پديد آورندگان :
عافي، الهه دانشگاه آزاد اسلامي واحد تهران مركزي، تهران، ايران , استكي، مهناز دانشگاه آزاد اسلامي واحد تهران مركزي، تهران، ايران , مداحي، محمدابراهيم دانشگاه آزاد اسلامي واحد تهران مركزي، تهران، ايران - گروه روان شناسي , حسني، فريبا دانشگاه آزاد اسلامي واحد تهران مركزي، تهران، ايران
كليدواژه :
شناخت درماني مبتني بر ذهن آگاهي , نوروفيدبك , كاركردهاي اجرايي , اختلال نقص توجه/بيش فعالي
چكيده فارسي :
زمينه و هدف: اختلال نقص توجه/بيش‌فعالي از اختلالات بسيار شايع روان‌پزشكي در كودكي است كه در صورت دريافت‌نكردن درمان مناسب مي‌تواند منجربه صدمات جبران‌ناپذيري شود. پژوهش حاضر با هدف مقايسهٔ اثربخشي شناختدرماني مبتني‌بر ذهنآگاهي و كاربرد نوروفيدبك بر كاركردهاي اجرايي (حافظهٔ فعال و توانايي برنامه‌ريزي) در كودكان مبتلا به اختلال نقص توجه/بيش‌فعالي صورت گرفت.
روش‌بررسي: روش پژوهش از نوع نيمه‌‌آزمايشي با طرح پيش‌آزمون و پس‌آزمون با گروه گواه بود. جامعهٔ اين پژوهش كودكان 9تا12سالهٔ مراجعه‌‌كننده به كلينيك‌هاي روان‌شناسي شهر تبريز بودند. از بين كودكان واجد شرايط، 45 كودك مبتلا به اختلال نقص توجه/بيش‌فعالي انتخاب شده و به‌صورت تصادفي در سه گروه شناختدرماني مبتني‌بر ذهنآگاهي و نوروفيدبك و گواه قرار گرفتند. از تمام آزمودني‌ها قبل و پس از اتمام درمان آزمون‌هاي حافظهٔ فعال وكسلر و برج لندن گرفته شد. سپس گروه‌هاي آزمايش تحت روش‌هاي درماني قرار گرفتند. داده‌هاي گرد‌آوري‌شده با استفاده از نرم‌افزار SPSS نسخهٔ 24 و به‌روش تحليل كوواريانس چندمتغيره تجزيه‌وتحليل شدند.
يافته‌ها: نتايج نشان داد كه شناختدرماني مبتني‌بر ذهنآگاهي و نوروفيدبك بر حافظهٔ فعال و توانايي برنامه‌ريزي كودكان مبتلا به نقص توجه/بيش‌فعالي مؤثر واقع مي‌شود (0٫001>p). همچنين شناختدرماني مبتني‌بر ذهنآگاهي درمقايسه با نوروفيدبك، برحسب تفاوت ميانگين پس‌آزمون‌ها تأثير بيشتري بر حافظهٔ فعال و توانايي برنامه‌ريزي در پس‌آزمون داشت.
نتيجه‌گيري: باتوجه به اثربخشي شناختدرماني مبتني‌بر ذهنآگاهي بر كاركردهاي اجرايي كودكان مبتلا به نقص توجه/بيش‌فعالي به درمانگران توصيه مي‌شود در به‌كارگيري از اين روش درماني، در كنار ساير روش‌ها مبادرت ورزند.
چكيده لاتين :
Background & Objectives: Attention–Deficit/Hyperactivity Disorder (ADHD) is a mental disorder marked by an ongoing pattern of inattention and hyperactivity–impulsivity that interferes with functioning or development. Inattention and hyperactivity/impulsivity are the key symptoms
of ADHD. ADHD is among the most prevalent childhood psychiatric disorders that could lead to irreversible complications and injuries if not given proper treatment. In terms of the etiology of ADHD, various issues have been discussed based on damage to executive functions. Among
the most critical executive functions, working memory and planning ability could be mentioned. Mindfulness–Based Cognitive Therapy (MBCT)
is a combination of cognitive–behavioral therapy and mindfulness therapy, and one of the methods of teaching sustained attention. Mindfulness
could be defined as directing attention in a specific, purpose–oriented way in the present and without judgment. Neurofeedback (NF) is another
non–pharmacological treatment option, which has recently gained significant experimental support concerning the improvement of the symptoms
of ADHD. NF attempts to teach the subject a self–regulation strategy by recording the brain's electrical waves and providing feedback. Feedback
is usually given to the person through sound or image, which helps to determine if it has made a significant change in their brainwave activity.
The present study aimed to compare the effects of MBCT and NF on executive functions (working memory & planning ability) in children with
ADHD.
Methods: This was a quasi–experimental study with a pretest–posttest and a control group design. The population of this study included all
children aged 9–12 years, referring to counseling and psychology clinics in Tabriz City, Iran. After observing the inclusion and exclusion criteria
of the research and implementing the Child Symptom Inventory–4 (CSI–4), Child Behavior Checklist (CBCL), Integrated Visual and Auditory
(IVA) scale, and diagnosis by a child psychologist, 45 ADHD children were selected. The study subjects were randomly divided into three
groups, as follows: MBCT, NF, and the controls. All subjects completed the Wechsler Memory Scale, Fourth Edition (WMS–IV), and the Tower
of London test before and after conducting the treatment. The reliability of the WMS–IV has been reported from 0.65 to 0.95. The validity of
this test was also reported from 0.66 to 0.92 (Abedi, Sadeghi, and Rabiei, 2011). The reliability of the Tower of London test was reported equal
to 0.80. The researchers also reported the validity of this test as 0.79 (Lezak, Howieson & Loring, 2004). The members of the MBCT group
received treatment in 15 sessions, and those of the NF group received 25 sessions of intervention; however, the control group received no
treatment. The collected data were analyzed by SPSS–24 using Multivariate Analysis of Covariance (ANCOVA) and Bonferroni posthoc test.
Results: The obtained data indicated that MBCT and NF affected the executive functions (working memory & planning ability) in children with
ADHD. Findings also revealed that MBCT had a more significant effect on executive functions (working memory & planning ability) in the
studied children with ADHD in the posttest phase, compared to the NF group (p<0.001).
Conclusion: Considering the effectiveness of MBCT on executive functions (working memory & planning ability) in children with ADHD, this study highlighted the importance of using this method, along with other approaches to reduce the ADHD symptoms.
