مقایسه اثربخشی توانبخشی شناختی کنترل مهاری، تحریک الکتریکی مغز و ترکیب توانبخشی کنترل مهاری و تحریک الکتریکی مغز بر کارکردهای اجرایی (بازداری رفتاری‌و انعطاف-پذیری شناختی) در کودکان مبتلا به اختلال نقص توجه/ بیش‌فعالی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری روانشناسی عمومی، گروه روانشناسی، واحد بروجرد، دانشگاه آزاد اسلامی، بروجرد، ایران.

2 استادیار، گروه روانپزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی اراک، اراک، ایران.

3 دانشیار، دانشکده روانشناسی و علوم تربیتی، دانشگاه علامه طباطبایی، تهران، ایران.

4 استادیار، گروه روانشناسی، دانشکده علوم انسانی، دانشگاه اراک، اراک، ایران.

چکیده

هدف: پژوهش حاضر با هدف مقایسه اثربخشی توانبخشی شناختی کنترل مهاری، تحریک الکتریکی مغز و ترکیب توانبخشی کنترل مهاری و تحریک الکتریکی مغز بر کارکردهای اجرایی (بازداری رفتاری و انعطاف­ پذیری شناختی) کودکان مبتلا به اختلال نقص توجه/ بیش ­فعالی انجام شد.
روش‌ها:  روش پژوهش حاضر، نیمه آزمایشی با طرح گروه کنترل نامعادل است. طرح نیمه آزمایشی پژوهش حاضر پیش‌آزمون- پس‌آزمون و پیگیری (2 ماهه) با گروه کنترل بود. جامعه مورد مطالعه شامل همه دارای اختلال ADHD شهر اراک در سال تحصیلی 99-1398 بود. نمونه پژوهش 60 نفر از دانش­ آموزان 8 تا 12 ساله شهر اراک بود که به مراکز مشاوره و خدمات روانشناختی دانش­ آموزی مراجعه و به پرسشنامه اختلال کمبود توجه بیش فعالی سوانسون و همکاران پاسخ دادند؛ از این بین افراد با نمره بالا در گروه ­های آزمایشی و گواه گماره شدند (هر گروه 15 نفر). برای جمع ­آوری داده­ های پژوهش از پرسشنامه اختلال کمبود توجه بیش فعالی سوانسون و همکاران، آزمون رایانه­ای برو/ نرو هافمن و کارت­های ویسکانسین گرانت و برگ استفاده شد. گروه­های آزمایشی برنامه توانبخشی شناختی مهاری نجاتی، و تحریک الکتریکی مغز را بر نقاط جلویی F4 و ترکیب این دو را دریافت کردند. داده­ ها با استفاده از نرم­افزار SPSS.26 و به روش تحلیل کواریانس مختلط با اندازه ­گیری مکرر تحلیل شدند..
یافته‌ها: یافته­ ها نشان داد که توانبخشی شناختی مهاری، تحریک الکتریکی فراقشری مغزی و ترکیب توانبخشی شناختی مهاری تحریک الکتریکی فراقشری مغزی بر بازداری رفتاری و انعطاف­ پذیری شناختی کودکان مبتلا به ADHD اثربخش هستند (001/0≥P). نتایج آزمون تعقیبی بنفرونی نشان داد که بین نمرات درون گروهی پیش آزمون و پس­ آزمون (اثر مداخله)، پیش ­آزمون و پیگیری (اثر زمان) و پس آزمون- پیگیری (ثبات مداخله) در نمرات خطای درجاماندگی، تکمیل طبقات و پاسخ غلط تفاوت وجود دارد (001/0≥P). نتایج نشان داد که بین گروه­ های آزمایشی و گواه تفاوت معناداری وجود دارد (05/0≥P). ولی بین گروه­های آزمایشی  توانبخشی شناختی کنترل مهاری، تحریک الکتریکی مغز و ترکیب توانبخشی کنترل مهاری و تحریک الکتریکی مغز تفاوتی وجود ندارد.
نتیجه‌گیری:  می­ توان نتیجه گرفت که از توانبخشی شناختی مهاری، تحریک الکتریکی فراقشری مغزی و ترکیب این دو می­ تواند به عنوان درمان واحد و یا در کنار سایر درمان­های روانشناختی برای کودکان مبتلا ADHD استفاده کرد.

کلیدواژه‌ها


عنوان مقاله [English]

Comparison of the effectiveness of cognitive rehabilitation of inhibitory control, electrical stimulation of the brain and the combination of inhibitory control and electrical stimulation of the brain on executive functions (behavioral inhibition and cognitive flexibility) in children with ADHD

نویسندگان [English]

  • Sara Arshadi 1
  • Mostafa Nokani 2
  • Mohammad Asgari 3
  • Touraj Sepahvand 4
1 PhD Student in General Psychology, Department of Psychology, Borujerd Branch, Islamic Azad University, Borujerd, Iran.
2 Assistant Professor, Department of Psychiatry, School of Medicine, Arak University of Medical Sciences, Arak, Iran.
3 Associate Professor, Faculty of Psychology and Educational Sciences, Allameh Tabatabaei University, Tehran, Iran.
4 Assistant Professor, Department of Psychology, Faculty of Humanities, Arak University, Arak, Iran.
چکیده [English]

Objective: The aim of this study was to compare the effectiveness of cognitive rehabilitation of inhibitory control, electrical stimulation of the brain and the combination of inhibitory control rehabilitation and electrical stimulation of the brain on executive functions (behavioral inhibition and cognitive flexibility) in children with ADHD.
Methods: The method of the present study is quasi-experimental with an unbalanced control group design. The quasi-experimental design of the present study was pretest-posttest and follow-up (2 months) with the control group. The study population included all those with ADHD in Arak in the academic year 2009-2010. The sample consisted of 60 8 to 12 year old students in Arak who referred to counseling centers and student psychological services and answered the questionnaire of Attention Deficit Hyperactivity Disorder Swanson et al. Experimental and control groups were assigned (15 people in each group). The Swanson et al. Attention Deficit Hyperactivity Disorder Questionnaire, Hoffman Go / Nero Computer Test, and Wisconsin-Grant and Berg Wisconsin Cards were used to collect research data. The experimental groups received the Negative Inhibitory Cognitive Rehabilitation Program, and electrical stimulation of the brain on the F4 anterior points and a combination of the two. Data were analyzed using SPSS.26 software and mixed covariance analysis with repeated measures.
Results: The results showed that inhibitory cognitive rehabilitation, extracortical electrical stimulation of the brain and combination of inhibitory cognitive electrical stimulation of extracortical cerebral stimulation are effective on behavioral inhibition and cognitive flexibility in children with ADHD (P ≥.0.001). The results of Benferoni post hoc test showed that between intra-group scores of pre-test and post-test (intervention effect), pre-test and follow-up (time effect) and post-test-follow-up (intervention stability) in scores of completion error, completion of classes and wrong answer There is a difference (P ≥.0.001). The results showed that there was a significant difference between experimental and control groups (P≥0.05). However, there is no difference between the experimental groups of cognitive inhibition rehabilitation, electrical brain stimulation and the combination of inhibitory control rehabilitation and electrical brain stimulation.
Conclusion: It can be concluded that inhibitory cognitive rehabilitation, extracortical electrical stimulation of the brain and a combination of the two can be used as a single treatment or in combination with other psychological therapies for children with ADHD.

کلیدواژه‌ها [English]

  • Cognitive Rehabilitation of Inhibitory Control
  • Electrical Stimulation of the Combination Therapy
  • Behavioral Inhibition
  • Cognitive Flexibility
  • Attention Deficit Hyperactivity Disorder
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