مقایسۀ اثربخشی رفتار درمانی دیالکتیکی و تنظیم هیجانی بر علائم کمبود توجه/ بیش‌فعالی و اضطراب در نوجوانان دختر مبتلا به اختلال نارسایی توجه/ بیش فعالی

محورهای موضوعی : تربیتی

پریسا ابوترابی کاشانی ¹ (دانشجوی دکترای روان‌شناسی، گروه روان‌شناسی، واحد اهواز، دانشگاه آزاد اسلامی، اهواز، ایران.)
فرح نادری ² (دانشیار گروه روان‌شناسی، واحد اهواز، دانشگاه آزاد اسلامی، اهواز، ایران.)
سحر صفرزاده ³ (استادیار گروه روان‌شناسی، واحد اهواز، دانشگاه آزاد اسلامی، اهواز، ایران.)
فریبا حافظی ⁴ (استادیار گروه روان‌شناسی، واحد اهواز، دانشگاه آزاد اسلامی، اهواز، ایران.)
زهرا افتخار صعادی ⁵ (استادیار گروه روان‌شناسی، واحد اهواز، دانشگاه آزاد اسلامی، اهواز، ایران.)

تاریخ دریافت : 1399/01/09 تاریخ پذیرش : 1399/05/28 تاریخ انتشار : 1400/06/01

کلید واژه: تنظیم هیجانی, اضطراب, علائم کمبود توجه/ بیش‌فعالی, رفتار درمانی دیالکتیکی, نوجوانان دختر,

چکیده مقاله :

هدف این پژوهش، مقایسۀ تأثیر رفتار درمانی دیالکتیکی و تنظیم هیجانی بر علائم کمبود توجه/بیش‌فعالی و اضطراب در نوجوانان مبتلا به اختلال نارسایی توجه/بیش‌فعالی بود. جامعۀ آماری پژوهش شامل کلیۀ دانش‌آموزان دختر مقطع متوسطۀ شهر تهران در سال تحصیلی 99-1398 بودند که 45 نفر از آنان با استفاده از روش نمونه‌گیری هدفمند انتخاب و به صورت تصادفی در دو گروه آزمایشی و یک گروه کنترل (هر گروه 15 نفر) قرار گرفتند. برای گردآوری اطلاعات از پرسشنامۀ علائم کمبود توجه/ بیش‌فعالی (Conner Erhardt & Sparrow, 1999) و اضطراب کودکان (Bimaher, 1997) استفاده شد. طرح پژوهش نیمه‌آزمایشی از نوع پیش‌آزمون، پس‌آزمون با گروه کنترل و مرحلۀ پیگیری بود. گروه‌های آزمایش تحت رفتار درمانی دیالکتیکی (12جلسه 60 دقیقه‌ای) و تنظیم هیجانی (8جلسه 45 دقیقه‌ای) قرار گرفتند و پس از یک ماه مرحلۀ پیگیری انجام شد. داده‌ها با استفاده از آزمون آماری تحلیل کوواریانس مورد تجزیه و تحلیل قرار گرفت. نتایج پژوهش نشان داد که هر دو رفتار درمانی دیالکتیکی و تنظیم هیجانی برکاهش علائم کمبود توجه/ بیش‌فعالی و اضطراب دانش‌آموزان اثربخشند (0.01p<)، همچنین نتایج تحلیل بنفرونی نشان داد، رفتار درمانی دیالکتیکی نسبت به تنظیم هیجانی، دارای تأثیر بیشتری برکاهش علائم کمبود توجه/بیش‌فعالی و بهبود اضطراب دانش‌آموزان است (0.05p<).

چکیده انگلیسی:

This study aimed to compare the effect of dialectical behavior therapy and emotional regulation on the symptoms of attention-deficit / hyperactivity disorder and anxiety in adolescents with attention-deficit / hyperactivity disorder. The statistical population of the study included all-female high school students in Tehran in the academic year 2019-2020. Using a purposive sampling method, 45 of them were selected and randomly divided into two experimental groups and one control group (15 students in each group). To collect data , the Connors, Erhardt & Sparrow (1999) Attention-Deficit / Hyperactivity Disorder Symptoms Questionnaire and Anxiety Questionnaire of Bimaher (1997)  were used. The research method was semi experimental with pre-test, post-test design, and follow-up with the control group. The experimental groups underwent dialectical behavior therapy (12 sessions of 60 minutes) and emotional regulation (8 sessions of 45 minutes). The follow-up was inducted after a month period. Data were analyzed using analysis of covariance. The results showed that both dialectical behavior therapy and emotional regulation were effective in reducing the symptoms of attention-deficit / hyperactivity disorder and students' anxiety (p<0.01). Also, the results of the analysis of covariance indicated that dialectical behavior therapy had a greater effect on reducing symptoms than emotional regulation. Attention-Deficit / Hyperactivity Disorder and Student Anxiety Improvement (p<0.05).

منابع و مأخذ:

Ackermann, K., Kirchner, M., Bernhard, A., Martinelli, A., Anomitri, C., Baker, R., ... & Herpertz-Dahlmann, B. (2019). Relational aggression in adolescents with conduct disorder: sex differences and behavioral correlates. Journal of Abnormal Child Psychology, 1-13.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

Bernstein, E. E., & McNally, R. J. (2017). Acute aerobic exercise helps overcome emotion regulation deficits. Cognition and emotion, 31(4), 834-843.

Boyle, C. C., Stanton, A. L., Ganz, P. A., Crespi, C. M., & Bower, J. E. (2017). Improvements in emotion regulation following mindfulness meditation: Effects on depressive symptoms and perceived stress in younger breast cancer survivors. Journal of Consulting and Clinical Psychology, 85(4), 397.

Cannon, J. L., & Umstead, L. K. (2018). Applying Dialectical Behavior Therapy to Self‐Harm in College‐Age Men: A Case Study. Journal of College Counseling, 21(1), 87-96.

Christiansen, H., Hirsch, O., Albrecht, B., & Chavanon, M. L. (2019). Attention-Deficit/Hyperactivity Disorder (ADHD) and Emotion Regulation Over the Life Span. Current psychiatry reports, 21(3), 17.

Davidsson, M., Hult, N., Gillberg, C., Särneö, C., Gillberg, C., & Billstedt, E. (2017). Anxiety and depression in adolescents with ADHD and autism spectrum disorders; correlation between parent-and self-reports and with attention and adaptive

 

functioning. Nordic Journal of Psychiatry, 71(8), 614-620.

Davis, M. L., Fletcher, T., McIngvale, E., Cepeda, S. L., Schneider, S. C., La Buissonnière Ariza, V., ... & Storch, E. A. (2019). Clinicians’ perspectives of interfering behaviors in the treatment of anxiety and obsessive-compulsive disorders in adults and children. Cognitive behaviour therapy, 1-16.

Diedrich, A., Hofmann, S. G., Cuijpers, P., & Berking, M. (2016). Self-compassion enhances the efficacy of explicit cognitive reappraisal as an emotion regulation strategy in individuals with major depressive disorder. Behaviour Research and Therapy, 82, 1-10.

Farokhzadi, F., Khajovand Khoshli, A., Mohammadi, M. R., Akbar Fahimi, M. and Ali Beigi, N. (2018). The Study of Emotion Regulation Control Effectiveness on attention-deficit / hyperactivity Symptoms in 7-14 Years Old Children. Journal of Exceptional Children (4)18,101-116.[Persion].

Fischer, S., & Peterson, C. (2015). Dialectical behavior therapy for adolescent binge eating, purging, suicidal behavior, and non-suicidal self-injury: A pilot study. Psychotherapy, 52(1), 78.

Fairchild, G., Hawes, D. J., Frick, P. J., Copeland, W. E., Odgers, C. L., Franke, B., ... & De Brito, S. A. (2019). Conduct disorder. Nature Reviews Disease Primers, 5(1), 43.

Gross, J. J. (2002). Emotion regulation: Affective, cognitive, and social consequences.  Psychophysiology, 39(3), 281-291.

 Houghton, S., Alsalmi, N., Tan, C., Taylor, M., & Durkin, K. (2017). Treating comorbid anxiety in adolescents with ADHD using a cognitive behavior therapy program approach. Journal of Attention Disorders, 21(13), 1094-1104.

Hunnicutt Hollenbaugh, K. M., & Lenz, A. S. (2018). An Examination of the Effectiveness of Dialectical Behavior Therapy Skills Groups. Journal of Counseling & Development, 96(3), 233-242.

Jensen CM, Steinhausen HC (2015) Comorbid mental disorders in children and adolescents with attention-deficit/hyperactivity disorder in a large nationwide study. Atten Defic Hyperact Disord 7:27–38

Jia, R. M. (2018). Social resilience in children with ADHD: buffers of externalizing behaviour, internalizing behaviour, and negative parenting (Doctoral dissertation, University of British Columbia). https://dx. doi.org/10 14288/1.0372346

Laezer KL. (2015). Effectiveness of psychoanalytic psychotherapy and behavioral therapy treatment in children with attention deficit hyperactivity disorder and oppositional defiant disorder. Journal of Infant, Child, and Adolescent Psychotherapy, 14(2):111-28.

Linehan M, Dexter-Mazze E. (2008). Dialectical Behavior Therapy For Borderline Personslity Disorder. Clinical handbook of psychological disorders: A step-by-step treatment manual, 136(2):365-462.

MacLeod, C. (2018). Current Range Of Treatments And Therapies In Children And Adolescents Diagnosed With ADHD; A Systematic Review Of The Literature.

https://digitalcommons.salemstate.edu/honors_theses/180/

Mennin, D. S., Fresco, D. M., O'Toole, M. S., & Heimberg, R. G. (2018). A randomized controlled trial of emotion regulation therapy for generalized anxiety disorder with and without co-occurring depression. Journal of consulting and clinical psychology, 86(3), 268.

Mokhtari, H., Rabeei, M., Salemi, S. H., (2015). Persian Version of Attention-deficit / Hyperactivity Self Rating Scale Psychometric Characteristics(ASRS). Journal of Iran  Psychiatry and  Clinical Psychology , (3)21, 144-153.[Persion].

Mohr-Jensen, C., Steen-Jensen, T., Bang-Schnack, M., & Thingvad, H. (2019). What do primary and secondary school teachers know about ADHD in children? Findings from a systematic review and a representative, nationwide sample of Danish teachers. Journal of Attention Disorders, 23(3), 206-219.

Nariman, M., Begian Koleh Maraz, M. J., Ahadi, B., Abolghasami, A. (2014). The Efficacy of Dialectic      Behavior Therapy Training on   Attention-Deficit / Hyperactivity Symptoms Reduction and Life Quality Improvement of Students. Journal of Clinical Psychology, (6)1, 39-51.[Persion].

Nasri, B., Castenfors, M., Fredlund, P., Ginsberg, Y., Lindefors, N., & Kaldo, V. (2020). Group Treatment for Adults With ADHD Based on a Novel Combination of Cognitive and Dialectical Behavior Interventions: A Feasibility Study. Journal of attention disorders, 24(6), 904-917.

Navarro-Haro, M. V., Modrego-Alarcón, M., Hoffman, H. G., López-Montoyo, A., Navarro-Gil, M., Montero-Marin, J., ... & Garcia-Campayo, J. (2019). Evaluation of a Mindfulness-Based Intervention with and without Virtual Reality Dialectical Behavior Therapy® Mindfulness Skills training for the Treatment of Generalized Anxiety Disorder in Primary Care: A Pilot Study. Frontiers in psychology, 10, 55.

Okumura, Y., Yamasaki, S., Ando, S., Usami, M., Endo, K., Hiraiwa-Hasegawa, M., ... & Nishida, A. (2019). Psychosocial Burden of Undiagnosed Persistent ADHD Symptoms in 12-Year-Old Children: A Population-Based Birth Cohort Study. Journal of Attention Disorders, 1087054719837746.

Pan, P. Y., & Yeh, C. B. (2017). Impact of depressive/anxiety symptoms on the quality of life of adolescents with ADHD: a community-based 1-year prospective follow-up study. European Child & Adolescent Psychiatry, 26(6), 659-667.

Perepletchikova, F., Nathanson, D., Axelrod, S. R., Merrill, C., Walker, A., Grossman, M., ... & Mauer, E. (2017). Randomized clinical trial of dialectical behavior therapy for preadolescent children with disruptive mood dysregulation disorder: Feasibility and outcomes. Journal of the American Academy of Child & Adolescent Psychiatry, 56(10), 832-840.

Rahmanfar, F., Hashamian, K., (2016). The Efficacy of Emotion Cognitive Regulation program on Anxiety Symptoms and Depression in Female Adolescents. Psychological Studies, (3) 12, 47-65.[Persion].

Renna, M. E., Seeley, S. H., Heimberg, R. G., Etkin, A., Fresco, D. M., & Mennin, D. S. (2018). Increased attention regulation from emotion regulation therapy for generalized anxiety disorder. Cognitive Therapy and Research, 42(2), 121-134.

Robins, T. G., Roberts, R. M., & Sarris, A. (2019). The effectiveness, feasibility, and acceptability of a dialectical behaviour therapy skills training group in reducing burnout and psychological distress in psychology trainees: A pilot study. Australian Psychologist, 54(4), 292-301.

Rüfenacht, E., Euler, S., Prada, P., Nicastro, R., Dieben, K., Hasler, R., ... & Weibel, S. (2019). Emotion dysregulation in adults suffering from attention deficit hyperactivity disorder (ADHD), a comparison with borderline personality disorder (BPD). Borderline Personality Disorder and Emotion Dysregulation, 6(1), 11.

Sella, F., Re, A. M., Lucangeli, D., Cornoldi, C., & Lemaire, P. (2019). Strategy selection in ADHD characteristics children: A study in arithmetic. Journal of Attention Disorders, 23(1), 87-98.

Salbach-Andrae H, Bohnekamp I, Pfeiffer E, Lehmkuhl U. (2008). Dialectical Behavior Therapy of Anorexia and Bulimia Nervosa Among Adolescents: A Case Series. Cogn & Behav Pract, 189(5):415-425.

Sánchez Muñoz de León, M., Lavigne Cerván, R., Romero Pérez, J. F., & Elósegui Bandera, E. (2019). Emotion regulation in participants diagnosed with attention deficit hyperactivity disorder, before and after an emotion regulation intervention. Frontiers in Psychology, 10, 1092.

Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2015). Emotion dysregulation in attention deficit hyperactivity disorder. Focus, 14(1), 127-144.

Shea, C. K., Lee, M. M., Lai, K. Y., Luk, E. S., & Leung, P. W. (2018). Prevalence of anxiety disorders in Hong Kong Chinese children with ADHD. Journal of Attention Disorders, 22(5), 403-413.

Telman, L. G., van Steensel, F. J., Maric, M., & Bögels, S. M. (2017). Are anxiety disorders in children and adolescents less impairing than ADHD and autism spectrum disorders? Associations with child quality of life and parental stress and psychopathology. Child Psychiatry & Human Development, 48(6), 891-902.

Tsang, T. W., Kohn, M. R., Efron, D., Clarke, S. D., Clark, C. R., Lamb, C., & Williams, L. M. (2015). Anxiety in young people with ADHD: Clinical and self-report outcomes. Journal of Attention Disorders, 19(1), 18-26.

van Stralen, J. (2016). Emotional dysregulation in children with attention-deficit/hyperactivity disorder. ADHD Attention Deficit and Hyperactivity Disorders, 8(4), 175-187.

Wofford, J. R., & Ohrt, J. H. (2018). An Integrated Approach to Counseling Children Diagnosed With ADHD, ODD, and Chronic Stressors. The Family Journal, 26(1), 105-109.