Methylphenidate or Family Mindfulness? Effects on Internalizing, Externalizing and Social Problems in Children with Attention Deficit Hyperactivity Disorder

Background: 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. Methods: 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). Results: 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. Conclusions: 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.