Razi Journal of Medical Sciences

other اثربخشی درمان مبتنی بر پذیرش و تعهد بر تنظیم هیجان و سلامت روانی در دانش آموزان مبتلا به بیش فعالی Effectiveness of Acceptance and Commitment Therapy on Emotion Regulation and Mental Health in Students with Attention Deficit Hyperactivity Disorder (ADHD) روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;"> زمینه و هدف: اختلال بیش‌فعالی/نقص توجه با مشکلات تنظیم هیجان و کاهش سلامت روانی در دانش‌آموزان همراه است. درمان مبتنی بر پذیرش و تعهد به‌عنوان رویکردی در ارتقای مهارت‌های روان‌شناختی مؤثر گزارش شده است. لذا هدف این مطالعه اثربخشی درمان مبتنی بر پذیرش و تعهد بر تنظیم هیجان و سلامت روانی در دانش آموزان مبتلا به بیش فعالی بود. روش کار: این پژوهش نیمه‌آزمایشی با طرح پیش‌آزمون-پس‌آزمون با گروه کنترل بر روی ۳۰ دانش‌آموز دختر مبتلا به بیش‌فعالی (۱۵ نفر گروه مداخله، ۱۵ نفر گروه کنترل) از شهرستان نور به صورت روش نمونه‌گیری هدفمند تصادفی انجام شد. ابزار گردآوری داده‌ها شامل پرسشنامه تنظیم هیجان گارنفسکی (2006) و پرسشنامه سلامت روان کودکان (CSI-4) بود. مداخله درمان مبتنی بر پذیرش و تعهد در ۸ جلسه ۹۰ دقیقه‌ای گروهی طبق پروتکل هیز و همکاران (2006) اجرا گردید. داده‌ها با آزمون تحلیل کوواریانس تک‌متغیره (ANCOVA) و با استفاده از نرم‌افزار SPSS نسخه ۲۶ تحلیل شد. یافته‌ها: نتایج نشان داد پس از کنترل اثر پیش‌آزمون، اثر مداخله درمان مبتنی بر پذیرش و تعهد بر تنظیم هیجان با 57/32=F و 0001/0>P معنادار بوده و اندازه اثر 65/0 است که نشان‌دهنده اثر قوی مداخله می‌باشد. همچنین اثر مداخله بر سلامت روانی با 62/29=F و 0001/0>P معنادار بوده و اندازه اثر 61/0 است. این نتایج تأیید می‌کند درمان مبتنی بر پذیرش و تعهد منجر به بهبود معنادار در تنظیم هیجان و ارتقای سلامت روانی دانش‌آموزان مبتلا به بیش‌فعالی شده است. نتیجه‌گیری: با توجه به نتایج این پژوهش، می‌توان نتیجه گرفت که درمان مبتنی بر پذیرش و تعهد می‌تواند به‌عنوان یک مداخله مکمل و مؤثر در کنار سایر خدمات آموزشی و درمانی برای دانش‌آموزان مبتلا به بیش‌فعالی به کار گرفته شود تا بتوان با ارتقای سلامت روانی و بهبود مهارت‌های تنظیم هیجان، مسیر رشد و سازگاری بهتر این دانش‌آموزان را در محیط مدرسه و زندگی روزمره هموار ساخت.<a name="_Hlk81950314"></a></div> <div> <table align="left" hspace="0" vspace="0"> <tbody> <tr> <td style="padding: 0in 12px; text-align: justify;" valign="top">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. </td> </tr> </tbody> </table> </div> <div style="text-align: justify;"></div> درمان مبتنی بر پذیرش و تعهد, تنظیم هیجان, سلامت روانی, بیش فعالی Acceptance and Commitment Therapy, Emotion Regulation, Mental Health, ADHD 578 588 http://rjms.iums.ac.ir/browse.php?a_code=A-10-8632-1&slc_lang=other&sid=1 Fazeh Fathi Livari فضه فتحی لیواری 3900319475328460089497 0009-0001-9240-8438 Yes Fatemeh Zarei Talebi فاطمه زارعی طالبی 3900319475328460089498 0009-0002-6257-3712 No MSc in Clinical Psychology, yazd Branch, Islamic Azad University, yazd, Iran Asma Rezaei Behzadi اسما رضائی بهزادی 3900319475328460089499 0009-0004-1256-4235 No Master's degree in Family Counseling, Counseling Department, Payam Noor University, Kahandezh Branch, Isfahan, Iran. کارشناسی ارشد مشاوره خانواده، گروه مشاوره، دانشگاه پیام نور، واحدکهندژ، اصفهان، ایران Elham Khorshidi Talab الهام خورشید طلب 3900319475328460089500 0009-0006-2396-3530 No Master of Counseling, Senior Department of Family Counseling, Khatam Unit, Non-Profit University, Tehran, Iran. Fateme Modab فاطمه مودب 3900319475328460089501 0009-0001-2232-8168 No Master of Clinical Psychology, Department of Psychology, Islamic Azad University, Maroodasht Branch, Shiraz, Iran. کارشناسی ارشد روانشناسی بالینی، واحد مرودشت، دانشگاه آزاد اسلامی، مرودشت، ایران Faezeh Mirzaei Khargoushki فائزه میرزایی خرگوشکی Faezeh.fm1374@gmail.com 3900319475328460089502 0009-0004-8292-6030 No : Master of Family Counseling, Counseling Group, Non-Profit University, Noor Branch, Mazandaran, Iran. کارشناسی ارشد مشاوره خانواده، گروه مشاوره، دانشگاه غیر انتفاعی، واحدنور، ایران