اثربخشی درمان مبتنی بر ذهن‌آگاهی بر میزان نشانه‌ها و ذهن‌آگاهی نوجوانان مبتلا به اختلال نارسایی توجه-فزون‌کنشی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکترای تخصصی روان‌شناسی، دانشگاه فردوسی مشهد، مشهد، ایران

2 دانشیار دانشکده‌ی علوم تربیتی و روان-شناسی، دانشگاه فردوسی مشهد، مشهد، ایران

چکیده

مقدمه: اختلال نارسایی توجه-فزون کنشی از شایع‌ترین اختلال‌های دوران کودکی است که اغلب تا دوران نوجوانی و بزرگسالی تداوم می‌یابد. تا کنون روش‌های درمانی مختلفی جهت بهبود نشانه‌های این اختلال به کار گرفته شده است. در سال‌های اخیر، درمان‌های مبتنی بر ذهن‌آگاهی از جمله روش‌هایی بوده که توجه بیشتر پژوهشگران را به خود جلب کرده است. این پژوهش نیز با هدف بررسی اثربخشی درمان مبتنی بر ذهن‌آگاهی بر میزان نشانه‌ها و  ذهن‌آگاهی نوجوانان مبتلا به اختلال نارسایی توجه-فزون کنشی به انجام رسید.
روش‌کار: پژوهش حاضر یک کارآزمایی بالینی با طرح پیش‌آزمون-پس آزمون با گروه شاهد می‌باشد. نمونه‌ی این پژوهش را 30 نفر از دانش‌آموزان دختر دبیرستان‌های دوره‌ی اول و دوم شهرستان گناباد که مبتلا به اختلال نارسایی توجه- فزون‌کنشی بودند، تشکیل دادند. ابزار مورد استفاده شامل مصاحبه‌ی بالینی، مقیاس درجه‌بندی اسنپ فرم والدین (SNAP-IV) و پرسش‌نامه‌ی ذهن‌آگاهی بودند. گروه آزمون هشت جلسه‌ی 90 دقیقه‌ای درمان مبتنی بر ذهن‌آگاهی را دریافت کردند و گروه شاهد در لیست انتظار قرار داشتند. داده‌ها با کمک آمار توصیفی و نیز با روش تحلیل کوواریانس تک‌متغیری در نرم‌افزار SPSS نسخه‌ی 20 تحلیل شدند.
یافته‌ها: بر اساس نتایج مشخص گردید گروه آزمون در مقایسه با شاهد نشانه‌های اختلال نارسایی توجه-فزون‌کنشی را در پس‌آزمون بهبود یافت (001/0P<). هم‌چنین نمره‌ی ذهن‌آگاهی گروه آزمون در مقایسه با شاهد در پس‌آزمون، تغییر معنی‌داری نشان داد (001/0P<).
نتیجه‌گیری: نتایج این پژوهش نشان داد درمان مبتنی بر ذهن‌آگاهی موجب بهبود نشانه‌های اختلال نارسایی توجه-فزون‌کنشی و ذهن‌آگاهی در نوجوانان مبتلا به اختلال نارسایی توجه-فزون‌کنشی گردیده است.

کلیدواژه‌ها

مراجع

  1. Barkley RA. Comparison of the DSM-IV combined typed of ADHD in a school-based sample of Latino Hispanic children. J Child Psychol Psychiatry 2005; 46(2): 166-79.
  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fifth ed. Washington, DC: American Psychiatric Association; 2013.
  3. Tavakkolizadeh J, Bolhari J, Mehryar A, Dezhkam M. [Epidemiology of attention deficit and disruptive behaviour disorders in elementary school children of Gonabad town, north east Iran]. Iranian journal of psychiatry and clinical psychology 1997; 3: 40-52. (Persian)
  4. Rubia K, Taylor E, Smith AB, Oksannen H, Overmeyer S, Newman S. Neuropsychological analysis of impulsiveness in childhood hyperactivity. Br J Psychiatry 2001; 179: 138-143.
  5. Weijer-Bergsma E, Esther A, Bruin I, Bogels S. The effectiveness of mindfulness training on behavioral problems and attentional functioning in adolescents with ADHD. J Child Fam Study 2012; 21: 775-87.
  6. Ingram S, Hechtman L, Morgenstern G. Outcome issues in ADHD: adolescent and adult long-term outcome. Ment Retard Dev Disabil Res Rev 1999; 5: 43-250.
  7. Barkley RA, Fischer M, Edelbrock CS, Smallish L. The adolescent outcome of hyperactive children diagnosed by research criteria: An 8-year prospective study. J Am Acad Child Adolesc Psychiatry 1990; 29: 546-57.
  8. Biederman J, Faraone S, Milberger S, Guite J, Mick E, Chen L. A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Arch Gen Psychiatry 1996; 53(5), 437.‏
  9. Biederman J, Mick E, Faraone SV. Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. Am J Psychiatry 2000; 157(5): 816-18.
  10. Martel M, Nikolas M, Nigg JT. Executive function in adolescents with ADHD. J Am Acad Child Adolesc Psychiatry 2007; 46(11): 1437-44.
  11. Miller M, Ho J, Hinshaw SP. Executive functions in girls with ADHD followed prospectively into young adulthood. Neuropsychology 2012; 26(3): 278.
  12. Toplak ME, Bucciarelli SM, Jain U, Tannock R. Executive functions: performance-based measures and the behavior rating inventory of executive function (BRIEF) in adolescents with attention deficit-hyperactivity disorder (ADHD). Child Neuropsychology 2009; 15(1): 53-72.
  13. Biederman J, Petty CR, Doyle AE, Spencer T, Henderson CS, Marion B, et al. Stability of executive function deficits in girls with ADHD: a prospective longitudinal follow up study into adolescence. Dev Neuropsychol 2008; 33(1): 44-61.
  14. Hinshaw SP, Carte ET, Fan C, Jassy JS, Owens EB. Neuropsychological functioning of girls with Attention-Deficit Hyperactivity Disorder followed prospectively into adolescence: evidence for continuing deficits? Neuropsychology 2007; 21(2): 263.
  15. Resnick RJ. Attention deficit-hyperactivity disorder in adults. In: Fisher CB, Lerner RM. (editors). Encyclopedia of applied developmental science. Thousand Oaks: Sage; 2005: 129-31.
  16. James A, Lai FH, Dahl C. Attention deficit hyperactivity disorder and suicide: A review of possible associations. Acta Psychiatr Scand 2004; 110: 408-15.
  17. Chronis AM, Jones HA, Raggi VL. Evidence-based psychosocial treatments for children and adolescents with attention-deficit hyperactivity disorder. Clin Psychol Rev 2006; 26(4): 486-502.
  18. Van der Oord S, Pri PJM, Oosterlaan J, Emmelkamp PMG. Efficacy of methylphenidate, psychosocial treatmentsand their combination in school-aged children with ADHD: A meta-analysis. Clin Psychol Rev 2008; 28: 783-800.
  19. Wolraich L, Wibbelsman J, Brown E, Steven W, Evans W, Gotlieb M, et al. Attention-Deficit Hyperactivity Disorder among aolescents: A review of the diagnosis, treatment, and clinical implications. Pediatrics 2005; 115(6): 1734-46.
  20. Van der Oord S, Bögels SM, Peijnenburg D. The effectiveness of mindfulness training for children with ADHD and mindful parenting for their parents. J Child Fam Stud 2012; 21(1): 139-47.
  21. Pelham WE, Fabiano GA. Evidence-based psychosocial treatments for Attention-Deficit Hyperactivity Disorder. J Clin Child Adolesc Psychol 2008; 37: 184-214.
  22. Brown KW, Ryan RM, Creswell JD. Mindfulness: Theoretical foundations and evidence for its salutary effects. Psychol Inquiry 2007; 18(4): 211-37.
  23. Smalley L, Loo K, Shrestha A, McGough J, Hale T. Mindfulness and attention deficit hyperactivity disorder. J Clin Psychol 2009; 65: 1087-98.
  24. Brown KW, Ryan RM. The benefits of being present. Mindfulness and its role in psychological well-being. J Pers Soc Psychol 2003; 84(4): 822-48.
  25. Schmertz SK, Anderson PL, Robins DL. The relation between self-report mindfulness and performance on tasks of sustained attention. J Psychopathol Behav Assess 2009; 31(1): 60-66.
  26. Evans DR, Baer RA, Segerstrom SC. The effects of mindfulness and self consciousness on persistence. Pers Individ Diff 2009; 47: 379-82.
  27. Barkley RA. Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychol Bull 1997; 121: 65-94.
  28. Chronis AM, Jones HA, Raggi VL. Evidence-based psychosocial treatments for children and adolescents with Attention-Deficit Hyperactivity Disorder. Clin Psychol Rev 2006; 26(4): 486-502.
  29. Zylowska L, Ackerman DL, Yang MH, Futrell JL, Horton NL, Hale TS, et al. Mindfulness meditation training in adults and adolescents With ADHD: A feasibility study. J Attention Disord 2008; 11(6): 737-46.
  30. Nejati V, Zabihzadeh A, Nikfarjam MR. The relationship between mindfulness and sustained attention, selective functions. Cognitive and behavioral science research 2012; 2(3): 31-42.
  31. Jha AP, Krompinger J, Baime MJ. Mindfulness training modifies subsystems of attention. Cogn Affect Behav Neurosci 2007; 7(2): 109-19.
  32. Moore A, Malinowski P. Meditation, mindfulness and cognitive flexibility. Conscious Cogn 2009; 18(1): 176-86.
  33. Teasdale JD, Segal Z, Williams JM. How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help? Behav Res Ther 1995; 33(1): 25-39.
  34. Heeren A, Philippot P. Changes in ruminative thinking mediate the clinical benefit of mindfulness: Preliminary findings. Mindfulness 2011; 2: 8-13.
  35. Semple RJ, Lee J, Rosa D, Miller LF. A randomized trial of mindfulness-based cognitive therapy for children: Promoting mindful attention to enhance social-emotional resiliency in children. J Child Fam Stud 2010; 19(2): 218-29.
  36. Chiesa A, Serretti A. A systematic review of neurobiological and clinical features of mindfulness meditations. Psychol Med 2010; 40: 1239-52.
  37. Kilpatrick LA, Suyenobu BY, Smith SR, Bueller JA, Goodman T, Creswell JD, et al. Impact of mindfulness-based stress reduction training on intrinsic brain connectivity. Neuro Image 2011; 56: 290-8.
  38. Burke CA. Mindfulness-based approaches with children and adolescents: A preliminary review of current research in an emergent field. J Child Fam Stud 2010; 10: 1-15.
  39. Black DS, Milam J, Sussman S. Sitting-meditation interventions among youth: A review of treatment efficacy. J Pediatrics 2011; 124: 532-41.
  40. Friedman R, Duyal G. [Treatment of children with attention deficit-hyperactivity]. Sadralsadat J, Mohammadi MR, Sadralsadat L. (translators). Tehran: Art; 2002. (Persian)
  41. Sdralsadat J, Hoshiary Z, Zamani R, Sadralsadat L. [Determination of psychometric indices of SNAP-IV rating scale in parent execution]. Journal of rehabilitation 2007; 3: 53-7. (Persian)
  42. Mohamadkhani P, Khanipur H. [Mindfulness-based therapy]. Tehran: University of social welfare and rehabilitation sciences; 2012. (persion)
  43. Hoseinzadehmaleki Z. [Efficacy of working memory training, parent education programs Barkley and combine the two intervention on improving executive functions and clinical symptoms in children with ADHD]. MS. Dissertation. Faculty of Education and Psychology, Ferdowsi University of Mashhad, 2012. (Persian)
  44. Grosswald SJ, Stixrud WR, Travis F, Bateh MA. Use of the transcendental meditation technique to reduce symptoms of attention deficit hyperactivity disorder (ADHD) by reducing stress and anxiety: an exploratory study. Curr Issues Educ 2008; 10(2): 1-16.
  45. Saltzman A, Goldin P. Mindfulness-based stress reduction for school-age children. In: Hayes SC, Greco LA. Acceptance and mindfulness interventions for children adolescents and families 2008. Oakland: New Harbinger; 2008: 139-61.
  46. Bögels S, Hoogstad B, van Dun L, de Schutter S, Restifo K. Mindfulness training for adolescents with externalizing disorders and their parents. Behav Cogn Psychother 2008; 36(2): 193-209.
  47. Kabat-Zinn, J. Mindfulness-Based interventions in context: Past, present and future. Clin Psychol Sci Pract 2003; 10: 144-56.
  48. Sanger KL, Dorjee D. Mindfulness training with adolescents enhances metacognition and the inhibition of irrelevant stimuli: Evidence from event-related brain potentials. Trend Neurosci Educ 2016; 5(1): 1-11.
  49. Germer CK. The Meaning of mindfulness. In: Germer CK, Siegel RD, Fulton PR. (editors). Handbook of mindfulness and psychotherapy. New York: Guilford; 2013: 3-28.
مجله اصول بهداشت روانی
دوره 19، شماره 1
آذر و دی 1395
صفحه 30-37

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