بررسی اثربخشی درمان گروهی شناختی- رفتاری در میزان اضطراب و خستگی‌پذیریِ دختران مبتلا به اختلال اضطراب فراگیر
محورهای موضوعی : تربیتیزهرا غمخوارفرد 1 , مریم بختیاری 2 , زهرا حاجی حیدری 3 , مینو پوراوری 4 , کارینه طهماسیان 5
1 - کاندید دکترای روان‌شناسی بالینی، دانشگاه علوم بهزیستی و توانبخشی، تهران، ایران.
2 - دانشیار گروه روان‌شناسی بالینی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.
3 - کارشناس ارشد مشاوره خانواده، دانشگاه علامه طباطبائی، تهران، ایران.
4 - کاندید دکتری مشاوره، دانشگاه الزهرا، تهران، ایران.
5 - دکترای روان‌شناسی بالینی، دانشگاه علوم بهزیستی و توانبخشی، تهران، ایران.
کلید واژه: دختران راهنمایی, درمان شناختی رفتاری, خستگی‌پذیری, اثربخشی, اختلال اضطراب فراگیر,
چکیده مقاله :
این پژوهش با هدف بررسی اثربخشی درمان گروهی شناختی رفتاری در میزان اضطراب و همچنین خستگی‌پذیری کودکان مبتلا به اختلال اضطراب فراگیر (GAD) انجام شد. جامعه مورد نظر شامل تمامی دختران 13- 11 ساله مبتلا به اختلال اضطراب فراگیر در شهر تهران بود. روش پژوهش شبه آزمایشی با طرح پیش‌آزمون پس‌آزمون دو گروهی با اندازه‌گیری مکرر بود. نمونة پژوهش شامل 32 نفر از دختران 13-11 ساله مبتلا به GAD بود که بر اساس ملاک‌های تشخیصی و آماری اختلالات روانی (DSM5) واجد ملاک‌های GAD باشند. افراد گروه نمونه به‌صورت در دسترس انتخاب و به‌صورت تصادفی در دو گروه آزمایش (16 نفر) و کنترل (16 نفر) جایگزین شدند. درمان شامل 18 جلسه 90 دقیقه‌ای بود که به‌صورت یک جلسه در هفته و بر مبنای درمان گروهی شناختی رفتاری بر روی گروه آزمایش انجام گرفت. در این پژوهش از پرسشنامه غربال‌گری اختلالات هیجانی مرتبط با اضطراب دوران کودکی (SCARED؛ بیرماهر و همکاران، 1997)، پرسشنامة تجدید نظر شدة اضطراب آشکار کودکان (RCMAS؛ رینولدز و ریچموند، 1978)، پرسشنامه میزان گرایش به خستگی (BPS؛ فارمر و ساندبرگ، 1986)، استفاده گردید. به‌منظور تجزیه‌وتحلیل داده‌ها از تحلیل واریانس یک راهه اندازه‌گیری مکرر استفاده شد. یافته‌های پژوهش نشان داد تغییرات معنی‌داری در اثر درمان شناختی رفتاری در میزان اضطرابِ افراد گروه آزمایش در مقایسه با گروه کنترل به وجود آمده است (05/0>p).
This study was carried out to investigate the effectiveness of group cognitive behavioral therapy in anxiety and boredom proneness in children who suffer from general anxiety disorder (GAD). The Statistical population included all of the girls who suffer GAD in Tehran (aged 11-13 years). The research method was two-group pretest-posttest design with repeated measure. The sample included 32 middle school girls who had major diagnosis of GAD based on DSM5. The samples were selected by available sampling and assigned to two groups (one experimental and one control group) by randomized allocation. The experimental group received group cognitive behavioral therapy in 18 sessions and one time in a week, with duration of 90 minutes. The scales were used in this study included of Screen for Child Anxiety Related Emotional Disorders (SCARED), Revised Children's Manifest Anxiety Scale (RCMAS), and Boredom Proneness Scale (BPS). One way ANOVA repeated measure was used for data analysis. The results of the study showed the effectiveness of group cognitive behavioral therapy on anxiety reduction (p<0/05).
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, text revision (5th ed.). Washington, DC: American Psychiatric Association.
Behra, E., DiMarco, I. D., Hekler, E. B., Mohlman, J. & Staples, A. M. (2009). Current theorerical models of generalized anxiety disorder (GAD): conceptual review and treatment implications. Journal of anxiety disorders, 23(8), 1011-1023.
Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., et al. (1997). The Screen for child anxiety related emotional disorders (SCARED): Scale construction and psychometric characteristics. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 545–553.
Breinholst, S., Esbjorn, B. H., Reinholdt-Dunne, M. L., & Stallard, P. (2012). CBT for the treatment of child anxiety disorders: A review of why parental involvement has not enhanced outcomes. Journal of Anxiety Disorders. 26, 416-424.
Carthy, T., Horesh, N., Apter, A., Edge, M. D., Gross, J. J. (2010). Emotional reactivity and cognitive regulation in anxious children. Behavior Research and Therapy, 48, 384–393.
Cepeda, C. (2010). Clinical manual for the psychiatric interview of children and adolescents. Washington, DC, American Psychiatric Association.
Dubi, K. Schneider, S. (2009). The Picture Anxiety Test (PAT): A new pictorial assessment of anxiety symptoms in young children. Journal of Anxiety Disorders, 23, 1148–1157.
Farmer, R., & Sundberg, N.D. (1986). Boredom proneness— The development and correlates of a new scale. Journal of Personality Assessment, 50(1), 4–17.
Flannery-Schroeder, E. C., & Kendall, P. C. (1996). Cognitive-behavioral therapy for anxious children: Therapist manual for group treatment, PA: Workbook Publishing.
Foa, E. B., Coles, M., & Huppert, J. D. (2010). Development and validation of a child version of the obsessive compulsive inventory. Behavior Therapy, 41, 121-132.
Ghamkhar Fard, Z., Schneider, S., Hudson, J. L., Habibi, M., Pooravari, M., & Haji Heidari, Z. (2014). Early maladaptive schemas as predictors of child anxiety: the role of child and mother schemas. Behavioral Research Center, 1(2).
Hill, C., Wait, P. & Creswell, C. (2016). Anxiety disorders in children and adolescent. Prediatrics and Child Health, 26(12), 548-553.
Hudson, J. L., & Schniering, C. A. (2015). Comparing outcomes for children with different anxiety disorders following cognitive behavioral therapy. Behavior Research and Therapy, 72, 30–37.
Osmanegaoglu, N., Creswell, C& Dodd, H. F. (2018) Intolerance and uncertainty, anxiety, and worry in children and adolescent: A meta-analysis. Journal of Affective Disorders, 225, 80-90.
Kendall, P. C., Compton, S. N. Walkup, J.T., Birmaher, B., Albano, A. N., Sherrill, J., Ginsburg, G., Rynn, M., McCracken, J., Gosch, E., Keeton, C., Bergman, L., Sakolskym, D., Suveg, C., Iyengar, S., March, J., & Piacentini, J. (2010). Clinical characteristics of anxiety disordered youth. Journal of Anxiety Disorders, 24, 360–365
Kendall, P. C., & Hedtke, K. A. (2006a). Cognitive-behavioral therapy for anxious children: Therapist manual, 3rd ed. Ardmore, PA: Workbook Publishing.
Kendall, P. C., & Hedtke, K. A. (2006b). The Coping Cat Workbook, 2nd ed. Ardmore, PA: Workbook Publishing.
Klein, R. G. (2009). Anxiety disorders. Journal of Child Psychology and Psychiatry, 50(1-2): 153-162.
Kodal, A., Fjermestad, K., Bjelland, I., Gjestad, R., Ost, L., Bjaastad, J. F., Haujlan, B. S.M., Havic, O. E., Heiervanf, E. & Wergeland, G. J. (2018). Long-term effectiveness of cognitive behavioral therapy for youth with anxiety disorders. Journal of Anxiety Disorders, 53, 58-67.
Krystal, A. D. (2012). Psychiatric Disorders and Sleep. Neurologic clinics, 30(4): 1389-1413.
LePera, N. (2011). Relationships Between Boredom Proneness, Mindfulness, Anxiety, Depression, and Substance Use. The New School for Social Research, 8(2), 15-25.
Muris, P., Mannens, J., Peters, L., & Meesters, C. (2017). The youth anxiety measure for DSM-5 (YAM-5): Correlations with anxiety, fear, and depression scales in non-clinical children, Journal of Anxiety Disorders, 53, 72-78.
Mychailyszyn, M. P., Mendez, J. L., & Kendall, P. C. (2011). Anxiety disorders and school functioning in youth: Comparisons by diagnosis and comorbidity. School Psychology Review.
Pieterse, A. L., Todd. N. R., Neville, H. A., & Carter. R. T. (2012). Received racism and mental health among Black American adults: a meta-analytic review. Journal of counselling psychology, 59(1): 1-9.
Reynolds, C. R., & Richmond, B. O. (1978). What I think and feel: A revised measure of child’s manifest anxiety. Journal of Abnormal Child Psychology, 6, 271–280.
Runyon, K. Chesnut, S. R., & Burley, H. (2018). Screening for childhood anxiety: A meta-analysis of the screen for child anxiety related emotional disorders. Journal of affective Disorders, 240, 220–229.
Sadock, B. J., Sadock, V. A, & Ruiz (2015). Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry (11th Eds). New York: Walters Kulwer.
Simpson, D., Suarez, L, Connolly, S. (2012). Treatment and outcomes for anxiety disorders among children and adolescents: a review of coping strategies and parental behaviors. Current psychiatry, 14(2): 87-95.
Struijs, S. Y., Lamers, F., Spinhoven, Ph., Does, W., & Penninx, B. W.J.H. (2018). The predictive specificity of psychological vulnerability markers for the course of affective disorders. Journal of Psychiatric Research, 103, 10-17
Todman, M. (2007, July). Psychopathology and boredom: A neglected association. Paper presented at the International Conference on Psychology, Athens, Greece.
Vodanovich, S. J. (2003). Psychometric measures of boredom: a review of the literature. The Journal of Psychology, 137(6), 569-595.
Waters, A. M., Mogg, K., Bradley, B. P. (2012). Direction of threat attention bias predicts treatment outcome in anxious children receiving cognitive-behavioral therapy. Behavior Research and Therapy, 50(6):428-34.
Whiteside, S. P., & Brown, A. M. (2008). Exploring the utility of the Spence Children’s Anxiety Scales parent- and child-report forms in a North American sample. Journal of Anxiety Disorders, 22, 1440–1446.
Witkiewitz, K., Bowen, S., Douglas, H., & Hsu, Sh. H. (2013). Mindfulness-Based Relapse Prevention for Substance Craving. Addictive Behaviors, 38(2), 1563-1571.
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