, Volume 8, Issue 3, pp 765–774 | Cite as

Self-Reported Mindful Attention and Awareness, Go/No-Go Response-Time Variability, and Attention-Deficit Hyperactivity Disorder

  • Julian R. KeithEmail author
  • Mallory E. Blackwood
  • Rano T. Mathew
  • Len B. Lecci


The abilities to stabilize the focus of attention, notice attention lapses, and return attention to an intended object following lapses are precursors for mindfulness. Individuals diagnosed with attention-deficit hyperactivity disorder (ADHD) are deficient in the attentional and self-control skills that characterize mindfulness. The present study assessed the relationship between mindfulness and ADHD in young adults using the Mindful Attention and Awareness Scale (MAAS), a computerized Go/No-Go task (the Test of Variables of Attention (TOVA)), the World Health Organization Adult Self-Report Scale (ASRS), a tool used as an adult ADHD screen, the Beck Anxiety Inventory (BAI), and the Beck Depression Inventory-II (BDI-II). We recruited 151 adult volunteers (ages 18 to 40); 100 with confirmed ADHD diagnoses and 51 control participants. Overall, participants with prior diagnoses of ADHD scored lower on the MAAS than controls and ASRS scores were strongly negatively correlated MAAS scores. Attention performance index, response time, and response-time variability subscales of the TOVA were positively correlated with MAAS scores and negatively correlated with ASRS scores. Intrasubject response-time variability on the TOVA, a parameter associated with attention lapses, was also strongly negatively correlated with MAAS scores. Overall, participants’ self-reported mindfulness, as measured by the MAAS, was strongly related to self-reports on a clinical measure of attention disorders, anxiety, depression, and multiple indices of concentration and mind wandering on a standardized Go/No-Go task, the TOVA.


Mindfulness Go/no-go Attention ADHD TOVA 


Compliance with Ethical Standards


This study was funded by NCCIH (R15AT007226).

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

Julian Keith declares that he has no conflict of interest. Mallory Blackwell declares that she has no conflict of interest. Rano Mathew declares that he has no conflict of interest. Len Lecci declares that he has no conflict of interest.


  1. Beck, A. T., & Steer, R. A. (1993). Beck anxiety inventory manual. San Antonio: The Psychological Corporation.Google Scholar
  2. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Beck depression inventory-II. San Antonio: The Psychological Corporation.Google Scholar
  3. Benjamini, Y., Krieger, A. M., & Yekutieli, D. (2006). Adaptive linear step-up procedures that control the false discovery rate. Biometrika, 93, 491–507.CrossRefGoogle Scholar
  4. Bernfort, L., Nordfeldt, S., & Persson, J. (2008). ADHD from a socio-economic perspective. Acta Paediatrica, 97, 239–245.CrossRefPubMedGoogle Scholar
  5. Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822–848.CrossRefPubMedGoogle Scholar
  6. Bueno, V. F., Kozasa, E. H., da Silva, M. A., Alves, T. M., Louzã, M. R., & Pompéia, S. (2015). Mindfulness meditation improves mood, quality of life, and attention in adults with attention deficit hyperactivity disorder. BioMed Research International, Article ID 962857.Google Scholar
  7. Buzy, W. M., Medoff, D. R., & Schweitzer, J. B. (2009). Intra-individual variability among children with ADHD on a working memory task: an ex-Gaussian approach. Child Neuropsychology, 15, 441–459.CrossRefPubMedPubMedCentralGoogle Scholar
  8. Carlson, L. E., & Brown, K. W. (2005). Validation of the mindful attention awareness scale in a cancer population. Journal of Psychosomatic Research, 58, 29–33.CrossRefPubMedGoogle Scholar
  9. Cassone, A. R. (2015). Mindfulness training as an adjunct to evidence-based treatment for ADHD within families. Journal of Attention Disorders, 19, 147–157.CrossRefPubMedGoogle Scholar
  10. Chan, D., & Woollacott, M. (2007). Effects of level of meditation experience on attentional focus: is the efficiency of executive or orientation networks improved? Journal of Alternative and Complementary Medicine, 13, 651–657.CrossRefPubMedGoogle Scholar
  11. Davidson, R. J. (2010). Empirical explorations of mindfulness: conceptual and methodological conundrums. Emotion, 10, 8–11.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Deng, Y.-Q., Li, S., & Tang, Y.-Y. (2014). The relationship between wandering mind, depression and mindfulness. Mindfulness, 5, 124–128.CrossRefGoogle Scholar
  13. Doshi, A. D., Hodgkins, P., Kahle, J., Sikirica, V., Cangelosi, M. J., Setyawan, J., et al. (2012). Economic impact of childhood and adult attention-deficit/hyperactivity disorder in the United States. Journal of the American Academy of Child & Adolescent Psychiatry, 51, 990–1002.CrossRefGoogle Scholar
  14. Edel, M.-A., Hölter, T., Wassink, K., & Juckel, G. (2014). A comparison of mindfulness-based group training and skills group training in adults with ADHD: an open study. Journal of Attention Disorders. doi: 10.1177/1087054714551635.Google Scholar
  15. Feifel, D. (2007). ADHD in adults: the invisible rhinoceros. Psychiatry, 4, 60–62.PubMedPubMedCentralGoogle Scholar
  16. Feige, B., Biscaldi, M., Saville, C. W. N., Kluckert, C., Bender, S., Ebner-Priemer, U., et al. (2013). On the temporal characteristics of performance variability in attention deficit hyperactivity disorder (ADHD). PloS One, 8, e69674.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Feldman, G., et al. (2007). Mindfulness and emotion regulation: the development and initial validation of the cognitive and affective mindfulness scale-revised (CAMS-R). Journal of Psychopathology and Behavioral Assessment, 29, 177–190.CrossRefGoogle Scholar
  18. Galla, B. M., Hale, T. S., Shrestha, A., Loo, S. K., & Smalley, S. L. (2012). The disciplined mind: associations between the Kentucky inventory of mindfulness skills and attention control. Mindfulness, 3, 95–103.CrossRefGoogle Scholar
  19. Gualtieri, C. T., & Johnson, L. G. (2005). ADHD: is objective diagnosis possible? Psychiatry, 2, 44–53.PubMedPubMedCentralGoogle Scholar
  20. Haydicky, J., Wiener, J., Badali, P., Milligan, K., & Ducharme, J. M. (2012). Evaluation of a mindfulness-based intervention for adolescents with learning disabilities and Co-occurring ADHD and anxiety. Mindfulness, 3, 151–164.CrossRefGoogle Scholar
  21. Heathcote, A. (1996). RTSYS: a DOS application for the analysis of reaction time data. Behavior Research Methods, Instruments, & Computers, 28, 427–445.CrossRefGoogle Scholar
  22. Hechtman, L. (2011). Prospective follow-up studies of ADHD: helping establish a valid diagnosis in adults. Journal of the American Academy of Child and Adolescent Psychiatry, 50, 533–535.CrossRefPubMedGoogle Scholar
  23. Hervey, A. S., Epstein, J. N., Curry, J. F., Tonev, S., Arnold, L. E., Conners, C. K., et al. (2006). Reaction time distribution analysis of neuropsychological performance in an ADHD sample. Child Neuropsychology, 12, 125–140.CrossRefPubMedGoogle Scholar
  24. Jha, A. P., Krompinger, J., & Baime, M. J. (2007). Mindfulness training modifies subsystems of attention. Cognitive, Affective & Behavioral Neuroscience, 7, 109–119.CrossRefGoogle Scholar
  25. Kabat-Zinn, J. (1994). Wherever you go, there you are: mindfulness meditation in everyday life. New York: Hyperion Books.Google Scholar
  26. Kabat-Zinn, J. (2016). A.D.D. Nation. Mindfulness, 7, 777–780.CrossRefGoogle Scholar
  27. Kessler, R. C., Adler, L., Ames, M., Barkley, R. A., Birnbaum, H., Greenberg, P., et al. (2005b). The prevalence and effects of adult attention deficit/hyperactivity disorder on work performance in a nationally representative sample of workers. Journal of Occupational and Environmental Medicine, 47, 565–572.CrossRefPubMedGoogle Scholar
  28. Kessler, R. C., Adler, L., Ames, M., Demler, O., Faraone, S., Hiripi, E., et al. (2005a). The World Health Organization adult ADHD self-report scale (ASRS): a short screening scale for use in the general population. Psychological Medicine, 35, 245–256.CrossRefPubMedGoogle Scholar
  29. Knouse, L. E., Zvorsky, I., & Safren, S. A. (2013). Cognitive Therapy Research, 37, 1220.CrossRefPubMedPubMedCentralGoogle Scholar
  30. Kollins, S. H., McClernon, F. J., & Epstein, J. N. (2009). Effects of smoking abstinence on reaction time variability in smokers with and without ADHD: an ex-Gaussian analysis. Drug and Alcohol Dependence, 100, 169–172.CrossRefPubMedGoogle Scholar
  31. Leark, R. A., Greenberg, L. M., Kindschi, C. L., Dupuy, T. R., & Hughes, S. J. (2007). Test of variables of attention continuous performance test. Los Alamitos: The TOVA Company.Google Scholar
  32. Leth-Steensen, C., Elbaz, Z. K., & Douglas, V. I. (2000). Mean response times, variability, and skew in the responding of ADHD children: a response time distributional approach. Acta Psychologica, 104, 167–190.CrossRefPubMedGoogle Scholar
  33. Lutz, A., Dunne, J. D., & Davidson, R. J. (2006). Meditation and the neuroscience of consciousness: an introduction. In M. Moscovitch, P. Zelazo & E. Thompson (eds.), The Cambridge handbook of consciousness (497–549). Cambridge University Press.Google Scholar
  34. Lutz, A., Slagter, H. A., Rawlings, N. B., Francis, A. D., Greischar, L. L., & Davidson, R. J. (2009). Mental training enhances attentional stability: neural and behavioral evidence. The Journal of Neuroscience, 29, 13418–13427.CrossRefPubMedPubMedCentralGoogle Scholar
  35. Marlatt, G. A., & Kristeller, J. L. (1999). Mindfulness and meditation. In W. R. Miller (Ed.), Integrating spirituality into treatment: resource for practitioners (pp. 67–84). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  36. Medvedev, O. N., Siegert, R. J., Feng, X. J., Billington, D. R., Jang, J. Y., & Krägeloh, C. U. (2015). Measuring trait mindfulness: how to improve the precision of the mindful attention awareness scale using a Rasch model. Mindfulness, 7, 384–395.CrossRefGoogle Scholar
  37. Mitchell, J. T., McIntyre, E. M., English, J. S., Dennis, M. F., Beckham, J. C., & Kollins, S. H. (2013). A pilot trial of mindfulness meditation training for ADHD in adulthood: impact on core symptoms, executive functioning, and emotion dysregulation. Journal of Attention Disorders. Published online 4 December 2013, 1087054713513328.Google Scholar
  38. Moore, A., & Malinowski, P. (2009). Meditation, mindfulness and cognitive flexibility. Consciousness and Cognition, 18, 176–186.CrossRefPubMedGoogle Scholar
  39. Mrazek, M. D., Mooneyham, B. W., & Schooler, J. W. (2014). Insights from quiet minds: the converging fields of mindfulness and mind-wandering. Meditation-Neuroscientific Approaches and Philosophical Implications, 2, 227–241.CrossRefGoogle Scholar
  40. Nelson, J. M., & Gregg, N. (2012). Depression and anxiety among transitioning adolescents and college students with ADHD, dyslexia, or comorbid ADHD/dyslexia. Journal of Attention Disorders, 16, 244–254.CrossRefPubMedGoogle Scholar
  41. Nyanaponika, T. (1962). The heart of Buddhist meditation: a handbook of mental training based on the Buddha’s way of mindfulness. London: Rider & Company.Google Scholar
  42. Prevatt, F., Dehili, V., Taylor, N., & Marshall, D. (2015). Anxiety in college students with ADHD relationship to cognitive functioning. Journal of Attention Disorders, 19, 222–230.CrossRefPubMedGoogle Scholar
  43. Rapgay, L., & Bystrisky, A. (2009). Classical mindfulness: an introduction to its theory and practice for clinical application. Annals of the New York Academy of Sciences, 1172, 148–162.CrossRefPubMedGoogle Scholar
  44. Ratcliff, R. (1979). Group reaction time distributions and an analysis of distribution statistics. Psychological Bulletin, 86, 446–461.CrossRefPubMedGoogle Scholar
  45. Schmertz, S. K.(2006). The Relation between Self-Report Mindfulness and Performance on Tasks of Attention. Thesis, Georgia State University.Google Scholar
  46. Schmertz, S. K., Anderson, P. L., & Robins, D. L. (2009). The relation between self-report mindfulness and performance on tasks of sustained attention. Journal of Psychopathology and Behavioral Assessment, 31, 60–66.CrossRefGoogle Scholar
  47. Smalley, S. L., et al. (2009). Mindfulness and attention deficit hyperactivity disorder. Journal of Clinical Psychology, 65, 1087–1098.CrossRefPubMedPubMedCentralGoogle Scholar
  48. Tang, Y., & Posner, M. (2009). Attention training and attention state training. Trends in Cognitive Sciences, 13, 222–227.CrossRefPubMedGoogle Scholar
  49. Vaurio, R. G., Simmonds, D. J., & Mostofsky, S. H. (2009). Increased intra-individual reaction time variability in attention-deficit/hyperactivity disorder across response inhibition tasks with different cognitive demands. Neuropsychologia, 47, 2389–2396.CrossRefPubMedPubMedCentralGoogle Scholar
  50. Way, B. M., Creswell, J. D., Eisenberger, N. I., & Lieberman, M. D. (2010). Dispositional mindfulness and depressive symptomatology: correlations with limbic and self-referential neural activity during rest. Emotion, 10, 12–24.CrossRefPubMedPubMedCentralGoogle Scholar
  51. Willcutt, E. G. (2012). The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics, 9, 490–499.CrossRefPubMedPubMedCentralGoogle Scholar
  52. Zylowska, L., Ackerman, D. L., Yang, M. H., Futrell, J. L., Horton, N. L., Hale, T. S., et al. (2008). Mindfulness meditation training in adults and adolescents with ADHD a feasibility study. Journal of Attention Disorders, 11, 737–746.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Julian R. Keith
    • 1
    Email author
  • Mallory E. Blackwood
    • 1
  • Rano T. Mathew
    • 1
  • Len B. Lecci
    • 1
  1. 1.Department of PsychologyUniversity of North Carolina, WilmingtonWilmingtonUSA

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