اثر بخشي درمان مبتني بر آموزش حل مسئله بر نشانه هاي رفتاري بروني سازي شده

Treatment Based on Problem-Solving Training on Externalized Behavioral Symptoms

زمينه و هدف: در سال‌هاي اخير توجه به مسائل و مشكلات رفتاري كودكان به‌عنوان يكي از موضوعات عمدهٔ روان‌شناسي و روان‌پزشكي افزايش يافته است. پژوهش حاضر با هدف بررسي اثربخشي درمان مبتني‌بر آموزش حل مسئله بر نشانه‌هاي اختلالات رفتاري بروني‌سازي‌شده صورت گرفت. روش‌بررسي: طرح پژوهش نيمه‌آزمايشي از نوع پيش‌آزمون و پس‌آزمون با گروه گواه بود. جامعهٔ آماري پژوهش را تمامي دانش‌آموزان پسر داراي نشانه‌هاي رفتاري بروني‌سازي‌شده تشكيل دادند كه در سال تحصيلي 99-1398 در مدارس دورهٔ اول دبيرستان شهرستان تبريز مشغول به تحصيل بودند. از ميان آن‌ها 30 نفر به‌عنوان داوطلب واجد شرايط انتخاب شدند و به‌صورت تصادفي در دو گروه آزمايش و گواه تخصيص يافتند. مقياس اختلالات رفتار ايذايي پلهام و ناژي (1992) به‌عنوان پيش‌آزمون و پس‌آزمون بر هر دو گروه اجرا شد. گروه آزمايش به‌مدت هشت جلسهٔ 60‌دقيقه‌اي، درمان مبتني‌بر آموزش حل مسئله را دريافت كرد. گروه گواه هيچ‌گونه آموزش درماني ويژه‌اي دريافت نكرد. درنهايت داده‌ها با استفاده از روش تحليل كوواريانس چندمتغيره و نرم‌افزار SPSS نسخهٔ 20 تحليل شدند. سطح معناداري آزمون‌ها در اين مطالعه برابر با 0٫05 در نظر گرفته شد. يافته‌ها: نتايج نشان داد كه با كنترل پيش‌آزمون، بين گروه‌هاي آزمايش و گواه در اختلالات نقص ‌توجه/بيش‌فعالي (0٫001>p)، نافرماني مقابله‌اي (0٫049=p)، سلوك (0٫003=p)، نشانه‌هاي نقص‌ توجه (0٫008=p)، بيش‌فعالي (0٫001>p) و دزدي و فريب (0٫004=p) تفاوت معنا‌داري وجود دارد؛ به‌طوري‌كه اين نشانه‌ها در گروه آزمايش كمتر از گروه گواه بوده است. نتيجه‌گيري: براساس يافته‌هاي پژوهش مي‌توان نتيجه گرفت درمان مبتني‌بر آموزش حل مسئله بر كاهش نشانه‌هاي رفتاري بروني‌سازي‌شده اثربخش خواهد بود.

Background & Objectives: The health status of each society’s members are of particular importance. Accordingly, paying attention to their mental health helps to improve their bio psychological health and their social functioning. However, in every community, some individuals encounter some problems that affect their bio psychological health. Recently, the behavioral issues of children, as a significant subject of psychology and psychiatry, have attracted much attention. Furthermore, they constitute a considerable part of the population of every society. Besides, numerous children experience emotional and behavioral problems, i.e., not only challenging to be resolved but also may continue into adulthood. Given the wide range of behavioral problems, there are several approaches to classifying them. The most common method of categorizing behavioral issues, introduced by Achenbach in 1991, concerns children's behavioral problems in two broad categories; internalized behaviors (e.g., withdrawal, obsession, sadness, shyness, fear, & delusion) and externalized behaviors (e.g., behaviors against others and the environment, including aggression, contention, & the destruction of property). The present study aimed to investigate the effectiveness of treatment based on problem–solving training on externalized behavioral symptoms. Methods: This was a quasi–experimental study with a pretest–posttest and a control group design. The statistical population of this study was all middle school students of Tabriz City, Iran, in the 2018–2019 academic year. Of them, 30 students were chosen by convenience sampling technique and were randomly divided into the experimental and control groups. The inclusion criteria were age range of 12–15 years, no learning disorders, no mental disability, no visual, auditory or motor impairments, as well as no medical conditions, such as diabetes, epilepsy, or heart disease that may influence the research process. First, Pelham and Gnagy’s Disruptive Behaviors Rating Scale (DBRS) (1992) was administered to both study groups. The experimental group then received 8 sessions of 60–minute treatment based on problem–solving training. Next, both groups were evaluated using DBRS. Finally, the obtained data were analyzed using Multivariate Analysis of Covariance (MANCOVA) in SPSS. Results: is the collected data suggested significant differences between the experimental and control groups in Attention–Deficit/Hyperactivity Disorder (ADHD) (p<0.001), oppositional defiant disorder (p=0.049), conduct disorder (p=0.003), attention deficit (p=0.008), hyperactivity (p<0.001), and deceitfulness or theft (p=0.004) symptoms. The mean value of attention deficit, hyperactivity, ADHD, oppositional defiant disorder, deceitfulness or theft, and conduct disorder were lower in the experimental group than the controls. In addition, the calculated eta coefficient indicated that 95% of individual differences in the posttest scores of behavioral disorders belonged to the effectiveness of the provided treatment. However, there was no significant difference between the experimental and control groups in terms of aggression, the destruction of property, and serious violations of rules. Conclusion: Based on the present study findings, providing treatment based on problem–solving training is effective in reducing externalized behavioral symptoms among individuals.