Targeting brain waves to reduce cognitive challenges in ADHD

Targeting brain waves to reduce cognitive challenges in ADHD

Targeting brain waves to reduce cognitive challenges in ADHD

Researchers have received £1.3 million from the Medical Research Council to investigate whether targeting theta brain wave activity could reduce cognitive challenges faced by people with ADHD.

With this new funding, researchers at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London will test whether a repetitive form of transcranial magnetic stimulation (TMS) – a technology which can alter brain waves – can reduce thinking and attention difficulties associated with ADHD by targeting theta wave activity.

The findings will determine whether theta brain waves could be a target for future ADHD interventions, and may provide evidence for TMS as a new, drug-free intervention to support people with ADHD.

The study, led by Dr Gráinne McLoughlin at the IoPPN with co-investigators Professor Katya Rubia, Dr Luke Mason and Dr Máté Gyurkovics (now at University of East Anglia), will use the new Electroencephalography (EEG) Suite and Transcranial Magnetic Stimulation (TMS) facilities at the Pears Maudsley Centre for Children and Young People.

“Our research has shown that when theta waves in frontal regions of the brain become unstable, people with ADHD have more difficulty maintaining consistent performance on everyday tasks. We are investigating whether using repetitive transcranial magnetic stimulation can modulate these wave patterns to improve cognitive performance – an approach that could provide new insights into treating aspects of ADHD that people find challenging.”
Dr Gráinne McLoughlin

Reader in Cognitive Neuroscience at the IoPPN and Principal Investigator of the study

“While stimulant medication is still the most effective short-term treatment for adults with ADHD, they have notable side effects, the longer-term effects are not yet known, and people with ADHD often prefer non-drug treatments. New brain stimulation methods like TMS have the potential to directly target the key differences in the brain function of people with ADHD that we have found over the past three decades and, as a result, improve cognitive abilities.”
Professor Katya Rubia

Professor of Cognitive Neuroscience at the IoPPN and co-investigator on the study

Brain waves are rhythmic patterns of neural activity in the brain which are thought to play a crucial role in the communication between brain cells (neurons), cognitive processes and overall brain function.

There are different types of brain waves which occur at different frequencies. When these waves are dysregulated, it can lead to cognitive or behavioural difficulties. These challenges are often seen in ADHD – in particular, cognitive control which allows people to regulate their thoughts, emotions and behaviours to achieve everyday goals.

The new funding will allow the researchers to explore how a specific type of brain wave (known as theta waves, which have a frequency of 4-8 Hertz) might be involved in the challenges faced by people with ADHD, and whether this could represent a new target for intervention.

They will investigate whether repetitive TMS can improve cognitive consistency in young adults with ADHD (ages 18 to 25), compared to neurotypical young adults, through targeting theta wave activity.

The research will take place at the new Clinical Research Facility at the Pears Maudsley Centre, which is set to be the leading facility in the UK dedicated to the investigation and treatment of mental health in children and young people. The Clinical Research Facility will be a space where children of all ages, from babies up to young adults, can participate in research to identify the root of mental health and neurodevelopmental conditions, and use this research to implement and monitor groundbreaking interventions.

“Dr McLoughlin’s project exemplifies how researchers at the Pears Maudsley Centre will use cutting edge, safe technologies within the Clinical Research Facility to develop innovative new treatments. By ‘fine-tuning’ key brain waves, this approach could tackle a root cause of some cognitive differences that can prove challenging for young people with ADHD.”
Professor Philip Shaw

Director of the King’s Maudsley Partnership for Children and Young People

This blog is also available to read on the IoPPN website.

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Warm and consistent parenting can lead to meaningful changes in brain function and learning style in children with behaviour problems

Warm and consistent parenting can lead to meaningful changes in brain function and learning style in children with behaviour problems

Warm and consistent parenting can lead to meaningful changes in brain function and learning style in children with behaviour problems

The research, published in Biological Psychiatry, is the first proof that evidence-based parenting programmes are accompanied by specific changes in children’s brain activity and decision‑making processes, and underscores the value of offering such programmes early in life.

78 boys with conduct problems (CPs) aged 5 to 10, and 35 matched controls, completed a reward‑learning task while undergoing functional MRI scanning. Families in the CP group then took part in a 10 -12‑week group parenting programme designed to encourage positive behaviour with warmth and praise.

At the end of the program, the participants were then sub-classified as either “improvers” or “persistent” based on whether they displayed an improvement in antisocial behaviour. All children then repeated the task and scan at a follow‑up session.

In the initial scans, researchers found that the insula, an important brain region that helps to anticipate whether something good (a reward) or bad (a punishment) might happen when we do something, was not activating or “lighting up” as much as it should when expecting a reward. However, after having taken part in the parenting programme, researchers found that the insula in the improvers group responded more like that of typically developing children, especially when they expected a reward.

Other brain areas also changed, including the ventromedial prefrontal cortex and the hippocampus, both of which are involved in making decisions and learning from outcomes. Again, these areas also showed more normal activity in the second scan after the intervention in children who improved.

“Parenting programmes are highly effective for many families. What’s been missing is a biological account of how children’s behaviour improves. We show that when behaviour gets better, so does the functioning of brain systems that evaluate rewards and punishments – particularly in the ventromedial prefrontal cortex and insula.”

Professor Michael Craig

Professor in Forensic & Neurodevelopmental Sciences at King’s IoPPN and the study’s senior author

The study also found changes in how these children learn from their experiences. After the parenting programme, the improved boys became slower to change their expectations after just one good or bad outcome, which may help them make more balanced decisions over time. They were also less likely to act impulsively and became more sensitive to the difference between reward and punishment.

Dr Arjun Sethi, the study’s lead author from King’s IoPPN said, “Using computational modelling, we found that responders learned more gradually and were less driven by a reflex to act. That combination – slower learning and reduced action bias – appears to support more thoughtful choices and fewer antisocial behaviours.”

Professor Stephen Scott, Professor and Consultant Child and Adolescent Psychiatrist at King’s IoPPN and one of the study’s authors said, “Evidence based parenting programmes like the ones explored in this study promote what I consider to be “love and limits”. They focus on developing closer relationships between parent and child, but also providing clear boundaries and expectations that reinforce good behaviour.

“This study, which is a world first, demonstrates not only that these programmes can impact the inner working of a developing child’s brain, but also provides valuable evidence of the value of programmes like these.”

Dr Bruce Clark, Medical Director of the King’s Maudsley Partnership said, “Issues relating to young people’s behaviour are amongst the most common we see being referred into our clinical services. This study highlights the importance of intervening early with evidence-based treatments, so that brain and behavioural changes are mitigated early. Within the King’s Maudsley Partnership we are testing and piloting interventions to provide support in the most timely and cost effective way.”

This study was funded by the Medical Research Council (MRC).

Successful Evidence-Based Parenting Programs are Associated With Brain Changes and Improved Reward Processing in Boys With Conduct Problems (DOI10.1016/j.biopsych.2025.06.008) (Sethi, Craig et al) was published in Biological Psychiatry.

For more information, please contact Patrick O’Brien (Media Manager)

You can also find this press release on King’s College, London website

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Day workshop in Cognitive Behavioural Therapy effectively reduces depression in 16-18 year olds

Day workshop in Cognitive Behavioural Therapy effectively reduces depression in 16-18 year olds

Day workshop in Cognitive Behavioural Therapy effectively reduces depression in 16-18 year olds

The Brief Educational workshops in Secondary Schools Trial found a day-long CBT course is an effective means of improving young people’s mental health.

New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London has found that providing 16-18 year olds with a day-long course in Cognitive Behavioral Therapy (CBT) was both a clinically and cost-effective means of improving their mental health.

The trial, known as Brief Educational workshops in Secondary Schools Trial (BESST) and published in The Lancet Psychiatry, was successfully adapted from the DISCOVER program, which was designed to help adults manage their feelings of stress. The study has been funded by the National Institute for Health and Care Research (NIHR).

Around one in 12 young people in England currently experience anxiety or depression. Despite this, the large majority remain untreated, and almost a quarter (24%) have no contact with specialist Child and Adolescent Mental Health Services (CAMHS).

This study recruited 900 students from 57 schools in England. Half were provided with signposting to mental health services and the standard care their school would usually provide. The other half were invited to a day-long workshop on CBT coping techniques for managing mood, anxiety, and stress, and provided with follow up phone calls to help incorporate those skills into real-life situations.

Researchers found that participants who attended the workshop showed significant improvements in their depression, anxiety, wellbeing and resilience after a six-month follow up.

“More than half of adult mental disorders start before the age of 15, and when we approached schools, we found that there was overwhelming number of young people actively seeking support. There is clearly an urgent need for early intervention to ensure that symptoms of poor mental health don’t persist and worsen. Our study set out to establish if there was a clinically and cost-effective way to do that at scale.

Dr June Brown

Associate Professor in Clinical Psychology and the study's lead author, King’s IoPPN

Dr June Brown said, “One of our main challenges was to adapt an adult therapeutic intervention which would be attractive and engaging for teenagers. In addition, previous studies have either been aimed at all students, some of whom aren’t necessarily in need of assistance, while others have taken a more targeted approach that potentially stigmatises those who might need support. Giving students the opportunity to self-refer means that we work with students who recognise that they’d like help.

“Our study shows that this intervention can be delivered at low cost by mental health professionals who can bridge the gap between schools and CAMHS.”

“Since the pandemic there is an increased need to support schools and adolescents with their mental health. While we found improvements in depression; anxiety; wellbeing; and resilience, the largest effect was seen in those students that had higher symptoms of depression at the start of the study, meaning that we reached and improved those students most vulnerable to depression.

Professor Ben Carter

Professor of Medical Statistics and the study's senior author, King's IoPPN

Professor Ben Carter, “The ultimate success of this has laid the groundwork for these workshops to be rolled out nationwide to provide an early intervention against depression and anxiety.” 

Karen Crowe, Senior Tutor for the Sixth Form & Curriculum Leader for Psychology at St Nicholas Catholic High School in Cheshire said, “Our school seeks to prioritise mental wellbeing and promote strategies that improve students’ mental health. We believe it is important to teach students how to become self-regulating individuals who can manage their own stress, which is why the school fully supported the BESST trial. We value techniques that provide students with skills to resolve problems, cope better with expectations, and build confidence, so the trial’s aims perfectly complement our school’s mission and ethos.”

Olivia Black, a student at St Nicholas Catholic High School who took part in the BESST trial said, “The study gave me new ways to manage my stress and remain productive during my studies. It was such a helpful process that allowed me to develop my personal strategies for maintaining good mental health. The skills and confidence gained from this trial motivated me to help start up our ‘breathing space’ initiative where sixth formers support younger students with their mental health.”

Can a brief accessible CBT programme in schools improve the mental health of 16–18-year-olds? Clinical and cost-effectiveness of a cluster randomised controlled trial in Brief Educational Workshops in Secondary Schools Trial (BESST) (DOI 10.1016/S2215-0366(24)00101-9) (June Brown, Kirsty James, Stephen Lisk, James Shearer, Sarah Byford, Paul Stallard, Jessica Deighton, David Saunders, Jynna Yarrum, Peter Fonagy, Timothy Weaver, Irene Sclare, Crispin Day, Claire Evans, Ben Carter) was published in Lancet Psychiatry. 

For more information, please contact Patrick O’Brien (Media Manager)

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IoPPN researchers find lonely secondary school students less likely to gain employment in adulthood

IoPPN researchers find lonely secondary school students less likely to gain employment in adulthood

IoPPN researchers find lonely secondary school students less likely to gain employment in adulthood

New research has found that there is a direct socioeconomic impact of loneliness in early adolescence.

a young girl holding a leaf

New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, in partnership with the University of Greenwich, has found that there is a direct socioeconomic impact of loneliness in early adolescence.

The research, published in Social Science and Medicine, found that lonely young adults are more likely to be out of education, employment, or training (NEET) and consider themselves less employable and lower on the economic ladder than their less lonely peers.

Sourcing data from the Environmental Risk (E-Risk) Longitudinal Twin Study, researchers followed the progress of 2,232 individuals born in England and Wales during 1994-1995. Participants were assessed at ages 12, 18 and 26 for levels of loneliness, as well as being asked to rate their social status. Participants’ employment status and employability were assessed at age 18.

Researchers found that young adults who had experienced loneliness earlier on in life experienced difficulties in young adulthood, even if they were no longer lonely. Researchers suggest that this demonstrates that loneliness impacts a person’s long term economic prospects and suggests that addressing loneliness in early adolescence could yield economic benefits through increased productivity.

“While there are clear impacts of loneliness on mental health from an early age, our study demonstrates that loneliness also negatively impacts a person’s employment prospects. We’ve shown that, from an early age, loneliness can have knock on effects on a person’s ability to compete in the job market. This not only harms a person’s chances in life, but also has direct costs to the economy.”

Bridget Bryan

PhD student at King’s IoPPN and the study’s lead author

Previous research in this field has suggested a two-way relationship between loneliness and social standing. By using data collected over time, this research showed that feeling lonely negatively influenced a person’s social standing down the line, but social standing did not affect their future loneliness.

“Our research is one of very few studies reporting on the impact of loneliness years later. If we are to create effective prevention strategies, we need to continue collecting data in order to unravel the long-term outcomes of loneliness at various stages of life.

“We need more longitudinal data to unravel the long-term outcomes of loneliness at various stages of life. This can offer insight for developing prevention strategies.”

Professor Louise Arseneault

Professor of Developmental Psychology at King’s IoPPN

The study’s researchers argue that their findings highlight the importance of effectively tackling loneliness in order to help both the individual and society.

“While we should never forget that loneliness impacts people of all ages, our research suggests that reducing loneliness in children and young people could yield benefits both for their own employment prospects and for the economy more widely.”

Dr Timothy Matthews

Lecturer in Psychology at University of Greenwich

This study was possible thanks to funding from the Colt Foundation and the Medical Research Council, with additional support from the National Institute of Child Health and Human Development and by the Jacobs Foundation.

The socioeconomic consequences of loneliness: evidence from a nationally representative longitudinal study of young adults (DOI 10.1016/j.socscimed.2024.116697) (Bridget T. Bryan, Katherine N. Thompson, Sidra Goldman-Mellor, Terrie E. Moffitt, Candice Odgers, Sincere Long Shin Soa, Momtahena Uddin Rahman, Jasmin Wertz, Timothy Matthews, Louise Arseneault) was published in Social Science and Medicine.

For more information, please contact Patrick O’Brien (Media Manager, King’s IoPPN

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Children with ADHD frequently use healthcare services before diagnosis, study finds

Children with ADHD frequently use healthcare services before diagnosis, study finds

Children with ADHD frequently use healthcare services before diagnosis, study finds

Children and young people with attention deficit hyperactivity disorder (ADHD) use healthcare services twice as often in the two years before their diagnosis, a study by researchers at the University of Nottingham and King’s College London has found.

The research, published today in the journal Archives of Disease in Childhood shows that children with the neurodevelopmental disorder are twice as likely to see their GP, go to hospital for an admission, and even have operations, compared to children without ADHD.

The researchers say the results support the need for healthcare professionals to consider a potential diagnosis of ADHD in children who use their services frequently. This is especially important in cases where the primary reason for attendance is not a mental or behavioural symptom, where ADHD may already be suspected. Children with ADHD use healthcare services for a wide range of common medical symptoms, such as tonsillitis, asthma, or eczema.

The research was carried out by Dr Vibhore Prasad and other researchers working at the University of Nottingham and King’s, funded by the Academy of Medical Sciences.

We know that children with ADHD often face long delays in diagnosis. We didn’t know, until now, that they seek help from the healthcare services twice as often as children without ADHD in the run up to diagnosis. Our findings demonstrate the need for further research so we can identify children with ADHD earlier to get them effective help. The results are significant because we know that identifying ADHD earlier can lead to effective treatment, including talking treatments and medicines, which can prevent a range of serious harms to young people and future adults.

Dr Vibhore Prasad

NIHR East Midlands Scholar, associated with the University of Nottingham, a visiting Lecturer at King's and a GP in Nottinghamshire

The study looked at medical records of children and young people aged between four and 17 years old from the Clinical Practice Research Datalink, a primary care database containing the records of around 15 million people from 730 GP practices and representing seven per cent of the population of the UK. The findings were based on around half of the patients from England who also had linked hospital medical records.

The research focused on the reasons why children see their GP, receive prescriptions from the GP, attend hospital for overnight admissions and have operations in hospital. It showed that children with ADHD make twice as much use of all these services in the two years before diagnosis compared to children without ADHD.

Dr Prasad’s study provides a powerful reminder of both the physical and mental health difficulties that young people have to confront in the years leading up to an ADHD diagnosis. At this point, we cannot be certain that earlier access to ADHD assessment and treatment would alleviate all these difficulties. However, Dr Prasad’s work does highlight that young people who have suspected ADHD are already a vulnerable group and may benefit from coordinated multi-disciplinary care that can provide holistic support whilst they are waiting for specialist mental health services.

Professor Edmund Sonuga-Barke and Dr Johnny Downs

King's IoPPN

Children and young people with ADHD regularly see healthcare professionals but guidance from organisations such as the National Institute for Health and Care Excellence (NICE) and the American Academy of Pediatrics does not currently detail how to detect ADHD earlier. Many parents or carers report needing to know about ADHD in order for the professionals to consider this as a diagnosis.

The researchers say this study shows that more should be done to develop and test interventions to identify ADHD earlier in primary care. There is also a need to urgently review how the health services cater for young people with undiagnosed ADHD.

Dr Vibhore visited the Lambeth ADHD Support Group on several occasions in the process of his research, and has diligently captured the voices of the parents and carers of young people with ADHD. This attention to detail and genuine interest in the welfare of families, has provided valuable insights into how families navigate the healthcare system and engage with their GP prior to an ADHD diagnosis. The identification of patterns of GP interaction for families with a child with ADHD offers valuable insights for both families themselves and professionals.

Michele Reilly

Lead of Lambeth ADHD Support Group

This is ground-breaking research that demonstrates to the Department of Health, NHS UK & local NHS Commissioners, that ADHD should not be trivialised and reduced to core symptoms of hyperactivity, impulsivity and inattention. Undiagnosed untreated ADHD is now proven to result in double the number of health care appointments and procedures children using the NHS for other avoidable health problems and accidents.

Dr Tony Lloyd

CEO, ADHD Foundation Neurodiversity Charity

The full study can be found here.

For more information, please contact Emily Webb (School Communications Manager – School of Academic Psychiatry

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Parent and child experiences of racism affect whole family’s mental health, according to new study

Parent and child experiences of racism affect whole family’s mental health, according to new study

Parent and child experiences of racism affect whole family’s mental health, according to new study

Parents’ experiences of racism affect their children’s mental health and vice versa, according to a new briefing published today, on World Mental Health Day, by Centre for Mental Health and the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London.

a young girl holding a leaf

A constant battle finds that racism has far-reaching impacts on parents, their children, and the relationships between them. Based on IoPPN research with both parents and teenagers from UK racialised communities, the briefing finds that both past and present experiences of racism can affect mental health across generations of a family.

The study provides more evidence that racism has a profound and negative impact on a person’s mental health. One participant described the daily fight against racism as “a constant battle that knocks you”. Parents referred to the “heavy” sadness of seeing their child experience racism at school, and one participant described “always [being] in that high-stress sensitive state because you’re always being triggered”. Another participant referred to the heightened fear for themselves and their family caused by racist threats on social media following England’s loss at Euro 2020.

A constant battle finds that daily experiences of racism also influence parent-child relationships, with parents attempting to limit their children’s exposure to racism and having to answer their children’s questions about racism.

The briefing calls on the Government to commit to tackling all forms of racism through a cross-government strategy. It also says that the Department for Health and Social Care and NHS England should fully resource work with racialised communities to design more racially equitable mental health support.

There are cascading effects in families following experiences of racism – impacting parenting, parent-child relationships, and family mental health. Parents and teenagers shared their first-hand knowledge and experiences through this research. Teenagers described growing up in British society that is biased against them and their parents, which they hope will change. Meanwhile, parents grappled with the reality that racism impacts their children, after generations of battling for change, and that their children must learn to adapt and cope. Our work documents urgent need for action by policymakers, teachers, mental health practitioners and researchers, who can help alleviate the burden on families facing racism.

Dr Yasmin Ahmadzadeh

Postdoctoral Research Associate at King's IoPPN

Kadra Abdinasir, Associate Director of Policy at Centre for Mental Health, said: “We know that racism harms people’s mental health and can have a lasting impact. This research builds on earlier studies demonstrating the trauma racism causes, while also highlighting the shared and distinct experiences of parents and teenagers in the UK. Like other forms of trauma, racial trauma requires a deep understanding and action from a broad range of practitioners and policymakers to better protect and support those affected.”

The research is the culmination of the TRADE Project (Transmission of experiences of Racism, Anxiety and Depression in families), which has been reviewing existing research and talking with parents and adolescents whose communities have historically experienced racism to better understand how experiences of racism can affect mental health, and how these negative experiences can transmit between generations. The TRADE Project is funded by the Economic and Social Research Council (ESRC) Emerging Minds Network, which is supported by UK Research and Innovation (UKRI).

For more information, contact ioppn-pr@kcl.ac.uk.

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