The Relationships Between Executive Functioning Deficits Related to ADHD and Mindfulness

128 Pages·2015·8.04 MB·English

by  Scott Andrew Flagg

Florida State University Libraries
Electronic Theses, Treatises and Dissertations The Graduate School
2014
The Relationships Between Executive
Functioning Deficits Related to ADHD and
Mindfulness
Scott Andrew Flagg
Follow this and additional works at the FSU Digital Library. For more information, please contact [email protected]
FLORIDA STATE UNIVERSITY
COLLEGE OF EDUCATION

THE RELATIONSHIPS BETWEEN EXECUTIVE FUNCTIONING DEFICITS RELATED TO
ADHD AND MINDFULNESS

By
SCOTT ANDREW FLAGG

A Dissertation submitted to the
Department of Educational Psychology and Learning Systems
in partial fulfillment of the
requirements for the degree of
Doctor of Philosophy

Degree Awarded
Summer Semester, 2014
Scott Andrew Flagg defended this dissertation on May 9, 2014.
The members of the supervisory committee were:

Frances Prevatt
Professor Directing Dissertation

Sandra Lewis
University Representative

Angela Canto
Committee Member

Shengli Dong
Committee Member

The Graduate School has verified and approved the above-named committee members, and
certifies that the dissertation has been approved in accordance with university requirements.

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TABLE OF CONTENTS
List of Tables ................................................................................................................................. iv
List of Figures ..................................................................................................................................v
Abstract ......................................................................................................................................... vii
1. INTRODUCTION .......................................................................................................................1
2. LITERATURE REVIEW ............................................................................................................6
3. METHODS ................................................................................................................................42
4. RESULTS .................................................................................................................................47
5. DISCUSSION ............................................................................................................................62
APPENDICES ...............................................................................................................................74
A. REGRESSION SCATTER PLOTS ......................................................................................74
B. INFORMED CONSENT AND SURVEY ............................................................................87
C. HUMAN SUBJECTS APPROVAL ....................................................................................105
REFERENCES ............................................................................................................................110
BIOGRAPHICAL SKETCH .......................................................................................................120

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LIST OF TABLES

1 Estimates of FFMQ and BDEFS Relatedness ...................................................................44

2 Frequencies and Percentages for Participant Demographics .............................................47

3 Frequencies and Percentages for Participant Demographics for ALEC Group .................48

4 Frequencies and Percentages for Participant Demographics for ELPS Group ..................49

5 Frequencies and Percentages for Participant Demographics for Meditation Group .........51

6 Cronbach Alpha Reliability and Descriptive Statistics for Composite Scores ..................52

7 Pearson Correlation Matrix between BDEFS and FFMQ Composites .............................53

8 Hypothesized vs Actual Effect Sizes .................................................................................53

9 Pearson Correlation Matrix for BDEFS Composites .........................................................54

10 Pearson Correlation Matrix for FFMQ Composites ..........................................................54

11 Results for Multiple Linear Regression with FFMQ Scores Predicting Manage Time .....55

12 Results for Multiple Linear Regression with FFMQ Scores Predicting Organization
Problem Solving.................................................................................................................56

13 Results for Multiple Linear Regression with FFMQ Scores Predicting Restraint.............57

14 Results for Multiple Linear Regression with FFMQ Scores Predicting Motivation .........57

15 Results for Multiple Linear Regression with FFMQ Scores Predicting Emotional
Regulation ..........................................................................................................................58

16 Results for Multiple Linear Regression with Gender and FFMQ Scores Predicting BDEF
Scores .................................................................................................................................59

17 Results for Multiple Linear Regression with ADHD Status and FFMQ Scores Predicting
BDEF Scores ......................................................................................................................60

18 Binary Logistic Regressions with FFMQ and BDEFS Scores Predicting ADHD Status ..61

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LIST OF FIGURES
1 Scatterplot between manage time scores (dependent variable) and observing scores
(predictor) ..........................................................................................................................74

2 Scatterplot between manage time scores (dependent variable) and describing scores
(predictor) ..........................................................................................................................74

3 Scatterplot between manage time scores (dependent variable) and acting with awareness
scores (predictor). ..............................................................................................................75

4 Scatterplot between manage time scores (dependent variable) and non-judging scores
(predictor) ..........................................................................................................................75

5 Scatterplot between manage time scores (dependent variable) and non-reacting scores
(predictor) ..........................................................................................................................76

6 Scatterplot between organization problem solving scores (dependent variable) and
observing scores (predictor). ..............................................................................................76

7 Scatterplot between organization problem solving scores (dependent variable) and
describing scores (predictor) ..............................................................................................77

8 Scatterplot between organization problem solving scores (dependent variable) and acting
with awareness scores (predictor) ......................................................................................77

9 Scatterplot between organization problem solving scores (dependent variable) and non-
judging scores (predictor) ..................................................................................................78

10 Scatterplot between organization problem solving scores (dependent variable) and non-
reacting scores (predictor) ..................................................................................................78

11 Scatterplot between restraint scores (dependent variable) and observing scores
(predictor) ..........................................................................................................................79

12 Scatterplot between restraint scores (dependent variable) and describing scores
(predictor) ..........................................................................................................................79

13 Scatterplot between restraint scores (dependent variable) and acting with awareness
scores (predictor) ...............................................................................................................80

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14 Scatterplot between restraint scores (dependent variable) and non-judging scores
(predictor) ..........................................................................................................................80

15 Scatterplot between restraint scores (dependent variable) and non-reacting scores
(predictor) ..........................................................................................................................81

16 Scatterplot between motivation scores (dependent variable) and observing scores
(predictor) ..........................................................................................................................81

17 Scatterplot between motivation scores (dependent variable) and describing scores
(predictor) ..........................................................................................................................82

18 Scatterplot between motivation scores (dependent variable) and acting with awareness
scores (predictor) ...............................................................................................................82

19 Scatterplot between motivation scores (dependent variable) and non-judging scores
(predictor) ..........................................................................................................................83

20 Scatterplot between motivation scores (dependent variable) and non-reacting scores
(predictor) ..........................................................................................................................83

21 Scatterplot between emotional regulation scores (dependent variable) and observing
scores (predictor) ...............................................................................................................84

22 Scatterplot between emotional regulation scores (dependent variable) and describing
scores (predictor) ...............................................................................................................84

23 Scatterplot between emotional regulation scores (dependent variable) and acting with
awareness scores (predictor) ..............................................................................................85

24 Scatterplot between emotional regulation scores (dependent variable) and non-judging
scores (predictor) ...............................................................................................................85

25 Scatterplot between emotional regulation scores (dependent variable) and non-reacting
scores (predictor) ...............................................................................................................86

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ABSTRACT
This study investigated the relationship(s) between deficits of executive functioning
ability and mindfulness as measured by Barkley’s Deficits in Executive Functioning Scale
(BDEFS) and the Five Facet Mindfulness Questionnaire (FFMQ) respectively. ADHD is a
disorder affecting millions of individuals, including children. Currently it is the most diagnosed
of all childhood psychological disorders with about half of those diagnosed continuing to
experience symptoms into adulthood (CDC, 2010). The psychological construct of ADHD has
been redefined recently by Barkley, opening the door for new conceptualization and treatment
options (Barkley 2012). ADHD has been described as being synonymous with deficits in EF
(Barkley, 2012). The current study’s purpose was to evaluate the relationship(s) that exist
between deficits of EF and mindfulness as evaluated by two prominent measures. Findings of
the current study suggest mindfulness is related to EF ability, regardless of ADHD status.
Mindfulness, as measured by higher scores on the FFMQ, appears to predict fewer EF deficits,
and lower total scores on the BDEFS. The current study also examined if gender or ADHD status
might influence the relationship between ADHD and mindfulness and concluded that they do
not. Finally, the study also evaluated if the FFMQ could predict ADHD status as accurately as
the BDEFS. The research findings indicate that both measures are significant predictors of
ADHD, with the BDEFS being slightly higher (77% compared to 66%). This study supports the
notion that mindfulness training might represent a viable treatment option for those with ADHD.

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CHAPTER 1
INTRODUCTION
The purpose of this study was to examine the relationships that exist between Barkley’s
Deficits in Executive Functioning Scale (BDEFS), a measure used to evaluate people with
Attention Deficit Hyperactivity Disorder (ADHD), and the Five Facet Mindfulness
Questionnaire (FFMQ), a common measure of mindfulness. This research was conducted as a
necessary foundation for future studies utilizing mindfulness training as an intervention for
people with ADHD. The study analyzed the relationship between the five factors of the BDEFS
and the five subscales of the FFMQ, along with relevant client demographic information. In this
text, the author will discuss the importance of the proposed study, provide a historical and
theoretical foundation of the constructs being examined, and outline current measures of
executive functioning (EF) and mindfulness. This author will also outline the methodology
required to evaluate the above constructs and conclude with the studies research findings.
Background of the Study
Attention deficit hyperactivity disorder (ADHD) is the most diagnosed of all childhood
psychological disorders. A 2010 report using data from 2003–2007 indicates the cost of ADHD
to society during these years to be between $143 and $266 billion (CDC, 2010). The expense
associated with this disorder was projected to increase by 5–10% per year, placing the cost in
excess of $300 billion annually by the year 2013. As of 2007, ADHD costs the healthcare system
annually between $21 billion and $44 billion for children alone and the education system around
$25 billion (CDC, 2010). The Centers for Disease Control now proposes, based on parent
reports, that one child in ten has ADHD. This statistic suggests a 22% increase in ADHD
diagnosis between 2003 and 2007 for those between the ages of 4 and 17 (CDC, 2010). The
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pattern of ADHD diagnosis in the United States may also be changing, as the same CDC report
found a 42% increase in ADHD identification in older teens and adults.
The symptoms of ADHD are well defined in the literature and have historically included
inattention, hyperactivity and impulsivity. A shift in emphasis has occurred in the last decade,
away from attentional deficits to deficits in EF. Current research now supports the notion that the
symptoms of ADHD are related to disregulation of EF and represent a disorder involving this
broader system of self-regulation (Barkley, 2011a; Barkley, Edwards, Laneri, Fletcher, &
Metevia, 2001).
EF encompasses a complex and extensive range of human activity, including cognitive
and behavioral regulation. Recently, both the theoretical and evaluatory aspects of EF have been
identified as being measured in an artificial manner that likely does not accurately capture the
daily processes of EF and associated functional impairments (Barkley, 2011a; Barkley &
Fischer, 2010). A recent measure of EF, the BDEFS, takes into account the concerns of daily
functional impairments and is reported to better capture the deficits in EF that individuals with
ADHD report. While the BDEFS holds promise in measuring deficits in EF, there remain gaps in
our understanding and evaluation of EF. A review of the mindfulness literature suggests a great
deal of overlap between EF and mindfulness; in fact, mindfulness training may represent a
treatment for people with deficits in EF and may directly address deficits found in individuals
with ADHD. The factors comprising the BDEFS appear inversely related to those of a common
measure of mindfulness, the FFMQ.
Mindfulness training typically involves concentrative meditation, the use of focused
attention on a single object (such as the breath) in the present moment, while maintaining a non-
judgmental state of mind and relaxed body. Mindfulness training has been suggested as a
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