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Volume 25, Issue 164 (10-2026)
Journal of Psychological Science 2026, 25(164): 1-19 |
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Royanfar M, Weisan M, Ahmadian H. (2026). Comparing the Effectiveness of Cognitive Rehabilitation and Transcranial Direct Current Stimulation in Improving Response Inhibition in Students with Attention-Deficit/Hyperactivity Disorder. , Journal of Psychological Science. 25(164), 1-19. doi: 10.66224/jps.25.164.19
URL: http://psychologicalscience.ir/article-1-3719-en.html
URL: http://psychologicalscience.ir/article-1-3719-en.html
Department of Psychology and Counseling Education, Farhangian University, Tehran, Iran. , m.visani@cfu.ac.ir
Abstract: (47 Views)
Background: Deficits in response inhibition are a core difficulty among students with attention-deficit/hyperactivity disorder (ADHD) and may adversely affect their academic performance and behavioral adjustment. Although cognitive rehabilitation and transcranial direct current stimulation (tDCS) have been used to improve executive functioning, evidence regarding their comparative effectiveness in improving response inhibition in these students remains limited. Comparing these interventions may therefore inform the selection of more effective approaches and enhance the quality of educational and clinical interventions.
Aims: This study aimed to compare the effectiveness of cognitive rehabilitation and tDCS in improving response inhibition in students with ADHD.
Methods: A quasi-experimental pretest–posttest design with a control group was employed. The study population comprised female students in Grades 4–6 attending primary schools in Hamadan, Iran, during the 2024–2025 academic year. Forty-five students with ADHD were selected through purposive sampling and randomly assigned to cognitive rehabilitation, tDCS, or control groups, with 15 participants in each group. The cognitive rehabilitation group received 12 sessions of an intervention based on the framework proposed by Miyake et al. (2000). The tDCS group received ten 10-minute sessions of stimulation at an intensity of 1.5 mA using an ActivaTek device. Data were collected using the Behavioral Inhibition System/Behavioral Activation System Scales (Carver & White, 1994) and the ADHD Rating Scale (DuPaul et al., 1998). Multivariate and univariate analyses of covariance were conducted using SPSS version 28.
Results: After controlling for pretest scores, the effect of group on improvement in response inhibition was statistically significant (p < .001). Bonferroni-adjusted pairwise comparisons indicated that both interventions were more effective than the control condition, and tDCS was more effective than cognitive rehabilitation (p < .001). A significant linear trend was also reported across the groups ordered as control, cognitive rehabilitation, and tDCS.
Conclusion: The findings highlight the potential of cognitive rehabilitation and tDCS to enhance response inhibition in students with ADHD. Incorporating these interventions into clinical programs, while accounting for individual needs and ensuring professional supervision and adherence to safety considerations, may help improve behavioral control in these students.
Aims: This study aimed to compare the effectiveness of cognitive rehabilitation and tDCS in improving response inhibition in students with ADHD.
Methods: A quasi-experimental pretest–posttest design with a control group was employed. The study population comprised female students in Grades 4–6 attending primary schools in Hamadan, Iran, during the 2024–2025 academic year. Forty-five students with ADHD were selected through purposive sampling and randomly assigned to cognitive rehabilitation, tDCS, or control groups, with 15 participants in each group. The cognitive rehabilitation group received 12 sessions of an intervention based on the framework proposed by Miyake et al. (2000). The tDCS group received ten 10-minute sessions of stimulation at an intensity of 1.5 mA using an ActivaTek device. Data were collected using the Behavioral Inhibition System/Behavioral Activation System Scales (Carver & White, 1994) and the ADHD Rating Scale (DuPaul et al., 1998). Multivariate and univariate analyses of covariance were conducted using SPSS version 28.
Results: After controlling for pretest scores, the effect of group on improvement in response inhibition was statistically significant (p < .001). Bonferroni-adjusted pairwise comparisons indicated that both interventions were more effective than the control condition, and tDCS was more effective than cognitive rehabilitation (p < .001). A significant linear trend was also reported across the groups ordered as control, cognitive rehabilitation, and tDCS.
Conclusion: The findings highlight the potential of cognitive rehabilitation and tDCS to enhance response inhibition in students with ADHD. Incorporating these interventions into clinical programs, while accounting for individual needs and ensuring professional supervision and adherence to safety considerations, may help improve behavioral control in these students.
Keywords: Cognitive Rehabilitation, Electrical Brain Stimulation, Response Inhibition, Attention-Deficit/Hyperactivity Disorder (ADHD)
Type of Study: Research |
Subject:
Special
Received: 2026/09/21 | Accepted: 2026/10/12 | Published: 2026/10/23
Received: 2026/09/21 | Accepted: 2026/10/12 | Published: 2026/10/23
References
1. سلیمانی، مهران و کاظمی منیر، نیلوفر (1399). اثربخشی تحریک الکتریکی مستقیم فراجمجمهای مغز بر افزایش انعطافپذیری شناختی و سرعت پردازش کودکان با نارسایی توجه/فزون کنشی. روانشناسی افراد استثنایی، 16(57)، 326-305. https://doi.org/10.22054/jep.2020.56456.3181
2. Berger, I., Dakwar-Kawar, O., Grossman, E. S., Nahum, M., & Kadosh, R. C. (2021). Scaffolding the attention-deficit/hyperactivity disorder brain using transcranial direct current and random noise stimulation: A randomized controlled trial. Clinical Neurophysiology, 132(3), 699-707. https://doi.org/ 10.1016/j.clinph.2021.01.005.
3. Bernadotte, A., & Zinchenko, O. (2025). tDCS and neurofeedback in ADHD treatment. Frontiers in Systems Neuroscience, 19, 1444283. https://doi.org/10.3389/fnsys.2025.1444283
4. Bussing, R., Fernandez, M., Harwood, M., Hou, W., Garvan, C. W., Eyberg, S. M., & Swanson, J. M. (2008). Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms: psychometric properties and normative ratings from a school district sample. Assessment, 15(3), 317-328. https://doi.org/10.1177/1073191107313888
5. Carver, C. S., & White, T. L. (1994). Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: The BIS/BAS Scales. Journal of Personality and Social Psychology, 67(2), 319–333. https://doi.org/10.1037/0022-3514.67.2.319
6. Cortese, S., Adamo, N., Del Giovane, C., Mohr-Jensen, C., Hayes, A. J., Carucci, S., ... & Cipriani, A. (2018). Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. The Lancet Psychiatry, 5(9), 727-738. https://doi.org/10.1016/S2215-0366(18)30269-4
7. Coutinho, T. V., Reis, S. P. S., Silva, A. G. D., Miranda, D. M., & Malloy-Diniz, L. F. (2018). Deficits in response inhibition in patients with attention-deficit/hyperactivity disorder: the impaired self-protection system hypothesis. Frontiers in Psychiatry, 8, 299. https://doi.org/10.3389/fpsyt.2017.00299
8. Danielson, M. L., Claussen, A. H., Bitsko, R. H., Katz, S. M., Newsome, K., Blumberg, S. J., ... & Ghandour, R. (2024). ADHD prevalence among US children and adolescents in 2022: diagnosis, severity, co-occurring disorders, and treatment. Journal of Clinical Child & Adolescent Psychology, 53(3), 343-360. https://doi.org/10.1080/15374416.2024.2335625
9. DuPaul, G. J., Power, T. J., Anastopoulos, A. D., & Reid, R. (1998). ADHD Rating Scale—IV: Checklists, norms, and clinical interpretation. The Guilford Press.
10. Español-Martín, G., Pagerols, M., Prat, R., Rivas, C., Ramos-Quiroga, J. A., Casas, M., & Bosch, R. (2023). The impact of attention-deficit/hyperactivity disorder and specific learning disorders on academic performance in Spanish children from a low-middle-and a high-income population. Frontiers in psychiatry, 14, 1136994. https://doi.org/10.3389/fpsyt.2023.1136994
11. Friedman, N. P., & Robbins, T. W. (2022). The role of prefrontal cortex in cognitive control and executive function. Neuropsychopharmacology, 47(1), 72-89. https://doi.org/10.1038/s41386-021-01132-0
12. Fu, Y., Qin, Z., Qin, L., Zhang, H., Liu, H., Huang, S., & Li, D. (2025). Multidimensional factors associated with ADHD core symptoms in children: cognition, sleep, behavior, and demographics. Frontiers in Psychiatry, 16, 1658202. https://doi.org/10.3389/fpsyt.2025.1658202
13. Gao, X., Zhong, L., He, H., Zhang, J., & Yang, W. (2026). Response inhibition and working memory in children with attention deficit hyperactivity disorders: An event-related potential study. Brain and Development, 48(2), 104517. https://doi.org/10.1016/j.braindev.2026.104517
14. Ghasemi Mehrabadi, Z. G., Safarzadeh, S., Ehteshamzadeh, P., & Bozorgi, Z. D. (2025). The Effectiveness of Cognitive Rehabilitation and Floortime Play Therapy on Time Perception in Students with Attention Deficit Hyperactivity Disorder (ADHD). International Journal of School Health, 12(3), 197. https://doi.org/10.30476/intjsh.2025.105126.1470
15. Guimarães, R. S. Q., Bandeira, I. D., Barretto, B. L., Wanke, T., Alves, C. O. C., Barretto, T. L., ... & Lucena, R. (2024). Efficacy and safety of transcranial direct current stimulation over the left dorsolateral prefrontal cortex in children and adolescents with attention-deficit/hyperactivity disorder: a randomized, triple-blinded, sham-controlled, crossover trial. Frontiers in Psychiatry, 14, 1217407. https://doi.org/10.3389/fpsyt.2023.1217407
16. Huang, R., & Liu, Y. (2025). Research progress of tDCS in the treatment of ADHD. Journal of Neural Transmission, 132(2), 237-251. https://doi.org/10.1007/s00702-024-02853-4
17. Indahlastari, A., Hardcastle, C., Albizu, A., Alvarez-Alvarado, S., Boutzoukas, E. M., Evangelista, N. D., ... & Woods, A. J. (2021). A systematic review and meta-analysis of transcranial direct current stimulation to remediate age-related cognitive decline in healthy older adults. Neuropsychiatric Disease and Treatment, 971-990. https://doi.org/10.2147/NDT.S259499
18. Jalilvand, M., Nikmanesh, Z., & Bagheri, F. (2022). Cognitive rehabilitation training in improving executive function, antisocial behaviors, and legal problems in children with attention-deficit/hyperactivity disorder. https://doi.org/10.32598/ijmtfm.v12i2.36951
19. Krauel, K., Brauer, H., Breitling-Ziegler, C., Freitag, C. M., Luckhardt, C., Mühlherr, A., ... & Prehn-Kristensen, A. (2025). Prefrontal transcranial direct current stimulation in pediatric attention-deficit/hyperactivity disorder: a randomized clinical trial. JAMA network open, 8(2), e2460477. https://doi.org/10.1001/jamanetworkopen.2024.60477.
20. Lee, Y., Mikami, A. Y., & Owens, J. S. (2021). Children’s ADHD symptoms and friendship patterns across a school year. Research on Child and Adolescent Psychopathology, 49(5), 643-656. https://doi.org/10.1007/s10802-021-00771-7
21. Liu, N., Liu, Q., Yang, Z., Xu, J., Fu, G., Zhou, Y., ... & Qian, Q. (2023). Different functional alteration in attention‐deficit/hyperactivity disorder across developmental age groups: a meta‐analysis and an independent validation of resting‐state functional connectivity studies. CNS Neuroscience & Therapeutics, 29(1), 60-69. https://doi.org/10.1111/cns.14032
22. Loetscher, T., Potter, K. J., Wong, D., & das Nair, R. (2019). Cognitive rehabilitation for attention deficits following stroke. Cochrane Database of Systematic Reviews, (11). https://doi.org/10.1002/14651858.CD002842.pub2
23. Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000). The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: A latent variable analysis. Cognitive psychology, 41(1), 49-100. https://doi.org/10.1006/cogp.1999.0734
24. Montiel, A. E., Normand, S., & Mikami, A. Y. (2026). Friendship Quality in Children With ADHD Seeking Treatment for Peer Problems: A Comparison of Boy-Boy, Girl-Girl, and Mixed-Gender Dyads. Research on Child and Adolescent Psychopathology, 54(4), 97. https://doi.org/10.1007/s10802-026-01490-7
25. Nitsche, M. A., & Paulus, W. (2001). Sustained excitability elevations induced by transcranial DC motor cortex stimulation in humans. Neurology, 57(10), 1899-1901. https://doi.org/10.1212/wnl.57.10.1899
26. Ogundele, M. O., & Ayyash, H. F. (2023). ADHD in children and adolescents: Review of current practice of non-pharmacological and behavioural management. AIMS Public Health, 10(1), 35. https://doi.org/10.3934/publichealth.2023004
27. Openneer, T. J., van der Meer, D., Marsman, J. B. C., Forde, N. J., Akkermans, S. E., Naaijen, J., ... & Dietrich, A. (2021). Impaired response inhibition during a stop-signal task in children with Tourette syndrome is related to ADHD symptoms: A functional magnetic resonance imaging study. The World Journal of Biological Psychiatry, 22(5), 350-361. https://doi.org/10.1080/15622975.2020.1813329.
28. Popit, S., Serod, K., Locatelli, I., & Stuhec, M. (2024). Prevalence of attention-deficit hyperactivity disorder (ADHD): systematic review and meta-analysis. European Psychiatry, 67(1), e68. https://doi.org/10.1192/j.eurpsy.2024.1786
29. Rafikhah, M., Fami, F. S., Ghasmzadeh, P., & Ghasmzadeh, S. (2026). Inhibitory control deficits in children and adolescents with ADHD: a comparative study. Asian Journal of Psychiatry, 105139.https://doi.org/10.1016/j.ajp.2026.105139
30. Salehinejad, M. A., Nejati, V., Mosayebi-Samani, M., Mohammadi, A., Wischnewski, M., Kuo, M. F., ... & Nitsche, M. A. (2020). Transcranial Direct Current Stimulation in ADHD: A Systematic Review of Efficacy, Safety, and Protocol-induced Electrical Field Modeling Results: Neurosci. Bull. Neuroscience bulletin, 36(10), 1191-1212. https://doi.org/10.1007/s12264-020-00501-x
31. Senderecka, M., Grabowska, A., Szewczyk, J., Gerc, K., & Chmylak, R. (2012). Response inhibition of children with ADHD in the stop-signal task: An event-related potential study. International Journal of Psychophysiology, 85(1), 93-105. https://doi.org/10.1016/j.ijpsycho.2011.05.007
32. Sohlberg, M. M., & Mateer, C. A. (2017). Cognitive rehabilitation: An integrative neuropsychological approach. Guilford Publications.
33. Soleymani, M., & Kazemimonir, N. (2020). The effectiveness of transcranial direct current stimulation (T DCS) on increase cognitive flexibility and processing speed among children with attention deficit/hyperactivity (ADHD). Educational Psychology, 16(57), 305-326. (in persian). https://doi.org/10.22054/jep.2020.56456.3181
34. Stagg, C. J., & Nitsche, M. A. (2011). Physiological basis of transcranial direct current stimulation. The Neuroscientist, 17(1), 37-53. https://doi.org/10.1177/1073858410386614
35. Westwood, S. J., Parlatini, V., Rubia, K., et al. (2023). Computerized cognitive training in attention-deficit/hyperactivity disorder (ADHD): A meta-analysis of randomized controlled trials with blinded and objective outcomes. Molecular Psychiatry. https://doi.org/10.1038/s41380-023-02000-7
36. Xu, P., Wu, D., Chen, Y., Wang, Z., & Xiao, W. (2020). The effect of response inhibition training on risky decision-making task performance. Frontiers in psychology, 11, 1806. https://doi.org/10.3389/fpsyg.2020.01806
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