Effectiveness of a virtual reality-based mindfulness intervention for ADHD symptoms in college students: A randomized controlled trial

Objective To evaluate the effectiveness of a virtual reality (VR)-based mindfulness intervention in reducing ADHD symptoms and improving cognitive and psychosocial outcomes among college students, compared to a non-immersive, video-based mindfulness control. Methods In this trial, 64 college students screening positive for ADHD symptoms (ASRS v1.1) were randomized 1:1 to an intervention group using the Headspace application on the Meta Quest Pro headset or a control group watching a guided meditation video; after six withdrawals, 58 participants (29 per group) were included in the per-protocol analysis. Both groups participated in three supervised sessions per week over four weeks (12 sessions total). Primary outcomes were ADHD symptom severity (ASRS v1.1) and cognitive-motor reaction time (BlazePod™). Secondary outcomes included depression (PHQ-9), anxiety (GAD-7), sleep quality (PSQI), academic engagement (UWES), and self-efficacy (GSE), assessed at baseline, mid-intervention, and post-intervention. Results Compared to the control group, the intervention group achieved significantly greater reductions in ASRS scores (−5.8 vs. −2.3 points; p < 0.001) and right-leg reaction times (−157.4 vs. −88.4 ms; p = 0.028; not significant after Holm correction, adjusted p = 0.056). The intervention group showed significantly larger improvements in depressive symptoms, anxiety, sleep quality, and academic engagement ( p < 0.01 for all). Self-efficacy improved in both groups with no significant between-group difference ( p = 0.151). Adverse events leading to withdrawal occurred in four participants: two in the VR group (severe motion sickness/cybersickness) and two in the control group (severe enteritis, unrelated to the intervention). Conclusion A four-week VR-based mindfulness intervention produced greater improvements in ADHD symptoms and related psychosocial outcomes compared to a video-based control in college students. These findings support further investigation of VR as a digital therapeutic adjunct for adult ADHD symptoms.