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

Neurofeedback, sham neurofeedback, and cognitive-behavioural group therapy in adults with attention-deficit hyperactivity disorder: a triple-blind, randomised, controlled trial.

Background: Many studies suggest that electroencephalographic (EEG) neurofeedback might be beneficial in the treatment of attention-deficit hyperactivity disorder (ADHD). However, numbers of well controlled studies are low and neurofeedback techniques are regarded as highly controversial. The present trial examined the efficacy (compared with sham neurofeedback) and efficiency (compared with meta-cognitive therapy) of a standard EEG neurofeedback protocol in adults with ADHD. Methods: We did a concurrent, triple-blind, randomised, controlled trial using authorised deception in adults with ADHD from one centre (University of Tübingen) in Tübingen, Germany. Participants were eligible if they fulfilled the DSM-IV-TR criteria for ADHD, were aged between 18 years and 60 years, and had no or stable use of medication for at least 2 months with no intention to change. We excluded participants wh…

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Real-time fMRI neurofeedback in adolescents with attention deficit hyperactivity disorder.

Attention Deficit Hyperactivity Disorder (ADHD) is associated with poor self-control, underpinned by inferior fronto-striatal deficits. Real-time functional magnetic resonance neurofeedback (rtfMRI-NF) allows participants to gain self-control over dysregulated brain regions. Despite evidence for beneficial effects of electrophysiological-NF on ADHD symptoms, no study has applied the spatially superior rtfMRI-NF neurotherapy to ADHD. A randomized controlled trial tested the efficacy of rtfMRI-NF of right inferior prefrontal cortex (rIFG), a key region that is compromised in ADHD and upregulated with psychostimulants, on improvement of ADHD symptoms, cognition, and inhibitory fMRI activation. To control for region-specificity, an active control group received rtfMRI-NF of the left parahippocampal gyrus (lPHG). Thirty-one ADHD boys were randomly allocated and had to learn to upregulate thei…

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Childhood Predictors of Adult Functional Outcomes in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (MTA).

Objective: Recent results from the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (ADHD; MTA) have demonstrated impairments in several functioning domains in adults with childhood ADHD. The childhood predictors of these adult functional outcomes are not adequately understood. The objective of the present study was to determine the effects of childhood demographic, clinical, and family factors on adult functional outcomes in individuals with and without childhood ADHD from the MTA cohort. Method: Regressions were used to determine associations of childhood factors (age range 7-10 years) of family income, IQ, comorbidity (internalizing, externalizing, and total number of non-ADHD diagnoses), parenting styles, parental education, number of household members, parental marital problems, parent-child relationships, and ADHD symptom severity with adult outcomes (mean age…

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Active Avoidance: Neural Mechanisms and Attenuation of Pavlovian Conditioned Responding.

Patients with anxiety disorders often experience a relapse in symptoms after exposure therapy. Similarly, threat responses acquired during Pavlovian threat conditioning often return after extinction learning. Accordingly, there is a need for alternative methods to persistently reduce threat responding. Studies in rodents have suggested that exercising behavioral control over an aversive stimulus can persistently diminish threat responses, and that these effects are mediated by the amygdala, ventromedial prefrontal cortex, and striatum. In this fMRI study, we attempted to translate these findings to humans. Subjects first underwent threat conditioning. We then contrasted two forms of safety learning: active avoidance, in which participants could prevent the shock through an action, and yoked extinction, with shock presentation matched to the active condition, but without instrumental cont…

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Compassionate Attention and Regulation of Eating Behaviour: A pilot study of a brief low-intensity intervention for binge eating.

A low-intensity 4-week intervention that included components of compassion, mindfulness, and acceptance was delivered to women diagnosed with binge eating disorder. Participants were randomly assigned to 1 of 2 conditions: intervention (n = 11) or waiting list control (n = 9). Participants in the intervention condition were invited to practise mindfulness, soothing rhythm breathing, and compassionate imagery practices with a focus on awareness and acceptance of emotional states and triggers to binge eating and engagement in helpful actions. Results revealed that, in the intervention group, there were significant reductions in eating psychopathology symptoms, binge eating symptoms, self-criticism, and indicators of psychological distress; there were significant increases in compassionate actions and body image-related psychological flexibility. Data suggest that developing compassion and …

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Trajectories and Predictors of Response to the Challenging Horizons Program for Adolescents With ADHD.

The Challenging Horizons After School Program is one of the only psychosocial interventions developed specifically for adolescents with attention-deficit/hyperactivity disorder (ADHD) that has demonstrated efficacy in multiple randomized controlled trials. To date, however, all research with the intervention has evaluated outcomes at the group level, and it is unclear whether all adolescents respond similarly, or if the intervention is particularly well suited for certain adolescents with ADHD. This type of information is needed to guide stakeholders in making informed choices as part of dissemination and implementation efforts. The purpose of this study was to evaluate trajectories of response to intervention for a large sample of middle-school age adolescents with ADHD (grades 6-8) who received the after-school intervention (N=112). An additional goal of the study was to evaluate poten…

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Mindful attention to breath regulates emotions via increased amygdala-prefrontal cortex connectivity.

Mindfulness practice is beneficial for emotion regulation; however, the neural mechanisms underlying this effect are poorly understood. The current study focuses on effects of attention-to-breath (ATB) as a basic mindfulness practice on aversive emotions at behavioral and brain levels. A key finding across different emotion regulation strategies is the modulation of amygdala and prefrontal activity. It is unclear how ATB relevant brain areas in the prefrontal cortex integrate with amygdala activation during emotional stimulation. We proposed that, during emotional stimulation, ATB down-regulates activation in the amygdala and increases its integration with prefrontal regions. To address this hypothesis, 26 healthy controls were trained in mindfulness-based attention-to-breath meditation for two weeks and then stimulated with aversive pictures during both attention-to-breath and passive v…

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Social anxiety is related to increased dwell time on socially threatening faces.

Background: Identification of reliable targets for therapeutic interventions is essential for developing evidence-based therapies. Threat-related attention bias has been implicated in the etiology and maintenance of social anxiety disorder. Extant response-time-based threat bias measures have demonstrated limited reliability and internal consistency. Here, we examined gaze patterns of socially anxious and nonanxious participants in relation to social threatening and neutral stimuli using an eye-tracking task, comprised of multiple threat and neutral stimuli, presented for an extended time-period. We tested the psychometric properties of this task with the hope to provide a solid stepping-stone for future treatment development. Methods: Eye gaze was tracked while participants freely viewed 60 different matrices comprised of eight disgusted and eight neutral facial expressions, presented f…

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Can the attention training technique turn one marshmallow into two? Improving children's ability to delay gratification.

The seminal Marshmallow Test (Mischel & Ebbesen, 1970) has reliably demonstrated that children who can delay gratification are more likely to be emotionally stable and successful later in life. However, this is not good news for those children who can't delay. Therefore, this study aimed to explore whether a metacognitive therapy technique, Attention Training (ATT: Wells, 1990) can improve young children's ability to delay gratification. One hundred children participated. Classes of 5-6 year olds were randomly allocated to either the ATT or a no-intervention condition and were tested pre and post-intervention on ability to delay gratification, verbal inhibition (executive control), and measures of mood. The ATT intervention significantly increased (2.64 times) delay of gratification compared to the no-intervention condition. After controlling for age and months in school, the ATT interve…

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Minor degree of hypohydration adversely influences cognition: a mediator analysis.

Background: Because the assumption that small changes in hydration status are readily compensated by homeostatic mechanisms has been little studied, the influence of hypohydration on cognition was examined. Objectives: We assessed whether a loss of <1% of body mass due to hypohydration adversely influenced cognition, and examined the possible underlying mechanisms. Design: A total of 101 individuals were subjected to a temperature of 30°C for 4 h and randomly either did or did not consume 300 mL H2O during that period. Changes in body mass, urine osmolality, body temperature, and thirst were monitored. Episodic memory, focused attention, mood, and the perceived difficulty of tasks were measured on 3 occasions. The data were analyzed with the use of a regression-based approach whereby we looked for variables that mediated the influence of hypohydration on psychological functioning. Result…

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Age-Dependent Effects of Methylphenidate on the Human Dopaminergic System in Young vs Adult Patients With Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial.

Importance: Although numerous children receive methylphenidate hydrochloride for the treatment of attention-deficit/hyperactivity disorder (ADHD), little is known about age-dependent and possibly lasting effects of methylphenidate on the human dopaminergic system. Objectives: To determine whether the effects of methylphenidate on the dopaminergic system are modified by age and to test the hypothesis that methylphenidate treatment of young but not adult patients with ADHD induces lasting effects on the cerebral blood flow response to dopamine challenge, a noninvasive probe for dopamine function. Design, setting, and participants: A randomized, double-blind, placebo-controlled trial (Effects of Psychotropic Drugs on Developing Brain-Methylphenidate) among ADHD referral centers in the greater Amsterdam area in the Netherlands between June 1, 2011, and June 15, 2015. Additional inclusion cri…

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Reducing neuropsychiatric symptoms in persons with dementia and associated burden in family caregivers using tailored activities: Design and methods of a randomized clinical trial.

Among over 5million people in the USA with dementia, neuropsychiatric symptoms (NPS) are almost universal, occurring across disease etiology and stage. If untreated, NPS can lead to significant morbidity and mortality including increased cost, distress, depression, and faster disease progression, as well as heightened burden on families. With few pharmacological solutions, identifying nonpharmacologic strategies is critical. We describe a randomized clinical trial, the Dementia Behavior Study, to test the efficacy of an activity program to reduce significant existing NPS and associated caregiver burden at 3 and 6months compared to a control group intervention. Occupational therapists deliver 8 in-home sessions over 3months to assess capabilities and interests of persons with dementia, home environments, and caregiver knowledge, and readiness from which activities are developed and famili…

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Cognitive-behavioural therapy in medication-treated adults with attention-deficit/hyperactivity disorder and co-morbid psychopathology: a randomized controlled trial using multi-level analysis.

Background: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by high rates of co-morbid psychopathology. Randomized controlled trials of multimodal interventions, combining pharmacological and psychological treatments, have shown a robust treatment effect for ADHD symptoms but outcomes for co-morbid symptoms have been mixed. This may be accounted for by the type of intervention selected and/or by methodological problems including lack of follow-up and low power. The current study addressed these limitations in a parallel-group randomized controlled trial conducted in Iceland. Method: A total of 95 adult ADHD patients who were already being treated with medication (MED) were randomly assigned to receive treatment as usual (TAU/MED) or 15 sessions of cognitive-behavioural therapy (CBT/MED) using the R&R2ADHD intervention which employs both grou…

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Effects of Group Psychotherapy, Individual Counseling, Methylphenidate, and Placebo in the Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial.

Importance: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with high prevalence in adulthood. There is a recognized need to assess the efficacy of psychotherapy in adult ADHD. Objective: To evaluate the efficacy of cognitive behavioral group psychotherapy (GPT) compared with individual clinical management (CM) and that of methylphenidate hydrochloride compared with placebo. Design, setting, and participants: Prospective, multicenter, randomized clinical trial of 18- to 58-year-old outpatients with ADHD from 7 German study centers. Patients were recruited between January 2007 and August 2010, treatment was finalized in August 2011, and final follow-up assessments occurred in March 2013. Interventions: Sessions of GPT and CM were held weekly for the first 12 weeks and monthly thereafter (9 months). Patients received either methylphenidate or placebo for 1 …

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Improving executive functioning in children with ADHD: training multiple executive functions within the context of a computer game. a randomized double-blind placebo controlled trial.

Introduction: Executive functions (EFs) training interventions aimed at ADHD-symptom reduction have yielded mixed results. Generally, these interventions focus on training a single cognitive domain (e.g., working memory [WM], inhibition, or cognitive-flexibility). However, evidence suggests that most children with ADHD show deficits on multiple EFs, and that these EFs are largely related to different brain regions. Therefore, training multiple EFs might be a potentially more effective strategy to reduce EF-related ADHD symptoms. Methods: Eighty-nine children with a clinical diagnosis of ADHD (aged 8-12) were randomized to either a full-active-condition where visuospatial WM, inhibition and cognitive-flexibility were trained, a partially-active-condition where inhibition and cognitive-flexibility were trained and the WM-training task was presented in placebo-mode, or to a full placebo-con…

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Attention Bias Modification training in individuals with depressive symptoms: A randomized controlled trial.

Background and objectives: Negative attentional biases are often considered to have a causal role in the onset and maintenance of depressive symptoms. This suggests that reduction of such biases may be a plausible strategy in the treatment of depressive symptoms. The present clinical randomized controlled trial examined long-term effects of a computerized attention bias modification (ABM) procedure on individuals with elevated depressive symptoms. Methods: In a double-blind study design, 77 individuals with ongoing mild to severe symptoms of depression were randomly assigned to one of three conditions: 1) ABM training (n = 27); 2) placebo (n = 27); 3) assessment-only (n = 23). In both the ABM and placebo conditions, participants completed 8 sessions of 216-trials (1728 in total) during a 2-week period. Assessments were conducted at pre-training and post-training (0, 2, 4, 8-week, 3, 7-mo…

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Does the Animal Fun program improve social-emotional and behavioural outcomes in children aged 4-6 years?

Animal Fun was designed to enhance motor and social development in young children. Its efficacy in improving motor skills was presented previously using a randomised controlled trial and a multivariate nested cohort design. Based on the Environmental Stress Hypothesis, it was argued that the program would also result in positive mental health outcomes, investigated in the current study. Pre-intervention scores were recorded for 511 children aged 4.83-6.17 years (M=5.42, SD=.30). Intervention and control groups were compared 6 months following intervention, and again in their first school year. Changes in teacher-rated prosocial behaviour and total difficulties were assessed using the Strengths and Difficulties Questionnaire, and data analysed using Generalised Linear Mixed Models. There was a significant improvement in prosocial behaviour of children in the intervention group six months …

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Extended-Release Mixed Amphetamine Salts vs Placebo for Comorbid Adult Attention-Deficit/Hyperactivity Disorder and Cocaine Use Disorder: A Randomized Clinical Trial.

Importance: Adult attention-deficit/hyperactivity disorder (ADHD) is prevalent but often unrecognized, in part because it tends to co-occur with other disorders such as substance use disorders. Cocaine use disorder is one such disorder with high co-occurrence of ADHD. Objective: To examine whether treatment of co-occurring ADHD and cocaine use disorder with extended-release mixed amphetamine salts is effective at both improving ADHD symptoms and reducing cocaine use. Design, setting, and participants: Thirteen-week, randomized, double-blind, 3-arm, placebo-controlled trial of participants meeting DSM-IV-TR criteria for both ADHD and cocaine use disorder conducted between December 1, 2007, and April 15, 2013, at 2 academic health center substance abuse treatment research sites. One hundred twenty-six adults diagnosed as having comorbid ADHD and cocaine use disorder were randomized to exte…

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Vitamin-mineral treatment of attention-deficit hyperactivity disorder in adults: double-blind randomised placebo-controlled trial.

Background: The role of nutrition in the treatment of attention-deficit hyperactivity disorder (ADHD) is gaining international attention; however, treatments have generally focused only on diet restriction or supplementing with one nutrient at a time. Aims: To investigate the efficacy and safety of a broad-based micronutrient formula consisting mainly of vitamins and minerals, without omega fatty acids, in the treatment of ADHD in adults. Method: This double-blind randomised controlled trial assigned 80 adults with ADHD in a 1:1 ratio to either micronutrients (n = 42) or placebo (n = 38) for 8 weeks (trial registered with the Australian New Zealand Clinical Trials Registry: ACTRN12609000308291). Results: Intent-to-treat analyses showed significant between-group differences favouring active treatment on self- and observer- but not clinician-ADHD rating scales. However, clinicians rated th…

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A randomized clinical trial of Cogmed Working Memory Training in school-age children with ADHD: a replication in a diverse sample using a control condition.

Background: Cogmed Working Memory Training (CWMT) has received considerable attention as a promising intervention for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in children. At the same time, methodological weaknesses in previous clinical trials call into question reported efficacy of CWMT. In particular, lack of equivalence in key aspects of CWMT (i.e., contingent reinforcement, time-on-task with computer training, parent-child interactions, supportive coaching) between CWMT and placebo versions of CWMT used in previous trials may account for the beneficial outcomes favoring CWMT. Methods: Eighty-five 7- to 11-year old school-age children with ADHD (66 male; 78%) were randomized to either standard CWMT (CWMT Active) or a well-controlled CWMT placebo condition (CWMT Placebo) and evaluated before and 3 weeks after treatment. Dependent measures included parent and tea…

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Self-compassion training modulates alpha-amylase, heart rate variability, and subjective responses to social evaluative threat in women.

A growing body of research has revealed that social evaluative stressors trigger biological and psychological responses that in chronic forms have been linked to aging and disease. Recent research suggests that self-compassion may protect the self from typical defensive responses to evaluation. We investigated whether brief training in self-compassion moderated biopsychological responses to the Trier Social Stress Test (TSST) in women. Compared to attention (placebo) and no-training control conditions, brief self-compassion training diminished sympathetic (salivary alpha-amylase), cardiac parasympathetic, and subjective anxiety responses, though not HPA-axis (salivary cortisol) responses to the TSST. Self-compassion training also led to greater self-compassion under threat relative to the control groups. In that social stress pervades modern life, self-compassion represents a promising a…

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Short-term improvement in insomnia symptoms predicts long-term improvements in sleep, pain, and fatigue in older adults with comorbid osteoarthritis and insomnia.

Unlabelled: In a primary care population of 367 older adults (aged ⩾60 years) with osteoarthritis (OA) pain and insomnia, we examined the relationship between short-term improvement in sleep and long-term sleep, pain, and fatigue outcomes through secondary analyses of randomized controlled trial data. Study participants, regardless of experimental treatment received, were classified either as improvers (⩾30% baseline to 2-month reduction on the Insomnia Severity Index [ISI]) or as nonimprovers. After controlling for treatment arm and potential confounders, improvers showed significant, sustained improvements across 18 months compared with nonimprovers in pain severity (P<0.001, adjusted mean difference=-0.51 [95% CI: -0.80, -0.21), arthritis symptoms (P<0.001, 0.63 [0.26, 1.00]), and fear avoidance (P=0.009, -2.27 [-3.95, -0.58]) but not in catastrophizing or depression. Improvers also s…

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The influence of Oxytocin on automatic motor simulation.

Motor simulation is important for imitation, action understanding, and a wide range of social cognitive skills. Furthermore, the neuropeptide hormone Oxytocin (OT) has also been related to social information processing in humans, improving perception of social stimuli and increasing altruism and trust. Surprisingly, however, a direct link between OT and motor simulation has never been systematically investigated. The current study examined this question using the imitation-inhibition task, a paradigm used to investigate automatic imitation behaviour and motor simulation. In this task, participants carry out simple finger movements while observing irrelevant movements that either match (congruent condition) or do not match (incongruent condition) the instructed movements. In a double-blind, placebo-controlled design, male participants were administered either OT (N=24) or placebo (N=24), …

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Sweet delusion. Glucose drinks fail to counteract ego depletion.

Initial acts of self-control have repeatedly been shown to reduce individuals' performance on a consecutive self-control task. In addition, sugar containing drinks have been demonstrated to counteract this so-called ego-depletion effect, both when being ingested and when merely being sensed in the oral cavity. However, since the underlying evidence is less compelling than suggested, replications are crucially required. In Experiment 1, 70 participants consumed a drink containing either sugar or a non-caloric sweetener between two administrations of delay-discounting tasks. Experiment 2 (N=115) was designed to unravel the psychological function of oral glucose sensing by manipulating the temporal delay between a glucose mouth rinse and the administration of the consecutive self-control task. Despite applying powerful research designs, no effect of sugar sensing or ingestion on ego depleti…

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Effects of oxytocin on attention to emotional faces in healthy volunteers and highly socially anxious males.

Background: Evidence suggests that individuals with social anxiety demonstrate vigilance to social threat, whilst the peptide hormone oxytocin is widely accepted as supporting affiliative behaviour in humans. Methods: This study investigated whether oxytocin can affect attentional bias in social anxiety. In a double-blind, randomized, placebo-controlled, within-group study design, 26 healthy and 16 highly socially anxious (HSA) male volunteers (within the HSA group, 10 were diagnosed with generalized social anxiety disorder) were administered 24 IU of oxytocin or placebo to investigate attentional processing in social anxiety. Attentional bias was assessed using the dot-probe paradigm with angry, fearful, happy and neutral face stimuli. Results: In the baseline placebo condition, the HSA group showed greater attentional bias for emotional faces than healthy individuals. Oxytocin reduced …

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