The Effect of Neurofeedback training on improving attention and inhibition skills in adults with Attention Deficit Disorder: A pilot experimental therapy

Subject Areas : Educational

nooshin basiri ¹ (Educational Sciences & Psychology Department, University of shiraz, shiraz, Iran. Lecturer in Shahid Ashrafi Esfahani University, faculty of law and theology, department of psychology and counseling, Isfahan, Iran.)
zahra khayyer ² (Educational Sciences & Psychology Department, University of Isfahan, Isfahan, Iran. Lecturer in Shahid Ashrafi Esfahani University, faculty of law and theology, department of psychology and counseling, Isfahan, Iran.)
habib hadian fard ³ (Professor, Clinical Psychology, University of Shiraz, Shiraz, Iran.)

Received: 2014-09-09 Accepted : 2020-06-08 Published : 2021-05-22

Keywords: attention deficit disorder, neurofeedback, Inhibition, Adult Attention Deficit/Hyperactivity Disorder,

Abstract :

Attention Deficit Disorder (ADD) is a lifelong disorder that affects many people. The purpose of this study was to investigate the effect of neurofeedback training on treatment of adult ADD. A pre-test-post-test control grouped, quasi-experimental study was carried out. The research population was individuals with ADD (18-40 years old) who were referred to the Psychotherapy and counseling Centers of Isfahan City.  20 patients were selected applying convenient sampling and randomly assigned to control or experiment groups. Conners Questionnaire, Slow Movement Test and Diagnostic Interview were applied prior to the intervention. Data were analyzed by MANCOVA in SPSS-23. The results showed that neurofeedback training up to 95.7% can ameliorate ADD symptoms and it was effective about 93%  in improvement of inhibition skills, in adults. In general speaking, it can be argued that, having attention deficit disorder causes brain wave disturbance and neurofeedback can modify and adjust it. The effects are clinically stable. Hence, neurofeedback training can be used as an alternative therapy for ADD treatment.

References:

Arns, M., & Kenemans, J. L. (2014). Neurofeedback in ADHD and insomnia: vigilance stabilization through sleep spindles and circadian networks. Neuroscience & Biobehavioral Reviews, 44, 183-194.

Aylward, E. H., Reiss, A. L., Reader, M. J., Singer, H. S., Brown, J. E., & Denckla, M. B. (1996). Basal ganglia volumes in children with attention-deficit hyperactivity disorder. Journal of Child Neurology, 11, 112–115.

Basiri, N., Khayyer, Z., Hadianfard, H., & Ghaderi, A. (2017). Comparison of the Effectiveness of Cognitive Behavioral Therapy and Neurofeedback: Reducing Insomnia Symptoms. Global Journal of Health Science, 9(7), 35.

Baumeister, S., Wolf, I., Holz, N., Boecker-Schlier, R., Adamo, N., Holtmann, M., ... & Brandeis, D. (2018). Neurofeedback training effects on inhibitory brain activation in ADHD: a matter of learning? Neuroscience, 378, 89-99.

Bluschke, A., Broschwitz, F., Kohl, S., Roessner, V., & Beste, C. (2016). The neuronal mechanisms underlying improvement of impulsivity in ADHD by theta/beta neurofeedback. Scientific reports, 6(1), 1-9.

Brown, T. E. (2006). Attention deficit disorder: The unfocused mind in children and adults. Yale University Press.

Carmody, D. Ravanski, DC (2001) EEG biofeedback training and attention deficit/hyperactivity disorder in an elementary school setting. journal of neurotherapy.4(3):5-27.

Castellanos, F. X., Giedd, J. N., Berquin, P. C., Walter, J. M., Sharp, W., Tran, T., ... & Zijdenbos, A. (2001). Quantitative brain magnetic resonance imaging in girls with attention-deficit/hyperactivity disorder. Archives of general psychiatry, 58(3), 289-295.

Castellanos, F. X., Giedd, J. N., Eckburg, P., Marsh, W. L., Vaituzis, A. C., Kaysen, D., ... & Rapoport, J. L. (1994). Quantitative morphology of the caudate nucleus in attention deficit hyperactivity disorder. The American Journal of Psychiatry.

Castellanos, F. X., Giedd, J. N., Marsh, W. L., Hamburger, S. D., Vaituzis, A. C., Dickstein, D. P., ... & Kaysen, D. (1996). Quantitative brain magnetic resonance imaging in attention-deficit hyperactivity disorder. Archives of general psychiatry, 53(7), 607-616.

Castellanos, F. X., Lee, P. P., Sharp, W., Jeffries, N. O., Greenstein, D. K., Clasen, L. S., ... & Zijdenbos, A. (2002). Developmental trajectories of brain volume abnormalities in children and adolescents with attention-deficit/hyperactivity disorder. Jama, 288(14), 1740-1748.

Castellanos, F. X., Marvasti, F. F., Ducharme, J. L., Walter, J. M., Israel, M. E., Krain, A., ... & Hommer, D. W. (2000). Executive function oculomotor tasks in girls with ADHD. Journal of the American Academy of Child & Adolescent Psychiatry, 39(5), 644-650.

Caye, A., Swanson, J. M., Coghill, D., & Rohde, L. A. (2018). Treatment strategies for ADHD: an evidence-based guide to select optimal treatment. Molecular psychiatry, 1.

 

Chabot, R. J., & Serfontein, G. (1996). Quantitative electroencephalographic profiles of children with attention deficit disorder. Biological psychiatry, 40(10), 951-963.

Coben, R., M. Linden (2010). "Neurofeedback for autistic spectrum disorder: a review of the literature." Applied psychophysiology and biofeedback 35(1): 83-105.

Cortoos, A., De Valck, E., Arns, M., Breteler, M. H., & Cluydts, R. (2010). An exploratory study on the effects of tele-neurofeedback and tele-biofeedback on objective and subjective sleep in patients with primary insomnia. Applied psychophysiology and biofeedback, 35(2), 125-134.

Diamond, A (2005). "Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity)." Development and psychopathology 17(03): 807-825.

Dunlop,j(2006). Focusing on success: Teaching students with attention deficit/hyperactivity disorder. Education alberta pub.

Durston, S., Hulshoff Pol, H. E., Schnack, H. G., Buitelaar, J. K., Steenhuis, M. P., Minderaa, R. B., et al. (2004). Magnetic resonance imaging of boys with attention-deficit/hyperactivity disorder and their unaffected siblings. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 332– 340.

Faraone, S. V., & Larsson, H. (2018). Genetics of attention deficit hyperactivity disorder. Molecular psychiatry, 1.

Fox, D. J., D. F. Tharp (2005). "Neurofeedback: an alternative and efficacious treatment for attention deficit hyperactivity disorder." Applied psychophysiology and biofeedback 30(4): 365-373.

Geladé, K., Janssen, T. W., Bink, M., van Mourik, R., Maras, A., Oosterlaan, J., ... & Maras, A. (2019). Behavioral effects of neurofeedback compared to stimulants and physical activity in ADHD: a randomized controlled trial. Neurofeedback in Children with ADHD, 19.

Hammond,C (2011) What is neurofeedback: An update Journal of Neurotherapy 15(4): 305-33.

Jadidi M, Ahadi H, Khoushabi K, Farrokhi N A (2012). A Comparative Study of Effectiveness of Neurofeedback and Ritalin on Improving Conduct Problems and Hyperactivity. Avicenna J Clin Med. 18 (4):53-59

Kaiser,D, (2010)Efficacy of neurofeedback on Adults with Attentional Deficit and related Disorders.Journal of Neurotherapy.

Karimi, L ., Zare, H & Hadianfard, H (2013). Effect of music on selective Attention in Children with Attention Deficit- Hyperactivity Disorder. Journal of exceptional children. 11(1): 33-44. [persian]

Khayyer Z, Oreyzi HR, Asgari K, Sikström S. Determining predictive variables in personal peacefulness: With regards to gender and marital status differences. Journal of Fundamentals of Mental Health 2019 Jan-Feb; 21(1): 14-31.

Lee, E. J., & Jung, C. H. (2017). Additive effects of neurofeedback on the treatment of ADHD: A randomized controlled study. Asian journal of psychiatry, 25, 16-21.

Linden,M.Habib,T(1996)A controlled study of the effects of EEG biofeedback on cognition and behavior of children with attention deficit disorder and learning disabilites.Biofeedback & self-Regulation.21(1):35-49

Lubar,J.F.,&Shouse,M.N. (1976).EEGandbehavioralchangesinahyperkineticchildconcurrentwithtraining of the sensorimotor rhythm (SMR): A preliminary report. Biofeedback and Self Regulation, 1, 293–306

Masterpasqua F, Healey K (2003). Neurofeedback in psychological practice, professional psychology.34(6):652-656.

Mochrie, K. D., Whited, M. C., Cellucci, T., Freeman, T., & Corson, A. T. (2018). ADHD, depression, and substance abuse risk among beginning college students. Journal of American college health, 1-5.

Mundy,P.Newell,L(2007)Attention, Joint Attention, and Social Cognition. Association for psychological Science.16(5):269-275.

Murphy, K. R. (1995). Empowering the adult with ADD. A comprehensive guide to attention deficit disorder in adults: Research, diagnosis, and treatment, 135-145.

Rossiter,TR.laVaque,TJ. (1995).A comparison of EEG biofeedback and psychostimulants in treating attention deficit/hyperactivity disorders.journal of neurotherapy.1:48-59.

Rubia, K., Criaud, M., Wulff, M., Alegria, A., Brinson, H., Barker, G., ... & Giampietro, V. (2019). Functional connectivity changes associated with fMRI neurofeedback of right inferior frontal cortex in adolescents with ADHD. NeuroImage, 188, 43-58.

Rubia,K.Alergria,A.Cubillo,A.Smith,A(2013)Effects of stimulants on brain Function in Attention-Deficit/Hyperactivity Disorder:A systematic Review and meta-analysis.journal of Biol Psychiatry.In press.

Sadeghi-Bazargani, H., Amiri, S., Hamraz, S., Malek, A., Abdi, S., & Shahrokhi, H. (2014). Validity and reliability of the Persian version of Conner’s adult ADHD rating scales: observer and self-report screening versions. Journal of Clinical Research & Governance, 3(1), 42-47.

Sadock, B. J., & Sadock, V. A. (2011). Kaplan and Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry. Lippincott Williams & Wilkins.

Steiner, N. J., Frenette, E. C., Rene, K. M., Brennan, R. T., & Perrin, E. C. (2014). Neurofeedback and cognitive attention training for children with attention-deficit hyperactivity disorder in schools. Journal of Developmental & Behavioral Pediatrics, 35(1), 18-27.

Tan, G., Thornby, J., Hammond, D. C., Strehl, U., Canady, B., Arnemann, K., & Kaiser, D. A. (2009). Meta-analysis of EEG biofeedback in treating epilepsy. Clinical EEG and neuroscience, 40(3), 173-179.

Van Doren, J., Arns, M., Heinrich, H., Vollebregt, M. A., Strehl, U., & Loo, S. K. (2019). Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis. European child & adolescent psychiatry, 28(3), 293-305.

Zhao, L., Wang, E., Zhang, X., Karama, S., Khundrakpam, B., Zhang, H., ... & Evans, A. C. (2015). Cortical structural connectivity alterations in primary insomnia: insights from MRI-based morphometric correlation analysis. BioMed research international, 2015.