Previously submitted to: JMIR mHealth and uHealth (no longer under consideration since Dec 08, 2025)
Date Submitted: Apr 2, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Positive emotion improves inattention symptoms and digital therapeutic performance outcomes in children with Attention deficit-hyperactivity disorder: Randomized controlled trial
ABSTRACT
Background:
Attention deficit-hyperactivity disorder (ADHD) is one of the most prevalent developmental disorders in children and adolescents. Digital therapeutics (DTx) have recently been shown to alleviate inattention, one of the core symptoms of ADHD. However, the effect of emotional status on the efficacy of DTx has not been established.
Objective:
This study aimed to examine whether emotional status influences the effectiveness of a DTx intervention, Neuro World, in children diagnosed with ADHD
Methods:
Twenty children with ADHD participated in an intervention using Neuro World, a DTx comprising five distinct content modules. Participants were also classified according to their emotional status -positive vs. negative- and emotional stability -stable vs. unstable. Emotional assessments were conducted throughout the intervention period. ADHD symptom changes were measured using pre- and post-intervention scores from the Korean Child Behavior Checklist (K-CBCL) and the Korean ADHD Rating Scale (K-ARS).
Results:
Participants with positive emotional status exhibited significantly higher performance in content 1 (Breathtaking Glass Bridge) and 4 (Space Travel) than those with negative emotional status. Additionally, children with stable emotional status demonstrated significant reductions in ADHD symptoms after the intervention, while those unstable emotional status did not show improvements in internalizing and inattention symptoms. Moreover, participants with positive overall emotional status during the intervention period showed significant decreases in K-CBCL and K-ARS scores, whereas those with negative overall emotional did not.
Conclusions:
These findings suggest that emotional status plays a critical role in both DTx performance and ADHD symptom improvement. The emotions context of children with ADHD should be considered when designing and administering DTx interventions. Clinical Trial: Clinical Research Information Service (CRiS), Republic of Korea; KCT0009326. Registered on April 11, 2024. URL: https://cris.nih.go.kr/cris/search/detailSearch.do?seq=26799&search_page=L
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