Volume 29, Issue 11 (1-2023)
RJMS 2023, 29(11): 578-588 |
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Fathi Livari F, Zarei Talebi F, Rezaei Behzadi A, Khorshidi Talab E, Modab F, Mirzaei Khargoushki F. Effectiveness of Acceptance and Commitment Therapy on Emotion Regulation and Mental Health in Students with Attention Deficit Hyperactivity Disorder (ADHD). RJMS 2023; 29 (11) :578-588
URL: http://rjms.iums.ac.ir/article-1-9126-en.html
URL: http://rjms.iums.ac.ir/article-1-9126-en.html
Fazeh Fathi Livari * 
, Fatemeh Zarei Talebi , Asma Rezaei Behzadi , Elham Khorshidi Talab , Fateme Modab , Faezeh Mirzaei Khargoushki
, Fatemeh Zarei Talebi , Asma Rezaei Behzadi , Elham Khorshidi Talab , Fateme Modab , Faezeh Mirzaei Khargoushki
Abstract: (14 Views)
| Background & Aims: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental disorders in children and adolescents, characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with academic performance, social functioning, and psychological well-being. One of the significant challenges faced by students with ADHD is poor emotion regulation, which often exacerbates behavioral problems, impairs peer relationships, and reduces overall mental health. Inadequate emotion regulation may also increase vulnerability to anxiety, depression, and oppositional behaviors in these students, negatively impacting their educational and social adaptation. Acceptance and Commitment Therapy (ACT), as a third-wave behavioral therapy, emphasizes mindfulness, acceptance of internal experiences, cognitive defusion, and committed action in alignment with personal values, aiming to increase psychological flexibility and adaptive functioning. Previous research has shown promising results for ACT in improving emotional and behavioral difficulties in various populations, but there is limited evidence specifically targeting emotion regulation and mental health in adolescents with ADHD. Therefore, the present study aimed to investigate the effectiveness of Acceptance and Commitment Therapy on improving emotion regulation and enhancing mental health in students diagnosed with ADHD. Methods: This semi-experimental study was conducted using a pre-test and post-test design with a control group. The statistical population consisted of all female middle school students diagnosed with ADHD in Nour County during the 2021-2022 academic year. Using purposive random sampling, 30 students who demonstrated poor emotion regulation and lower levels of mental health based on screening assessments were selected and randomly assigned to an intervention group (n=15) and a control group (n=15). Data collection tools included the Garnefski Cognitive Emotion Regulation Questionnaire (CERQ, 2006), an 18-item self-report scale with nine subscales assessing various cognitive coping strategies, and the Child Symptom Inventory (CSI-4), a standardized screening tool aligned with DSM-IV criteria for assessing psychiatric symptoms in children and adolescents. The intervention group received Acceptance and Commitment Therapy in eight 90-minute group sessions based on the protocol developed by Hayes et al. (2006), focusing on mindfulness skills, acceptance of unpleasant emotions, cognitive defusion techniques, values clarification, and committed action planning to align behaviors with personal values despite challenging thoughts and emotions. The control group received no intervention during the study period. Data analysis was performed using descriptive statistics (mean, standard deviation) and inferential statistics, specifically univariate analysis of covariance (ANCOVA), to control for pre-test scores and assess the post-test differences between groups. All analyses were conducted using SPSS version 26, and a significance level of p<0.05 was considered. Results: The findings revealed that after controlling for pre-test scores, the intervention had a significant effect on improving emotion regulation (F=32.57, p<0.0001) with a large effect size (η²=0.65), indicating a strong impact of ACT on enhancing the students' ability to manage and regulate emotions effectively. Furthermore, the intervention significantly improved mental health outcomes in the students (F=29.62, p<0.0001) with a large effect size (η²=0.61), reflecting meaningful improvements in psychological well-being, reduction of behavioral symptoms, and emotional stability in the intervention group compared to the control group. The results align with previous studies highlighting the effectiveness of ACT in improving psychological flexibility, reducing experiential avoidance, and fostering adaptive emotion regulation, leading to better mental health outcomes among adolescents. Conclusion: In conclusion, the present study demonstrates that Acceptance and Commitment Therapy can be effectively utilized as a complementary and impactful intervention alongside educational and therapeutic services for students with ADHD. By focusing on the development of mindfulness, acceptance, cognitive defusion, and commitment to valued actions, ACT facilitates improvements in emotion regulation and promotes better mental health among adolescents struggling with ADHD symptoms. These improvements may contribute to enhanced adaptability in school environments, better interpersonal relationships, and overall psychological resilience in the face of challenges commonly experienced by these students. Given the chronic and pervasive nature of ADHD and its associated emotional difficulties, incorporating ACT within school-based mental health programs and clinical interventions can serve as a preventive and supportive strategy, enhancing the growth and functional outcomes of adolescents with ADHD in their educational and daily lives. Further research with larger sample sizes and longitudinal follow-up is recommended to examine the sustainability of the therapeutic effects and the potential for integration with other evidence-based interventions targeting ADHD symptoms, emotion regulation deficits, and co-occurring emotional and behavioral issues in this population. |
Type of Study: Research |
Subject:
Clinical Psychiatry
