Razi Journal of Medical Sciences

fa تاثیر درمان مبتنی بر پذیرش و تعهد بر ویژگی‌های روانشناختی کودکان دارای اختلال ADHD The effect of treatment based on acceptance and commitment on the psychological characteristics of children with ADHD روانشناسی بالینی Clinical Psychiatry پژوهشي Research زمینه و هدف: اختلال نقص توجه /بیش فعالی یک اختلال عصبی رشدی است که دارای سه ویژگی اصلی نارسایی توجه ، بیش فعالی و تکانشگری میباشد. هدف از پژوهش حاضر تعیین تاثیر درمان مبتنی بر پذیرش و تعهد بر ویژگیهای روانشناختی کودکان دارای اختلال ADHD بود. روش کار: جامعه آماری تحقیق آزمایشی و کاربردی حاضر که به صورت میدانی با طرح پیش آزمون-پس آزمون و پیگیری انجام شد را دانشآموزان دارای اختلال ADHD در شهرستان خرم آباد تشکیل دادند که به صورت در دسترس 28 نفر از افراد داوطلب و واجد شرایط به عنوان نمونه انتخاب و به صورت تصادفی به دو گروه کنترل و تجربی تقسیم شدند. سپس آزمودنیهای گروه تجربی طی 9 جلسه دو ساعته و هر هفته یک جلسه تحت مداخلات درمان مبتنی بر پذیرش و تعهد قرار گرفتند. برای اندازهگیری متغیرهای پژوهش از پرسشنامه کیفیت زندگی کودکان و پکیج درمان مبتنی بر پذیرش و تعهد استفاده شد. نهایتا دادهها با استفاده از آزمونهای تحلیل واریانس با اندازهگیری مکرر و تعقیبی بونفرونی تجزیه و تحلیل شدند. یافتهها: نتایج نشان داد اثر زمان و تعامل زمان در گروه بر عملکرد جسمانی، عملکرد عاطفی، عملکرد اجتماعی، عملکرد تحصیلی و کیفیت زندگی تاثیر معناداری دارد. همچنین مشخص شد بین پیش آزمون و پس آزمون و پیش آزمون و پیگیری تفاوت معنداری وجود دارد که نشان دهنده تاثیر مداخله بر متغیرهای تحقیق میباشد. نتیجهگیری: با توجه به نتایج تحقیق توصیه میشود محققین و متخصصین جهت بهبود ویژگیهای روانشناختی کودکان دارای اختلال ADHD از درمان مبتنی بر پذیرش و تعهد استفاده کنند.      Introduction Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has three main features: inattention, hyperactivity, and impulsivity (1). People with ADHD have abnormalities in some areas of their personality. For example, in the brains of these children, the network system that plays a role in attention and alertness does not function properly (2). These children also have problems in the cerebellum and frontal lobes, especially the prefrontal lobe, which play a role in planning, organizing, decision-making, time perception, memory, inhibition, and thinking (3). They have difficulty focusing on a task or following instructions. Such a child may be spontaneously attracted to interesting things, but they have serious trouble paying attention to repetitive or less interesting tasks and topics. The most common complaints about inattention include: the child not listening to what is said, not following instructions, not completing homework and tasks. Given that there are different types of attention, it is not sufficient and correct to say that the child has low attention. In fact, a child can have a deficiency in only one type of attention (7). Given the negative impact of hyperactivity on individual and social life and the numerous mental and emotional problems that these children experience, researchers are constantly seeking to discover a method or methods to minimize the negative effects of hyperactivity and, as a result, improve the mental state of these children. And in this context, different methods have been used and different results have been obtained. In this context, one of these methods is acceptance and commitment therapy. Acceptance and Commitment Therapy, as one of the emerging third-generation therapies, seems to be more suitable for Iranian patients due to its integration with Eastern techniques. Acceptance and Commitment Therapy is rooted in a philosophical theory called functional contextualism and is based on a research program on language and cognition called the relational frame theory. Acceptance and commitment therapy has six central processes that lead to psychological flexibility. These six processes are acceptance, faultfinding, self as context, connection to the present, values, and committed action (8).  Acceptance and commitment therapy follows a model of health, not disease, and assumes that human psychological problems related to unhappiness and emotional disorders are caused by language. Accordingly, it works primarily on language to help people cope with cognitive and emotional problems (9). Considering the negative effects of hyperactivity on individual and social life, on the one hand, and the lack of general consensus on choosing the best intervention to help hyperactive children, the positive effect of acceptance and commitment therapy on psychological factors of parents of hyperactive children And since, after reviewing the research conducted in Iran and abroad, no research has been conducted on the effect of acceptance and commitment therapy on the psychological characteristics of hyperactive children, the present study seems necessary. Method The statistical population of the present semi-experimental and applied research, which was conducted in the field with a pre-test-post-test and follow-up design, consisted of students with ADHD in Khorramabad city. 28 volunteers and eligible individuals (with ADHD, not using medication, not receiving any treatment) were selected as a sample and randomly divided into two control and experimental groups. Then, the experimental group subjects underwent acceptance and commitment therapy interventions for 9 two-hour sessions, one session per week. To measure the research variables in the previous, immediate, and follow-up stages, the Children's Quality of Life Questionnaire and the Acceptance and Commitment Therapy Package were used. In addition, this article has been approved by the Research Ethics Committee of the Islamic Azad University of Ahvaz under the number IR.IAU.AHVAZ.REC.1399.117. Finally, descriptive statistics methods including mean and standard deviation and inferential statistics methods including repeated measures analysis of variance test and Bonferroni post hoc test were used to analyze the data using SPSS version 24 software. Results The results of the repeated measures analysis of variance test showed that for all variables, the provision of a treatment program based on acceptance and commitment was significant in the time factor and the interactive effect of time and group was significant (Table 1). The results showed that there was a significant difference between the pre-test and post-test in all research variables (quality of life and its components), which indicates the effect of the intervention based on acceptance and commitment. It was also found that there was a significant difference between the pre-test and follow-up in all variables, which indicates confirmation of the effect of time. Finally, no significant difference was observed between the post-test and follow-up, indicating the stabilization of the intervention effect (Table 2). Discussion The results of the present study showed that acceptance and commitment therapy has a significant effect on the quality of life and components of academic, physical, emotional, and social functioning in children with ADHD. It was also found that the effect of this intervention is lasting. In line with the findings of the present study, Fereydouni et al. (2018) showed in their study that acceptance and commitment therapy has a significant effect on increasing the psychological well-being score of transgender individuals (14). In another study in this regard, Hyunsak et al. (2018) showed that acceptance and commitment therapy increases psychological flexibility, reduces stress, and improves well-being (15). Also, Azizi Borujeni et al. (2016) showed in their research that acceptance and commitment therapy increased the quality of life and reduced the hours of Internet use in high school students with Internet addiction in the experimental group compared to the control group (16). In another study in the same field, Aafi et al. (2020) compared the effectiveness of mindfulness-based cognitive therapy and neurofeedback on the emotional self-regulation of ADHD children and concluded that mindfulness-based cognitive therapy had a greater effect on the emotional self-regulation of these children compared to neurofeedback (17). In another study in the same field and in line with the findings of the present study, they investigated the effectiveness of mentalization-based therapy on the quality of life of children with attention deficit/hyperactivity disorder (ADHD) and concluded that this therapy is effective on the quality of life of children in all dimensions. Researchers believe that this treatment can improve the quality of life of these children, especially in emotional functioning and emotion regulation, by promoting mentalization in ADHD children and their parents (4).   درمان مبتنی بر پذیرش و تعهد, ADHD, ویژگی‌های روانشناختی treatment based on acceptance and commitment, ADHD, psychological characteristics 0 0 http://rjms.iums.ac.ir/browse.php?a_code=A-10-8100-3&slc_lang=fa&sid=1 Tayebe Bahaadini طیبه بهاء الدینی t.bahaadini@gmail.com 3900319475328460090854 3900319475328460090854 Yes Islamic Azad University دانشگاه آزاد شهر کرد Hojjatollah Najafi Khorramabad حجت اله نجفی خرم آباد meysamaaa@yahoo.com 3900319475328460090855 3900319475328460090855 No Islamic Azad University دانشگاه آزاد اهواز