International Journal of High Risk Behaviors and Addiction

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Effectiveness of Neurofeedback on Executive Functions and Tendency Toward High-Risk Behaviors in Adolescents with Attention Deficit Hyperactivity Disorder

Roghieh Nooripour 1 , Simin Hosseinian 2 , * , Gholam Ali Afrouz 3 and Nour-Mohammad Bakhshani 4
Authors Information
1 Department of Counseling, Faculty of Educational Sciences and Psychology, Alzahra University, Tehran, IR Iran
2 Department of Counseling, Faculty of Educational Sciences and Psychology, Alzahra University, Tehran, IR Iran
3 Department of Psychology and Education of Exceptional Children, Faculty of Education and Psychology, University of Tehran, IR Iran
4 Department of Psychiatry and Clinical Psychology, Research Center for Health of Adolescents and Children, Zahedan University of Medical Sciences, Zahedan, IR Iran
Article information
  • International Journal of High Risk Behaviors and Addiction: December 31, 2018, 7 (4); e82012
  • Published Online: September 3, 2018
  • Article Type: Research Article
  • Received: July 11, 2018
  • Accepted: July 17, 2018
  • DOI: 10.5812/ijhrba.82012

To Cite: Nooripour R, Hosseinian S , Afrouz G A , Bakhshani N. Effectiveness of Neurofeedback on Executive Functions and Tendency Toward High-Risk Behaviors in Adolescents with Attention Deficit Hyperactivity Disorder, Int J High Risk Behav Addict. 2018 ; 7(4):e82012. doi: 10.5812/ijhrba.82012.

Copyright © 2018, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Patients and Methods
4. Results
5. Discussion
  • 1. Bhaijiwala M, Chevrier A, Schachar R. Withholding and canceling a response in ADHD adolescents. Brain Behav. 2014;4(5):602-14. doi: 10.1002/brb3.244. [PubMed: 25328838]. [PubMed Central: PMC4086366].
  • 2. Humphreys KL, Watts EL, Dennis EL, King LS, Thompson PM, Gotlib IH. Stressful life events, ADHD symptoms, and brain structure in early adolescence. J Abnorm Child Psychol. 2018;21:1-12. doi: 10.1007/s10802-018-0443-5. [PubMed: 29785533].
  • 3. Hartman CA, Geurts HM, Franke B, Buitelaar JK, Rommelse NNJ. Changing ASD-ADHD symptom co-occurrence across the lifespan with adolescence as crucial time window: Illustrating the need to go beyond childhood. Neurosci Biobehav Rev. 2016;71:529-41. doi: 10.1016/j.neubiorev.2016.09.003. [PubMed: 27629802].
  • 4. Carter Leno V, Chandler S, White P, Pickles A, Baird G, Hobson C, et al. Testing the specificity of executive functioning impairments in adolescents with ADHD, ODD/CD and ASD. Eur Child Adolesc Psychiatry. 2018;27(7):899-908. doi: 10.1007/s00787-017-1089-5. [PubMed: 29224173]. [PubMed Central: PMC6013506].
  • 5. Becker SP, Langberg JM. Attention-deficit/hyperactivity disorder and sluggish cognitive tempo dimensions in relation to executive functioning in adolescents with ADHD. Child Psychiatry Hum Dev. 2014;45(1):1-11. doi: 10.1007/s10578-013-0372-z. [PubMed: 23443466].
  • 6. Biederman J, Monuteaux MC, Doyle AE, Seidman LJ, Wilens TE, Ferrero F, et al. Impact of executive function deficits and attention-deficit/hyperactivity disorder (ADHD) on academic outcomes in children. J Consult Clin Psychol. 2004;72(5):757-66. doi: 10.1037/0022-006X.72.5.757. [PubMed: 15482034].
  • 7. Lambek R, Tannock R, Dalsgaard S, Trillingsgaard A, Damm D, Thomsen PH. Validating neuropsychological subtypes of ADHD: how do children with and without an executive function deficit differ? J Child Psychol Psychiatry. 2010;51(8):895-904. doi: 10.1111/j.1469-7610.2010.02248.x. [PubMed: 20406332].
  • 8. Nigg JT, Willcutt EG, Doyle AE, Sonuga-Barke EJ. Causal heterogeneity in attention-deficit/hyperactivity disorder: do we need neuropsychologically impaired subtypes? Biol Psychiatry. 2005;57(11):1224-30. doi: 10.1016/j.biopsych.2004.08.025. [PubMed: 15949992].
  • 9. Coghill DR, Hayward D, Rhodes SM, Grimmer C, Matthews K. A longitudinal examination of neuropsychological and clinical functioning in boys with attention deficit hyperactivity disorder (ADHD): improvements in executive functioning do not explain clinical improvement. Psychol Med. 2014;44(5):1087-99. doi: 10.1017/S0033291713001761. [PubMed: 23866120].
  • 10. Guler AS, Scahill L, Jeon S, Taskin B, Dedeoglu C, Unal S, et al. Use of multiple informants to identify children at high risk for ADHD in Turkish school-age children. J Atten Disord. 2017;21(9):764-75. doi: 10.1177/1087054714530556. [PubMed: 24799319].
  • 11. Fair DA, Nigg JT, Iyer S, Bathula D, Mills KL, Dosenbach NU, et al. Distinct neural signatures detected for ADHD subtypes after controlling for micro-movements in resting state functional connectivity MRI data. Front Syst Neurosci. 2012;6:80. doi: 10.3389/fnsys.2012.00080. [PubMed: 23382713]. [PubMed Central: PMC3563110].
  • 12. Charach A, Yeung E, Climans T, Lillie E. Childhood attention-deficit/hyperactivity disorder and future substance use disorders: comparative meta-analyses. J Am Acad Child Adolesc Psychiatry. 2011;50(1):9-21. doi: 10.1016/j.jaac.2010.09.019. [PubMed: 21156266].
  • 13. Lee SS, Humphreys KL, Flory K, Liu R, Glass K. Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: a meta-analytic review. Clin Psychol Rev. 2011;31(3):328-41. doi: 10.1016/j.cpr.2011.01.006. [PubMed: 21382538]. [PubMed Central: PMC3180912].
  • 14. Molina BS, Pelham WE Jr. Attention-deficit/hyperactivity disorder and risk of substance use disorder: developmental considerations, potential pathways, and opportunities for research. Annu Rev Clin Psychol. 2014;10:607-39. doi: 10.1146/annurev-clinpsy-032813-153722. [PubMed: 24437435]. [PubMed Central: PMC4097844].
  • 15. Barkley RA, Fischer M, Smallish L, Fletcher K. Young adult follow-up of hyperactive children: antisocial activities and drug use. J Child Psychol Psychiatry. 2004;45(2):195-211. [PubMed: 14982236].
  • 16. Faregh N, Derevensky J. Gambling behavior among adolescents with attention deficit/hyperactivity disorder. J Gambl Stud. 2011;27(2):243-56. doi: 10.1007/s10899-010-9211-3. [PubMed: 20658352].
  • 17. Sarver DE, McCart MR, Sheidow AJ, Letourneau EJ. ADHD and risky sexual behavior in adolescents: conduct problems and substance use as mediators of risk. J Child Psychol Psychiatry. 2014;55(12):1345-53. doi: 10.1111/jcpp.12249. [PubMed: 24813803]. [PubMed Central: PMC4479401].
  • 18. Boyer T. The development of risk-taking: A multi-perspective review. Dev Rev. 2006;26(3):291-345. doi: 10.1016/j.dr.2006.05.002.
  • 19. Stern A, Malik E, Pollak Y, Bonne O, Maeir A. The efficacy of computerized cognitive training in adults with ADHD: A randomized controlled trial. J Atten Disord. 2016;20(12):991-1003. doi: 10.1177/1087054714529815. [PubMed: 24756172].
  • 20. Wang GJ, Volkow ND, Wigal T, Kollins SH, Newcorn JH, Telang F, et al. Long-term stimulant treatment affects brain dopamine transporter level in patients with attention deficit hyperactive disorder. PLoS One. 2013;8(5). e63023. doi: 10.1371/journal.pone.0063023. [PubMed: 23696790]. [PubMed Central: PMC3655054].
  • 21. Coghill DR, Seth S, Pedroso S, Usala T, Currie J, Gagliano A. Effects of methylphenidate on cognitive functions in children and adolescents with attention-deficit/hyperactivity disorder: evidence from a systematic review and a meta-analysis. Biol Psychiatry. 2014;76(8):603-15. doi: 10.1016/j.biopsych.2013.10.005. [PubMed: 24231201].
  • 22. van Lieshout M, Luman M, Buitelaar J, Rommelse NN, Oosterlaan J. Does neurocognitive functioning predict future or persistence of ADHD? A systematic review. Clin Psychol Rev. 2013;33(4):539-60. doi: 10.1016/j.cpr.2013.02.003. [PubMed: 23528892].
  • 23. Greenhill LL, Swanson JM, Vitiello B, Davies M, Clevenger W, Wu M, et al. Impairment and deportment responses to different methylphenidate doses in children with ADHD: the MTA titration trial. J Am Acad Child Adolesc Psychiatry. 2001;40(2):180-7. doi: 10.1097/00004583-200102000-00012. [PubMed: 11211366].
  • 24. Faraone SV, Buitelaar J. Comparing the efficacy of stimulants for ADHD in children and adolescents using meta-analysis. Eur Child Adolesc Psychiatry. 2010;19(4):353-64. doi: 10.1007/s00787-009-0054-3. [PubMed: 19763664].
  • 25. Minder F, Zuberer A, Brandeis D, Drechsler R. Informant-related effects of neurofeedback and cognitive training in children with ADHD including a waiting control phase: a randomized-controlled trial. Eur Child Adolesc Psychiatry. 2018;27(8):1055-66. doi: 10.1007/s00787-018-1116-1. [PubMed: 29396712].
  • 26. Bazanova OM, Auer T, Sapina EA. On the efficiency of individualized theta/beta ratio neurofeedback combined with forehead EMG training in ADHD children. Front Hum Neurosci. 2018;12:3. doi: 10.3389/fnhum.2018.00003. [PubMed: 29403368]. [PubMed Central: PMC5785729].
  • 27. Clarke AR, Barry RJ, McCarthy R, Selikowitz M. Electroencephalogram differences in two subtypes of attention-deficit/hyperactivity disorder. Psychophysiology. 2001;38(2):212-21. [PubMed: 11347867].
  • 28. Barry RJ, Clarke AR, Johnstone SJ. A review of electrophysiology in attention-deficit/hyperactivity disorder: I. Qualitative and quantitative electroencephalography. Clin Neurophysiol. 2003;114(2):171-83. [PubMed: 12559224].
  • 29. Song DH, Shin DW, Jon DI, Ha EH. Effects of methylphenidate on quantitative EEG of boys with attention-deficit hyperactivity disorder in continuous performance test. Yonsei Med J. 2005;46(1):34-41. doi: 10.3349/ymj.2005.46.1.34. [PubMed: 15744803]. [PubMed Central: PMC2823055].
  • 30. Gevensleben H, Holl B, Albrecht B, Schlamp D, Kratz O, Studer P, et al. Distinct EEG effects related to neurofeedback training in children with ADHD: a randomized controlled trial. Int J Psychophysiol. 2009;74(2):149-57. doi: 10.1016/j.ijpsycho.2009.08.005. [PubMed: 19712709].
  • 31. Duric NS, Assmus J, Gundersen D, Elgen IB. Neurofeedback for the treatment of children and adolescents with ADHD: a randomized and controlled clinical trial using parental reports. BMC Psychiatry. 2012;12:107. doi: 10.1186/1471-244X-12-107. [PubMed: 22877086]. [PubMed Central: PMC3441233].
  • 32. Meisel V, Servera M, Garcia-Banda G, Cardo E, Moreno I. Reprint of "Neurofeedback and standard pharmacological intervention in ADHD: a randomized controlled trial with six-month follow-up". Biol Psychol. 2014;95:116-25. doi: 10.1016/j.biopsycho.2013.09.009. [PubMed: 24055220].
  • 33. Lofthouse N, Arnold LE, Hersch S, Hurt E, DeBeus R. A review of neurofeedback treatment for pediatric ADHD. J Atten Disord. 2012;16(5):351-72. doi: 10.1177/1087054711427530. [PubMed: 22090396].
  • 34. Conners CK, Erhardt D, Epstein JN, Parker JDA, Sitarenios G, Sparrow E. Self-ratings of ADHD symptoms in adults I: Factor structure and normative data. J Atten Disord. 2016;3(3):141-51. doi: 10.1177/108705479900300303.
  • 35. Davari-Ashtiani R, Jazayeri F, Arabgol F, Razjouyan K, Khademi ,M. [Psychometric properties of Persian version of Conners’ adult attention deficit/hyperactivity disorder rating scale (screening form-self reporting)]. Iran J Psychiatry Clin Psychol. 2014;20(3):243-51. Persian.
  • 36. Gullone E, Moore S, Moss S, Boyd C. The adolescent risk-taking questionnaire. J Adolesc Res. 2016;15(2):231-50. doi: 10.1177/0743558400152003.
  • 37. Zadeh Mohammadi A, Ahmadabadi Z, Heidari M. [Construction and assessment of psychometric features of iranian adolescents risk-taking scale]. Iran J Psychiatry Clin Psychol. 2011;17(3):218-25. Persian.
  • 38. Stuss DT, Levine B, Alexander MP, Hong J, Palumbo C, Hamer L, et al. Wisconsin Card Sorting Test performance in patients with focal frontal and posterior brain damage: effects of lesion location and test structure on separable cognitive processes. Neuropsychologia. 2000;38(4):388-402. [PubMed: 10683390].
  • 39. Pirzadeh J. Primary standardization of Wisconsin Card Sorting Test (WCST) in Tehran and Tabriz city [dissertation]. Tarbiat Moallem University, Tehran, Iran; 2008.
  • 40. Janssen TWP, Bink M, Weeda WD, Gelade K, van Mourik R, Maras A, et al. Learning curves of theta/beta neurofeedback in children with ADHD. Eur Child Adolesc Psychiatry. 2017;26(5):573-82. doi: 10.1007/s00787-016-0920-8. [PubMed: 27866283]. [PubMed Central: PMC5394134].
  • 41. Kropotov JD, Grin-Yatsenko VA, Ponomarev VA, Chutko LS, Yakovenko EA, Nikishena IS. Changes in EEG spectrograms, event-related potentials and event-related desynchronization induced by relative beta training in ADHD children. J Neurother. 2007;11(2):3-11. doi: 10.1300/J184v11n02_02.
  • 42. Jensen O, Tesche CD. Frontal theta activity in humans increases with memory load in a working memory task. Eur J Neurosci. 2002;15(8):1395-9. [PubMed: 11994134].
  • 43. Mizuhara H, Wang LQ, Kobayashi K, Yamaguchi Y. A long-range cortical network emerging with theta oscillation in a mental task. Neuroreport. 2004;15(8):1233-8. [PubMed: 15167540].
  • 44. Luu P, Tucker DM, Makeig S. Frontal midline theta and the error-related negativity: neurophysiological mechanisms of action regulation. Clin Neurophysiol. 2004;115(8):1821-35. doi: 10.1016/j.clinph.2004.03.031. [PubMed: 15261861].
  • 45. Bastiaansen MC, van Berkum JJ, Hagoort P. Syntactic processing modulates the theta rhythm of the human EEG. Neuroimage. 2002;17(3):1479-92. [PubMed: 12414287].
  • 46. Monastra VJ, Monastra DM, George S. The effects of stimulant therapy, EEG biofeedback, and parenting style on the primary symptoms of attention-deficit/hyperactivity disorder. Appl Psychophysiol Biofeedback. 2002;27(4):231-49. [PubMed: 12557451].
  • 47. Vernon D, Egner T, Cooper N, Compton T, Neilands C, Sheri A, et al. The effect of training distinct neurofeedback protocols on aspects of cognitive performance. Int J Psychophysiol. 2003;47(1):75-85. [PubMed: 12543448].
  • 48. Gil Y, Seo S, Lee J. EEG analysis of frontal lobe activities by decision stimuli. Second International Conference on Future Generation Communication and Networking. 13-15 Dec. 2008; Hainan Island, China. IEEE; 2008.
  • 49. Jacobs J, Hwang G, Curran T, Kahana MJ. EEG oscillations and recognition memory: theta correlates of memory retrieval and decision making. Neuroimage. 2006;32(2):978-87. doi: 10.1016/j.neuroimage.2006.02.018. [PubMed: 16843012].
  • 50. Ghosh T, Jahan M, Singh AR. The efficacy of electroencephalogram neurofeedback training in cognition, anxiety, and depression in alcohol dependence syndrome: A case study. Ind Psychiatry J. 2014;23(2):166-70. doi: 10.4103/0972-6748.151705. [PubMed: 25788809]. [PubMed Central: PMC4361982].
  • 51. Kollei I, Horndasch S, Erim Y, Martin A. Visual selective attention in body dysmorphic disorder, bulimia nervosa and healthy controls. J Psychosom Res. 2017;92:26-33. doi: 10.1016/j.jpsychores.2016.11.008. [PubMed: 27998509].
  • 52. Benitez VL, Vales C, Hanania R, Smith LB. Sustained selective attention predicts flexible switching in preschoolers. J Exp Child Psychol. 2017;156:29-42. doi: 10.1016/j.jecp.2016.11.004. [PubMed: 28024178]. [PubMed Central: PMC5253114].
  • 53. Gruzelier J. A theory of alpha/theta neurofeedback, creative performance enhancement, long distance functional connectivity and psychological integration. Cogn Process. 2009;10 Suppl 1:S101-9. doi: 10.1007/s10339-008-0248-5. [PubMed: 19082646].

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