كليدواژه :
هيپنوتراپي شناختي رفتاري , اختلالات اضطرابي , اضطراب جدايي , اضطراب اجتماعي , مدرسه هراسي
چكيده فارسي :
زمينه و هدف: از مشكلات رواني بسيار مهم در بيماران مبتلا به ديابت نوع يك، افزايش اختلالات اضطرابي است. پژوهش حاضر با هدف بررسي اثربخشي هيپنوتراپي شناختي‌رفتاري بر كاهش اختلالات اضطرابي كودكان 8 تا 12ساله مبتلا به ديابت نوع يك انجام شد.
روش بررسي: طرح پژوهش حاضر، نيمه‌آزمايشي همراه با پيش‌آزمون-پس‌آزمون و پيگيري با گروه گواه بود. جامعهٔ آماري تمامي كودكان 8 تا 12ساله مبتلا به ديابت نوع يك، مراجعه‌كننده به مراكز درمان ديابت شهر شيراز در سال 1397 بودند. افراد از بين مراكز درماني دو مركز به‌شيوهٔ نمونه‌گيري دردسترس انتخاب شد. از ميان آن‌ها تعداد سي نفر داراي اختلالات اضطرابي، به‌طور تصادفي در دو گروه آزمايش و گواه قرار گرفتند. ابزار پژوهش پرسشنامهٔ اختلالات مرتبط با اضطراب كودكان بيرماهر (1999) بود. براي آزمودني‌هاي گروه آزمايش به‌مدت پنج هفته و هر هفته يك‌جلسهٔ دوساعته مداخلهٔ هيپنوتراپي شناختي‌رفتاري اجرا شد. پس‌آزمون بعد از اتمام دوره و پيگيري در سه ماه بعد انجام پذيرفت. داده‌ها با استفاده از آزمون آناليز واريانس با اندازه‌گيري مكرر در سطح معناداري 0٫05 توسط نرم‌افزارSPSS نسخهٔ 23 تجزيه‌و‌تحليل شدند.
يافته‌ها: نتايج نشان داد كه پنج جلسه آموزش هيپنوتراپي شناختي‌رفتاري موجب كاهش معنادار نمرات اضطراب كلي (0٫001>p)، اضطراب اجتماعي (0٫001>p)، هراس اجتماعي‌شكل (0٫001>p) و مدرسه‌هراسي (0٫001>p) شده است.
نتيجه‌گيري: پژوهش حاضر نشان داد كه تمرينات هيپنوتراپي شناختي‌رفتاري موجب كاهش اختلالات اضطرابي كودكان مبتلا به ديابت نوع يك مي‌شود و مي‌توان از اين درمان براي كاهش اضطراب و بهبود كيفيت زندگي اين كودكان استفاده كرد.
چكيده لاتين :
Background & Objectives: Type 1 diabetes is among the most prevalent chronic disorders in childhood. Moreover, the incidence of diabetes has increased dramatically over the last 20 years. It potentially threatens the lives of children, impacting the bio–psychological status of affected
children and their families. A significant psychological problem in patients with type 1 diabetes is an increased frequency of anxiety disorders.
To treat psychological problems, in addition to pharmacotherapy, several cognitive therapies have been devised by researchers during recent
years. The most commonly used treatments for anxiety disorders include behavioral therapy, Cognitive–Behavioral Therapy (CBT), family
interventions, and pharmacotherapy, or a combination of them. CBT helps the therapist to identify defined patterns and ineffective behaviors
and use organized behavioral assignments to address them. This treatment focuses on emotion, cognition, and behavior. Furthermore, hypnosis
is a therapeutic approach that could cure anxiety disorders in diabetic children. Psychologists obtain numerous therapeutic achievements using
the principles of the cognitive approach; however, the combination of behavioral therapy and hypnotherapy approaches could lead to a more
rapid and deeper impact on patients. Cognitive–behavioral hypnotherapy covers several basic techniques, including relaxation, guided imagery,
cognitive reconstruction, gradual desensitization, and hypnotic skills training. Thus, the present study aimed to investigate the effects of
cognitive–behavioral hypnotherapy on anxiety disorders in children aged 8–12 year with type 1 diabetes.
Methods: This was a quasi–experimental study with a pretest–posttest and a control group design. The statistical population of this study was
all 8–to 12–years–old children with diabetes referring to diabetes treatment centers in Shiraz City, Iran, in 2018. Among the treatment centers,
two were selected by convenience sampling method; of which, 30 individuals with anxiety disorders were randomly selected as the experimental
(n=15) and control (n=15) groups. The research tool was the Screen for Child Anxiety Related Disorders (SCARED) designed by Birmaher
(1999) to assess the symptoms of anxiety disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM–
IV) criteria in children and adolescents aged 8 to 17 years. The experimental group was then subjected to cognitive–behavioral hypnotherapy
for 5 weeks; one 2–hour session per week. However, the control group received no intervention. The posttest was performed after the completion
of the treatment course and the follow–up was conducted three months later. The obtained data were analyzed by repeated–measures Analysis
of Variance (ANOVA) in SPSS at the significance level of 0.05.
Results: The repeated–measures ANOVA results suggested that hypnosis therapy reduced the overall anxiety (p<0.001), social phobia
(p<0.001), social anxiety (p<0.001), and school phobia (p<0.001) in the investigated children with type 1 diabetes; however, it had no significant
effect on the anxiety and the separation anxiety of this group.
Conclusion: In general, cognitive–behavioral hypnotherapy could improve anxiety disorders in children aged 8 to 12 years. The present study
results supported the findings of previous studies; they indicated the beneficial effects of cognitive–behavioral hypnotherapy on reducing the
types of anxiety and its destructive consequences on the lives of children with type 1 diabetes. Additionally, children are responsive hypnosis
subjects and more likely to be hypnotized than adults. Besides, their hypnosis capabilities are reduced by increased age, rationalization, and
becoming more realistic. It is therefore possible to use this therapeutic approach to treat the types of anxiety and other acquired diseases in children.
