The effectiveness of a mindfulness-based stress reduction program in improving self-management skills and reducing social anxiety in hyperactive adolescents with attention deficit hyperactivity disorder

Authors
Abstract
Attention deficit hyperactivity disorder (ADHD) in adolescence is associated with persistent deficits in self-regulation, poor self-management skills, and increased social-emotional problems, including social anxiety. The aim of the present study was to investigate the effectiveness of a mindfulness-based stress reduction program on self-management skills and social anxiety in adolescents with ADHD. The study was conducted in a quasi-experimental manner with a pre-test-post-test design with a control group and a two-month follow-up. The study population included adolescents aged 13 to 15 years with this disorder, 30 of whom were selected using a convenience method and randomly assigned to two experimental and control groups. The experimental group participated in eight 90-minute sessions of a mindfulness-based stress reduction program, while the control group was on a waiting list. The research instruments included the Adolescent Self-Management Questionnaire and the Adolescent Social Anxiety Scale, which were administered in three stages: pre-test, post-test, and follow-up. Data were analyzed using repeated measures multivariate analysis of variance. The results showed that the implementation of the mindfulness-based stress reduction program significantly increased self-management skills and significantly reduced social anxiety in the experimental group compared to the control group, and these effects remained largely stable at the two-month follow-up. Based on the findings, the mindfulness-based stress reduction program can be used as a complementary and effective intervention in improving cognitive-behavioral functions and reducing social-emotional problems in adolescents with attention deficit hyperactivity disorder.
Keywords

Akiki, T. J., Jubeir, J., Bertrand, C., Tozzi, L., & Williams, L. M. (2025). Neural circuit basis of pathological anxiety. Nature Reviews Neuroscience, 26(1), 5–22.
Alum, E. U. (2025). Optimizing patient education for sustainable self-management in type 2 diabetes. Discover Public Health, 22(1), 44.
Alves, F., Figueiredo, D. V., & Vagos, P. (2023). Acceptance and commitment therapy for social anxiety disorder in adolescence: Preliminary appraisal based on a case study approach. Clinical Case Studies, 22(4), 343-362.
Barkley, R. A., & Poillion, M. J. (1994). Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment. Behavioral disorders, 19(2), 150-152.
Bashirinia, S., Motamed, N., Bahreini, M., & Ravanipour, M. (2026). The effects of an empowering self-management model on sense of coherence and self-efficacy among adolescent girls with internet addiction in Bushehr, Iran: a randomized controlled trial. BMC Public Health, 26(1), 424. Law, E. F., Tham, S. W., Howard, W., Ward, T. M., & Palermo, T. M. (2024). Executive functioning and self-management processes mediate the relationship between insomnia and pain-related disability. The journal of pain, 25(1), 273-283.
Bauer, W. S., Schiffman, R. F., Ellis, J. L., Erickson, J. M., Polfuss, M., Taani, M. H., & Sawin, K. J. (2025). An integrative review of the use of the individual and family self-management theory in research. Advances in Nursing Science, 48(2), E41–E58.
Bellato, A., Perrott, N. J., Marzulli, L., Parlatini, V., Coghill, D., & Cortese, S. (2025). Systematic review and meta-analysis: Effects of pharmacological treatment for attention-deficit/hyperactivity disorder on quality of life. Journal of the American Academy of Child & Adolescent Psychiatry, 64(3), 346–361.
Cortese, S., Bellgrove, M. A., Brikell, I., Franke, B., Goodman, D. W., Hartman, C. A., … & Faraone, S. V. (2025). Attention‐deficit/hyperactivity disorder (ADHD) in adults: Evidence base, uncertainties and controversies. World Psychiatry, 24(3), 347–371.
Gu, Q., Liu, J., Zhang, X., Huang, A., Yu, X., Wu, K., & Huang, Y. (2025). Association between heavy metals exposure and risk of attention deficit hyperactivity disorder (ADHD) in children: A systematic review and meta-analysis. European Child & Adolescent Psychiatry, 34(3), 921–941.
Heravi, M. M., Khosravan, S., Mohammadi, A., & Mansoorian, M. R. (2023). Effects of self-management training on smartphone dependence in low to moderate adolescent males’ users. Behaviour Change, 40(1), 67-75.
Hou, Y., Yu, L., Liu, D., Wilson-Lemoine, E., Wu, X., Moreira, J. P., … & Payne, J. M. (2025). Systematic review and meta-analysis: Attention-deficit/hyperactivity disorder symptoms in children with neurofibromatosis Type 1. Journal of the American Academy of Child & Adolescent Psychiatry, 64(4), 447–462.
Husgafvel, V. (2018). The ‘universal dharma foundation’of mindfulness-based stress reduction: Non-duality and mahāyāna buddhist influences in the work of jon kabat-zinn. Contemporary Buddhism, 19(2), 275-326.
Jäger, M., Zangger, G., Bricca, A., Dideriksen, M., Smith, S. M., Midtgaard, J., ... & Skou, S. T. (2024). Mapping interventional components and behavior change techniques used to promote self-management in people with multimorbidity: a scoping review. Health psychology review, 18(1), 165-188.
Jiang, L., & Yoo, Y. (2024). Adolescents’ short-form video addiction and sleep quality: the mediating role of social anxiety. BMC psychology, 12(1), 369.
Langer, K., Jentsch, V. L., & Wolf, O. T. (2023). Rapid effects of acute stress on cognitive emotion regulation. Psychoneuroendocrinology, 151, 106054.
Leocadio, P., Kelleher, C., Fernandez, E., & Hawkes, C. P. (2023). Adolescents’ experiences of transition to self-management of type 1 diabetes: Systematic review and future directions. The Science of Diabetes Self-Management and Care, 49(6), 477-492.
Li, T., Chen, B., Li, Q., Wu, X., Li, Y., & Zhen, R. (2023). Association between bullying victimization and post-traumatic stress disorders among Chinese adolescents: a multiple mediation model. BMC psychiatry, 23(1), 758.
Ohi, K., Fujikane, D., Takai, K., Kuramitsu, A., Muto, Y., Sugiyama, S., & Shioiri, T. (2025). Clinical features and genetic mechanisms of anxiety, fear, and avoidance: A comprehensive review of five anxiety disorders. Molecular Psychiatry, 30(10), 4928–4936.
Olukoya, M., Oluwasakinju, O., Olatokun, T., & Busayo, R. (2025). Microbial influences on neurodevelopment: Implications for autism spectrum disorders and attention deficit hyperactivity disorder. International Journal of Life Science Research Archive, 9(10.53771).
Schlieter, J. (2017). Buddhist insight meditation (Vipassanā) and Jon Kabat-Zinn’s “Mindfulness-based Stress Reduction”: an example of dedifferentiation of religion and medicine?. Journal of contemporary religion, 32(3), 447-463.
Sharei, A., Ebrahimi, M., Ahmadi Ochtapeh, P., Mahdavirad, H., & Jamshiddoust Miyanroudi, F. (2023). The Effectiveness of Strength-Based Therapy in Improving Self-Esteem and Reducing Suicidal Thoughts of Women Affected by Domestic Violence in Ardebil. Preventive Counseling, 4(1), 31-44.
Sharei, A., Kasaei, E. A., & Salmani, A. (2024). The Effect of Mindfulness Therapy on Emotion Regulation, Cognitive Self-Awareness, and Tendency to High-Risk Behaviors in Orphaned and Poorly Monitored Adolescents: A Quasi-Experimental Study.
Sheikh, J., Allotey, J., Sobhy, S., Plana, M. N., Martinez-Barros, H., Naidu, H., … & Thangaratinam, S. (2025). Maternal paracetamol (acetaminophen) use during pregnancy and risk of autism spectrum disorder and attention deficit/hyperactivity disorder in offspring: Umbrella review of systematic reviews. BMJ, 391.
Sun, R., Li, W., Lu, S., & Gao, Q. (2023). Psychological needs satisfaction and smartphone addiction among Chinese adolescents: The mediating roles of social anxiety and loneliness. Digital Health, 9, 20552076231203915.
Tam, L. Y. C., Taechameekietichai, Y., & Allen, J. L. (2025). Individual child factors affecting the diagnosis of attention deficit hyperactivity disorder (ADHD) in children and adolescents: A systematic review. European Child & Adolescent Psychiatry, 34(5), 1469–1496.
Temircan, Z. (2022). Assessment of executive functioning and social emotional learning among adolescents. Psikiyatride Güncel Yaklaşımlar, 14(Suppl. 1), 286-292.
Town, R., Hayes, D., March, A., Fonagy, P., & Stapley, E. (2024). Self-management, self-care, and self-help in adolescents with emotional problems: a scoping review. European child & adolescent psychiatry, 33(9), 2929-2956.
Westwood, S. J., Aggensteiner, P. M., Kaiser, A., Nagy, P., Donno, F., Merkl, D., … & European ADHD Guidelines Group. (2025). Neurofeedback for attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. JAMA Psychiatry, 82(2), 118–129.
Yerys, B. E., Tao, S., Shea, L., & Wallace, G. L. (2025). Attention-deficit/hyperactivity disorder in Medicaid-enrolled autistic adults. JAMA Network Open, 8(2), e2453402–e2453402