Mindfulness-Based Attention as a Moderator of the Relationship Between ADHD and Comordid

131 Pages·2017·0.44 MB·English

by  Alana Jacobs

Pacific University
CommonKnowledge
School of Graduate Psychology College of Health Professions
7-25-2011
Mindfulness-Based Attention as a Moderator of the
Relationship Between ADHD and Comordid
Disorders
Alana Jacobs
Pacific University
Recommended Citation
Jacobs, Alana (2011). Mindfulness-Based Attention as a Moderator of the Relationship Between ADHD and Comordid Disorders
(Master's thesis, Pacific University). Retrieved from:
http://commons.pacificu.edu/spp/232
This Thesis is brought to you for free and open access by the College of Health Professions at CommonKnowledge. It has been accepted for inclusion in
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[email protected].
Mindfulness-Based Attention as a Moderator of the Relationship Between
ADHD and Comordid Disorders
Abstract
ADHD continues to be a problem affecting not only those with the disorder themselves but also the people
they interact with and are close to, as well as society as a whole. Although some treatment options exist, a large
percentage of individuals with ADHD remain untreated and many of those who do obtain treatment continue
to struggle with the disorder. Those with ADHD and one or more co-occurring psychological disorders are
particularly in need of alternative treatment options. To inform the development of alternative treatment
options particularly for this population, further research on the relationship between ADHD and frequently
co-occurring psychological disorders is critical. A number of studies have suggested that ADHD is predictive
of depression, anxiety, and alcohol abuse. Studies examining these relationships have not largely focused on
the possible presence of a moderating variable. Mindfulness may be conceptually related to these risk factors,
as many of the impairments involved in ADHD are shown to improve in association with mindfulness
practice, and mindfulness-based interventions have been found to reduce symptoms of depression, anxiety,
and alcohol abuse. Few studies however have examined how mindfulness might be related to ADHD. The aim
of this thesis was to investigate the relationship between ADHD and the following factors: (1) depression, (2)
anxiety, (3) alcohol abuse, and (4) mindfulness. As expected, a significant positive relationship was found
between ADHD and depression. Also, as expected, significant negative relationships were found between
mindfulness and ADHD, mindfulness and depression, and mindfulness and anxiety. Contrary to expectations,
a significant relationship was not found between ADHD and anxiety or between ADHD and alcohol
consumption. Further, contrary to expectations, level of mindfulness did not significantly moderate the
relationship between ADHD and depression, ADHD and anxiety, or ADHD and alcohol consumption. Thus,
the present study’s findings did not support the hypothesis that having a disposition towards mindfulness
serves as protective factor when it comes to the relationship between ADHD and depression, anxiety, and
alcohol consumption. The implications and limitations of these findings, as well as recommendations for
future research are discussed.
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MINDFULNESS-BASED ATTENTION AS A MODERATOR OF THE RELATIONSHIP
BETWEEN ADHD AND COMORBID DISORDERS

A THESIS
SUBMITTED TO THE FACULTY
OF
SCHOOL OF PROFESSIONAL PSYCHOLOGY
PACIFIC UNIVERSITY
HILLSBORO, OREGON
BY
ALANA JACOBS
IN PARTIAL FULFILLMENT OF THE
REQUIREMENTS FOR THE DEGREE
OF
MASTER OF SCIENCE IN CLINICAL PSYCHOLOGY
July 25, 2011

APPROVED:
Michael S. Christopher, Ph.D
ii
Abstract

ADHD continues to be a problem affecting not only those with the disorder themselves but also
the people they interact with and are close to, as well as society as a whole. Although some
treatment options exist, a large percentage of individuals with ADHD remain untreated and many
of those who do obtain treatment continue to struggle with the disorder. Those with ADHD and
one or more co-occurring psychological disorders are particularly in need of alternative treatment
options. To inform the development of alternative treatment options particularly for this
population, further research on the relationship between ADHD and frequently co-occurring
psychological disorders is critical. A number of studies have suggested that ADHD is predictive
of depression, anxiety, and alcohol abuse. Studies examining these relationships have not largely
focused on the possible presence of a moderating variable. Mindfulness may be conceptually
related to these risk factors, as many of the impairments involved in ADHD are shown to
improve in association with mindfulness practice, and mindfulness-based interventions have
been found to reduce symptoms of depression, anxiety, and alcohol abuse. Few studies however
have examined how mindfulness might be related to ADHD. The aim of this thesis was to
investigate the relationship between ADHD and the following factors: (1) depression, (2)
anxiety, (3) alcohol abuse, and (4) mindfulness. As expected, a significant positive relationship
was found between ADHD and depression. Also, as expected, significant negative relationships
were found between mindfulness and ADHD, mindfulness and depression, and mindfulness and
anxiety. Contrary to expectations, a significant relationship was not found between ADHD and
anxiety or between ADHD and alcohol consumption. Further, contrary to expectations, level of
mindfulness did not significantly moderate the relationship between ADHD and depression,
ADHD and anxiety, or ADHD and alcohol consumption. Thus, the present study’s findings did
iii
not support the hypothesis that having a disposition towards mindfulness serves as protective
factor when it comes to the relationship between ADHD and depression, anxiety, and alcohol
consumption. The implications and limitations of these findings, as well as recommendations for
future research are discussed.

Keywords: Mindfulness, ADHD, depression, anxiety, and alcohol consumption.

Acknowledgements
iv
Thank you to my thesis advisor, Michael Christopher, who calmly and patiently guided
me through this process from the very beginning. Without his time, encouragement, and genuine
accepting and non-judgmental manner, this thesis would not have been accomplished.

Thank you to my parents, brother (particular thanks for being incredible), grandparents,
extended family, and friends, all who I love dearly and saw me through all the bumps along the
road in this journey.

Table of Contents
Page
v
ABSTRACT....................................................................................................................................ii
ACKNOWLEDGEMENTS...........................................................................................................iv
LIST OF TABLES.........................................................................................................................ix
INTRODUCTION...........................................................................................................................1
REVIEW OF LITERATURE..........................................................................................................4
Clinical Picture of ADHD............................................................................................................4
ADHD, Predominately Inattentive Type.............................................................................5
ADHD, Predominately Hyperactive-Impulsive Type..........................................................5
Symptom Presentation into Adulthood ...............................................................................6
Prevalence Rates .........................................................................................................................7
Etiology .......................................................................................................................................7
Diagnostic/Special Considerations .............................................................................................9
Impairment ................................................................................................................................10
Cognitive ...........................................................................................................................10
Academic ..........................................................................................................................11
Workforce .........................................................................................................................11
Interpersonal/Family .........................................................................................................12
Societal Impact ..................................................................................................................13
ADHD & Psychological Functioning .......................................................................................14
Depression .........................................................................................................................15
Anxiety ..............................................................................................................................16
Alcohol Abuse ..................................................................................................................18
Low Treatment Rates for Adult ADHD …………………………………………………19
vi

Current Treatments for ADHD .................................................................................................19
Medications .......................................................................................................................19
Psychosocial Interventions ................................................................................................22
Mindfulness................................................................................................................................25
Definition ..........................................................................................................................25
Background .......................................................................................................................25
Concentration Meditation vs. Mindfulness .......................................................................27
Mechanisms of Change .....................................................................................................28
Exposure ...............................................................................................................28
Cognitive Change ..................................................................................................28
Self-management ..................................................................................................29
Acceptance ............................................................................................................30
Mindfulness-Based Therapies & Outcomes .....................................................................30
Mindfulness-Based Stress Reduction ...................................................................30
Mindfulness-Based Cognitive Therapy ................................................................31
Acceptance and Commitment Therapy .................................................................32
Dialectical Behavior Therapy ...............................................................................33
Overall Effect Size .........................................................................................................33
Mindfulness & Alcohol/Substance Use......................................................................34
Further Mindfulness Findings & Connection to ADHD...................................................35
Attention & The Brain ..........................................................................................36
Behavioral & Affective Control/Impulsivity ........................................................37
Self Regulation ......................................................................................................39
vii
Relationships .........................................................................................................40
Working Memory ..................................................................................................41
Mindfulness Interventions for ADHD ..............................................................................41
PURPOSE OF PRESENT STUDY ..............................................................................................46
Statement of Hypotheses ...........................................................................................................47
Hypothesis 1.......................................................................................................................47
Hypothesis 2.......................................................................................................................47
Hypothesis 3.......................................................................................................................47
Hypothesis 4.......................................................................................................................47
METHOD .....................................................................................................................................48
Participants ................................................................................................................................48
Measures ...................................................................................................................................50
Demographic Questionnaire …………………………………………………………….50

Adult ADHD Self-Report Scale (ASRS) ……………………………………………….50

The Mindfulness Attention Awareness Scale (MAAS) …………………………………50

Center for Epidemiologic Studies Depression Scale (CES-D) ………………………….51

Penn State Worry Questionnaire (PSWQ) ……………………………………………....51

Alcohol Use Disorders Identification Test (AUDIT) …………………………………...52

Procedure ..................................................................................................................................53
RESULTS .....................................................................................................................................55
Data Cleaning ............................................................................................................................55
Distribution Characteristics and Descriptive Characteristics ...................................................55
Analysis 1...........................................................................................................................57