اثر بخشی آموزش کارکردهای اجرایی بر نشانه‌های اضطراب، نارسایی توجه و مهارت‌های اجتماعی کودکان مبتلا به اختلال بیش‌فعالی در تبریز
محورهای موضوعی : روانشناسی تربیتیعلیرضا رزمی 1 , معصومه آزموده 2 , اکبر رضایی 3 , تورج هاشمی 4
1 - گروه روانشناسی، دانشکده علوم انسانی و تربیتی، واحد تبریز، دانشگاه آزاد اسلامی، تبریز، ایران
2 - گروه روانشناسی، دانشکده علوم انسانی و تربیتی، واحد تبریز، دانشگاه آزاد اسلامی، تبریز، ایران
3 - استاد گروه روانشناسی، دانشگاه پیام‌نور، تهران، ایران
4 - گروه روانشناسی، دانشکده علوم انسانی و تربیتی، دانشگاه تبریز، ایران
کلید واژه: اضطراب, مهارت‌های اجتماعی, کارکردهای اجرایی, اختلال نارسایی توجه/ بیش‌فعالی,
چکیده مقاله :
هدف پژوهش حاضر تعیین اثر بخشی آموزش کارکردهای اجرایی (توجه، بازداری پاسخ، حافظه فعال) بر نشانه‌های اضطراب، نارسایی توجه و مهارت‌های اجتماعی کودکان مبتلا به بیش‌فعالی در تبریز بود. این تحقیق به روش نیمه آزمایشی، در یک طرح پیش‌آزمون-پس‌آزمون، با گروه کنترل انجام گرفت. جامعه آماری مشتمل بر کلیه دانش‌آموزان پسر ابتدایی مدارس ناحیه 4 آموزش و پرورش شهر تبریز بود. از بین جامعه مذکور نمونه ای به حجم 30 نفر به روش نمونه‌گیری هدفمند انتخاب و در دو گروه آزمایش و کنترل به طور تصادفی جایگزین شدند. سپس هر دو گروه مورد پیش‌آزمون قرار گرفته و به پرسشنامه‌های CSI-4، اضطراب آشکار کودکان رینولدز و ریچموند (RCMAS) و مقیاس درجه بندی مهارت‌های اجتماعی (SSRS) پاسخ دادند. در مرحله بعد گروه آزمایش در 10 جلسه (60 دقیقه‌ای) آموزش کارکردهای اجرایی شرکت کردند و در ادامه از هر دو گروه پس‌آزمون به عمل آمد. پس از گردآوری داده‌ها فرضیه‌های تحقیق با استفاده از آزمون تحلیل کوواریانس به وسیله نرم‌افزار SPSS تحلیل شدند. نتایج نشان داد که آموزش کارکردهای اجرایی بر نشانه‌های اضطراب، نارسایی توجه و مهارت‌های اجتماعی کودکان مبتلا به بیش‌فعالی مؤثر بود.
The aim of this study was to determine the effectiveness of executive function training (attention, response inhibition, working memory) on symptoms of anxiety, attention deficit and social skills in children with ADHD in Tabriz. This quasi-experimental study was performed in a pretest-posttest design with a control group. The statistical population included all primary school students in District 4 of Tabriz. From the mentioned population, a sample of 30 people was selected by purposive sampling method and randomly replaced in experimental and control groups. Both groups were then pretested and answered the CSI-4 questionnaire, Reynolds and Richmond Child Anxiety Scale (RCMAS) and the Social Skills Rating Scale (SSRS). In the next stage, the experimental group participated in 10 sessions (60 minutes) of executive function training, and then both groups underwent post-test. After collecting data, research hypotheses were analyzed using analysis of covariance using SPSS software. The results showed that executive function training was effective on symptoms of anxiety, attention deficit and social skills in children with ADHD.
آهنگر قربانی، زهره؛ حسین خانزاده، عباسعلی؛ خسرو جاوید، مهناز و صادقی، عباس (1394). اثربخشی اموزش کارکردهای اجرایی بر مهارت‌های اجتماعی دانش‌آموزان با نارسا خوانی. فصلنامه افراد استثنایی، 5(19)، 163- 186.
تقوی، محمدرضا و علیشاهی، محمدجواد (1382). بررسی اعتبار و روایی پرسشنامه اضطراب آشکار کودکان(RCMAS) ، مجله روان شناسی، 7(4)، 357- 343.
تهرانی دوست؛ مهدی، رادگودرزی؛ رضا، سپاسی، میترا و علاقه‌بندراد، جواد (1382). نقایص کارکردهای اجرایی در کودکان مبتلا به اختلال نارسایی توجه / بیش‌فعالی، تازه های علوم شناختی، 5(1)، 9-1.
کوثری، لیلا و علیزاده، حمید (1389). مقایسه مهارت‌های اجتماعی دانش‌آموزان با اختلال نارسایی توجه / بیش‌فعالی و دانش‌آموزان بدون این اختلال در مقطع دبستان، مطالعات روان شناختی. 6(3)، 109-134.
علیزاده، حمید (1383). اختلال نارسایی توجه/ فزون جنبشی، ویژگی‌ها، ارزیابی و درمان. تهران: انتشارات رشد.
فردکهن، محمود و غباری‌بناب، باقر (1388). مقایسه مهارت‌های اجتماعی و پیشرفت تحصیلی دانش‌آموزان استثنایی در مدارس تلفیقی و استثنایی. پژوهش در حیطه کودکان استثنایی، 5(31). 63 - 73.
گرجیان، فاطمه و عبدالهی، محمدحسین (1395). مقایسه‌‌ی کارکردهای اجرایی و تخمین شناختی و سوگیری تعبیر در افراد دارای اختلال اضطراب اجتماعی و افراد سالم. فصلنامه روانشناسی شناختی، 4(3)، 46-53.
هارجی، او. و ساندرز، کا (1384). مهارت‌های اجتماعی در ارتباط بین فردی، ترجمه: بیگی، خشایار و فیروز بخت، مهرداد. تهران: انتشارات رشد.
وزیری، آزاده؛ احدی، حسن؛ مکوندی، بهنام؛ عسگری، پرویز و بختیارپور، سعید (1397). اثربخشی آموزش کارکردهای اجرایی در کاهش نشانه‌های کودکان مبتلا به اختلالات اضطرابی. فصلنامه مطالعات روان شناسی تربیتی، 3(29) ،277-257.
Ahangar gorbani, Z., Hossein Khanzadeh, A. A., Khosrow Javid, M., & Sadeghi, A., (2016). The effectiveness of executive function training on social skills of students with dyslexia. Quarterly Journal of Exceptional People, 5(19): 163-182 [In Persian].
Alizadeh, H. (2005). Attention Deficit / Hyperactivity Disorder, Characteristics, Evaluation and Treatment. Tehran: Roshd Publications[In Persian].
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders. 5th ed. Washington DC: USA.
Bannon, S., Gonsalves, C. J., Croft, R. J., & Boyce, P. M. (2006). Executive function in obsessive compulsive disorder: state or trait deficits. Australian and New Zealand Journal of Psychiatry, 40(107): 1031-1138.
Barkley, R. A. (2006). Attention Deficit Hyperactivity Disorder: A handbook for diagnosis and treatment (3 rd ed.). New York: Gilford Press.
Biederman, J. (2005). Absence of gender effects on attention deficit hyperactivity disorder: findings in nonreferred subjects. American Journal of Psychiatry, 162(6): 1083-1089
Charman, T., Carrol, F., & Sturge, C. (2001). Theory of mind, executive function, And social competence in boy with ADHD. Emotional and behavioral Difficulties, 6(1): 31- 49.
Coolidge, F. L., Thede. L. L, & Young. S. E. (2000). Heritability and Comorbidity of attention deficit hyperactivity disorder with behavioral Disorders and executive functions deficits: A preliminary investigation. Developmental Neurophysiology, 17(3): 273- 287.
Daniel Mares, M. A., Mcluckie, A., Scheartz., M., & Saini, M. (2007). Executive Functions impairments in children with attention Deficit hyperactivity disordetr: Do they differ between school and hom Invironments? Canadian Journal of psychiatry, 52(8): 527-538.
Dawson, P; & Guare, R. (2004). Executive skills in children and adolescents: A practical guide to assessment and intervention. New York: Guilford Press.
Dukte, S., & Stober, J. (2001). Test Anxiety and Working Memory. Journal of Developmental Psychology. 28(3): 689-692.
Eslinger. P. J., Flaherty –Craig, C. V., & Chakara. F. (2013). Handbook of Clinical Neurology, Neurological Rehabilitation. Vol. 110 (3rd series).
Fard Kohan, Mahmoud and Ghobari Bonab, Baqer (2009. Comparison of social skills and academic achievement of exceptional students in integrated and exceptional schools. Research in exceptional children, 31 (11): 63-73 [In Persian].
Fisher, M., Barkley, R., A., Smallish, L., & Fletcher, K. (2005). Executive functioning in hyperactive children, as young adults: attention, inhibition, response perseveration, and the impact of comorbidity. Developmental Neuro psychology. 27(1): 107-133.
Franke, B., Faraone, S. V., Asherson, P., Buitelaar, J., Bau, C. H., Ramos-Quiroga, J. A., Mick, E., Grevet, E. H., Johansson, S., Haavik, J., & et al. (2012). The genetics of attention deficit/hyperactivity disorder in adults, a review. Psychiatry. 17(5): 960–987.
Fredriksen, M., Dahl, A. A., Martinsen, E. W., Klungsoyr, O., Faraone, S. V., & Peleikis, D. E. )2014(. Childhood and persistent ADHD symptoms associated with educational failure and long-term occupational disability in adult ADHD. Atten. Defic. Hyperact. Disord. 6(3): 87–99.
Fujii, Y., Kitagawa, K., Shimizu, Y., Shimizu, N., Toyomaki, A., Hashimoto, N., Kako, Y., Tanaka T, Asakura, S., Koyama, T., & Kusumi, I. (2013). Severity of Generalized Social Anxiety Disorder Correlates with Low Executive. Journal of Neuroscience Letters. 543(3): 42-46.
Goldberg, M. C., Mostofsky. S. H., Cutting, L. E., Mahone, E., M., Aslor, B. C., Denckla, M. B., & Landa, R. J. (2005). Subtle executive impainrment in children with autism and children with ADHD. Journal of Autism and Developmental Disorders, 35(3): 279-293.
Goldstein, S., & Golstein, M. (1998). Managing Attention Deficit Hyperacv ity Disorder in: aguide for praco ners (2nd ed). New York, Ny: John Wiley.
Gorjian, F., & Abdullahi, M, H, (2017). Comparison of executive and cognitive functions and interpretation bias in people with social anxiety disorder and healthy people. Journal of Cognitive Psychology, 4(3): 46-53[In Persian].
Gresham, F., & Elliot, S. N. (1990). The social skills rating sestem.
Harji, O., & Saunders, K. (2006). Social skills in interpersonal communication, translation: Beigi, Khashayar and Firooz Bakht, Mehrdad. Tehran: Roshd Publications[In Persian].
Jonathan, B. (2004). Social skills deficits. In E. Mash & L. Terdal (Eds.), Behavioral assessment of childhood disorders (pp.347-396). New York: The Guilford Press.
Kempton, S., Vance, A., Maruff, P., Luk, E., Costin, J., & Pantelis, C. (2001). Executive Functions and attention deficit hyperactivity disorder: Stimulant medication and better executive Function performance in children. Psychological Medicine, 29(3): 527- 538.
Kowsari, L., & Alizadeh, H. (2011). Comparison of students' social skills with attention deficit / hyperactivity disorder and students without this disorder in primary school, psychological studies. 6(3): 51-55 [In Persian].
Langley, K. ADHD Genetics. In Oxford Textbook of Attention Deficit Hyperactivity Disorder; Oxford University Press: Oxford, UK, 2018; Chapter 3; p. 19.
Lee Park. K., Loman, S., & Miller, M. A. (2007). Social skills. Adaptive Behavior Assessment-II: Clinical Use and Interpretation, Elsevier Inc.
Mares, D., McLuckie, A., Schwartz, M., & Saini, M. (2007). Executive Function Impairments in Children with Attention-Deficit Hyperactivity Disorder: Do They Differ Between School and Home Environments. The Canadian Journal of Psychiatry. 52(8): 237-245.
Mc Closkey, G., Perkins, L., & Divner, B. (2009). Assessment and Intervention for Executive Function Difficulties. New York: Routledge Press.
Micco, J., Henin, A., Biederman, J., Petty, C., & Beker, D. (2009). Executive function in patients with depression and anxiety. Journal of Depress Anxiety. 26(10):780-790.
Rapport, M. D., Bolden, J., Kofler MJ., Sarver, DE., Raiker, JS., & Alderson, M. R. (2009). Hyperactivity in boys with attention- deficit/ hyperactivity disorder (ADHD): A ubiquitous core symptom or manifestation of working memory deficits? Journal of Abnormal Child Psychology. 9(13):521-534.
Seidman, Larry J., (2006). neuropsychological Functioning in people with ADHDacross the lifespan. Journal of Clinical Psychology Review. 26(19): 466- 485.
Taqawi, M. R., Alishahi, M. J. (2004). Assessing the validity and reliability of the Manifest Obvious Anxiety Questionnaire (RCMAS) Journal of Psychology, Winter. 7(14): 343-357 [In Persian].
Tehrani Doost, M., Radgoodarzi, R., Sepasi, M., & Alaghband Rad, J. (2003). Executive dysfunctions in children with attention deficit / hyperactivity disorder, Cognitive Science News. 5(1): 1-9 [In Persian].
Valerna, E. M., & Seidman, L. J. (2006). Neuropsychology of attention deficit hyperactivity disorder in preschoolers. Infant and Young children, 19(2): 94-108.
Waziri, A., Ahadi, H., Makoundi, B., Askari, P., & Bakhtiarpour, S. (2019). The effectiveness of executive function training in reducing the symptoms of children with anxiety disorders. Journal of Educational Psychology Studies. 29(20): 277-257 [In Persian].
Wilcockson, T. D. W., & Sanal, N. E. M. (2016). Heavy cannabis uses and attentional avoidance of anxiety-related stimuli. Addictive Behaviors Reports, 3(4): 38-42.
Willcutt, E. G., Doyle, A. E., Nigg, J. T., Faraone, S. V., & Pennington, B. F. (2005). Validity of the executive function theory of attention deficit/hyperactivity disorder: A meta-analytic review. Biological Psychiatry. 57(10): 1336-1346.
_||_Ahangar gorbani, Z., Hossein Khanzadeh, A. A., Khosrow Javid, M., & Sadeghi, A., (2016). The effectiveness of executive function training on social skills of students with dyslexia. Quarterly Journal of Exceptional People, 5(19): 163-182 [In Persian].
Alizadeh, H. (2005). Attention Deficit / Hyperactivity Disorder, Characteristics, Evaluation and Treatment. Tehran: Roshd Publications[In Persian].
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders. 5th ed. Washington DC: USA.
Bannon, S., Gonsalves, C. J., Croft, R. J., & Boyce, P. M. (2006). Executive function in obsessive compulsive disorder: state or trait deficits. Australian and New Zealand Journal of Psychiatry, 40(107): 1031-1138.
Barkley, R. A. (2006). Attention Deficit Hyperactivity Disorder: A handbook for diagnosis and treatment (3 rd ed.). New York: Gilford Press.
Biederman, J. (2005). Absence of gender effects on attention deficit hyperactivity disorder: findings in nonreferred subjects. American Journal of Psychiatry, 162(6): 1083-1089
Charman, T., Carrol, F., & Sturge, C. (2001). Theory of mind, executive function, And social competence in boy with ADHD. Emotional and behavioral Difficulties, 6(1): 31- 49.
Coolidge, F. L., Thede. L. L, & Young. S. E. (2000). Heritability and Comorbidity of attention deficit hyperactivity disorder with behavioral Disorders and executive functions deficits: A preliminary investigation. Developmental Neurophysiology, 17(3): 273- 287.
Daniel Mares, M. A., Mcluckie, A., Scheartz., M., & Saini, M. (2007). Executive Functions impairments in children with attention Deficit hyperactivity disordetr: Do they differ between school and hom Invironments? Canadian Journal of psychiatry, 52(8): 527-538.
Dawson, P; & Guare, R. (2004). Executive skills in children and adolescents: A practical guide to assessment and intervention. New York: Guilford Press.
Dukte, S., & Stober, J. (2001). Test Anxiety and Working Memory. Journal of Developmental Psychology. 28(3): 689-692.
Eslinger. P. J., Flaherty –Craig, C. V., & Chakara. F. (2013). Handbook of Clinical Neurology, Neurological Rehabilitation. Vol. 110 (3rd series).
Fard Kohan, Mahmoud and Ghobari Bonab, Baqer (2009. Comparison of social skills and academic achievement of exceptional students in integrated and exceptional schools. Research in exceptional children, 31 (11): 63-73 [In Persian].
Fisher, M., Barkley, R., A., Smallish, L., & Fletcher, K. (2005). Executive functioning in hyperactive children, as young adults: attention, inhibition, response perseveration, and the impact of comorbidity. Developmental Neuro psychology. 27(1): 107-133.
Franke, B., Faraone, S. V., Asherson, P., Buitelaar, J., Bau, C. H., Ramos-Quiroga, J. A., Mick, E., Grevet, E. H., Johansson, S., Haavik, J., & et al. (2012). The genetics of attention deficit/hyperactivity disorder in adults, a review. Psychiatry. 17(5): 960–987.
Fredriksen, M., Dahl, A. A., Martinsen, E. W., Klungsoyr, O., Faraone, S. V., & Peleikis, D. E. )2014(. Childhood and persistent ADHD symptoms associated with educational failure and long-term occupational disability in adult ADHD. Atten. Defic. Hyperact. Disord. 6(3): 87–99.
Fujii, Y., Kitagawa, K., Shimizu, Y., Shimizu, N., Toyomaki, A., Hashimoto, N., Kako, Y., Tanaka T, Asakura, S., Koyama, T., & Kusumi, I. (2013). Severity of Generalized Social Anxiety Disorder Correlates with Low Executive. Journal of Neuroscience Letters. 543(3): 42-46.
Goldberg, M. C., Mostofsky. S. H., Cutting, L. E., Mahone, E., M., Aslor, B. C., Denckla, M. B., & Landa, R. J. (2005). Subtle executive impainrment in children with autism and children with ADHD. Journal of Autism and Developmental Disorders, 35(3): 279-293.
Goldstein, S., & Golstein, M. (1998). Managing Attention Deficit Hyperacv ity Disorder in: aguide for praco ners (2nd ed). New York, Ny: John Wiley.
Gorjian, F., & Abdullahi, M, H, (2017). Comparison of executive and cognitive functions and interpretation bias in people with social anxiety disorder and healthy people. Journal of Cognitive Psychology, 4(3): 46-53[In Persian].
Gresham, F., & Elliot, S. N. (1990). The social skills rating sestem.
Harji, O., & Saunders, K. (2006). Social skills in interpersonal communication, translation: Beigi, Khashayar and Firooz Bakht, Mehrdad. Tehran: Roshd Publications[In Persian].
Jonathan, B. (2004). Social skills deficits. In E. Mash & L. Terdal (Eds.), Behavioral assessment of childhood disorders (pp.347-396). New York: The Guilford Press.
Kempton, S., Vance, A., Maruff, P., Luk, E., Costin, J., & Pantelis, C. (2001). Executive Functions and attention deficit hyperactivity disorder: Stimulant medication and better executive Function performance in children. Psychological Medicine, 29(3): 527- 538.
Kowsari, L., & Alizadeh, H. (2011). Comparison of students' social skills with attention deficit / hyperactivity disorder and students without this disorder in primary school, psychological studies. 6(3): 51-55 [In Persian].
Langley, K. ADHD Genetics. In Oxford Textbook of Attention Deficit Hyperactivity Disorder; Oxford University Press: Oxford, UK, 2018; Chapter 3; p. 19.
Lee Park. K., Loman, S., & Miller, M. A. (2007). Social skills. Adaptive Behavior Assessment-II: Clinical Use and Interpretation, Elsevier Inc.
Mares, D., McLuckie, A., Schwartz, M., & Saini, M. (2007). Executive Function Impairments in Children with Attention-Deficit Hyperactivity Disorder: Do They Differ Between School and Home Environments. The Canadian Journal of Psychiatry. 52(8): 237-245.
Mc Closkey, G., Perkins, L., & Divner, B. (2009). Assessment and Intervention for Executive Function Difficulties. New York: Routledge Press.
Micco, J., Henin, A., Biederman, J., Petty, C., & Beker, D. (2009). Executive function in patients with depression and anxiety. Journal of Depress Anxiety. 26(10):780-790.
Rapport, M. D., Bolden, J., Kofler MJ., Sarver, DE., Raiker, JS., & Alderson, M. R. (2009). Hyperactivity in boys with attention- deficit/ hyperactivity disorder (ADHD): A ubiquitous core symptom or manifestation of working memory deficits? Journal of Abnormal Child Psychology. 9(13):521-534.
Seidman, Larry J., (2006). neuropsychological Functioning in people with ADHDacross the lifespan. Journal of Clinical Psychology Review. 26(19): 466- 485.
Taqawi, M. R., Alishahi, M. J. (2004). Assessing the validity and reliability of the Manifest Obvious Anxiety Questionnaire (RCMAS) Journal of Psychology, Winter. 7(14): 343-357 [In Persian].
Tehrani Doost, M., Radgoodarzi, R., Sepasi, M., & Alaghband Rad, J. (2003). Executive dysfunctions in children with attention deficit / hyperactivity disorder, Cognitive Science News. 5(1): 1-9 [In Persian].
Valerna, E. M., & Seidman, L. J. (2006). Neuropsychology of attention deficit hyperactivity disorder in preschoolers. Infant and Young children, 19(2): 94-108.
Waziri, A., Ahadi, H., Makoundi, B., Askari, P., & Bakhtiarpour, S. (2019). The effectiveness of executive function training in reducing the symptoms of children with anxiety disorders. Journal of Educational Psychology Studies. 29(20): 277-257 [In Persian].
Wilcockson, T. D. W., & Sanal, N. E. M. (2016). Heavy cannabis uses and attentional avoidance of anxiety-related stimuli. Addictive Behaviors Reports, 3(4): 38-42.
Willcutt, E. G., Doyle, A. E., Nigg, J. T., Faraone, S. V., & Pennington, B. F. (2005). Validity of the executive function theory of attention deficit/hyperactivity disorder: A meta-analytic review. Biological Psychiatry. 57(10): 1336-1346.