Effectiveness of Mindfulness-Based Parenting Programs in Reducing Parenting Stress in Parents of Children and Adolescents with Attention-Deficit/ Hyperactivity Disorder: Systematic Review and Meta-Analysis

Chanakarn  Tumthammarong; Chanvit  Pornnoppadol; Wanlop  Atsariyasing

doi:10.33192/Smj.2022.45

Authors

Chanakarn Tumthammarong Division of Child and Adolescent Phychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University
Chanvit Pornnoppadol Division of Child and Adolescent Psychiatry, Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University
Wanlop Atsariyasing Division of Child and Adolescent Psychiatry, Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok

DOI:

https://doi.org/10.33192/Smj.2022.45

Keywords:

Attention-deficit/hyperactivity disorder, mindfulness-based parenting program, parenting stress

Abstract

Objective: To systematically evaluate the effectiveness of mindfulness-based parenting programs in reducing parenting stress in parents of children and adolescents with ADHD.
Materials and Methods: Studies published in English or Thai before February 2020 were identified through the PubMed, Embase, and Thai-Journal Citation Index databases. Studies were included if they used mindfulness-based parenting interventions for parents of children and adolescents with ADHD, and parenting stress was measured. The risk of bias was evaluated with the Cochrane risk-of-bias assessment tool for randomized trials, and with the
ROBIN-I tool for non-randomized studies.
Results: Six studies were included. The 2 randomized controlled trials reported significant reductions in parenting stress in the intervention groups compared with the control groups at post-test, and this effect was maintained at the 8-week follow-up of one of the studies. However, the 4 pre-experimental studies reported conflicting results. Two reported significant reductions in parenting stress from pre- to post-intervention, with one of those studies reporting a further reduction in parental stress at the 6-week follow-up. In contrast, another study reported a significant reduction in parental stress from pre- to post-intervention for fathers but not mothers; this effect was maintained at the 8-week follow-up. The fourth study reported no significant changes in parental stress from preto post-intervention. A meta-analysis of 3 studies demonstrated no significant changes in parenting stress from pre- to post-intervention.
Conclusion: The effectiveness of mindfulness-based parenting programs in reducing parenting stress in parents of children and adolescents with ADHD is still inconclusive, although promising. Further studies are needed.

References

Martin A. Lewis’s Child and Adolescent Psychiatry: A Comprehensive Textbook; 2018.

Elia J, Ambrosini P, Berrettini W. ADHD characteristics: I. Concurrent co-morbidity patterns in children & adolescents. Child Adolesc Psychiatry Ment Health. 2008;2(1):15.

Biederman J, Petty CR, Dolan C, Hughes S, Mick E, Monuteaux MC, et al. The long-term longitudinal course of oppositional defiant disorder and conduct disorder in ADHD boys: findings from a controlled 10-year prospective longitudinal follow-up study. Psychol Med. 2008;38(7):1027-36.

Biederman J, Faraone S, Keenan K, Benjamin J, Krifcher B, Moore C, et al. Further Evidence for Family-Genetic Risk Factors in Attention Deficit Hyperactivity Disorder: Patterns of Comorbidity in Probands and Relatives in Psychiatrically and Pediatrically Referred Samples. Arch Gen Psychiatry. 1992;49(9):728-38.

Wozniak J, Biederman J, Kiely K, Ablon JS, Faraone SV, Mundy E, et al. Mania-Like Symptoms Suggestive of Childhood-Onset Bipolar Disorder in Clinically Referred Children. J Am Acad Child Adolesc Psychiatry. 1995;34(7):867-76.

Vance A, Harris K, Boots M, Talbot J, Karamitsios M. Which anxiety disorders may differentiate attention deficit hyperactivity disorder, combined type with dysthymic disorder from attention deficit hyperactivity disorder, combined type alone? Aust N Z J Psychiatry. 2003;37(5):563-9.

Bowen R, Chavira DA, Bailey K, Stein MT, Stein MB. Nature of anxiety comorbid with attention deficit hyperactivity disorder in children from a pediatric primary care setting. Psychiatry Res. 2008;157(1-3):201-9.

Vance A, Costin J, Barnett R, Luk E, Maruff P, Tonge B. Characteristics of Parent- and Child-Reported Anxiety in Psychostimulant Medication Naïve, Clinically Referred Children with Attention Deficit Hyperactivity Disorder, Combined Type (ADHD-CT). Aust N Z J Psychiatry. 2002;36(2):234-9.

Pastor P, Reuben C. Diagnosed attention deficit hyperactivity disorder and learning disability: United States, 2004-2006. Vital and health statistics Series 10, Data from the National Health Survey. 2008;10:1-14.

Erenberg G. The Relationship Between Tourette Syndrome, Attention Deficit Hyperactivity Disorder, and Stimulant Medication: A Critical Review. Semin Pediatr Neurol. 2005;12(4):217-21.

Arias A, Gelernter J, Chan G, Weiss R, Brady K, Farrer L, et al. Correlates of co-occurring ADHD in drug-dependent subjects: Prevalence and features of substance dependence and psychiatric disorders. Addict Behav. 2008;33(9):1199-207.

Insa I, Alda JA, Chamorro M, Espadas M, Huguet A. Difference in Psychic Distress Lived by Parents With ADHD Children and Parents With Healthy Children: Focus on Gender Differences. J Atten Disord. 2021;25(3):332-9.

Bögels SM, Hellemans J, van Deursen S, Römer M, van der Meulen R. Mindful Parenting in Mental Health Care: Effects on Parental and Child Psychopathology, Parental Stress, Parenting, Coparenting, and Marital Functioning. Mindfulness. 2014;5(5):536-51.

Khoury B, Lecomte T, Fortin G, Masse M, Therien P, Bouchard V, et al. Mindfulness-based therapy: A comprehensive metaanalysis. Clin Psychol Rev. 2013;33(6):763-71.

Townshend K. Conceptualizing the key processes of Mindful Parenting and its application to youth mental health. Australas Psychiatry. 2016;24(6):575-7.

Duncan LG, Coatsworth JD, Gayles JG, Geier MH, Greenberg MT. Can mindful parenting be observed? Relations between observational ratings of mother-youth interactions and mothers’ self-report of mindful parenting. J Fam Psychol. 2015;29(2):276-82.

Bögels S, Restifo K. Mindful parenting: A guide for mental health practitioners. New York, NY, US: W. W. Norton & Company; 2014. xii, 384-xii, p.

Bögels SM, Lehtonen A, Restifo K. Mindful parenting in mental health care. Mindfulness. 2010;1(2):107-20.

Swanson J, Schuck S, Mann M, Carlson C, Hartman C, Sergeant J, et al. Over-identification of extreme behavior in the evaluation and diagnosis of ADHD/HKD. Accessible online at http:www. ADHD net Accessed February. 2001;20.

Swanson J, Schuck S, Mann-Porter M, Carlson C, Hartman C, Sergeant J. Categorical and dimensional definitions and evaluations of symptoms of ADHD: History of the SNAP and the SWAN rating scales. Int J Educ Psychol Assess. 2012;10(1):51-70.

Swanson J, Schuck S, Mann M, Carlson C, Hartman K, Sergeant J, et al. Categorical and dimensional definitions and evaluations of symptoms of ADHD: The SNAP and the SWAN rating scales 2005. Available from: www.adhd.net/SNAP_SWAN.pdf.

Brites C, Salgado-Azoni CA, Ferreira TL, Lima RF, Ciasca SM. Development and applications of the SWAN rating scale for assessment of attention deficit hyperactivity disorder: a literature review. Braz J Med Biol Res. 2015;48(11):965-72.

Abidin RR. Parenting Stress Index, Third Edition: Professional Manual: Psychological Assessment Resources, Inc.; 1995.

Brock A, Vermulst AA, Gerris JRM, Abidin RR. De Nijmeegse Ouderlijke Stress Index. Cezin. 1990;2(2):57-75.

Sheras PL, Abidin RR, Konold TR. Stress Index for Parents of Adolescents: Professional Manual. Lutz, FL: Psychological Assessment Resources; 1998.

Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.

Sterne JAC, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919.

Lo HHM, Wong S, Wong J, Yeung J, Snel E, Wong S. The Effects of Family-Based Mindfulness Intervention on ADHD Symptomology in Young Children and Their Parents: A Randomized Control Trial. J Atten Disord. 2017;24(5):667-80.

Dexing Z, Chung CSK, Ming LHH, Ha CCY, Yin CJC, Tsun TK, et al. Mindfulness-Based Intervention for Chinese Children with ADHD and Their Parents: a Pilot Mixed-Method Study. Mindfulness. 2017;8(4):859-72.

Behbahani M, Zargar F, Assarian F, Akbari H. Effects of Mindful Parenting Training on Clinical Symptoms in Children with Attention Deficit Hyperactivity Disorder and Parenting Stress: Randomized Controlled Trial. Iran J Med Sci. 2018;43(6):596-604.

van der Oord S, Bögels SM, Peijnenburg D. The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents. J Child Fam Stud. 2012;21(1):139-47.

Haydicky J, Shecter C, Wiener J, Ducharme JM. Evaluation of MBCT for adolescents with ADHD and their parents: Impact on individual and family functioning. Journal of Child and Family Studies. 2015;24(1):76-94.

van de Weijer-Bergsma E, Formsma AR, de Bruin EI, Bögels SM. The Effectiveness of Mindfulness Training on Behavioral Problems and Attentional Functioning in Adolescents with ADHD. Journal of Child and Family Studies.2012;21(5):775-87.