مداخله‌ای در تکانشگری و خودکنترلی نوجوانان دارای اختلال نامنظم خلقی اخلال گرانه: اثربخشی و کارآمدی طرحواره درمانی ذهنیت مدار و آموزش کنترل تکانه

نوع مقاله : مقاله پژوهشی

نویسندگان

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

2 استادیار گروه روانشناسی عمومی، واحد بوشهر، دانشگاه آزاد اسلامی، بوشهر، ایران

3 استادیار گروه روانشناسی عمومی، دانشگاه سلمان فارسی، کازرون، ایران.

چکیده

هدف: این پژوهش با هدف مقایسه اثربخشی طرحواره درمانی ذهنیت مدار و آموزش کنترل تکانه بر تکانشگری و خودکنترلی نوجوانان دارای اختلال نامنظم خلقی اخلال گرانه انجام شد.
روش‌ها: روش آزمایشی و طرح پژوهش حاضر پیش‌آزمون- پس‌آزمون و پیگیری چند گروهی بود. جامعه­ی آماری این پژوهش را کلیه­ی نوجوانان پسر 10 تا 17 ساله شهر شیراز که در سال تحصیلی 99-1398 در مدارس این شهر مشغول به تحصیل می­باشند تشکیل می­دهند. نمونه­ی پژوهش 60 نفر از نوجوانان پسر دارای اختلال نامنظم خلقی اخلال‌گرانه بود که از میان نوجوانان پسری که نمره­ی بالا در مقیاس خودگزارش دهی پرسشنامه سیاهه رفتاری کودک آخنباخ و پرسشنامه غربالگری اختلال نامنظم خلقی اخلال گرانهانه لاپورته و همکاران  بود به روش نمونه­گیری تصادفی خوشه­ای چند مرحله­ای از نواحی آموزش و پرورش شهر شیراز انتخاب و در دو گروه آزمایشی و یک گروه کنترل به طور تصادفی گمارده شدند. ابزارهای پژوهش، مصاحبه بالینی ساختاریافته، مقیاس خودگزارش دهی پرسشنامه سیاهه رفتاری کودک آخنباخ، مقیاس خود کنترلی تانجی، بامیستر و بون و مقیاس تکانشگری پاتون و همکاران بود. داده­های جمع آوری شده با استفاده از آزمون تحلیل کواریانس آمیخته با اندازه­گیری مکرر مورد تجزیه و تحلیل آماری قرار گرفتند.
یافته‌ها: نتایج نشان داد که آموزش گروهی طرحواره درمانی ذهنیت مدار و آموزش کنترل تکانه بر کاهش تکانشگری و افزایش خودکنترلی نوجوانان دارای اختلال نامنظم خلقی اخلال گرانه مؤثر بوده است و بین دو گروه آزمایش و کنترل در مرحله پس­آزمون و پیگیری در میزان خودکنترلی و تکانشگری تفاوت معنادار وجود دارد (001/0≥P).
نتیجه‌گیری: بنابراین می توان نتیجه گرفت از آموزش­های طرحواره درمانی ذهنیت مدار و مهارتهای کنترل تکانه می توان به عنوان روش­های مداخله ای مناسب در کنار درمان دارویی سود جست.

کلیدواژه‌ها


عنوان مقاله [English]

Intervention in Impulsivity and Self-Control of Adolescents with Disruptive mood dysregulation disorder: Effectiveness and Effectiveness of Schema Modes Therapy and Impulse Control Training

نویسندگان [English]

  • Nila Pashangian 1
  • Moloud Keykhosrovani 2
  • Naser Amini 2
  • Moslem Abbasi 3
1 Ph. D Candidate, Department of General Psychology, Bushehr Branch, Islamic Azad University, Bushehr, Iran.
2 Assistant Professor, Department of General Psychology, Bushehr Branch, Islamic Azad University, Bushehr, Iran
3 Assistant Professor, Department of General Psychology, Salman Farsi University, Kazerun, Iran
چکیده [English]

Objective: This study aims to compare the effectiveness of schema modes therapy and Impulse Control Training was performed on the impulsivity and self-control of adolescents with disruptive mood dysregulation disorder.
Methods:  The experimental method and design of the present study were pre-test-post-test and multi-group follow-up. The statistical population of this study consists of all adolescents aged 10 to 17 years old in Shiraz who are studying in the schools of this city in the academic year 2019-2020. The sample consisted of 60 male adolescents with disruptive mood dysregulation disorder among the male adolescents who scored high on the self-report scale of the Achenbach child behavior inventory and the disruptive mood dysregulation disorder Laporte et al. Multi-stage cluster random sampling method was selected from education areas of Shiraz and randomly assigned to two experimental groups and a control group. The research instruments were structured clinical interviews, the self-report scale of the Achenbach child behavior Inventory, the self-control scale by Tangney and et al, and the Impulsiveness of Patton et al scale. The collected data were statistically analyzed using repeated measures covariance analysis.
Results: The results showed that group training of subjective schema modes therapy and impulse control training was effective in reducing impulsivity and increasing self-control of adolescents with disruptive mood dysregulation disorder (P≤0.001).
Conclusion: Therefore, it can be concluded that subjective schema modes therapy and impulse control training can be used as appropriate intervention methods along with drug therapy.

کلیدواژه‌ها [English]

  • Impulse control training
  • Schema modes therapy
  • Impulsivity
  • Self-control
  • Disruptive mood dysregulation disorder
جاوید، محبوبه؛ محمدی، نوراله و رحیمی، چنگیز (1391). ویژگی های روانسنجی نسخه فارسی یازدهمین ویرایش مقیاس تکانشگری بارت. فصلنامه علمی - پژوهشی روش­ها و مدل­های روان‌شناختی، 2 (8)، 23-34.
زارع بهرام آبادی، مهدی و  گنجی، کامران. (1393). بررسی شیوع اختلال نارسایی‌توجه/بیش فعالی و همبودی آن با اختلال یادگیری در دانش‌آموزان دبستانی. مجله ناتوانی‌های یادگیری، 3(4)، 25-43.
ژندا، لوئیس. آزمون­های شخصیت. ترجمه بشارت و حبیب نژاد (1388). انتشارات آییژ.
Achecnback, T. M. & Rescorla, L. A. (2001). Manual for the ASEBA School–Age Forms & Profiles. Burlington, VT: University of Vermont. Research Center for Children, Youth, and Families.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). American Psychiatric Pub.
Bach, B., Farrell, J. M. (2018). Schemas and modes in borderline personality disorder: The mistrustful, shameful, angry, impulsive, and unhappy child. Psychiatry Research, 259, 323-329. [Doi: 10.1016/j.psychres.2017.10.039]
Behary, W. T., & Dieckmann, E. (2011). Schema therapy for narcissism: The art of empathic confrontation, limit-setting, and leverage. The Handbook of narcissism and narcissistic personality disorder: Theoretical approaches, empirical findings, and treatments, PP: 445-456.
Bowlin, S. L., & Baer, R. A. (2012). Relationship between mindfulness, self-control, and psychological functioning. Personality and Individual Differences. 52, 411-415. [Doi: 10.1016/j.paid.2011.10.050]
Camarista, G. (2012). Creative, self- efficacy, anxiety, and problem solving performance of the potential mathematically gifted. International Research Conference for Globalization and Sustainability. La Paz, Iloilo City, Philippines.
Clarkson, J. J., Hirt, E. R., Jia, L., & Alexander, M. B. (2010). When perception is more than reality: The effects of perceived versus actual resource depletion on self-regulatory behavior. Journal of Personality and Social Psychology, 98(1), 29–46. [Doi: 10.1037/a0017539]
Daly, M., Baumeister, R. F., Delaney, L., & MacLachlan, M. (2014). Self-control and its relation to emotions and psychobiology: Evidence from a day reconstruction method study. The Journal of Behavioral Medicine, 37(1), 81- 93. [Doi: 10.1007/s10865-012-9470-9]
Estévez, A., Ozerinjauregi, N., Herrero-Fernández, D., & Jauregui, P. (2019). The mediator role of early maladaptive schemas between childhood sexual abuse and impulsive symptoms in female survivors of CSA. Journal of Interpersonal Violence, 34 (4), 763-784.   [DOI: 10.1177/0886260516645815]
Hilden, H. M., Rosenström, T., Karila, I., Elokorpi, A., Torpo, M., Arajärvi, R., Isometsä, E. (2021). Effectiveness of brief schema group therapy for borderline personality disorder symptoms: a randomized pilot study. Nordic Journal of Psychiatry, 75(3), 176-185. [Doi: 10.1080/08039488.2020.1826050]
Knackfuss, A., Leibenluft, E., Brotman, M. A., de Moura Silveira Júnior, É., Simioni, A., Teixeira, L. S., Gerchmann, L., Fijtman, A., Trasel, A. R., Sperotto, D., Manfro, A. G., Kapczinski, F., Sant'Anna, M. K., & Salum, G. A. (2020). Differentiating irritable mood and disruptive behavior in adults. Trends in Psychiatry and Psychotherapy, 42(4), 375–386. [Doi: 10.1590/2237-6089-2019-0078]
Kopf-Beck, J., Zimmermann, P., Egli, S., Rein, M., Kappelmann, N., Fietz, J., Tamm, J., Rek, K., Lucae, S., Brem, A. K., Sämann, P., Schilbach, L., & Keck, M. E. (2020). Schema therapy versus cognitive behavioral therapy versus individual supportive therapy for depression in an inpatient and day clinic setting: study protocol of the OPTIMA-RCT. BMC Psychiatry, 20 (1), 506.[Doi: 10.1186/s12888-020-02880-x]
Kring, A. M., Sheri, L., Johnson, C., & John, M. (2012). Abnormal psychology, 12th Edition.
Laporte, P. P., Matijasevich, A., Munhoz, T. N., Santos, I. S., Barros, A. J. D., Pine, D. S., Rohde, L. A., Leibenluft, E., Salum, G. A. (2021).  Disruptive mood dysregulation disorder: Symptomatic and syndromic Thresholds and diagnostic operationalization. Journal of the American Academy of Child & Adolescent Psychiatry's, 60(2), 286-295. [Doi: 10.1016/j.jaac.2019.12.008]
Laporte, P. P., Matijasevich, A., Munhoz, T. N., Santos, I. S.,Barros, A. J. D., Samuel Pine, D., Rohde, L. A., Leibenluft, E.,
Salum1, G. A. (2019). Disruptive mood dysregulation disorder: Symptomatic and syndromic thresholds and diagnostic operationalization. Journal of the American Academy of Child & Adolescent Psychiatry, 60 (2), 286-295. [Doi: 10.1016/j.jaac.2019.12.008]
Linke, J. O., Adleman, N. E., Sarlls, J., Ross, A., Perlstein, S., Frank, H. R., Towbin, K. E., Pine, D. S., Leibenluft, E., Brotman, M. A. (2020). White matter microstructure in pediatric bipolar disorder and disruptive mood dysregulation disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 59(10), 1135-1145.  [Doi: 10.1016/j.jaac.2019.05.035]
Mayer, J. D., Salovey, P., Caruso, D. R., Sitarenios, G. (2003). Measuring emotional intelligence with the MSCEIT V2.0. Emotion, 3(1), 97-105.  [Doi: 10.1037/1528-3542.3.1.97]
Moeller, F. G., Barratt, E. S., Dougherty, D. M., Schmitz, J M. and Swann, A. C. (2001). Psychiatric aspects impulsivity. American Journal of Psychiatry, 158(11), 1783-1793.  [Doi: 10.1176/appi.ajp.158.11.1783]
Mulraney, M., Silk, T. J., Gulenc, A., Efron, D., Hazell, P., Sciberras, E. (2021). Persistence of disruptive mood dysregulation disorder in children with attention-deficit/hyperactivity disorder. Journal of Affective Disorders, 278, 502-505. [Doi: 10.1016/j.jad.2020.09.109]
Nilsen, F. A., Bang, H., Boe, O., Martinsen, Ø. L., Lang-Ree, O. C., Røysamb, E. (2021). The Multidimensional Self-Control Scale (MSCS): Development and validation. Psychological Assessment, 32(11), 1057-1074. [Doi:10.1037/pas0000950]
Patton, J.H., Stanford, M.S. and Barratt, E.S. (1995) Factor structure of the barratt impulsiveness scale. Journal of Clinical Psychology, 51(6),768-74. [Doi: 10.1002/1097-4679(199511)51:6<768::aid-jclp2270510607>3.0.co;2-1]
Peeters, N., Stappenbelt, S., Burk, W. J., van Passel, B., & Krans, J. (2021). Schema therapy with exposure and response prevention for the treatment of chronic anxiety with comorbid personality disorder. The British Journal of Clinical Psychology, 60 (1), 68–76.  [Doi: 10.1111/bjc.12271]
Piquero, A. R., Jennings, W. G., Farrington, D. P., Diamond, B., Gonzalez, J. M. R. (2016). A meta-analysis update on the effectiveness of early self-control improvement programs to improve self-control and reduce delinquency. Journal of Experimental Criminology, 12(2), 229-248. [Doi:10.1007/s11292-016-9257-z]
Poushaneha, K., Ghobari Bonab, B., & Hasanzadeh Namin, F. (2010). Effect of training impulse control on increase attention of children with attention–deficit/hyperactivity disorder. Procedia Social and Behavioral Sciences, 5, 983–987.  [Doi:10.1016/j.sbspro.2010.07.222]
Richard-Lepouriel, H., Kung, A., Hasler, R., Bellivier, F., Prada, P., Gard, S., Ardu, S., Kahn, J., Dayer, A., Henry, C., Aubry, J., Leboyer, M., Perroud, N., & Étain, B. (2019). Impulsivity and its association with childhood trauma experiences across bipolar disorder, attention deficit hyperactivity disorder and borderline personality disorder. Journal of Affective Disorders, 244, 33-41. [Doi: 10.1016/j.jad.2018.07.060]
Robinson, M. D., Klein, R. J. (2021). The momentary and the macro in action control: A motor control analysis of impulse control difficulties. Emotion (Washington, D.C.).
Soleimani, E., Hassani, M., & Talebi, M. (2018). The effectiveness of impulsive control training on quality of life in bully students. International Journal of Psychology, 12 (2), 24-45.
Sperry, L. (1999). Cognitive behavior therapy of DSM-IV disorder. USA: unner/ Mazel.
Stoddard, J., Wiggins, J. L., Wakschlag, L. S. (2021). Editorial: Defining the clinical boundary of disruptive mood dysregulation disorder symptoms in youth. Journal of the American Academy of Child & Adolescent Psychiatry's, 60(2), 216-218. [Doi: 10.1016/j.jaac.2020.12.019]
Tangney, J., Baumeister, R. F., & Boone, A. L. (2004). High self-control predicts good adjustment, less pathology, better grades, and interpersonal success. Journal of Personality, 72, 271–324.  [Doi: 10.1111/j.0022-3506.2004.00263.x]
Van Dijk, M., Veenstra, M. S., Bouman, R., Peekel, J., Veenstra, H., Van Dalen, J., & Voshaar, O. (2019). Group schema-focused therapy enriched with psychomotor therapy versus treatment as usual for older adults with cluster B and/or C personality disorders: a randomized trial. BMC Psychiatry, 19 (1), 26. [Doi: 10.1186/s12888-018-2004-4]
Van Maarschalkerweerd, F. A. T., Engelmoer, I. M., Simon, S., Arntz, A. (2021). Addressing the punitive parent mode in schema therapy for borderline personality disorder: Short-term effects of the empty chair technique as compared to cognitive challenging. Journal of Behavior Therapy and Experimental Psychiatry, 73,101678.
Vogel. M. and Van Ham, M. (2018). Unpacking the relationships between Impulsivity, neighborhood disadvantage, and adolescent violence: An application of a neighborhood-based group decomposition. Journal of Youth and Adolescence, 47(4), 859-871.
Waxman, S. E. (2011). A systematic review of Impulsivity in eating disorders. Impulsivity in eating disorders. European Eating Disorders Review, 17(3), 408–425. [Doi: 10.1002/erv.952]
Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner's guide. Guilford Press.
Zamani, N., Ahmadi, V., Ataie Moghanloo, V., & Mirshekar, S. (2014). Comparing the Effectiveness of two Therapeutic Methods of Dialectical Behavior Therapy and Cognitive Behavior Therapy on the Improvement of Impulsive Behavior in the Patients Suffering from Major Depressive Disorder (MDD) Showing a Tendency to Suicide.  Journal of Ilam University of Medical Sciences, 22 (5), 45-54.
Zare bahramabadi, M., & Ganji, K. (2014). The study of prevalence of attention deficit / hyperactivity disorder (ADHD) and it’s comorbidity with learning disorder (LD) in primary school’s students. Journal of Learning Disabilities, 3(4), 25-43. (Persian) [http://jld.uma.ac.ir/article_187.html?lang=en]