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Department of Psychology, Kashan Branch, Islamic Azad University, Kashan, Iran
Abstract:   (1623 Views)
This study aimed to explore the effectiveness of metacognitive training in improving behavioral inhibition, attentional control, working memory, and mitigating impulsivity among adolescents with attention-deficit/hyperactivity disorder (ADHD). A quasi-experimental pretest–posttest design with a control group was employed. The sample consisted of 30 adolescents aged 16–18 years who were diagnosed with ADHD and randomly assigned to experimental and control groups. The experimental group participated in eight weekly sessions of metacognitive training, whereas the control group received no intervention. Data were collected using the Barratt Impulsiveness Scale (BIS-11), Stroop Color–Word Test, Wisconsin Card Sorting Test (WCST), and Digit Span Test. The data were analyzed using multivariate analysis of covariance (MANCOVA). The findings indicated that metacognitive training significantly improved behavioral inhibition and attention shifting while also diminishing impulsive behaviors in the experimental group compared to the control group (p < .01). However, no significant improvement was observed in working memory. These results suggest that metacognitive training is particularly effective on boosting self-regulatory and attentional processes rather than core cognitive capacities. Overall, the study supports the use of metacognitive interventions as an effective non-pharmacological approach for ameliorating behavioral regulation and reducing impulsivity in adolescents with ADHD, while highlighting the need for complementary strategies to address working memory deficits.
     
Type of Study: Research | Subject: Special
Received: 2025/10/1 | Revised: 2026/10/6 | Accepted: 2026/07/11

References
1. Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121(1), 65-94. [DOI:10.1037/0033-2909.121.1.65] [PMID] [PMCID]
2. Barkley, R. A. (2006). A handbook for diagnosis and treatment. New York: Guilford Publications, 3-75.
3. Barratt, E. S. (1993). Impulsivity: Integrating cognitive, behavioral, biological, and environmental data. In W. G. McCown, J. L. Johnson, & M. B. Shure (Eds.), The impulsive client: Theory, research, and treatment (pp. 39-56). American Psychological Association. [DOI:10.1037/10500-003]
4. Basile, A., Toplak, M. E., & Andrade, B. F. (2021). Using metacognitive methods to examine emotion recognition in children with ADHD. Journal of Attention Disorders, 25(2), 245-257. [DOI:10.1177/1087054718808602] [PMID]
5. Capodieci, A., Re, A. M., Fracca, A., Borella, E., & Carretti, B. (2019). The efficacy of a training that combines activities on working memory and metacognition: Transfer and maintenance effects in children with ADHD and typical development. Journal Of Clinical and Experimental Neuropsychology, 41(10), 1074-1087. [DOI:10.1080/13803395.2019.1651827] [PMID]
6. Cortese, S., Ferrin, M., Brandeis, D., Buitelaar, J., Daley, D., Dittmann, R. W., ... & European ADHD Guidelines Group. (2015). Cognitive training for attention-deficit/hyperactivity disorder: meta-analysis of clinical and neuropsychological outcomes from randomized controlled trials. Journal of the American Academy of Child & Adolescent Psychiatry, 54(3), 164-174. [DOI:10.1016/j.jaac.2014.12.010] [PMID]
7. Dörrenbächer-Ulrich, L., Dilhuit, S. & Perels, F. Investigating the relationship between self-regulated learning, metacognition, and executive functions by focusing on academic transition phases: a systematic review. Curr Psychol. 43, 16045-16072 (2024). [DOI:10.1007/s12144-023-05551-8]
8. Emek Savaş, D. D., Yerlikaya, D., Yener, G. G., & Öktem Tanör, Ö. (2020). Validity, Reliability and Normative Data of the Stroop Test Çapa Version. Turkish Journal of Psychiatry, 31(1), 9. [DOI:10.5080/u23549] [PMID]
9. Grant, D. A., & Berg, E. A. (1948). A behavioral analysis of degree of reinforcement and ease of shifting to new responses in a Weigl-type card-sorting problem. Journal of Experimental Psychology, 38(4), 404-411. https://doi.org/10.1037/h0059831 [DOI:10.1037/h0060811] [PMID]
10. Groves, N. B., Kofler, M. J., Wells, E. L., Day, T. N., & Chan, E. S. (2020). An examination of relations among working memory, ADHD symptoms, and emotion regulation. Journal of Abnormal Child Psychology, 48(4), 525-537. [DOI:10.1007/s10802-019-00612-8] [PMID] [PMCID]
11. Heaton, R. K. (1981). Wisconsin card sorting test. Psychological assessment resources.
12. Isfandnia, F., El Masri, S., Radua, J., & Rubia, K. (2024). The effects of chronic administration of stimulant and non-stimulant medications on executive functions in ADHD: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 162, 105703. [DOI:10.1016/j.neubiorev.2024.105703] [PMID]
13. Javid, M., Mohammadi, N., & Rahimi, C. (2012). Psychometric properties of an Iranian version of the Barratt Impulsiveness Scale-11 (BIS-11). Journal of Psychological Models and Methods, 2(8), 23-34.
14. Kofler, M. J., Soto, E. F., Fosco, W. D., Irwin, L. N., Wells, E. L., & Sarver, D. E. (2020). Working memory and information processing in ADHD: Evidence for directionality of effects. Neuropsychology, 34(2), 127. [DOI:10.1037/neu0000598] [PMID] [PMCID]
15. Lambek R, Sonuga-Barke E, Tannock R, Sørensen AV, Damm D, & Thomsen PH (2018). Are there distinct cognitive and motivational sub-groups of children with ADHD? Psychological Medicine, 48(10), 1722-1730 [DOI:10.1017/S0033291717003245] [PMID]
16. Lenartowicz, A., DeSchepper, B., & Simpson, G. V. (2024). Training of awareness in ADHD: Leveraging metacognition. Journal of Psychiatric Brain Science, 9(5), e240006. [DOI:10.20900/jpbs.20240006]
17. Luo, X., Guo, J., Liu, L., Zhao, X., Li, D., Li, H., Zhao, Q., Wang, Y., Qian, Q., Wang, Y., Song, Y., & Sun, L. (2019). The Neural Correlations of Spatial Attention and Working Memory Deficits in Adults with ADHD. Neuroimage Clinical. [DOI:10.1016/j.nicl.2019.101728]
18. MacLeod, C. M. (1991). Half a century of research on the Stroop effect: an integrative review. Psychological Bulletin, 109(2), 163. [DOI:10.1037/0033-2909.109.2.163] [PMID]
19. Mattfeld, A. T., Whitfield-Gabrieli, S., Biederman, J., Spencer, T., Brown, A., Fried, R., & Gabrieli, J. D. (2016). Dissociation of working memory impairments and attention-deficit/hyperactivity disorder in the brain. NeuroImage: Clinical, 10, 274-282. [DOI:10.1016/j.nicl.2015.12.003] [PMID] [PMCID]
20. Patton, J. H., Stanford, M. S., & Barratt, E. S. (1995). Factor structure of the Barratt Impulsiveness Scale. Journal of Clinical Psychology, 51(6), 768-774. https://doi.org/10.1002/1097-4679(199511)51:6<768::AID-JCLP2270510607>3.0.CO;2-1 [DOI:10.1002/1097-4679(199511)51:63.0.CO;2-1] [PMID]
21. Pisacco, N. M. T., Sperafico, Y. L. S., Enricone, J. R. B., Guimarães, L. S. P., Rohde, L. A., & Dorneles, B. V. (2018). Metacognitive interventions in text production and working memory in students with ADHD. Psicologia: Reflexão e Crítica, 31, 5. [DOI:10.1186/s41155-017-0081-9] [PMID] [PMCID]
22. Polanczyk, G. V., et al. (2014). ADHD prevalence meta-analysis. International Journal of Epidemiology, 43(2), 434-442. [DOI:10.1093/ije/dyt261] [PMID]
23. Qiu, H., Liang, X., Wang, P., Zhang, H., & Shum, D. H. K. (2023). Efficacy of non-pharmacological interventions on executive functions in children and adolescents with ADHD: A systematic review and meta-analysis. Asian Journal of Psychiatry, 87, 103692. [DOI:10.1016/j.ajp.2023.103692] [PMID]
24. Rahimi, C., Hashemi, R., & Mohamadi, N. (2011). The utility of the wisconsin card sorting test in differential diagnosis of cognitive disorders in Iranian psychiatric patients and healthy subjects. Iranian Journal of Psychiatry, 6(3), 99.
25. Ramos-Galarza, C., Brito, D., Rodríguez, B., Guerrero, B., Cruz-Cárdenas, J., & Bolaños-Pasquel, M. (2024). Systematic review of executive function stimulation methods in the ADHD population. Journal of Clinical Medicine, 13(14), 4208. [DOI:10.3390/jcm13144208] [PMID] [PMCID]
26. Reise, S. P., Moore, T. M., Sabb, F. W., Brown, A. K. (2013). The Barratt Impulsiveness Scale-11: Reassessment of its structure in a community sample. Psychological Assessment, 25(2), 631-642. [DOI:10.1037/a0032161] [PMID] [PMCID]
27. Robledo-Castro, C., Lerma-Castaño, P. R., & Bonilla-Santos, G. (2023). Effect of cognitive training programs based on computer systems on executive functions in children with ADHD: A systematic review. Journal of Attention Disorders, 27(13), 1467-1487. [DOI:10.1177/10870547231187164] [PMID]
28. Sala, G., & Gobet, F. (2019). Cognitive training does not enhance general cognition. Trends in Cognitive Sciences, 23(1), 9-20. [DOI:10.1016/j.tics.2018.10.004] [PMID]
29. Senkowski, D., Ziegler, T., Singh, M., Heinz, A., He, J., Silk, T., & Lorenz, R. C. (2024). Assessing inhibitory control deficits in adult ADHD: A systematic review and meta-analysis of the stop-signal task. Neuropsychology Review, 34(2), 548-567. [DOI:10.1007/s11065-023-09592-5] [PMID] [PMCID]
30. Shepard, E., Sweeney, C., Thompson, L., Jacobs, S., Grimm, J., & Weyandt, L. L. (2023). Effectiveness of executive functioning training among heterogeneous adolescent samples: A systematic review. Applied Neuropsychology: Child, 12(4), 327-343. [DOI:10.1080/21622965.2022.2106436] [PMID]
31. Sisakhti, M., Sahaf, R., Delazar, Z., & Farrahi, H. (2024). The Digit Span Test: Normative data for the Iranian normal population. Caspian Journal of Neurological Sciences, 10(1), 23-31. [DOI:10.32598/CJNS.10.38.459.2]
32. Soleymani, E., Alipour, M., & Soleymani, M. (2019). The study of automatic and controlled data processing speed based on the Stroop test in students with math learning disability. Shefaye Khatam, 7(3), 32-41 [DOI:10.29252/shefa.7.3.32]
33. Soleymani, E., Abbasi, M., & Toghyani, E. (2017). The effectiveness of cognitive-metacognitive strategies on the performance of attention-memory of students with ADHD. Journal of cognitive strategies in learning, 4(7),1_21.
34. Strauss, E., Sherman, E. M. S., & Spreen, O. (2006). A compendium of neuropsychological tests: Administration, Norms, and Commentary (3rd ed.). Oxford University Press.
35. Stroop, J. R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18, 643-662. [DOI:10.1037/h0054651]
36. Thomas, R. (2020). Supporting adolescents with attentional difficulties to develop their metacognition skills: an action research project (Doctoral dissertation, University of Sheffield).
37. Vasconcelos, A. G., Malloy-Diniz, L., & Correa, H. (2012). Systematic review of psychometric proprieties of Barratt Impulsiveness Scale Version 11 (BIS-11). Clinical Neuropsychiatry, 9(2). Wechsler, D. (2008). Wechsler Memory Scale-Fourth Edition (WMS-IV) Technical and Interpretive Manual. Pearson.
38. Westwood, S. J., Parlatini, V., Rubia, K., Cortese, S., & Sonuga-Barke, E. J. (2023). Computerized cognitive training in attention-deficit/hyperactivity disorder (ADHD): a meta-analysis of randomized controlled trials with blinded and objective outcomes. Molecular Psychiatry, 28(4), 1402-1414. [DOI:10.1038/s41380-023-02000-7] [PMID] [PMCID]
39. Wilde, N. J., Strauss, E., & Tulsky, D. S. (2004). Memory span on the Wechsler scales. Journal of Clinical and Experimental Neuropsychology, 26(4), 539-549. [DOI:10.1080/13803390490496605] [PMID]
40. Wolraich, M. L., Hagan, J. F., Allan, C., Chan, E., Davison, D., Earls, M., ... & Zurhellen, W. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4). [DOI:10.1542/peds.2019-2528] [PMID] [PMCID]

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