have also shown that mindfulness practice reduces activity and functional connectivity in the amygdala and the anterior cingulate cortex. Mindfulness meditation increases the density and thickness of gray matter in the prefrontal cortex. Based on the above discussion, the current paper points out the shortcomings of existing research in relation to the contents and methodologies used, and then proposes possible future research directions.

Key words: children with Attention Deficit Hyperactivity Disorder, mindfulness meditation, intervention, psychological mechanism, brain mechanism