اثر بخشی درمان مبتنی بر ذهنی سازی بر کیفیت زندگی کودکان مبتلا به اختلال کم توجهی/ بیش فعالی (ADHD)
محورهای موضوعی : تکتونواستراتیگرافیفاطمه قنبری 1 , قاسم نظیری 2 , بنفشه امیدوار 3
1 - دانشگاه آزاد اسلامی
2 - روانشناسی - دانشکده اقتصاد و مدیریت- دانشگاه ازاد اسلامی- شیراز - ایران
3 - دکتری تخصصی مشاوره خانواده، استادیار، گروه روانشناسی، واحد شیراز، دانشگاه آزاد اسلامی، شیراز، ایران.
کلید واژه: کیفیت زندگی, اختلال کم توجهی/ بیش فعالی, درمان مبتنی بر ذهنی سازی,
چکیده مقاله :
هدف از مطالعه حاضر سنجش اثربخشی درمان مبتنی بر ذهنی سازی برای کودکان (MBT-C) بر کیفیت زندگی کودکان مبتلا به اختلال کم توجهی/ بیش فعالی (ADHD) است. جامعهی آماری این پژوهش شامل کودکان مبتلا به اختلال کم توجهی/ بیش فعالی سنین مدرسه (6 تا 12 سال) شهر شیراز است و نمونهی مورد پژوهش از بین بیماران مراجعه کننده به کلینیک های سرپایی خدمات روانشناختی شهر شیراز انتخاب شدند و مطالعه بر روی آنها انجام شد. نمونهی این پژوهش شامل 60 نفر مراجعه کننده کودک مبتلا به ADHD بود. شرکت کنندگان به مدت حداقل 12 هفته تحت درمان قرار گرفتند. این پژوهش به روش آزمایشی با اندازه گیری های مکرر با سه گروه مداخله انجام شد. نتایج نشان داد که این درمان بر کیفیت زندگی کودکان به خصوص در ترکیب با درمان دارویی در تمام ابعاد اثربخش بوده است. بنابراین می توان دریافت که این درمان از طریق ارتقاء ظرفیت ذهنی سازی در کودکان ADHD و والدینشان می تواند کیفیت زندگی این کودکان را به خصوص در کارکرد عاطفی و تنظیم هیجانی بهبود بخشد.
Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent psychiatric diagnosis. These children have many problems in different aspects of their life. The aim of present study was to determine the effectiveness of Mentalization-Based Treatment for children (MBT-C) on improvement of the quality of life among school-aged children 6 to 12 with ADHD. A Sample consisting of 60 children with diagnosis of ADHD was selected and then randomly assigned to experimental and control groups. This experimental study was carried out in mixed method with three groups of interventions including MBT-C, pharmacotherapy with Methylphenidate and combination intervention. Each child participated in 12 to 36 separate sessions of interventions. The results indicated important improvements in all aspects of children's quality of life through MBT-C, especially in combination with methylphenidate. Therefore, this kind of intervention through the capacity of mentalizing in children and their parents can improve the quality of life especially affective functions and emotional regulation.
انجمن روانپزشکی آمریکا. (1394). راهنمای تشخیصی و آماری اختلال های روانی: ویرایش پنجم (DSM-5: ترجمه رضاعی و همکاران). تهران: ارجمند. (تاریخ انتشار به زبان اصلی 2013).
Afi, A., Esteki, M., Madahi, M. E., Hasani, F. (2020). Comparing the effects of mindfulness-based cognitive therapy and neurofeedback on emotional self-regulation in children with attention deficit/hyperactivity disorder. MEJDS, 10, 75.
Asen, E., & Fonagy, P. (2012a). Mentalization-based family therapy. In A. W. Bateman & P. Fonagy (Eds.), Handbook of mentalizing in mental health practice (pp. 107–129). Arlington, VA: American Psychiatric Publishing.
Asen, E., & Fonagy, P. (2012b). Mentalization-based therapeutic interventions for families. Journal of Family Therapy, 34, 347–370.
Asgari Nekah, S. M., & Abedi, Z. (2014). The effectiveness of executive functions based play therapy on improving response inhibition, planning and working memory in children with attention deficit hyperactivity disorder. Journal of Cognitive Psychology, 2 (1), 41-51.
Badoud, D., Rufenacht, E., Debbane, M., Perroud, N. (2018). Mentalization-based treatment for adults with attention- deficit/hyperactivity disorder: a pilot study. Research in Psychotherapy: Psychopathology, Process and Outcome, 21, 149-154.
Barkley, R. A. (1997) ADHD and the nature of self-control. New York, NY: Guilford Press.
Bateman, A., & Fonagy, P. (2016). Mentalization-based treatment for personality disorders: A practical guide. New York: Oxford University Press.
Choi-Kain, L. W., & Gunderson, J. G. (2008). Mentalization: Ontogeny, assessment, and application in the treatment of borderline personality disorder. American Journal of Psychiatry, 165(9), 1127-1135.
Dehkordian, P., Hamid, N., Beshlideh, K., & Mehrabizade, H. M. (2017). The effectiveness of mindful parenting, social thinking and exercise on quality of life in ADHD children. Int J Pediatr, 5, 4295-4302.
Fearon, P., Target, M., Sargent, J., Williams, L. L., McGregor, JM, Bleiberg, E., & Fonagy, P. (2006). Short-term mentalization and relational therapy (SMART): An integrative family therapy for children and adolescents. In J. G Allen & P. Fonagy (Eds), Handbook of mentalization-based treatment (pp. 201-222). Chichester, England: Jone Wiley & Sons.
Fonagy, P., & Bateman, A. W. (2006). Mechanisms of change in mentalisation-based therapy with BPD. Journal of Clinical Psychology, 62 (4), 411-430.
Fonagy, P., & Campbell, C. (2017). Mentalizing attachment and epistemic trust: how psychotherapy can promote resilience. Psychiatria Hungarica: A Magyar Pszichiatriai Tarsasag Tudomanyos Folyoirata, 32(3), 283-287.
Fonagy, P., & Luyten, P. (2009). A developmental, mentalization- based approach to the understanding and treatmentof borderline personality disorder. Development and Psychopathology, 21(4), 1355-1381.
Fonagy, P., Gergely, G., Jurist, E. L., & Target, M. (2002). Affect Regulation, Mentalization, and the Development of the Self. New York, NY: Other Press.
Fonagy, P., & Target, M. (1996). Playing with reality: I. Theory of mind and the normal development of psychic reality. International Journal of Psycho-Analysis, 77, 217-233.
Fonagy, P., & Target, M. (2002). Early intervention and the development of self-regulation. Psychoanalytic Inquiry: A Topical Journal for Mental Health Professionals, 22(3), 307-335.
Ghanizadeh, A., Mohammadi, MR., Yazdanshenas, A. (2006). Psychometric properties of the Farsi translation of the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. BMC Psychiatry, 6: 10.
Gilmore, K. (2016). A psychoanalytic perspective on attention-deficit/hyperactivity disorder. Pennsylvania State Univ, 1260-1293.
Gjervan, B., Torgersen, T., Rusmussen, k., & Nordahl, H. G. (2012) ADHD symptoms are defferentially related to specific aspects of quality of life. J. Of Atten. Disorders, 18(7), 1-9.
Karterud S, & Bateman A. (2011). Manual for mentalization based psycho educational group therapy (MBT-I). Oslo: Gyldendal Akademisk.
Keaveny, E., & Midgley, N., Asen, E., Bevington, D., Fearon, P., Fonagy, P., … Wood, S. (2012). Minding the family mind: The development and initial evaluation of mentalization based treatment for families. In N. Midgley & I. Vrouva (Eds.), minding the child: Mentalization-based interventions with children, young people and their families (pp. 98-112). London, England: Routledge.
Meppelink, R., Bruin, E. I., & Bögels, S. M. (2016). Meditation or Medication? Mindfulness training versus medication in the treatment of childhood ADHD: a randomized controlled trial. BMC Psychiatry, 16, 267.
Midgley, N., Ensink, K., Lindqvist, K., Malberg, N., & Muller, N. (2017). Mentalization-based treatment for children: A time-limited approach. Washington, DC: American Psychological Association.
Mohammedian, H., Akbari, H., Gilasi, H. R., Gharlipour, A., Moazemi Goudarzi, A., Aghajani, M., Monsef A. M., Tahvilian, H., & Azar-Abdar, A. (2014). Validation of Pediatric Quality of Life Questionnaire (PedsQL) in Kashan city. Scientific Journal of Ilam University of Medical Sciences, 22 (3), 10-18.
Stavrou, P. D. (2019). Outcomes of psychodynamic psychotherapy with incorporated mentlization-focused approaches for children with ADHD and mentalization impairment. EC Psychology and Psychiatry, 8 (11), 155-179.
Varni, J. W., Seid, M., & Kurtin, P. S. (2001). PedsQL™ 4.0: Reliability and validity of the Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales in healthy and patient populations. Medical care, 39(8), 800-812.
Xue, J., Zhang, Y., & Huang, Y. (2019). A meta- analytic investigation of the impact of mindfulness-based interventions on ADHD symptoms. Medicine, 98:23.
Yang, H. S., Tai, Y. M., Yang, L. K., Gau, S. F. S. (2013). Prediction of childhood ADHD symptoms to quality of life in young adults: adult ADHD and anxiety/depression as mediators. Res Dev Disabil, 34, 3168-3181.
_||_