مقایسه اثربخشی بازی‌درمانی مبتنی بر رویکرد گشتالت وآموزش مدیریت رفتاری والدین (PMT) بر سرعت پردازش و حافظه فعال کودکان با نشانه‌های نارسایی توجه- بیش‌فعالی (ADHD)

محورهای موضوعی : تکتونواستراتیگرافی

منیره شهراد ¹ (دانشجوی دکترای روانشناسی تربیتی، گروه روانشناسی، واحد تبریز، دانشگاه آزاد اسلامی، تبریز، ایران)
سید داوود حسینی نسب ² (استاد گروه روان‌شناسی، واحد تبریز، دانشگاه آزاد اسلامی، تبریز، ایران)
مرضیه علیوندی وفا ³ (استادیار گروه روان‌شناسی، واحد تبریز، دانشگاه آزاد اسلامی، تبریز، ایران)

تاریخ دریافت : 1401/12/06 تاریخ پذیرش : 1402/01/26 تاریخ انتشار : 1402/02/01

کلید واژه: حافظه فعال, سرعت پردازش, بازی درمانی مبتنی بر رویکرد گشتالت, مدیریت رفتاری والدین, نارسایی توجه-بیش فعالی,

چکیده مقاله :

مقدمه:
پژوهش حاضر با هدف مقایسه اثربخشی بازی‌درمانی مبتنی بر رویکرد گشتالت وآموزش مدیریت رفتاری والدین بر سرعت پردازش و حافظه فعال کودکان با نشانه‌های نارسایی توجه- بیش‌فعالی انجام شد.
مواد و روش‌ها:
این پژوهش از نظر هدف از نوع تحقیقات کاربردی و از نظر ماهیت داده‌ها از نوع تحقیق کمی و از نظر اجرا، تحقیق نیمه‌تجربی با طرح پیش آزمون-پس آزمون و گروه کنترل بود. جامعه آماری را کلیه کودکان ۷ الی ۱۲ سال که به دلیل داشتن نشانه‌های نقص توجه/بیش فعالی، در نیمه دوم سال 1400 و سه ماهه اول 1401 به مراکز مشاوره و روانشناسی و درمانگاه بیمارستان رازی شهر تبریز مراجعه کردند، تشکیل می‌دهد. برای انتخاب نمونه‌ی تحقیق، تعداد 16نفر برای هر گروه به شکل نمونه‌گیری هدفمند انتخاب‌شده و به شکل گمارش تصادفی در دو گروه آزمایش و یک گروه کنترل (48نفر) قرار داده شدند. ابزارهای مورداستفاده پژوهش دو مقیاس سرعت پردازش و حافظه فعال وکسلر4 بود.
یافته‌ها:
براساس نتایج تحلیل کوواریانس چندمتغیره، تفاوت معنی‌داری در میزان اثربخشی دو روش مداخله بازی‌درمانی و مدیریت رفتاری مشاهده شد (05/0>p)؛ بررسی اندازه اثر نشان داد که بیشترین تفاوت در نمره کل سرعت پردازش با ضریب 478/0 مشاهده شد.
نتیجه‌گیری:
در کل، چنین استنباط می‌شود که مداخله بازی‌درمانی مبتنی بر رویکرد گشتالت پتانسیل اثربخشی در جهت افزایش ظرفیت حافظه فعال و سرعت پردازش را دارد و متخصصان آموزشی و درمانی می‌توانند جهت کنترل بیش‌فعالی کودکان، از این مداخله استفاده نمایند.

چکیده انگلیسی:

Introduction:
The present study was conducted with the aim of comparing the effectiveness of play therapy based on the Gestalt approach and parent behavioral management training on processing speed and working memory of children with signs of attention deficit hyperactivity disorder.
Materials and Methods:
This research was applied research in terms of purpose, quantitative research in terms of the nature of the data, and semi-experimental research with a pre-test-post-test design and a control group in terms of implementation. The statistical population consisted of all children aged 7 to 12 years who referred to counseling and psychology centers and clinics of Razi Hospital in Tabriz in the second half of 2022 and the first quarter of 2023 due to symptoms of attention deficit/hyperactivity disorder. To select the research sample, 16 people were selected for each group in the form of purposeful sampling and randomly assigned to two experimental groups and one control group (48 people). The tools used in the research were two Wechsler4 processing speed and working memory scales.
Findings:
Based on the results of multivariate covariance analysis, the effect size values showed that the biggest difference was in the total score of processing speed with a coefficient of 0.478. was observed. The comparison of the interventions showed that the effectiveness of the Gestalt-based play therapy intervention on processing speed and working memory was significantly higher than the parent behavior management training intervention (p<0.05).

منابع و مأخذ:

Refrences

1. Hallahan DP, Kauffman JM, Pullen PC. Exceptional learners: An introduction to special education, 13th Edition. Upper Saddle River, NJ: Pearson; 2015.

2. Turgay A, Ginsberg L, Sarkis E, Jain R, Adeyi B, Gao J, Richards C. "Executive function deficits in children with attention-deficit/ hyperactivity disorder and improvement with lisdexamfetamine dimesylate in an open-label study". Journal of child and adolescent psychopharmacology;2010: 20(6), 503- 511. doi:10.1089/cap.2009.0110

3. Chuang YC, Wang CY, Huang WL. et al. Two meta-analyses of the association between atopic diseases and core symptoms of attention deficit hyperactivity disorder. Sci Rep 12, 3377: (2022). https://doi.org/10.1038/s41598-022-07232-1

4. Willcut E. The Prevalence of DSM-IV Attention-Deficit/ Hyperactivity Disorder: A MetaAnalytic Review. Neurotherapeutics; (2012):  9(2):490–499. doi: 10.1007/s13311-012-0135-8

5. Swanson HL, Harris KR. Handbook of learning disabilities: Guilford Press: 2013.

6. Adler LA. Monitoring adults with ADHD: A focus on executive andbehavioral function. J Clin Psychiatry; 2010, 71(8), e18. doi: 10.4088/JCP.9066tx3c

7. Marchman VA, Fernald A. Speed of word recognition and vocabulary knowledge in infancy predict cognitive and language outcomes in later childhood. Developmental Science; 2018, 11(3), F9–16. doi:10.1111/j.1467-7687.(2018).00671

8. Liaqat R. Bagheri Karimi A. Bayat S, Meli M. the effectiveness of sensory integration therapy on working memory performance and processing speed of children with attention deficit hyperactivity disorder, the first international conference on culture, psychopathology and Education, Tehran; 2019: https://civilica.com/doc/649288

9. Brown T, Chen J, Robertson B. Improved Executive Function in Adults Diagnosed With Attention-Deficit/ Hyperactivity Disorder as Measured by the Brown Attention-Deficit Disorder Scale Following Treatment With SHP465 Mixed Amphetamine Salts Extended-Release: Post Hoc Analyses From 2 Randomized, Placebo-Controlled Studies. Journal of Attention Disorders; 2022: Vol. 26(2) 256–266. https://doi.org/10.1177/1087054720961819

10. Baltruschat L. Addressing working memory in children with autism through behavioral intervention. Research in Autism Spectrum Disorders; 2011: 5(1), 267-276. doi:10.1016/j.rasd.2010.04.008

11. Klingberg T. Training and plasticity of working memory. Trends Cogn Sci. 2010 Jul; 14(7):317-24. doi: 10.1016/j.tics.2010.05.002.

12. horasani Zadeh A, Bahrami H, Ahadi H. Effectiveness of working memory training on recovery from behavioral symptoms (attention-deficit and impulsivity) of children with attention-deficit/hyperactivity psychologicalscience;2018; (69)17; 537-544. URL: http://psychologicalscience.ir/article-1-258-en.html

13. Schneider WX, Einhäuser W, Horstmann G. Introduction to competitive visual processing across space and time: attention, memory, and prediction. Ann N Y Acad Sci. 2015;1339:v-viii. doi: 10.1111/nyas.12744. PMID: 25809212.

14. NejatiV, Derakhshan Z, Mohtasham A.The effect of comprehensive working memory training on executive functions and behavioral symptoms in children with attention deficit-hyperactivity disorder (ADHD). Asian Journal of Psychiatry;Volume 81.2023;ISSN 1876-2018. https://doi.org/10.1016/j.ajp.2023.103469.

15. Moses M, Tiego J, Demontis D. Working memory and reaction time variability mediate the relationship between polygenic risk and ADHD traits in a general population sample. Mol Psychiatry 27, 5028–5037 (2022). https://doi.org/10.1038/s41380-022-01775-5

16. Cai B, Cai S, He H, He L, Chen Y, Wang A. Multisensory Enhancement of Cognitive Control over Working Memory Capture of Attention in Children with ADHD. Brain Sciences. 2023; 13(1):66. https://doi.org/10.3390/brainsci13010066

17. Ortega R, López V, Carrasco X. Neurocognitive mechanisms underlying working memory encoding and retrieval in Attention-Deficit/Hyperactivity Disorder. Sci Rep 10, 7771 (2020). https://doi.org/10.1038/s41598-020-64678-x

18. Wong TY, Chang YT, Wang MY, Chang YH. The effectiveness of child-centered play therapy for executive functions in children with attention-deficit/hyperactivity disorder. Clin Child Psychol Psychiatry. 2022 Sep 20:13591045221128399. doi: 10.1177/13591045221128399. Epub ahead of print. PMID: 36125333.

19. Rezaee Rezvan S, Kareshki H, Pakdaman M. The Effectiveness of Play Therapy based on Cognitive - Behavioral Therapy on Social Adjustment of preschool children. Pajouhan Sci J 2022; 20 (1): 33-40
URL: http://psj.umsha.ac.ir/article-1-901-en.html

20. Khodabakhshi-Koolaee A, Akhalaghi-Yazdi R, Hojati Sayah M. Investigating Gestalt-based Play Therapy on Anxiety and Loneliness in Female Labour Children With Sexual Abuse: A Single Case Research Design (SCRD). JCCNC 2019; 5 (3): 147-156
URL: http://jccnc.iums.ac.ir/article-1-228-en.html

21. Raffagnino R. Gestalt Therapy Effectiveness: A Systematic Review of Empirical Evidence. Open Journal of Social Sciences, 2019; 7, 66-83. doi: 10.4236/jss.2019.76005

22. Vasconcelos A, Monsores J, Almeida T. et al. Applying Gestalt approach as a method for teaching computer science practice in the classroom: A case study in primary schools in Brazil. Educ Inf Technol (2022). https://doi.org/10.1007/s10639-022-11278-z

23. Monsores J, Almeida TRP, Toledo Quadros LC, Toledo Quadros JR. "Technology and Gestaltism: A Robotic-Based Learning Aid Tool," in IEEE Latin America Transactions,2020: vol. 18, no. 08, pp. 1441-1447. doi: 10.1109/TLA.2020.9111680.

24. Mohammadi S, Madani Y, Ajeya J. The effectiveness of play therapy based on Gestalt approach on anxiety and aggression of children with attention deficit/hyperactivity disorder. 2015. Master's thesis, University of Tehran

25. Mallahi K, ghodrati S, vatankhah H. Effectiveness of Gestalt Group Play Therapy to Aggression and Social skills of Children Sexual Abused in the Child labor's Group. JPEN 2019; 6 (1):54-63
URL: http://jpen.ir/article-1-397-fa.html

26. Sohrabi N. Comparing the effectiveness of story therapy, play therapy, and flower therapy in reducing separation anxiety in Shiraz children. 2018. Master's thesis, Islamic Azad University, Marvdasht Branch, Faculty of Educational Sciences and Psychology

27. Asjad AT, Iqbal N, Masroor U. Effectiveness of play therapy in enhancing social skills in intellectually disabled children. Rawal Med J. 2017; 3:42. : https://www.researchgate.net/publication/318760596

28. Stulmaker HL, Ray, DC. Child-centered play therapy with young children who are anxious: A controlled trial. Children and Youth Services Review, 2015; 57, 127-133.  Doi: 10.1016/J.CHILDYOUTH.2015.08.005

29. Davidson B, Satchi NS, Venkatesan L. Effectiveness of Play Therapy upon Anxiety among Hospitalised Children. Int J Adv Res, Ideas Innov Technol. 2017; 3(5):441-4.  www.IJARIIT.com

30. Wilkes-Gillan S, Bundy A, Cordier R, Lincoln M. Evaluation of a pilot parent-delivered play-based intervention for children with attention deficit hyperactivity disorder. Am J Occup Ther. 2014 Nov-Dec; 68(6):700-9. doi: 10.5014/ajot.2014.012450. PMID: 25397765.

31. Merrill BM, Monopoli WJ, Rejman E. Supporting Parents of Children with ADHD During COVID-19 School Closures: A Multiple-Baseline Trial of Behavioral Parent Training for Home Learning. School Mental Health .2023. https://doi.org/10.1007/s12310-023-09569-y

32. Kostyrka-Allchorne K, Ballard C, Byford S. Online Parent Training for The Initial Management of ADHD referrals (OPTIMA): the protocol for a randomised controlled trial of a digital parenting intervention implemented to support parents and children on a treatment waitlist. Trials 23, 1003; 2022. https://doi.org/10.1186/s13063-022-06952-z

33. Chronis-Tuscano A, O’Brien K, Danko C. Supporting caregivers of children with ADHD: An integrated parenting program: Therapist guide.2021. Oxford University Press

34. Rezaeefard A. The role of resilience and parenting styles in predicting parental stress of mothers of students with ADHD / Attention Deficit Hyperactivity Disorder. Journal of School Psychology, 2022; 10(4): 73-85. doi: 10.22098/jsp.2022.1454

35. Adlkhah S, Faramarzi S, Aghaei A. Comparing the effectiveness of parent-child communication package with parent-child interaction therapy on Affective/Behavioral Disorders and sustainability in children with Attention Deficit/Hyperactivity Disorder: case study. Empowering Exceptional Children, 2022; 13(2): 21-11. doi: 10.22034/ceciranj.2022.290145.1553

36. El-Deen GMS, Yousef AM, Mohamed AE. Socio-demographic and clinical correlates of parenting style among parents having ADHD children: a cross-section study. Middle East Curr Psychiatry, 2021.; 28, 72 . https://doi.org/10.1186/s43045-021-00151-3

37. hajbabay ravandi A, Tajali P, Ghanaripanah A, Shahriari Ahmadi M. The Effectiveness of a Positive Parenting Program on general Health and Marital Adjustment of Mothers of Children with ADHD. Counseling Culture and Psycotherapy, 2022; 13(51): 207-230. doi: 10.22054/qccpc.2022.65898.2881

38. Sheikhi Velashani Z, Javadzadeh Shahshahani F. Effectiveness of positive parenting program on attention deficiency and hyperactivity-impulsivity of children with Attention Deficit and Hyperactivity Disorder. Empowering Exceptional Children, 2020; 11(4): 25-36. doi: 10.22034/ceciranj.2020.222232.1353

39. Madani SS, Pournemat M. The effectiveness of positive parenting education for mothers of children with ADHD to reduce symptoms and children's academic achievement. JNIP, 2020; 6 (10): 1-12
URL: http://jnip.ir/article-1-378-fa.html

40. Maddah Z, Ghalenoee M, Mohtashami J, Pourhoseingholi MA, Esmaieli R, Naseri-Salahshour V. The effectiveness of PMT program on parent-child relationship in parents with ADHD children: A randomized trial. Med J Islam Repub Iran. 2018; 22;32:89. doi: 10.14196/mjiri.32.89.

41. Ghasemi N, Nori L, Abdi Zarrin S. The Effect of Parent Management Training (PMT) on the Reduction of Behavioral Symptoms in Children with Attention Deficit Hyperactivity Disorder (ADHD). J Child Ment Health 2019; 6 (2):1-12 URL: http://childmentalhealth.ir/article-1-464-en.html

42. Feizollahi J, Sadeghi M, Rezaei F. The Effect of Cognitive Behavioral Play Therapy and Its Integration with Parental Management Training on Symptoms of ADHD in 7-11 Year Old Children: A Quasi-Experimental Study. JRUMS, 2020; 19 (2) :155-172
URL: http://journal.rums.ac.ir/article-1-4970-en.html

43. Sadeghi A, Rabiee M, Abedi MR. Validation and reliability of the wechsler intelligence scale for children-IV.  2011; 7(28): 377-386. https://jip.stb.iau.ir/article_512280.html?lang=fa

44. Bloom R. Gestalt play therapy. Translated by Behnoud Bahmanesh and Parisa Ranjgar. Tehran: Danesh Arzin Jahan Publications. 2019.

45. Kazdien A. A practical guide to treating behavioral problems of children and adolescents "Parent Management Training". Translated by Faezeh Hazardastan; Ahmad Abedi and Noushin Mousavi Madani. Esfahan: Eshar Pisht. 2016.