تأثیر مداخله مبتنی بر ذهن آگاهی بر برنامه ریزی نوجوانان با علایم زیر آستانه تشخیص اختلال نقص توجه-بیش فعالی در آزمون برج لندن

محورهای موضوعی : روش ها و مدل های روانشناختی

بهناز کیانی ¹ , حبیب هادیان فرد ²

1 - دانشجوی کارشناسی ارشد دانشگاه شیراز.
2 - دانشیار، عضو هیئت علمی دانشگاه شیراز

تاریخ دریافت : 1395/05/05 تاریخ پذیرش : 1395/05/05 تاریخ انتشار : 1395/02/01

کلید واژه: برنامه ریزی, آموزش مراقبه ذهن آگاهی, اختلال نقص توجه-بیش فعالی, آزمون برج لندن,

چکیده مقاله :

    ذهن آگاهی از راه مکانیزم‌های فرا تشخیصی از جمله برنامه ریزی اثرگذار است. هدف این مطالعه بررسی تأثیر آموزش مراقبه ذهن آگاهی بر کارکرد برنامه ریزی نوجوانان دختر با علایم زیر آستانه تشخیص اختلال نقص توجه- بیش فعالی (ADHD) در آزمون برج لندن (TLT) بود. این پژوهش آزمایشی شامل طرح پیش آزمون-پس آزمون با گروه کنترل بود. جامعه آماری این پژوهش تمام نوجوانان دختر (13 تا 15 سال) با علایم زیر آستانه تشخیص ADHD بود که پس از غربالگری، 30 نفر به عنوان اعضای نمونه به گونه تصادفی در گروههای درمان (15 نفر) و کنترل (15 نفر) گمارده شدند. تمرین های مراقبه ذهن آگاهی در 8 جلسه 90 دقیقه‌ای در طول 8 هفته به گروه درمان ارایه شد. اما، گروه کنترل هیچ آموزشی دریافت نکرد. TLT پیش از مداخله و 1 ماه پس از اتمام مداخله در مورد هر دو گروه اجرا شد. نتایج تحلیل کوواریانس یک راهه نشان داد که کارکرد برنامه ریزی گروه درمان در TLT از نظر تعداد مسئله‌های حل شده صحیح و نمره صحیح درصدی در 1 ماه پس از پایان مداخله در مقایسه با گروه کنترل با اندازه اثر بالا، به گونه معناداری بهبود می‌یابد (05/0>P). اما، تفاوتی معنادار بین دو گروه در زمان برنامه ریزی و زمان کل در 1 ماه پس از مداخله وجود نداشت. در مجموع، آموزش مراقبه ذهن آگاهی کارکرد برنامه‌ریزی در TLT را در نوجوانان دختر ADHD زیر آستانه تشخیص بهبود می‌بخشد. تلاش‌های توسعه درمان باید جمعیت‌های بالینی را هدف قرار دهد که مشکلاتی در این مکانیزم‌ فرا تشخیصی نشان می‌دهند.

چکیده انگلیسی:

    Mindfulness is effective via transdiagnostic mechanisms such as planning. The aim of this study was to evaluate the impact of mindfulness meditation training on planning function of female adolescents with subthreshold symptoms of attention deficit-hyperactivity disorder (ADHD) in Tower of London Test (TLT). The current study was experimental including pretest-posttest design with control group. The statistical population of this study was all female adolescents (13 to 15 years) with subthreshold ADHD symptoms that after screening, 30 subjects as the members of sample were randomly assigned to the treatment group (n = 15) and control group (n = 15). Mindfulness meditation practices was presented to the treatment group in 8 sessions of 90 minutes during 8-week however, the control group received no training. TLT was performed on both groups before and 1 month after intervention. The results of one-way analysis of covariance showed that the planning function of the treatment group in TLT was improved significantly (p<0.05) in number of correctly solved items and percentage correct score in 1 month after intervention relative to the control group with large effect size however, there was no significant difference between two groups in planning time and total time in 1 month after intervention. Totally, mindfulness meditation training improves the planning function in TLT in subthreshold ADHD female adolescents. Treatment development efforts should target clinical populations that exhibit difficulties in this transdiagnostic mechanism.

منابع و مأخذ:

Asato, M. R., Sweeney, J. A., & Luna, B. (2006). Cognitive processes in the development of TOL performance. Neuropsychologia, 44(12), 2259-2269.

- Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. psychological bulletin, 121(1), 65-94.

-Bishop, S. R., Lau, M., Shapiro, S., Carlson, L., Anderson, N. D., Carmody, J., & al., e. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11(3), 230-241.

-Bull, R., Espy K. A., & Senn. T. E. (2004). A comparison of performance on the Towers of London and Hanoi in young children. Journal of Child Psychology and Psychiatry, 45, 743–754.

-Chiang, H. L., & Gau, S. S. (2014). Impact of executive functions on school and peer functions in youths with ADHD. Research In Developmental Disabilities, 35(5), 963-972.

-Chiang, H. L., Huang, L. W., Gau, S. S., & Shang, C. Y. (2013). Associations of symptoms and subtypes of attention-deficit hyperactivity disorder with visuospatial planning ability in youth. Research In Developmental Disabilities, 34(9), 2986-2995.

-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.

-Chiesa, A., & Serretti, A. (2011). Mindfulness based cognitive therapy for psychiatric disorders: a systematic review and meta-analysis. Psychiatry Research, 187(3), 441-453.

-Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2 ed.). Hillsdale, NJ: Lawrence Earlbaum Associates.

-Fjorback, L. O., Arendt, M., Ornbol, E., Fink, P., & Walach, H. (2011). Mindfulness-based stress reduction and mindfulness-based cognitive therapy: a systematic review of randomized controlled trials. Acta Psychiatrica Scandinavica, 124(2), 102-119.

-Gollwitzer, P. M. (1996). The volitional benefits of planning. In P. M. Gollwitzer & J. A. Bargh (Eds.), The Psychology of Action: Linking Cognition and Motivation to Behavior (pp. 287-312). New York: Guilford Press.

-Hölzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How Does Mindfulness Meditation Work? Proposing Mechanisms of Action from a Conceptual and Neural Perspective. Perspectives on Psychological Science, 6(6), 537-559.

-Jaeggi, S. M., Buschkuehl, M., Perrig, W. J., & Meier, B. (2010). The concurrent validity of the N-back task as a working memory measure. Memory, 18(4), 394-412.

-Injoque-Ricle, I., & Burin, D. I. (2008). Validity and reliability of the Tower of London task for children: A preliminary study. Revista Argentina de Neuropsicología, 11, 21–31.

-Injoque-Ricle, I., & Burin, D. I. (2011). Working memory and planning in children: Validation of the Tower of London Task. Neuropsicología Latinoamericana, 3, 31–38.

-Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delacorte.

-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.

-Lezak, M. D. (1995). Neuropsychological assessment (3 ed.). New York: Oxford University Press.

-Lin, Y. J., Chen, W. J., & Gau, S. S. (2013). Neuropsychological functions among adolescents with persistent subsyndromal and remitted attention-deficit/ hyperactivity disorder. Psychological Medicine, 27, 1-13.

-Mitchell, J. T., McIntyre, E. M., English, J. S., Dennis, M. F., Beckham, J. C., & Kollins, S. H. (2013). A Pilot Trial of Mindfulness Meditation Training for ADHD in Adulthood: Impact on Core Symptoms, Executive Functioning, and Emotion Dysregulation. Journal of Attention Disorders.

-Mitchell, J. T., Zylowska, L., & Kollins, S. H. (2015). Mindfulness meditation training for attention-deficit/hyperactivity disorder in adulthood: Current empirical support, treatment overview, and future directions. Cognitive and Behavioral Practice. 22(2), 172-191.

-Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000). The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: A latent variable analysis. Cognitive Psychology, 41, 49-100.

-Perchet, C., Revol, O., Fourneret, P., Mauguiere, F., & Garcia-Larrea, L. (2001). Attention shifts and anticipatory mechanics in hyperactive children: An ERP study using the Posner paradigm. Biological Psychiatry, 50(1), 44-57.

-Phillips, L. H., Wynn, V., Gilhooly, K. J., Della Sala, S., & Logie, R. H. (1999). The role of memory in the Tower of London task. Memory, 7(2), 209-231.

-Rinsky, J. R., & Hinshaw, S. P. (2011). Linkages between childhood executive functioning and adolescent social functioning and psychopathology in girls with ADHD. Child Neuropsychol, 17, 368-390.

-Scholnick, E. K. (1994). Planning. Encyclopedia of Human Behavior (Vol. 3). Orlando, FL: Academic Press.

-Scholnick, E. K., & Friedman, S. L. (1993). Planning in context: Developmental and situational considerations. International Journal of Behavioral Development, 16(2), 145-167.

-Scholnick, E. K., Friedman, S. L., & Wallner-Allen, K. E. (1997). What do they really measure? A comparative analysis of planning tasks. In S. L. Friedman & E. K. Scholnick (Eds.), The Developmental Psychology of Planning: Why, How, and When Do We Plan? (pp. 127-156). Mahwah, N.J: Lawrence Erlbaum Associates.

-Shallice, T. (1982). Specific impairments of planning. Philosophical Transactions of the Royal Society B: Biological Sciences, 298(1089), 199-209.

-Soprano, A. M. (2003). Excecutive function assessment in children.Revista de Neurologia, 37, 44–50.

-Swanson, J., Schuck, S., Mann, M., Carlson, C., Hartman, C. A., Sergeant, J. A., & al., e. (2012). Categorical and Dimensional Definitions and Evaluations of Symptoms of ADHD: History of the SNAP and the SWAN Rating Scales. International Journal of Educational and Psychological Assessment, 10(1), 21-70.

-Welsh, M. C., Satterlee-Cartmell, T., & Stine, M. (1999). Towers of Hanoi and London: Contribution of working memory and inhibition to performance. Brain Cognition, 41(2), 231-242.

-Zylowska, L. (2012). The mindfulness prescription for adult ADHD: An 8-step program for strengthening attention, managing emotions, and achieving your goals (1 ed.). Boston: Shambhala.

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