اثربخشی مداخلة مبتنی بر ذهن‌آگاهی بر نشانه‌های نارسایی توجه/ فزون‌کنشی زیر آستانة تشخیص و مشکلات برونی‌سازی نوجوانان

محورهای موضوعی : روان‌شناسی بالینی

اشکان ناصح ¹ (دانشجوی دکتری روان‌شناسی بالینی دانشگاه شاهد)
لیلا حیدری نسب ² (استادیار دانشگاه شاهد)
محمدرضا شعیری ³ (دانشیار دانشگاه شاهد)

تاریخ دریافت : 1397/01/18 تاریخ پذیرش : 1397/01/18 تاریخ انتشار : 1396/10/01

کلید واژه: مشکلات برونی‌سازی‌, نوجوانان, مداخلة مبتنی بر ذهن‌آگاهی, نشانه‌های نارسایی توجه/ فزون‌کنشی زیر آستانة تشخیص,

چکیده مقاله :

این پژوهش اثربخشی مداخلة مبتنی بر ذهن‌آگاهی را بر کاهش نشانه‌های نارسایی توجه/ فزون‌کنشی زیر آستانة تشخیص و مشکلات برونی‌سازی‌ نوجوانان بررسی کرد. فهرست رفتاری کودک و فرم خودگزارش‌دهی نوجوانان نظام سنجش مبتنی بر تجربة آشنباخ در نمونة 253 نفری از نوجوانان و مادران آن‌ها اجرا شد. 24 نفر از نوجوانانی که بنابر نتایج فهرست رفتاری کودکان، نمره‌های مرزی در زیرمقیاس مشکلات توجه و نمره‌های بالا در مشکلات برونی‌سازی‌ داشتند و نشانه‌های آن‌ها در فرم خودگزارش‌دهی نوجوانان نیز تأیید شده بود، به‌تصادف در دو گروه آزمایش (12 نفر) و کنترل (12 نفر) قرار گرفتند. گروه آزمایش 8 جلسة مداخلة مبتنی بر ذهن‌آگاهی در مدت 8 هفته دریافت کرد. گروه کنترل در این بازه زمانی هیچ مداخله‌ای دریافت نکرد. داده‌های کمّی با استفاده از آزمون تحلیل واریانس چندمتغیری تحلیل شد و یافته‌ها نشان داد که پس از مداخله نشانه‌های نارسایی توجه/ فزون‌کنشی و مشکلات برونی‌سازی‌ در نوجوانان گروه آزمایش در مقایسه با نوجوانان گروه کنترل کاهش معنادار داشته است. یافته‌های این پژوهش کاربرد بالینی در پیشگیری و درمانگری نشانه‌های نارسایی توجه/ فزون‌کنشی و مشکلات برونی‌سازی نوجوانان در فضاهای بالینی و مدارس دارد.

چکیده انگلیسی:

the present study examined the efficacy of mindfulness based intervention in reducing subclinical attention deficit/hyperactivity symptoms and externalizing problems in adolescents. The Child Behavior Checklist (CBCL) and the Youth Self–report (YSR) of Achenbach System of Empirically Based Assessment (ASEBA) were administered to a sample of 253 adolescents and their mothers. Twenty four of adolescents who scored borderline in attention problem subscale, scored high in externalizing problems scale of CBCL, and their scores had been confirmed by the Youth Self-report were selected and randomly assigned into either experimental (n=12) or control (n=12) groups. The experimental group received 8 mindfulness based intervention sessions for 8 weeks. The data were analyzed using multivariate analysis of variance (MANOVA). The results indicated that attention deficit/ hyperactivity symptoms and externalizing problems reduced significantly in experimental group compared to control group. The findings of this study may be of practical importance for prevention and treatment of adolescents' attention deficit/ hyperactivity symptoms and externalizing problems in clinical settings and schools.

منابع و مأخذ:

کیانی، ب. و هادیان‌فر، ح. (1395). تأثیر درمان مبتنی بر آموزش مراقبة ذهن‌آگاهی بر بی‌نظمی هیجانی در نوجوانان ADHD غیربالینی. مجلة روان‌شناسی مدرسه، 5 (1)، 118-138.

مینایی، ا. (1384). کتابچه راهنمای فرم‌های سن مدرسه نظام سنجش مبتنی بر تجربة آشنباخ. تهران: پژوهشگاه مطالعات آموزش و پرورش.

نریمانی، م.، بگیان‌کوله‌مرز، م.، احدی، ب. و ابوالقاسمی، ع. (1393). اثربخشی آموزش رفتاردرمانی دیالکتیکی گروهی بر کاهش نشانه‌های اختلال نقص توجه/ بیش‌فعالی و بهبود کیفیت زندگی دانش‌آموزان. مجلة روان‌شناسی بالینی، 1(21)، 39-51.

 

Abdolahzade, Z., Mashhadi, A., & Tabibi, Z. (2017). Effectiveness of mindfulness-based therapy on the rate of symptoms and mindfulness in adolescents with attention-deficit hyperactivity disorder. Journal of Fundamentals of Mental Health, 19(1), 30-37.

Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school–age forms and profiles. Burlington: University of Vermont.

American Academy of Pediatrics. (2011). ADHD: clin­ical practice guideline for the diagnosis, evalua­tion, and treatment of ADHD in children and ado­lescents. Pediatrics, 128(5), 1-16.

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th Ed.). Washington, DC: Author.

Balazs, J., & Kereszteny, A. (2014). Subthreshold attention deficit hyperactivity in children and adolescents: systematic review. European Child & Adolescent Psychiatry, 23, 393-408.

Barkley, R. A. (2003). Attention-Deficit/ Hyperactivity Disorder. In E. J. Mash, R. A. Barkley (Eds.), Child Psychopathology (pp. 75-143). New York: Guilford Press.

Barkley, R. A. (2010). Deficient emotional self-regula­tion is a core component of ADHD. Journal of ADHD and Related Disorders, 1, 5-37.

Bear, R. (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125-143.

Bogels, S. M., Hoogstad, B., Van Dun, L., Schutter, S. D., & Restifo, K. (2008). Mindfulness training for ado­lescents with externalizing disorders and their par­ents. Behavioural and Cognitive Psychotherapy, 36, 193-209.

Boonstra, A. M., Oosterlaan, J., Sergeant, J. A., & Bui­telaar, J. K. (2005). Executive functioning in adult ADHD: A meta-analytic review. Psychological Medicine, 35(8), 1097-1108.

Broderick, P. C., & Jennings, P. A. (2012). Mindfulness for adolescents: A promising approach to support­ing emotion regulation and preventing risky behavior. New Directions for Youth Development, 136, 111-126.

Broderick, P. C., & Metz, S. (2009). Learning to BREATHE: A pilot trial of a mindfulness curric­ulum for adolescents. Advances in School Mental Health Promotion, 2(1), 35-46.

Bussing, R., Porter, P., Zima, B. T., Mason, D., Garvan, C., & Reid R. (2012). Academic outcome trajec­tories of students with ADHD: does exceptional education status matter? Journal of Emotional and Behavioral Disorders. 20, 131-143.

Chambers, R., Gullone, E., & Allen, N. B. (2009). Mindful emotion regulation: An integrative review. Clinical Psychology Review, 29, 560-572.

Chiesa, A., Calati, R., & Serretti, A. (2011). Does mind­fulness training improve cognitive abilities? A systematic review of neuropsychological findings. Clinical Psychology Review, 31(3), 449-464.

Cho, S. C., Kim, H. W., Kim, B. N., Shin, M. S., Yoo, H. J., Kim, J. W., Bhang, S. Y., & Cho, I. H. (2011). Are teacher ratings and parent ratings dif­ferently associated with children’s intelligence and cognitive performance? Psychiatry Investiga­tion, 8, 15-21.

Christoff, K., Gordon, A. M., Smallwood, J., Smith, R., & Schooler, J. W. (2009). Experience sampling during fMRI. Proceedings of the National Acad­emy of Science of the United States of America, 106, 8719-8742.

Coholic, D. (2011). Exploring the feasibility and bene­fits of arts-based mindfulness based practices with young people in need: Aiming to improve aspects of self-awareness and resilience. Child Youth Care Forum, 40, 303-317.

Emavardhana, T. (1997). Changes in self-concept, ego defense mechanism and religiosity following seven-day Vipassana meditation retreats. Journal for the Scientific Study of Religion, 36, 194-206.

Fergusson, D. M., Boden J. M., & Horwood, L. J. (2010). Classification of behavior disorders in adolescence: scaling methods, predictive validity, and gender differences. Journal of Abnormal Psy­chology, 119, 699-712.

Fernandes, S. S., Machado, M., & Machado, F. (2015). Parental acceptance, parental stress, and quality of life: A study with parents of ADHD children. Italian Journal of Special Education for Inclusion, 3(1), 71-83.

Ford, T., Goodman, R., & Meltzer, H. (2003). The British child and adolescent mental health survey 1999: the prevalence of DSM-IV disorders. Jour­nal of the American Academy of Child and Ado­lescent Psychiatry, 42, 1203-1211.

Gratz, K. L., & Tull, M. T. (2010). Emotion regula­tion as a mechanism of change in acceptance- and mindfulness-based treatments. InRuth A. Baer (Ed.), Assessing mindfulness and ac­ceptance processes in clients: Illuminating the theory and practice of change. (pp. 107–133). Oakland, CA: Context Press/ New Harbinger Publications.

Haydicky, J., Shecter, C., Wiener, J., & Ducharme, J. M. (2015). Evaluation of MBCT for adolescents with ADHD and their parents: Impact on individ­ual and family functioning. Journal of Child & Family Studies, 24, 76-94.

Hoza, B., Murray-close, d., Arnold, L. E., Hinshaw, S. P., Hechtman, L., & The MTA Cooperative Group (2010). Time-dependent changes in positively biased self-perceptions of children with ADHD. A developmental psychopathology perspective. De­velopment and Psychopathology, 22, 375-390.

Jha, A. P., Krompinger, J., & Baime, M. J. (2007). Mindfulness training modifies subsystems of attention. Cognitive, Affective, and Behavioral Neuroscience, 7(2), 109-19.

Keil, V., & Price, J. M. (2006). Externalizing behavior disorders in child welfare setting. Children and Youth Services Review, 28(7), 761–779.

Keng, S. L., Smoski, M. J., & Robins, C. J. (2011). Effects of mindfulness on psychological health: A review of empirical studies. Clinical Psychology Review, 31(6), 1041-1056.

Krishnakumar, S., & Robinson, M. D. (2015). Main­taining an even keel: an affect-mediated model of mindfulness and hostile work behavior. Emotion, 15, 579-589.

Langberg, J. M., Epstein, J. N., Simon, J. O., Loren, R. E. A., Arnold, L. E., Hechtman, L., Hinshaw, S. P., Hoza, B., Jensen, P. S. & Pelham, W. E. (2010). Parent agreement on ratings of children’s attention-deficit/ hyperactivity disorder and broadband exter­nalizing behaviors. Journal of Emotional and Behavioral Disorders, 18, 41-50.

Malmberg, K., Edbom, T., Wargelius, H. L., & Larsson, J. O. (2011). Psychiatric problems associated with subthreshold ADHD and disruptive behaviour diagnoses in teenagers. Acta Paediatrica, 100, 1468-1475.

Moyer, C. A., Donnelly, M. P., Anderson, J. C., Valek, K. C., Huckaby, S. J., Wiederholt, D. A., & Rice, B. L. (2011). Frontal electroencephalographic asymmetry associated with positive emotion is produced by very brief meditation training. Psy­chology Science, 22(10), 1277-1279.

Pelham W. E., & Fabiano, G. A. (2008). Evidence-based psychosocial treatments for attention defi­cit/ hyperactivity disorder. Journal of Clinical Child & Adolescent Psychology, 37, 184-212.

Peters, J. R., Smart, L. M., Eisenlohr-Moul, T. A., Geiger, P. J., Smith, G. T., & Baer, R. A. (2015). Anger rumination as a mediator of the relationship between mindfulness and aggression: the utility of a multidimensional mindfulness model. Journal of Clinical Psychology, 71, 871-884.

Rielly, N. E., Craig, W. M., & Parker, K. C. (2006). Peer and parenting characteristics of boys and girls with subclinical attention problems. Journal of Attention Disorders, 9, 598–606.

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Synop­sis of Psychiatry (11th Ed., Vol. 2). New York: Wolters Kluwer.

Semple, R. J., Lee, J., Rosa, D., & Miller, L. F. (2010). A randomized trial of mindfulness–based cogni­tive therapy for children: Promoting mindful at­tention to enhance social-emotional resiliency in children. Journal of Child and Family Studies, 19, 218-229.

Shankman, S. A., Lewinsohn, P. M., Klein, D. N., Small, J. W., Seeley, J. R., & Altman, S. E. (2009). Subthreshold conditions as precursors for full syn­drome disorders: a 15-year longitudinal study of multiple diagnostic classes. Journal of Child Psy­chology & Psychiatry, 50, 1485-1494.

Sharma, M. K., Sharma, M. P., & Marimuthu, P. (2016). Mindfulness-based program for manage­ment of aggression among youth. Indian Journal of Psychological Medicine, 38(3), 213-216.

Shultz, B. K., & Evans, S. W. (2015). A practical guide to implementing school–based interventions for adolescents with ADHD. Switzerland: Springer.

Sibley, M. H., Kuriyan, A. B., Evans, S. W., Waxmon­sky, J. G., & Smith, B. H. (2014). Pharmacologi­cal and psychosocial treatments for adolescents with ADHD: An updated systematic review of the literature. Clinical Psychology Review, 34, 218-232.

Sonuga-Barke, E. J. S., Brandeis, D., Cortese, S., Daley, D., Ferrin, M., Holtmann, M., & Sergeant, J. (2013). Nonpharmacological interventions for ADHD: Systematic review and meta-analyses of randomized controlled trials of dietary and psy­chological treatments. American Journal of Psy­chiatry, 170, 275-289.

Steeger, C. M., Gondoli, D. M., Gibson, B. S., & Morrissey, R. A. (2015). Combined cognitive and parent training interventions for adolescents with ADHD and their mothers: A randomized con­trolled trial. Child Neuropsychology, 22, 394-419.

Tang, Y. Y., Ma, Y., Wang, J., Fan, Y., Feng, S., Lu, Q., & Posner, M. I. (2007). Short-term meditation training improves attention and self-regulation. proceedings of the National academy of sciences of the United States of America, 104(43), 17152-17156.

Teper, R., & Inzlicht, M. (2013). Meditation, mindful­ness and executive control. Social cognitive and Affective Neuroscience, 8(1), 85-92.

Van de Weijer-Bergsma, E., Formsma, A. R., Bruin, E. I. D., & Bogels, S. M. (2012). The effectiveness of mindfulness training on behavioral Problems and attentional functioning in adolescents with ADHD. Journal of Child & Family Studies, 21, 775-787.

 Van den Hoofdakker, B. J., Nauta, M. H., Van den Veen-Mulders, L. J., Sytema, S., Emmelkamp, P. M. G., Minderaa, R. B., et al. (2010). Behavioral parent training as an adjunct to routine care in chil­dren with attention deficit/ hyperactivity disorder: moderators of treatment response. Journal of Pediatric Psychology, 35, 317-326.

Van der Oord, S., Bogels, S. M., & Peijnenburg, D. (2012). The effectiveness of mindfulness training for children with ADHD and mindful parenting for their parents. Journal of Child & Family Stud­ies, 21,139-147.

Young, S., & Amarasinghe, M. (2010). Practitioner re­view: Non–pharmacological treatments for ADHD: A lifespan approach. Journal of Child Psychology and Psychiatry, 51(2), 116–133.

Zare, H., Khaleghi Delavar, F., Zare, M., & Shayeghian, Z. (2016). Effect of mindfulness in reducing aggression and impulsivity in adoles­cents. Journal of Research and Health, 6(1), 113-121.

Zeidan, F., Johnson, S. K., Diamond, B. J., David, Z., & Goolkasian, P. (2010). Mindfulness meditation improves cognition: Evidence of brief mental training. Consciousness and Cognition, 19(2), 597-605.

Zylowska, L. (2012). The mindfulness prescription for adult ADHD. Boston: TRUMPETER.

Zylowska, L., Ackerman, D. L., Yang, M. H., Futrell, J, L., Horton, N. L., Hale, T. S., Pataki, C., & Smalley, S. L. (2008). Mindfulness meditation training in adults and adolescents with ADHD: A feasibility study. Journal of Attention Disorders; 11(6), 737-746