Attention and distraction

وَأَنذِرۡهُمۡ يَوۡمَ ٱلۡحَسۡرَةِ إِذۡ قُضِيَ ٱلۡأَمۡرُ وَهُمۡ فِي غَفۡلَةࣲ وَهُمۡ لَا يُؤۡمِنُونَ

for they are heedless and do not believe

ٱقۡتَرَبَ لِلنَّاسِ حِسَابُهُمۡ وَهُمۡ فِي غَفۡلَةࣲ مُّعۡرِضُونَ

Ever closer to people draws their reckoning, while they turn away, heedless

قُلۡ يَٰٓأَهۡلَ ٱلۡكِتَٰبِ لِمَ تَصُدُّونَ عَن سَبِيلِ ٱللَّهِ مَنۡ ءَامَنَ تَبۡغُونَهَا عِوَجࣰ ا وَأَنتُمۡ شُهَدَآءُۗ وَمَا ٱللَّهُ بِغَٰفِلٍ عَمَّا تَعۡمَلُونَ

Say, ‘People of the Book, why do you turn the believers away from God’s path and try to make it crooked, when you yourselves [should be] witnesses to the [truth]? God is not heedless of anything you do.’

وَإِذَا كُنتَ فِيهِمۡ فَأَقَمۡتَ لَهُمُ ٱلصَّلَوٰةَ فَلۡتَقُمۡ طَآئِفَةࣱ مِّنۡهُم مَّعَكَ وَلۡيَأۡخُذُوٓاْ أَسۡلِحَتَهُمۡۖ فَإِذَا سَجَدُواْ فَلۡيَكُونُواْ مِن وَرَآئِكُمۡ وَلۡتَأۡتِ طَآئِفَةٌ أُخۡرَىٰ لَمۡ يُصَلُّواْ فَلۡيُصَلُّواْ مَعَكَ وَلۡيَأۡخُذُواْ حِذۡرَهُمۡ وَأَسۡلِحَتَهُمۡۗ وَدَّ ٱلَّذِينَ كَفَرُواْ لَوۡ تَغۡفُلُونَ عَنۡ أَسۡلِحَتِكُمۡ وَأَمۡتِعَتِكُمۡ فَيَمِيلُونَ عَلَيۡكُم مَّيۡلَةࣰ وَٰحِدَةࣰۚ وَلَا جُنَاحَ عَلَيۡكُمۡ إِن كَانَ بِكُمۡ أَذࣰ ى مِّن مَّطَرٍ أَوۡ كُنتُم مَّرۡضَىٰٓ أَن تَضَعُوٓاْ أَسۡلِحَتَكُمۡۖ وَخُذُواْ حِذۡرَكُمۡۗ إِنَّ ٱللَّهَ أَعَدَّ لِلۡكَٰفِرِينَ عَذَابࣰ ا مُّهِينࣰ ا

When you [Prophet] are with the believers, leading them in prayer, let a group of them stand up in prayer with you, taking their weapons with them, and when they have finished their prostration, let them take up their positions at the back. Then let the other group, who have not yet prayed, pray with you, also on their guard and armed with their weapons: the disbelievers would dearly like you to be heedless of your weapons and baggage, in order for them to take you in a single assault. You will not be blamed if you lay aside your arms when you are overtaken by heavy rain or illness, but be on your guard. Indeed, God has prepared a humiliating punishment for the disbelievers

وَلَقَدۡ ذَرَأۡنَا لِجَهَنَّمَ كَثِيرࣰ ا مِّنَ ٱلۡجِنِّ وَٱلۡإِنسِۖ لَهُمۡ قُلُوبࣱ لَّا يَفۡقَهُونَ بِهَا وَلَهُمۡ أَعۡيُنࣱ لَّا يُبۡصِرُونَ بِهَا وَلَهُمۡ ءَاذَانࣱ لَّا يَسۡمَعُونَ بِهَآۚ أُوْلَٰٓئِكَ كَٱلۡأَنۡعَٰمِ بَلۡ هُمۡ أَضَلُّۚ أُوْلَٰٓئِكَ هُمُ ٱلۡغَٰفِلُونَ

We have created many jinn and people who are destined for Hell, with hearts they do not use for comprehension, eyes they do not use for sight, ears they do not use for hearing. They are like cattle, no, even further astray: these are the ones who are entirely heedless

وَٱذۡكُر رَّبَّكَ فِي نَفۡسِكَ تَضَرُّعࣰ ا وَخِيفَةࣰ وَدُونَ ٱلۡجَهۡرِ مِنَ ٱلۡقَوۡلِ بِٱلۡغُدُوِّ وَٱلۡأٓصَالِ وَلَا تَكُن مِّنَ ٱلۡغَٰفِلِينَ

[Prophet], remember your Lord inwardly, in all humility and awe, without raising your voice, in the mornings and in the evenings- do not be one of the heedless

Warn them of the day of remorse. The Day of Remorse is the Day of Resurrection. Wretchedness preceded for one group without their having committing disobedience, and felicity for another group without their having done beautiful deeds. The Day of Remorse is the first day in the era of the Beginningless, when it was ruled and decreed that everyone would be given what was suited for him: One would be driven away without any offense, and the other caressed but not because of obedience. For one a robe of elevation was woven without bias, and the other was burned in the fire of severance without iniquity. One was full of joy on the carpet of gentleness and heard the address, “So rejoice in your sale!” [9:111]. The other was in the pit of abandonment with the attribute of deprivation and tasted the venom of “Die in your rage!” [3:119]. Yes, He put into effect the precedent as He knew it, and H

And warn them threaten O Muhammad (s) the disbelievers of Mecca of the Day of Regret namely the Day of Resurrection on which the sinner will regret not having been virtuous in the life of this world when the matter will be decided for them thereupon that they be chastised while they in this world are yet heedless of it and do not believe in it the Day of Resurrection.

Nigh has drawn for mankind the people of Mecca the deniers of the Resurrection their reckoning on the Day of Resurrection yet they are heedless of it disregardful of the preparation required for it by way of embracing faith.

The Virtues of Surat Al-Anbiya' Al-Bukhari recorded that 'Abdur-Rahman bin Yazid said that 'Abdullah said, "Banu Isra'il, Al-Kahf, Maryam, Ta Ha and Al-Anbiya' - they are among the earliest and most beautiful Surahs and they are my treasure." بِسْمِ اللَّهِ الرَّحْمَٰنِ الرَّحِيمِ In the Name of Allah, the Most Gracious, the Most Merciful. اقْتَرَبَ لِلنَّاسِ حِسَابُهُمْ وَهُمْ فِي غَفْلَةٍ مُّعْرِضُونَ - مَا يَأْتِيهِم مِّن ذِكْرٍ مِّن رَّبِّهِم مُّحْدَثٍ إِلَّا اسْتَمَعُوهُ وَهُمْ يَلْعَبُونَ - لَاهِيَةً قُلُوبُهُمْ ۗ وَأَسَرُّوا النَّجْوَى الَّذِينَ ظَلَمُوا هَلْ هَٰذَا إِلَّا بَشَرٌ مِّثْلُكُمْ ۖ أَفَتَأْتُونَ السِّحْرَ وَأَنتُمْ تُبْصِرُونَ - قَالَ رَبِّي يَعْلَمُ الْقَوْلَ فِي السَّمَاءِ وَالْأَرْضِ ۖ وَهُوَ السَّمِيعُ الْعَلِيمُ - بَلْ قَالُوا أَضْغَاثُ أَحْلَامٍ بَلِ افْتَرَاهُ بَلْ هُوَ شَاعِرٌ فَلْيَأْتِنَا بِآيَةٍ كَمَا أُرْسِلَ الْأَوَّلُونَ - مَا آمَنَتْ قَبْلَهُم مِّن ق

(And when thou (O Muhammad) art among them and arrangest (their) worship for them�) [4:102]. The teacher Abu �Uthman al-Za�farani al-Muqri� informed us in the year [4]25> Abu Muhammad �Abd Allah ibn Muhammad ibn �Ali ibn Ziyad al-Suddi in the year 363> Abu Sa�id al-Fadl ibn Muhammad al-Jazari in the Sacred Mosque, Mecca, in 304> �Ali ibn Ziyad al-Lahji> Abu Qurrah Musa ibn Tariq> Sufyan> Mansur> Mujahid> Abu �Ayyash al-Zurraqi who said: �We performed the prayer of Zuhr with the Messenger of Allah, Allah bless him and give him peace, upon which the idolaters exclaimed: �They were in a vulnerable situation, why did we not attack them by surprise?� Then they said: �There shall come another prayer which is more beloved to them than their own fathers, which is the midafternoon (�Asr) prayer�. Gabriel, peace be upon him, then came down with these verses between the Zuhr and the �Asr prayers. (

And remember thy Lord in thyself. The rememberers are three men: One remembers with the tongue while the heart is unaware. Another remembers with both tongue and heart, but his work is in danger, as has been said, " The self-purifiers are in grave danger. " Still another is silent with the tongue but his heart is drowned in Him. The Pir of the Tariqah said, " O God, how can I remember, for I myself am all remembrance? I have given the harvest of my marks to the wind. How can I remember Him whom I have not for- gotten? O remembrance of the spirits, remembered by the hearts, and mentioned by the tongues! Remember me with Your bounty and make me happy with gentle remembrance! "

حَدَّثَنَا عَبْدُ اللَّهِ بْنُ يُوسُفَ، أَخْبَرَنَا مَالِكٌ، عَنْ يَحْيَى بْنِ سَعِيدٍ، عَنْ عَبْدِ الرَّحْمَنِ الأَعْرَجِ، عَنْ عَبْدِ اللَّهِ ابْنِ بُحَيْنَةَ ـ رضى الله عنه ـ أَنَّهُ قَالَ إِنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم قَامَ مِنِ اثْنَتَيْنِ مِنَ الظُّهْرِ لَمْ يَجْلِسْ بَيْنَهُمَا، فَلَمَّا قَضَى صَلاَتَهُ سَجَدَ سَجْدَتَيْنِ ثُمَّ سَلَّمَ بَعْدَ ذَلِكَ‏.‏

Narrated `Abdullah bin Buhaina:Allah's Messenger (ﷺ) got up after the second rak`a of the Zuhr prayer without sitting in between (the second and the third rak`at). When he finished the prayer he performed two prostrations (of Sahu) and then finished the prayer with Taslim

حَدَّثَنَا أَبُو الْوَلِيدِ، حَدَّثَنَا شُعْبَةُ، عَنِ الْحَكَمِ، عَنْ إِبْرَاهِيمَ، عَنْ عَلْقَمَةَ، عَنْ عَبْدِ اللَّهِ ـ رضى الله عنه ـ أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم صَلَّى الظُّهْرَ خَمْسًا فَقِيلَ لَهُ أَزِيدَ فِي الصَّلاَةِ فَقَالَ ‏ "‏ وَمَا ذَاكَ ‏"‏‏.‏ قَالَ صَلَّيْتَ خَمْسًا‏.‏ فَسَجَدَ سَجْدَتَيْنِ بَعْدَ مَا سَلَّمَ‏.‏

Narrated' `Abdullah:Once Allah's Messenger (ﷺ) offered five rak`at in the Zuhr prayer, and somebody asked him whether there was some increase in the prayer. Allah's Messenger (ﷺ) said, "What is that?" He said, "You have offered five rak`at." So Allah's Messenger (ﷺ) performed two prostrations of Sahu after Taslim

أَخْبَرَنَا إِسْحَاقُ بْنُ إِبْرَاهِيمَ، قَالَ أَنْبَأَنَا عَبْدُ اللَّهِ بْنُ إِدْرِيسَ، قَالَ أَنْبَأَنَا ابْنُ جُرَيْجٍ، عَنِ ابْنِ أَبِي عَمَّارٍ، عَنْ عَبْدِ اللَّهِ بْنِ بَابَيْهِ، عَنْ يَعْلَى بْنِ أُمَيَّةَ، قَالَ قُلْتُ لِعُمَرَ بْنِ الْخَطَّابِ ‏{‏ لَيْسَ عَلَيْكُمْ جُنَاحٌ أَنْ تَقْصُرُوا، مِنَ الصَّلاَةِ إِنْ خِفْتُمْ أَنْ يَفْتِنَكُمُ الَّذِينَ كَفَرُوا ‏}‏ فَقَدْ أَمِنَ النَّاسُ ‏.‏ فَقَالَ عُمَرُ رضى الله عنه عَجِبْتُ مِمَّا عَجِبْتَ مِنْهُ فَسَأَلْتُ رَسُولَ اللَّهِ صلى الله عليه وسلم عَنْ ذَلِكَ فَقَالَ ‏"‏ صَدَقَةٌ تَصَدَّقَ اللَّهُ بِهَا عَلَيْكُمْ فَاقْبَلُوا صَدَقَتَهُ ‏"‏ ‏.‏

It was narrated that Ya'la bin Umayyah said:"I said to 'Umar bin Al-Khattab: 'There is no sin on you if you shorten salah and if you fear that the disbelievers may put you in trial (attack you). But now the people are safe.' 'Umar said: 'I wondered the same thing, so I asked the Messenger of Allah (ﷺ) about that and he said: This is a favor from Allah (SWT) to you, so accept His favor

أَخْبَرَنَا قُتَيْبَةُ، قَالَ حَدَّثَنَا اللَّيْثُ، عَنِ ابْنِ شِهَابٍ، عَنْ عَبْدِ اللَّهِ بْنِ أَبِي بَكْرِ بْنِ عَبْدِ الرَّحْمَنِ، عَنْ أُمَيَّةَ بْنِ عَبْدِ اللَّهِ بْنِ خَالِدٍ، أَنَّهُ قَالَ لِعَبْدِ اللَّهِ بْنِ عُمَرَ إِنَّا نَجِدُ صَلاَةَ الْحَضَرِ وَصَلاَةَ الْخَوْفِ فِي الْقُرْآنِ وَلاَ نَجِدُ صَلاَةَ السَّفَرِ فِي الْقُرْآنِ ‏.‏ فَقَالَ لَهُ ابْنُ عُمَرَ يَا ابْنَ أَخِي إِنَّ اللَّهَ عَزَّ وَجَلَّ بَعَثَ إِلَيْنَا مُحَمَّدًا صلى الله عليه وسلم وَلاَ نَعْلَمُ شَيْئًا وَإِنَّمَا نَفْعَلُ كَمَا رَأَيْنَا مُحَمَّدًا صلى الله عليه وسلم يَفْعَلُ ‏.‏

It was narrated from Umayyah bin 'Abdullah bin Khalid that:He said to 'Abdullah bin 'Umar: "We find (mention of) prayer when one is at home (i.e., not traveling) and prayer at times of fear in the Qur'an, but we do not find any mention in the Qur'an of prayer when traveling. Ibn Umar said to him: 'O son of my brother, Allah (SWT) send Muhammad (ﷺ) to us when we did not know anything, and all we should do is to do that which we saw Muhammad (ﷺ) doing

حَدَّثَنَا ابْنُ نُمَيْرٍ، حَدَّثَنَا ابْنُ فُضَيْلٍ، حَدَّثَنَا الأَعْمَشُ، عَنْ إِبْرَاهِيمَ، عَنْ عَلْقَمَةَ، عَنْ عَبْدِ اللَّهِ ـ رضى الله عنه ـ قَالَ كُنَّا نُسَلِّمُ عَلَى النَّبِيِّ صلى الله عليه وسلم وَهُوَ فِي الصَّلاَةِ فَيَرُدُّ عَلَيْنَا، فَلَمَّا رَجَعْنَا مِنْ عِنْدِ النَّجَاشِيِّ سَلَّمْنَا عَلَيْهِ فَلَمْ يَرُدَّ عَلَيْنَا وَقَالَ ‏ "‏ إِنَّ فِي الصَّلاَةِ شُغْلاً ‏"‏‏.‏

Narrated `Abdullah:We used to greet the Prophet (ﷺ) while he was praying and he used to answer our greetings. When we returned from An-Najashi (the ruler of Ethiopia), we greeted him, but he did not answer us (during the prayer) and (after finishing the prayer) he said, "In the prayer one is occupied (with a more serious matter)

حَدَّثَنَا ابْنُ نُمَيْرٍ، حَدَّثَنَا إِسْحَاقُ بْنُ مَنْصُورٍ، حَدَّثَنَا هُرَيْمُ بْنُ سُفْيَانَ، عَنِ الأَعْمَشِ، عَنْ إِبْرَاهِيمَ، عَنْ عَلْقَمَةَ، عَنْ عَبْدِ اللَّهِ ـ رضى الله عنه ـ عَنِ النَّبِيِّ صلى الله عليه وسلم نَحْوَهُ‏.‏

Narrated `Abdullah:The same as No. 290. from the Prophet

فدلت هذه الحكايات والأخبار مع ما سبق على أن الأصل في الصلاة الخشوع وحضور القلب وأن مجرد الحركات مع الغفلة قليل الجدوى في المعاد والله أعلم

والحضور مضاد للعزوب والغفلة وإن لم يكن مفصلا

وأما ذكر الرعاية : فمثل قول الذاكر : الله معي والله ناظر إلي الله شاهدي ونحو ذلك مما يستعمل لتقوية الحضور مع الله وفيه رعاية لمصلحة القلب ولحفظ الأدب مع الله والتحرز من الغفلة والاعتصام من الشيطان والنفس

يريد بالخفي ههنا : الذكر بمجرد القلب بما يعرض له من الواردات وهذا ثمرة الذكر الأول ويريد بالخلاض من القيود : التخلص من الغفلة والنسيان والحجب الحائلة بين القلب وبين الرب سبحانه والبقاء مع الشهود : ملازمة الحضور مع المذكور ومشاهدة القلب له حتى كأنه يراه

ثم يتشعب من كل واحدة من هذه الخصال العشر عشر أخرى من الرذائل لم نطول بذكرها وتفصيل آحادها مثل الأنفة والغضب والبغضاء والطمع وحب طلب المال والجاه للتمكن من الغلبة والمباهاة والأشر والبطر وتعظيم الأغنياء والسلاطين والتردد إليهم والأخذ من حرامهم والتجمل بالخيول والمراكب والثياب المحظورة والاستحقار للناس بالفخر والخيلاء والخوض فيما لا يعني وكثرة الكلام وخروج الخشية والخوف والرحمة من القلب واستيلاء الغفلة عليه حتى لا يدري المصلي منهم في صلاته ما صلى وما الذي يقرأ ومن الذي يناجيه ولايحس بالخشوع من قلبه مع استغراق العمر في العلوم التي تعين في المناظرة مع أنها لا تنفع في الآخرة من تحسين العبارة وتسجيع اللفظ وحفظ النوادر إلى غير ذلك من أمور لا تحصى

وإذا أردت منهم هذا القدر كما ينبغي فانظر وقت أخذك في القراءة إذا أعرضت عن واجبها وتدبرها وتعقلها وفهم ما أريد بكل آية وحظك من الخطاب بها وتنزيلها على أدواء قلبك والتقيد بها كيف تدرك الختمة أو أكثرها أو ما قرأت منها بسهولة وخفة مستكثرا من القراءة فإذا ألزمت نفسك التدبر ومعرفة المراد والنظر إلى ما يخصك منه والتعبد به وتنزيل دوائه على أدواء قلبك والإستشفاء به لم تكد تجوز السورة أو الآية إلى غيرها وكذلك إذا جمعت قلبك كله على ركعتين أعطيتهما ما تقدر عليه من الحضور والخشوع والمراقبة لم تكد أن تصلي غيرهما إلا بجهد فإذا خلا القلب من ذلك عددت الركعات بلا حساب فالإستكثار من الطاعات دون مراعاة آفاتها وعيوبها ليتوب منها هي توبة العامة

Effects of L-theanine-caffeine combination on sustained attention and inhibitory control among children with ADHD: a proof-of-concept neuroimaging RCT.: We examined the acute effects of L-theanine, caffeine and their combination on sustained attention, inhibitory control and overall cognition in boys with attention deficit hyperactivity disorder (ADHD). L-Theanine (2.5 mg/kg), caffeine (2.0 mg/kg), their combination and a placebo were administered in a randomized four-way repeated-measures crossover with washout, to five boys (8-15 years) with ADHD. Functional magnetic resonance imaging (fMRI) was performed during a Go/NoGo task and a Stop-signa

Stimulating meditation: a pre-registered randomised controlled experiment combining a single dose of the cognitive enhancer, modafinil, with brief mindfulness training.: Background: Mindfulness-meditation has a variety of benefits on well-being. However, individuals with primary attentional impairments (e.g. attention deficit disorder) or attentional symptoms secondary to anxiety, depression or addiction, may be less likely to benefit, and require additional mindfulness-augmenting strategies. Aims: To determine whether a single dose of the cognitive enhancer, modafinil, acutely increases subjective and behavioural indices of mindfulness, and augments brief mindf

Mind Wandering (Internal Distractibility) in ADHD: A Literature Review.: Objective: Mind wandering, the unintended shifting of attention from a task, has been previously associated with symptoms of ADHD. To this end, we conducted a literature search to investigate the association between mind wandering and ADHD. Method: We conducted a systematic search of the literature of relevant articles assessing mind wandering and ADHD in PubMed, PsycINFO/OVID, and Medline. Included were original articles in English that had operationalized definitions of ADHD and mind wandering

A novel digital intervention for actively reducing severity of paediatric ADHD (STARS-ADHD): a randomised controlled trial.: Background: Attention-deficit hyperactivity disorder (ADHD) is a common paediatric neurodevelopmental disorder with substantial effect on families and society. Alternatives to traditional care, including novel digital therapeutics, have shown promise to remediate cognitive deficits associated with this disorder and may address barriers to standard therapies, such as pharmacological interventions and behavioural therapy. AKL-T01 is an investigational digital therapeutic designed to target attenti

Randomised sham-controlled study of high-frequency bilateral deep transcranial magnetic stimulation (dTMS) to treat adult attention hyperactive disorder (ADHD): Negative results.: Objectives: Recent studies support the possible effectiveness of repetitive transcranial magnetic stimulation (rTMS) as a treatment for attention deficit hyperactivity disorder (ADHD). The objective of this study was to evaluate the safety and possible efficacy of bilateral prefrontal deep rTMS for the treatment of adult ADHD. Methods: Twenty-six adult ADHD patients were randomised blindly to sham or actual deep TMS (dTMS). Twenty daily sessions were conducted using the bilateral H5 dTMS coil (B

Atomoxetine treatment of attention-deficit/hyperactivity disorder in young adults with assessment of functional outcomes: a randomized, double-blind, placebo-controlled clinical trial.: Background: Attention-deficit/hyperactivity disorder (ADHD) is associated with significant impairment in multiple functional domains. This trial evaluated efficacy in ADHD symptoms and functional outcomes in young adults treated with atomoxetine. Methods: Young adults (18-30 years old) with ADHD were randomized to 12 weeks of double-blind treatment with atomoxetine (n = 220) or placebo (n = 225). The primary efficacy measure of ADHD symptom change was Conners' Adult ADHD Rating Scale (CAARS): In

Pharmacological and psychosocial treatments for adolescents with ADHD: an updated systematic review of the literature.

Smith, Waschbusch, Willoughby, and Evans (2000) reviewed a small treatment literature on ADHD in adolescents and concluded that methylphenidate stimulant medication was a well-established treatment and behavior therapy (BT) demonstrated preliminary efficacy. This review extends and updates the findings of the prior one based on the previous 15years of research. Studies published since 1999 were identified and coded using standard criteria and effect sizes were calculated where appropriate. Highlights of the last 15years of research include an expansion of pharmacological treatment options and developmentally appropriate psychosocial treatment packages for adolescents with ADHD. Additionally, nonstimulant medications (e.g., atomoxetine) are now approved for the treatment of ADHD in adolescence. The review concludes that medication and BT produce a similar range of therapeutic effects on t…

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Pharmacogenetics of response to methylphenidate in adult patients with Attention-Deficit/Hyperactivity Disorder (ADHD): a systematic review.

Methylphenidate (MPH) is a first line option in the psychopharmacologic treatment of adults with Attention-Deficit/Hyperactivity Disorder (ADHD). However, there is a considerable proportion of adult patients who do not respond to treatment with MPH or discontinue drug therapy. Since effects of genetic variants in the response to MPH treatment might explain these negative outcomes, we conducted an electronic systematic search of MEDLINE-indexed literature looking for articles containing information about pharmacogenetics of ADHD in adults published until January, 2012. The keywords used were 'ADHD', 'Attention-Deficit/Hyperactivity Disorder' and 'gene' in combination with methylphenidate, amphetamine or atomoxetine. Only 5 pharmacogenetic studies on adult ADHD met inclusion criteria. The results evidenced that most findings obtained so far are negative, and all studies focused on MPH resp…

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Long-term efficacy and safety of treatment with stimulants and atomoxetine in adult ADHD: a review of controlled and naturalistic studies.

Attention-deficit/hyperactivity disorder (ADHD) is a common disorder of childhood that often persists into adulthood. Although stimulant medications are recommended as the first-line treatment for ADHD because of their documented short-term effects in children and adults, less is known about their effects on long-term outcome in adults. Here we review the long-term efficacy and safety of the stimulant drugs methylphenidate and amphetamine, as well as the related compound atomoxetine. We performed a systematic review to identify direct and indirect effects of stimulant therapy on long-term outcome in adults. Five randomized controlled trials (RCTs), and 10 open-label extension studies of initial short-term RCTs, with total follow-up of at least 24weeks, were identified. All these RCTs found that medication was significantly more efficacious than placebo in treating ADHD in adults, and the…

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Obesity and ADHD: clinical and neurobiological implications.

Although quite overlooked, increasing evidence points to a significant association between attention-deficit/hyperactivity disorder (ADHD) and obesity. Here, we present an updated systematic review and a critical discussion of studies on the relationship between ADHD and obesity, with a particular emphasis on the possible behavioral, neurobiological, and genetics underlying mechanisms. Available empirically based studies indicate that the prevalence of ADHD in clinical samples of patients seeking treatment for their obesity is higher than that in the general population. Moreover, although still limited, current evidence shows that individuals with ADHD have higher-than-average body mass index z-scores and/or significantly higher obesity rates compared with subjects without ADHD. Three mechanisms underlying the association between ADHD and obesity have been proposed: (1) obesity and/or fa…

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Cost effectiveness of pharmacotherapies for attention-deficit hyperactivity disorder: a systematic literature review.

Background: Attention-deficit hyperactivity disorder (ADHD) is a common psychiatric disorder that impairs the quality of life for patients and their families and is associated with considerable direct and indirect costs. Pharmacotherapies for ADHD, including stimulants and non-stimulants, are often used to treat patients with ADHD. However, the costs, effectiveness and adverse effects of these agents vary. Therefore, information regarding the cost effectiveness of different pharmacological treatments is needed to better inform payers in the allocation of limited resources. Objectives: The objectives of this study were to conduct a systematic literature review of economic evaluations of pharmacotherapies for ADHD treatments and to assess the cost effectiveness of different interventions based on the existing studies. Methods: A systematic literature review of economic evaluations of pharm…

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Does mindfulness training improve cognitive abilities? A systematic review of neuropsychological findings.

Mindfulness meditation practices (MMPs) are a subgroup of meditation practices which are receiving growing attention. The present paper reviews current evidence about the effects of MMPs on objective measures of cognitive functions. Five databases were searched. Twenty three studies providing measures of attention, memory, executive functions and further miscellaneous measures of cognition were included. Fifteen were controlled or randomized controlled studies and 8 were case-control studies. Overall, reviewed studies suggested that early phases of mindfulness training, which are more concerned with the development of focused attention, could be associated with significant improvements in selective and executive attention whereas the following phases, which are characterized by an open monitoring of internal and external stimuli, could be mainly associated with improved unfocused sustain…

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A systematic review of neurobiological and clinical features of mindfulness meditations.

Background: Mindfulness meditation (MM) practices constitute an important group of meditative practices that have received growing attention. The aim of the present paper was to systematically review current evidence on the neurobiological changes and clinical benefits related to MM practice in psychiatric disorders, in physical illnesses and in healthy subjects. Method: A literature search was undertaken using Medline, ISI Web of Knowledge, the Cochrane collaboration database and references of retrieved articles. Controlled and cross-sectional studies with controls published in English up to November 2008 were included. Results: Electroencephalographic (EEG) studies have revealed a significant increase in alpha and theta activity during meditation. Neuroimaging studies showed that MM practice activates the prefrontal cortex (PFC) and the anterior cingulate cortex (ACC) and that long-ter…

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A systemic review of the roles of n-3 fatty acids in health and disease.

Attention to the role of n-3 long-chain fatty acids in human health and disease has been continuously increased during recent decades. Many clinical and epidemiologic studies have shown positive roles for n-3 fatty acids in infant development; cancer; cardiovascular diseases; and more recently, in various mental illnesses, including depression, attention-deficit hyperactivity disorder, and dementia. These fatty acids are known to have pleiotropic effects, including effects against inflammation, platelet aggregation, hypertension, and hyperlipidemia. These beneficial effects may be mediated through several distinct mechanisms, including alterations in cell membrane composition and function, gene expression, or eicosanoid production. A number of authorities have recently recommended increases in intakes of n-3 fatty acids by the general population. To comply with this recommendation a vari…

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Mindfulness meditation for substance use disorders: a systematic review.

Relapse is common in substance use disorders (SUDs), even among treated individuals. The goal of this article was to systematically review the existing evidence on mindfulness meditation-based interventions (MM) for SUDs. The comprehensive search for and review of literature found over 2000 abstracts and resulted in 25 eligible manuscripts (22 published, 3 unpublished: 8 randomized controlled trials, 7 controlled nonrandomized, 6 noncontrolled prospective, and 2 qualitative studies, and 1 case report). When appropriate, methodological quality, absolute risk reduction, number needed to treat, and effect size were assessed. Overall, although preliminary evidence suggests MM efficacy and safety, conclusive data for MM as a treatment of SUDs are lacking. Significant methodological limitations exist in most studies. Further, it is unclear which persons with SUDs might benefit most from MM. Fu…

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Father participation in behavioral parent training for ADHD: review and recommendations for increasing inclusion and engagement.

Research on parenting has generally focused on mothers, with fathers' parenting approaches and interventions for fathers being relatively less studied. To investigate the involvement of fathers in behavioral parent training (BPT), the literature on BPT for attention-deficit/hyperactivity disorder (ADHD) was reviewed. A systematic review of this literature (N = 32) indicated that the majority of research studies are composed of mothers as participants in treatment and raters of outcome (87% of reviewed studies did not include information on father-related outcomes). Present barriers to father participation in BPT (e.g., content of classes, characteristics of fathers) are discussed. Strategies for increasing father participation are offered and include establishing the expectation that fathers will be involved in treatment at initial clinical contacts, collecting treatment-related informat…

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An automated behavioral measure of mind wandering during computerized reading.

Mind wandering is a ubiquitous phenomenon in which attention shifts from task-related to task-unrelated thoughts. The last decade has witnessed an explosion of interest in mind wandering, but research has been stymied by a lack of objective measures, leading to a near-exclusive reliance on self-reports. We addressed this issue by developing an eye-gaze-based, machine-learned model of mind wandering during computerized reading. Data were collected in a study in which 132 participants reported self-caught mind wandering while reading excerpts from a book on a computer screen. A remote Tobii TX300 or T60 eyetracker recorded their gaze during reading. The data were used to train supervised classification models to discriminate between mind wandering and normal reading in a manner that would generalize to new participants. We found that at the point of maximal agreement between the model-base…

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Testing the validity of the attention control video: An eye-tracking approach of the ego depletion effect.

The attention control video has been frequently applied to test the ego depletion effect. However, its validity has never been tested, a shortcoming we address in this preregistered study. In the first task, self-control strength was temporarily depleted in the depletion condition (n = 56) but remained intact in the control condition (n = 56). The attention control video served as the secondary task, and we assumed that the depletion condition would perform significantly worse compared to the control condition. Attention regulation was measured with an eye-tracking device. The results revealed that the gaze behavior in the two conditions differed statistically significantly; however, the actual difference was small, indicating that the attention control video may not be an optimal measure of self-control.

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Aging ebbs the flow of thought: adult age differences in mind wandering, executive control, and self-evaluation.

Two experiments examined the relations among adult aging, mind wandering, and executive-task performance, following from surprising laboratory findings that older adults report fewer task-unrelated thoughts (TUTs) than do younger adults (e.g., Giambra, 1989; Jackson & Balota, 2012). Because older adults may experience more ability- and performance-related worry during cognitive tasks in the laboratory, and because these evaluative thoughts (known as task-related interference, "TRI") might be sometimes misclassified by subjects as task-related, we asked subjects to distinguish task-related thoughts from TRI and TUTs when probed during ongoing tasks. In Experiment 1, younger and older adults completed either a go/no-go or a vigilance version of a sustained attention to response task (SART). Older adults reported more TRI and fewer TUTs than did younger adults while also performing more acc…

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Mind wandering perspective on attention-deficit/hyperactivity disorder.

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder associated with a range of mental health, neurocognitive and functional problems. Although the diagnosis is based on descriptions of behaviour, individuals with ADHD characteristically describe excessive spontaneous mind wandering (MW). MW in individuals with ADHD reflects constant mental activity which lacks topic stability and content consistency. Based on this review of the neural correlates of ADHD and MW, we outline a new perspective on ADHD: the MW hypothesis. We propose that altered deactivation of the default mode network, and dysfunctional interaction with the executive control network, leads to excessive and spontaneous MW, which underpins symptoms and impairments of ADHD. We highlight that processes linked to the normal neural regulation of MW (context regulation, sensory decoupling, salien…

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On mind wandering, attention, brain networks, and meditation.

Human attention selectively focuses on aspects of experience that are threatening, pleasant, or novel. The physical threats of the ancient times have largely been replaced by chronic psychological worries and hurts. The mind gets drawn to these worries and hurts, mostly in the domain of the past and future, leading to mind wandering. In the brain, a network of neurons called the default mode network has been associated with mind wandering. Abnormal activity in the default mode network may predispose to depression, anxiety, attention deficit, and posttraumatic stress disorder. Several studies show that meditation can reverse some of these abnormalities, producing salutary functional and structural changes in the brain. This narrative review presents a mechanistic understanding of meditation in the context of recent advances in neurosciences about mind wandering, attention, and the brain n…

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Is working memory training effective?

Working memory (WM) is a cognitive system that strongly relates to a person's ability to reason with novel information and direct attention to goal-relevant information. Due to the central role that WM plays in general cognition, it has become the focus of a rapidly growing training literature that seeks to affect broad cognitive change through prolonged training on WM tasks. Recent work has suggested that the effects of WM training extend to general fluid intelligence, attentional control, and reductions in symptoms of ADHD. We present a theoretically motivated perspective of WM and subsequently review the WM training literature in light of several concerns. These include (a) the tendency for researchers to define change to abilities using single tasks, (b) inconsistent use of valid WM tasks, (c) no-contact control groups, and (d) subjective measurement of change. The literature review …

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Beneficial effect of napping on mood and cognitive performance in adolescent athletes.

Adolescent athletes often experience chronic sleep deprivation, impairing mood, cognitive and athletic performance. While napping benefits adults, its effects in adolescent athletes remain unclear. We examined whether a 60-min nap (NAP) improves mood, attention, and declarative learning in 12 male adolescent basketball players. They completed two randomized and counterbalanced conditions: NAP and control rest. Mood and subjective sleepiness were assessed in pre- and post-conditions and objective attention was measured after both conditions. Declarative learning was evaluated using word-pair task at baseline and after 4, 8, and 72 h. Objective sleep quality and quantity were measured via actigraphy. Napping enhanced attention (p = 0.006, d = 0.98, Δ=+14.55%) and improved declarative learning at 4 h (p = 0.003, d = 1.09, Δ=+8.40%) and 72 h (p = 0.021, d = 0.78, Δ=+8.95%) retest. Mood param…

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Short-Term Effects of Heart Rate Variability Biofeedback on Working Memory.

Drawing upon the well-documented impact of long-term heart rate variability biofeedback (HRVB) on psychophysiological responses, this study seeks to explore the short-term effects arising from a single HRVB session during and after paced breathing exercise. The research aligns with the neurovisceral integration model, emphasizing the link between heart rate variability (HRV) levels and cognitive performance. Therefore, a randomized controlled trial employing a between-subjects design was conducted with 38 participants. Each participant was assigned to either the paced breathing intervention group or the spontaneous breathing control group. The study assessed various parameters such as cardiac vagal tone, evaluated through vagally mediated HRV measures, and working memory, measured using the N-back task. Additionally, participants' affective states were assessed through self-reported ques…

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Impact of a physical exercise intervention on psychological resilience and mental ill-being in medical-naïve children with attention-deficit/hyperactivity disorder: a pilot randomised controlled trial.

The study aimed to evaluate whether a 12-week physical exercise intervention would improve psychological resilience and mental ill-being (e.g. internalising and externalising symptoms) in medical-naïve children with Attention-Deficit/Hyperactivity Disorder (ADHD). In a parallel two-group randomised controlled trial (RCT) design, 30 children between 8-12 years (Mage = 8.62 ± 1.37) formally diagnosed with ADHD were assigned to a 12-week physical exercise intervention group (three sessions per week for 60 mins, moderate-to-vigorous physical activity [MVPA] intensity) or a control group (treatment as usual). Psychological resilience was measured by a self-reported Chinese version of the 25-item Connor-Davidson Resilience Scale, and mental ill-being was assessed by a parent-reported Chinese version of the 113-item Achenbach's Child Behavior Checklist. The 12-week physical exercise interventio…

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The short and long-term effects of a lifestyle intervention in children with mental illnesses: a randomized controlled trial (Movementss study).

Background: A lifestyle including poor diet, physical inactivity, excessive gaming and inadequate sleep hygiene is frequently seen among Dutch children. These lifestyle behaviors can cause long-term health problems later in life. Unhealthy lifestyle and poor physical health are even more prevalent among children with mental illness (MI) such as autism, attention-deficit/hyperactivity disorder, depression, and anxiety. However, research on lifestyle interventions among children with MI is lacking. As a result, there are currently no guidelines, or treatment programs where children with MI and poor lifestyle can receive effective support. To address these issues and to provide insight into the effectiveness of lifestyle interventions in children with MI and their families, the Movementss study was designed. This paper describes the rationale, study design, and methods of an ongoing randomi…

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Association Between Stimulant Treatment and Substance Use Through Adolescence Into Early Adulthood.

Importance: Possible associations between stimulant treatment of attention-deficit/hyperactivity disorder (ADHD) and subsequent substance use remain debated and clinically relevant. Objective: To assess the association of stimulant treatment of ADHD with subsequent substance use using the Multimodal Treatment Study of ADHD (MTA), which provides a unique opportunity to test this association while addressing methodologic complexities (principally, multiple dynamic confounding variables). Design, setting, and participants: MTA was a multisite study initiated at 6 sites in the US and 1 in Canada as a 14-month randomized clinical trial of medication and behavior therapy for ADHD but transitioned to a longitudinal observational study. Participants were recruited between 1994 and 1996. Multi-informant assessments included comprehensively assessed demographic, clinical (including substance use),…

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Parent training in non-violent resistance for children with attention deficit hyperactivity disorder: a controlled outcome study.

Current forms of parent training for childhood attention deficit hyperactivity disorder (ADHD) are often insufficient. Many families drop out of the training, and treatment gains are often not maintained. Nonviolent resistance parent training (NVR) focuses on helping parents resist the child's negative behaviors without escalating the problem. NVR helps parents to fulfill an anchoring function, supporting the child through presence, self-regulation, structure, and support network. This study is a randomized controlled trial designed to assess the efficacy of NVR in the treatment of childhood ADHD. Participants were Israeli parents of children with primary ADHD diagnosis (N = 101; 5-13 years old; 79% male participants) randomly assigned to either 12-session NVR (N = 50) or waiting list (N = 51). Measures were administered before and after treatment and at a 4-month follow-up. ADHD outcome…

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Transcranial Direct Current Stimulation vs Sham for the Treatment of Inattention in Adults With Attention-Deficit/Hyperactivity Disorder: The TUNED Randomized Clinical Trial.

Importance: Transcranial direct current stimulation (tDCS) may improve symptoms of inattention in adults with attention-deficit/hyperactivity disorder (ADHD). However, previous trials are characterized by small sample sizes, heterogeneous methodologies, and short treatment periods using clinic-based tDCS. Objective: To determine the efficacy and safety of home-based tDCS in treating inattention symptoms in adult patients with ADHD. Design, setting, and participants: Randomized, double-blind, parallel, sham-controlled clinical trial (tDCS for the Treatment of Inattention Symptoms in Adult Patients With ADHD [TUNED]), conducted from July 2019 through July 2021 in a single-center outpatient academic setting. Of 277 potential participants screened by phone, 150 were assessed for eligibility on site, and 64 were included. Participants were adults with ADHD, inattentive or combined subtype. Ex…

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A randomised controlled trial (MindChamp) of a mindfulness-based intervention for children with ADHD and their parents.

Background: Family mindfulness-based intervention (MBI) for child attention-deficit/hyperactivity disorder (ADHD) targets child self-control, parenting and parental mental health, but its effectiveness is still unclear. Methods: MindChamp is a pre-registered randomised controlled trial comparing an 8-week family MBI (called 'MYmind') in addition to care-as-usual (CAU) (n = 55) with CAU-only (n = 48). Children aged 8-16 years with remaining ADHD symptoms after CAU were enrolled together with a parent. Primary outcome was post-treatment parent-rated child self-control deficits (BRIEF); post hoc, Reliable Change Indexes were explored. Secondary child outcomes included ADHD symptoms (parent/teacher-rated Conners' and SWAN; teacher-rated BRIEF), other psychological symptoms (parent/teacher-rated), well-being (parent-rated) and mindfulness (self-rated). Secondary parent outcomes included self-…

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The effect of ego depletion on challenge and threat evaluations during a potentially stressful public speaking task.

It has been well established that challenge and threat evaluations affect the performance of potentially stressful tasks. However, the factors that influence these evaluations have rarely been examined. Objective: This study examined the effects of ego depletion on challenge and threat evaluations during a public speaking task. Method: 262 participants (150 males, 112 females; Mage = 20.5, SD = 4.3) were randomly assigned to either an ego depletion or control group. Participants then completed self-report measures of trait self-control. The ego depletion group performed a written transcription task requiring self-control, while the control group transcribed the text normally. Before the public speaking task, participant's challenge and threat evaluations and subjective ratings of performance were assessed via self-report items. Results: The results of independent t-tests supported the ef…

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