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

Methylphenidate treatment of adult male prison inmates with attention-deficit hyperactivity disorder: randomised double-blind placebo-controlled trial with open-label extension.

Background: Attention-deficit hyperactivity disorder (ADHD) is highly prevalent in prison inmates, but pharmacological treatment has not yet been evaluated in this group. Aims: To evaluate osmotic-release oral system (OROS) methylphenidate in adult male long-term prison inmates with ADHD. Method: Randomised, double-blind, placebo-controlled 5-week trial, followed by 47-week open-label extension in 30 prison inmates with ADHD and comorbid disorders. Primary outcome was level of ADHD symptoms after 5 weeks, evaluated by a masked assessor. Secondary outcomes were self-reported ADHD symptoms, global severity and global functioning throughout the 52-week trial, and post hoc treatment response and numbers needed to treat (NNT) (trial registration: NCT00482313.) Results: Treatment significantly improved ADHD during the trial (P<0.001; Cohen's d = 2.17), with reduced symptom severity and improve…

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Efficacy and safety of the novel α₄β₂ neuronal nicotinic receptor partial agonist ABT-089 in adults with attention-deficit/hyperactivity disorder: a randomized, double-blind, placebo-controlled crossover study.

Rationale: α(4)β(2) Neuronal nicotinic receptors (NNRs) are implicated in the pathophysiology of attention-deficit/hyperactivity disorder (ADHD). Objectives: This study examined the efficacy and safety of the α(4)β(2) NNR partial agonist ABT-089 versus placebo in adults with ADHD. Methods: In this multicenter, randomized, double-blind, placebo-controlled crossover study, subjects received placebo followed by ABT-089 (2 mg once daily [QD], 5 mg QD, 15 mg QD, 40 mg QD, or 40 mg twice daily [BID]), or vice versa, in a 2 × 2 crossover design. Each treatment period was 4 weeks, separated by a 2-week washout period. The primary efficacy endpoint was the Conners' Adult ADHD Rating Scale-Investigator Rated (CAARS:Inv) total score at the end of each treatment period. Secondary outcomes based on clinician- and self-rated efficacy scales were evaluated. Results: Of the 221 subjects enrolled, 171 me…

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Long-term efficacy and safety outcomes with OROS-MPH in adults with ADHD.

Methylphenidate (MPH) is widely prescribed for adults with attention deficit hyperactivity disorder (ADHD), but data on long-term treatment and maintenance of effect are lacking. Osmotic release oral system-methylphenidate (OROS-MPH) was evaluated in a 52-wk open-label study in subjects who had previously completed a short-term placebo-controlled trial and short-term open-label extension. Efficacy was assessed using the investigator- and subject-rated Conners' Adult ADHD Rating Scales (CAARS:O-SV and CAARS:S-S), and the Clinical Global Impression - Severity (CGI-S), Sheehan Disability Scale (SDS) and Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q). Subjects completing ≥52 wk of treatment were eligible for a 4-wk randomized, placebo-controlled withdrawal phase in which loss of treatment effect was assessed using CAARS:O-SV and CGI-S. In the open-label phase (n=156), mea…

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Evaluating a comprehensive strategy to improve engagement to group-based behavioral parent training for high-risk families of children with ADHD.

Behavioral parent training (BPT) is an evidence-based intervention for the treatment of attention-deficit/hyperactivity disorder (ADHD) and related disruptive behavioral disorders of childhood. Despite convincing data on effectiveness, engagement to BPT, particularly for high-risk families, has been a long standing, yet understudied, issue. Data from a clinical trial of a comprehensive BPT approach to enhance engagement and outcomes (the Strategies to Enhance Positive Parenting [STEPP] program) are presented herein. The STEPP program was compared to a traditional group-based BPT program on propensity to attend treatment, propensity to complete homework over the course of treatment, and dropout from BPT. Additionally, factors empirically related to engagement to treatment and targeted by the STEPP program were analyzed to determine whether these factors were enhanced by participation in t…

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Long-term functional outcome in adult prison inmates with ADHD receiving OROS-methylphenidate.

In a recent randomized, double-blind, placebo-controlled trial, we established a robust efficacy (Cohen's d = 2.17) of osmotic release oral system-methylphenidate (OROS-methylphenidate) delivered 72 mg daily for 5 weeks versus placebo on attention deficit hyperactivity disorder (ADHD) symptoms, global severity and global functioning in 30 adult male prison inmates with ADHD and coexisting disorders. Outcomes continued to improve during the subsequent 47-week open-label extension with OROS-methylphenidate delivered at a flexible daily dosage of up to 1.3 mg/kg body weight. In the present study, we evaluated long-term effectiveness and maintenance of improvement over the cumulated 52-week trial on cognition, motor activity, institutional behaviour and quality of life. Post hoc, we explored the associations between investigators' and self-ratings of ADHD symptoms and between ratings of symp…

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Working memory training and transfer in older adults.

There has been a great deal of interest, both privately and commercially, in using working memory training exercises to improve general cognitive function. However, many of the laboratory findings for older adults, a group in which this training is of utmost interest, are discouraging due to the lack of transfer to other tasks and skills. Importantly, improvements in everyday functioning remain largely unexamined in relation to WM training. We trained working memory in older adults using a task that encourages transfer in young adults (Chein & Morrison, 2010). We tested transfer to measures of working memory (e.g., Reading Span), everyday cognitive functioning [the Test of Everyday Attention (TEA) and the California Verbal Learning Test (CVLT)], and other tasks of interest. Relative to controls, trained participants showed transfer improvements in Reading Span and the number of repetitio…

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Changes in neuropsychological functioning following treatment for late-life generalised anxiety disorder.

Background: Generalised anxiety disorder (GAD) in older adults is associated with neuropsychological impairment. Aims We examined neuropsychological functioning in older adults with GAD in comparison with psychiatrically healthy older adults at baseline, and we examined changes following a 12-week placebo-controlled trial of escitalopram. Method: A total of 160 participants without dementia aged ≥60 with current GAD and 37 individuals in a comparison group without psychiatric history underwent neuropsychological assessment. Of these, 129 participants with GAD were reassessed post-treatment (trial registration: NCT00105586). Results: The participants with GAD performed worse than the comparison group in information processing speed, working memory, inhibition, problem-solving (including concept formation and mental flexibility) and immediate and delayed memory. Neuropsychological function…

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The immediate impact of different types of television on young children's executive function.

Objective: The goal of this research was to study whether a fast-paced television show immediately influences preschool-aged children's executive function (eg, self-regulation, working memory). Methods: Sixty 4-year-olds were randomly assigned to watch a fast-paced television cartoon or an educational cartoon or draw for 9 minutes. They were then given 4 tasks tapping executive function, including the classic delay-of-gratification and Tower of Hanoi tasks. Parents completed surveys regarding television viewing and child's attention. Results: Children who watched the fast-paced television cartoon performed significantly worse on the executive function tasks than children in the other 2 groups when controlling for child attention, age, and television exposure. Conclusions: Just 9 minutes of viewing a fast-paced television cartoon had immediate negative effects on 4-year-olds' executive fu…

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Does computerized working memory training with game elements enhance motivation and training efficacy in children with ADHD?

This study examined the benefits of adding game elements to standard computerized working memory (WM) training. Specifically, it examined whether game elements would enhance motivation and training performance of children with ADHD, and whether it would improve training efficacy. A total of 51 children with ADHD aged between 7 and 12 years were randomly assigned to WM training in a gaming format or to regular WM training that was not in a gaming format. Both groups completed three weekly sessions of WM training. Children using the game version of the WM training showed greater motivation (i.e., more time training), better training performance (i.e., more sequences reproduced and fewer errors), and better WM (i.e., higher scores on a WM task) at post-training than children using the regular WM training. Results are discussed in terms of executive functions and reinforcement models of ADHD…

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Zinc for attention-deficit/hyperactivity disorder: placebo-controlled double-blind pilot trial alone and combined with amphetamine.

Objective: To explore effects of zinc supplementation in American children with attention-deficit/hyperactivity disorder (ADHD). Mideastern trials reported significant benefit from 13-40 mg elemental zinc as the sulfate. Method: We randomly assigned 52 children aged 6-14 with DSM-IV ADHD to zinc supplementation (15 mg every morning [qAM] or two times per day [b.i.d.] as glycinate, n = 28) or matched placebo (n = 24) for 13 weeks: 8 weeks monotherapy and then 5 weeks with added d-amphetamine (AMPH). AMPH dose was weight-standardized for 2 weeks and then clinically optimized by week 13. Zinc glycinate was chosen as having less gastrointestinal discomfort than sulfate. Hypotheses were that zinc would improve inattention more than placebo by effect size of d > 0.25 at 8 weeks; zinc+AMPH would improve ADHD symptoms more than placebo+AMPH by d > 0.25, and optimal dose of AMPH with zinc would b…

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Predictors of treatment outcome in adults with ADHD treated with OROS® methylphenidate.

Background: We conducted a post-hoc analysis of the Long-Acting MethylpheniDate in Adult attention-deficit hyperactivity disorder (LAMDA) study to investigate predictors of response in adults with ADHD randomly assigned to Osmotic Release Oral System (OROS)(®)-methylphenidate hydrochloride (MPH) 18, 36 or 72 mg or placebo. Methods: LAMDA comprised a 5-week, double-blind (DB) period, followed by a 7-week, open-label (OL) period. A post-hoc analysis of covariance and a logistic regression analysis were undertaken to detect whether specific baseline parameters or overall treatment compliance during the double-blind phase contributed to response. The initial model included all covariates as independent variables; a backward stepwise selection method was used, with stay criteria of p<0.10. Six outcomes were considered: change from baseline CAARS:O-SV (physician-rated) and CAARS:S-S (self-repo…

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Effects of sleep inertia after daytime naps vary with executive load and time of day.

The effects of executive load on working memory performance during sleep inertia after morning or afternoon naps were assessed using a mixed design with nap/wake as a between-subjects factor and morning/afternoon condition as a within-subject factor. Thirty-two healthy adults (mean 22.5 ± 3.0 years) attended two laboratory sessions after a night of restricted sleep (6 hrs), and at first visit, were randomly assigned to the Nap or Wake group. Working memory (n-back) and subjective workload were assessed approximately 5 and 25 minutes after 90-minute morning and afternoon nap opportunities and at the corresponding times in the Wake condition. Actigraphically assessed nocturnal sleep duration, subjective sleepiness, and psychomotor vigilance performance before daytime assessments did not vary across conditions. Afternoon naps showed shorter EEG assessed sleep latencies, longer sleep duratio…

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A one year trial of methylphenidate in the treatment of ADHD.

Objective: To determine the effects of long-term methylphenidate treatment on symptom severity and social adjustment in adult ADHD. Method: Adults (n = 116) meeting operational diagnostic criteria for ADHD (the "Utah Criteria") entered a randomized double-blind crossover trial of methylphenidate and placebo. Participants who improved on immediate-release methylphenidate entered a 12-month, open-label trial. Outcomes were assessed using the Wender-Reimherr Adult Attention Deficit Disorder Scale (WRAADDS), Clinical Global Impression-Improvement (CGI-I), global assessment of functioning (GAF), and the Weissman Social Adjustment Scale (WSAS). Results: In the double-blind trial more patients improved (50% reduction of symptoms) receiving methylphenidate (74%) than placebo (21%, p = .001). During the open-label trial, symptom severity decreased 80% from baseline, and the WSAS decreased >50% in…

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Feasibility and preliminary outcomes of a school-based mindfulness intervention for urban youth.

Youth in underserved, urban communities are at risk for a range of negative outcomes related to stress, including social-emotional difficulties, behavior problems, and poor academic performance. Mindfulness-based approaches may improve adjustment among chronically stressed and disadvantaged youth by enhancing self-regulatory capacities. This paper reports findings from a pilot randomized controlled trial assessing the feasibility, acceptability, and preliminary outcomes of a school-based mindfulness and yoga intervention. Four urban public schools were randomized to an intervention or wait-list control condition (n=97 fourth and fifth graders, 60.8% female). It was hypothesized that the 12-week intervention would reduce involuntary stress responses and improve mental health outcomes and social adjustment. Stress responses, depressive symptoms, and peer relations were assessed at baseline…

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A controlled trial of working memory training for children and adolescents with ADHD.

This study assessed the efficacy of a 5-week, intensive working memory training program for 52 children and adolescents (ages 7-17) who had Attention-Deficit/Hyperactivity Disorder (ADHD) and other comorbid diagnoses. This study provided a treatment replication since the waitlist control group also completed training and was included in the follow-up data analyses. Parents and teachers completed paper-and-pencil measures of working memory, executive functioning, and ADHD symptoms at baseline, posttreatment, and 4-month follow-up. Parent ratings indicated that participants improved on inattention, overall number of ADHD symptoms, initiation, planning/organization, and working memory. Teacher ratings approached significance at posttreatment and at 4-month follow-up on and Initiate scale. Working memory training appears promising as an intervention in improving executive functioning and ADH…

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A placebo-controlled trial of atomoxetine in marijuana-dependent individuals with attention deficit hyperactivity disorder.

This study evaluated the effects of atomoxetine on the symptoms of attention deficit hyperactivity disorder (ADHD) and marijuana use in marijuana-dependent adults. In conjunction with motivational interviewing, participants received either atomoxetine (n = 19) or matching placebo (n = 19) for 12 weeks. Participants randomized to atomoxetine had greater improvement in ADHD on the Clinical Global Impression-Improvement scale than participants treated with placebo. No treatment group differences in self-rated ADHD symptoms, overall Wender-Reimherr Adult Attention Deficit Disorder Scale scores, or marijuana use outcomes were noted. These results suggest that atomoxetine may improve some ADHD symptoms but does not reduce marijuana use in this population. 

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Neuroplasticity-based cognitive training in schizophrenia: an interim report on the effects 6 months later.

Background: New cognitive treatments for schizophrenia are needed that drive persistent gains in cognition and functioning. Using an innovative neuroplasticity-based cognitive training approach, we report our interim findings on the effects on cognition and functional outcome at 6 months after treatment. Methods: Thirty-two clinically stable schizophrenia subjects were randomly assigned to either targeted cognitive training (TCT, N = 22) or a computer games (CGs) control condition (N = 10). Twelve TCT subjects completed 50 hours of auditory based training; 10 TCT subjects completed an additional 50 hours of training targeting visual and cognitive control processes. Subjects were assessed on neurocognition and functional outcome after training and at 6-month follow-up. Results: Both TCT subject groups showed significant durable gains at 6 months on measures of verbal learning/memory and c…

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Using computerized games to teach face recognition skills to children with autism spectrum disorder: the Let's Face It! program.

Background: An emerging body of evidence indicates that relative to typically developing children, children with autism are selectively impaired in their ability to recognize facial identity. A critical question is whether face recognition skills can be enhanced through a direct training intervention. Methods: In a randomized clinical trial, children diagnosed with autism spectrum disorder were pre-screened with a battery of subtests (the Let's Face It! Skills battery) examining face and object processing abilities. Participants who were significantly impaired in their face processing abilities were assigned to either a treatment or a waitlist group. Children in the treatment group (N = 42) received 20 hours of face training with the Let's Face It! (LFI!) computer-based intervention. The LFI! program is comprised of seven interactive computer games that target the specific face impairmen…

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Differential effects of mindful breathing, progressive muscle relaxation, and loving-kindness meditation on decentering and negative reactions to repetitive thoughts.

Decentering has been proposed as a potential mechanism of mindfulness-based interventions but has received limited empirical examination to date in experimental studies comparing mindfulness meditation to active comparison conditions. In the present study, we compared the immediate effects of mindful breathing (MB) to two alternative stress-management techniques: progressive muscle relaxation (PMR) and loving-kindness meditation (LKM) to test whether decentering is unique to mindfulness meditation or common across approaches. Novice meditators (190 female undergraduates) were randomly assigned to complete one of three 15-min stress-management exercises (MB, PMR, or LKM) presented by audio recording. Immediately after the exercise, participants completed measures of decentering, frequency of repetitive thoughts during the exercise, and degree of negative reaction to thoughts. As predicted…

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OROS-methylphenidate or placebo for adult smokers with attention deficit hyperactivity disorder: racial/ethnic differences.

Objective: To explore racial/ethnic difference in OROS-methylphenidate (OMPH) efficacy when added to nicotine patch and counseling for treating nicotine dependence among smokers with attention deficit hyperactivity disorder (ADHD). Method: Participants were adult smokers with ADHD (202 whites and 51 non-whites) randomly assigned to OMPH or placebo in a multi-site, randomized controlled trial. Study outcomes were complete, prolonged, and point-prevalence abstinence at the end of treatment, and weekly ratings of ADHD symptoms, tobacco withdrawal symptoms, and desire to smoke. Results: The rate of four-week complete abstinence (no slips or lapses) was significantly higher with OMPH than placebo among non-white (OMPH=42.9%, placebo=13.3%, chi(2)(1)=5.20, p=0.02) but not white participants (OMPH=23.1%, placebo=23.5%, chi(2)(1)=0.00, p=0.95). Patterns of prolonged and point-prevalence abstinen…

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Efficacy and specificity of intensive cognitive rehabilitation of attention and executive functions in multiple sclerosis.

Objective: To evaluate the efficacy of a computer-based intensive training program of attention, information processing and executive functions in patients with clinically-stable relapsing-remitting (RR) multiple sclerosis (MS) and low levels of disability. DESIGN, PATIENTS AND INTERVENTIONS: A total of 150 patients with RR MS and an Expanded Disability Status Scale (EDSS) score of < or =4 were examined. Information processing, working memory and attention were assessed by the Paced Auditory Serial Addition Test (PASAT) and executive functions by the Wisconsin Card Sorting Test (WCST). Twenty patients who scored below certain cut-off measures in both tests were included in this double-blind controlled study. Patients were casually assigned to a study group (SG) or a control group (CG) and underwent neuropsychological evaluation at baseline and after 3 months. Patients in the SG received …

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Effects of sleep deprivation on dissociated components of executive functioning.

Study objectives: We studied the effects of sleep deprivation on executive functions using a task battery which included a modified Sternberg task, a probed recall task, and a phonemic verbal fluency task. These tasks were selected because they allow dissociation of some important executive processes from non-executive components of cognition. Design: Subjects were randomized to a total sleep deprivation condition or a control condition. Performance on the executive functions task battery was assessed at baseline, after 51 h of total sleep deprivation (or no sleep deprivation in the control group), and following 2 nights of recovery sleep, at fixed time of day (11:00). Performance was also measured repeatedly throughout the experiment on a control task battery, for which the effects of total sleep deprivation had been documented in previously published studies. Setting: Six consecutive d…

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Sleep deprivation impairs object-selective attention: a view from the ventral visual cortex.

Background: Most prior studies on selective attention in the setting of total sleep deprivation (SD) have focused on behavior or activation within fronto-parietal cognitive control areas. Here, we evaluated the effects of SD on the top-down biasing of activation of ventral visual cortex and on functional connectivity between cognitive control and other brain regions. Methodology/principal findings: Twenty-three healthy young adult volunteers underwent fMRI after a normal night of sleep (RW) and after sleep deprivation in a counterbalanced manner while performing a selective attention task. During this task, pictures of houses or faces were randomly interleaved among scrambled images. Across different blocks, volunteers responded to house but not face pictures, face but not house pictures, or passively viewed pictures without responding. The appearance of task-relevant pictures was unpred…

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Engaging in imagery versus verbal processing of worry: Impact on negative intrusions in high worriers.

Chronic, excessive, and uncontrollable worry is the defining characteristic of generalised anxiety disorder. Worry largely consists of verbal thought and it has been postulated that this predominance of verbal thought in worry may contribute to its perseveration. In an investigation of this issue, high worriers were trained to engage in either imagery or verbal processing. Mentation was sampled before and after a five-minute period of worry during which participants engaged in either imagery of the worry topic or verbal processing of the worry topic. Verbal worry resulted in a significant increase in negative intrusions, consistent with previous research. Furthermore, imagery was associated with a decrease in negative intrusions. The results support the theory that the predominantly verbal nature of worry may be responsible for the uncontrollability and maintenance of worry.

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Childrens' learning and behaviour and the association with cheek cell polyunsaturated fatty acid levels.

Increasing interest in the role of omega-3 fatty acids in relation to neurodevelopmental disorders (e.g. ADHD, dyslexia, autism) has occurred as a consequence of some international studies highlighting this link. In particular, some studies have shown that children with ADHD may have lower concentrations of polyunsaturated fatty acids (PUFAs), particularly omega-3, in their red blood cells and plasma, and that supplementation with omega-3 fatty acids may alleviate behavioural symptoms in this population. However, in order to compare levels it seems appropriate to establish fatty acid levels in a mainstream school aged population and if levels relate to learning and behaviour. To date no study has established this. For this study, cheek cell samples from 411 typically developing school children were collected and analysed for PUFA content, in order to establish the range in this populatio…

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