Effectiveness of Acceptance and Commitment Therapy on the Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) and Academic Procrastination of Adolescents with ADHD

Document Type : Original article

Authors

1 Department of Educational Psychology, Faculty of Humanities and Psychology, Tabriz Branch, Azad University of Tabriz, Tabriz , Iran

2 Department of educational science, Faculty of educational science and psychology, Tabriz Branch, Islamic Azad university of Tabriz, Tabriz, Iran

3 Department of educational science, Faculty of educational science and psychology, Islamic Azad university of Tabriz, Tabriz, Iran

Abstract

Background and Aim: ACT, as a promising approach, has received a lot of attention in the treatment of children and adolescents problem. The aim of the present study was to investigate the effectiveness of acceptance and commitment therapy on ADHD symptoms and academic procrastination of ADHD adolescents.
Materials and Methods: Following a pretest-posttest with control group quasi-experimental design, 16 adolescents with ADHD were selected from among clients of Psychiatric and Psychological Service centers with regard to the inclusion criteria and then randomly assigned into experimental (n=8) or control groups (n=8). Child Symptom Index (CSI-4) and Savari’s Academic Procrastination Scale were completed prior to the interventions by all participants and then participants of experiment group individually received a 10-session ACT intervention, while control group received no intervention. After the intervention, the in instruments were completed by participants again.
Results: The results of covariance analysis showed that the intervention had no significant effect on inattentiveness, but it was effective on hyperactivity/impulsivity. Also, the results showed that interventions reduced deliberate procrastination, caused by physical-mental fatigue and lack of schedule, and the total score of procrastination.
Conclusion:, Findings implicate that ACT is effective and promising intervention, specially for hyperactivity/impulsivity symptoms and procrastination.

Keywords

Main Subjects


  1. American Psychiatric Association. Diagnostic and Statistical Manualof Mental Disorders, 5th ed., (DSM-5). Washington, DC: American Psychiatric Association; 2013.##
  2. Barkley RA, Fischer M, Smallish L, & Fletcher, K. The persistence of attention deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. Journal of Abnormal Psychology. 2002; 111:279–289. ##
  3. Brook U. & Boaz M. Attention deficit and learning disabilities among high school pupils in Holon (Israel). Patient education and counseling. 2005; 58(2):164-167. ##
  4. Aman GM, Armstrong S, Buican B, Sillick T. Four-year follow up of children with low intelligence and ADHD: a replication. Research in developmental disabilities. 2002; 23(2):110-134. ##
  5. Retz W, Freitage CM, Retz-Junginger P, Wenzler D, Schneider M, Kissling C, Thome J, & Rosler M. A functional serotonin transporter promoter gene polymorphism increase ADHD symptom in delinquents: Interaction with diverse childhood environment. Psychiatry Research. 2008; 185 (2):123-131.  ##
  6. Lahey BB, Pelham WE, Stein MA, Loney J, Trapani C, Nugent K, et al. Validity of DSM-IV attention-deficit/hyperactivity disorder for younger children. Journal of the American Academy of Child and Adolescent Psychiatry. 1998; 37 (7):695-702. ##
  7. Usami M. Functional consequences of attention-deficit hyperactivity disorder on children and their families. Psychiatry and Clinical Neuroscience. 2016; 70(8): 303-317. ##
  8. Dewitte S, Schouwenburg HC. Procrastination, temptations, and incentives: the struggle between the present and the future in procrastinators and the punctual. European Journal of Personality. 2002; 16(6):469–489. ##
  9. Schouwenburg HC, Groenewoud T. Study motivation under social temptation: effects of trait procrastination. Personality and Individual Differences. 2001; 30(2):229–240. ##
  10. Deci EL, & Ryan RM. The ‘‘what’’ and ‘‘why’’ of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry. 2000; 11: 227–268. ##
  11. Schraw G, Wadkins T, & Olafson L. Doing the things, we do: A grounded theory of academic procrastination. Journal of Educational Psychology. 2007; 99 (1):12-25. ##
  12. Niermann HCM, & Scheres A. the relation between procrastination and symptoms of attention-deficit hyperactivity disorder (ADHD) in undergraduate students. International Journal of Methods in Psychiatric Research. 2014; 23 (4):411-421. ##
  13. Langberg JM, Epstein JN, Graham AJ. Organizational-skills interventions in the treatment of ADHD. Expert Review of Neurotherapeutics. 2008; 8(10):1549–1561. ##
  14. Newark PE, Stieglitz R. Therapy-relevant factors in adult ADHD from a cognitive behavioral perspective. ADHD Attention Deficit Hyperactivity Disorders. 2010; 2(2):59-72. ##
  15. Ramsay JR, Rostain AL. A cognitive therapy approach for adult attention-deficit/hyperactivity disorder. Journal of Cognitive Psychotherapy. 2003; 17(4):319-334. ##
  16. Schachter HM, Pham B, King J, Langford S, & Moher D. How efficacious and safe is short-acting methylphenidate for the treatment of attention-deficit hyperactivity disorder in children and adolescents? A meta-analysis. Canadian Medical Association Journal. 2001; 165:1475–1488. ##
  17. Dallnic A, Smith SW, Brank EM, & Penfield RD. Classroom-based cognitive-behavioral intervention to prevent aggression: Efficiency and social validity. Journal of School Psychology. 2006; 44:123-139. ##
  18. Hofmann SG, Sawyer AT, Witt AA, & Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting and Clinical Psychology. 2010; 78:169–183. ##
  19. Burke CA. Mindfulness-based approaches with children and adolescents: A preliminary review of current research in an emergent field. Journal of Child and Family Studies. 2010; 19:133-144. ##
  20. Grosswald SJ, Stixrud AWR, Stixrud W, Travis AF, & Bateh MA. Use of transcendental meditation technique to reduce symptoms of attention deficit hyperactivity disorder (ADHD) by reducing stress and anxiety: An exploratory study. Current Issues in Education. 2008; 10:1–16. ##
  21. Singh N, Singh AN, Lancioni GE, Singh J, Winton ASW, & Adkins AD. Mindfulness training for parents and their children with ADHD increases the children’s compliance. Journal of Child and Family Studies. 2010; 19: 157–174. ##
  22. Zylowska L, Ackermann DL, Yang MH, Futrell JL, Horton NL, Hale S, et al. Mindfulness meditation training in adults and adolescents with ADHD. A feasibility study. Journal of Attention Disorders. 2007; 11: 737–746. ##
  23. Van der Oord S, Bogels SM, Peijnenburg D. The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents. Journal of Child and Family Studies. 2012; 21:139–147. ##
  24. Hayes SC, Barnes-Holmes D, & Roche B. Relational frame theory: A post- Skinnerian account of human language and cognition. New York: Plenum Press, 2001. ##
  25. Öst LG. The efficacy of Acceptance and Commitment Therapy: An updated systematic review and meta-analysis. Behaviour Research and Therapy. 2014; 61: 105-121.  ##
  26. Hayes SC, Strosahl KD, &Wilson KG. Acceptance and Commitment Therapy: the process and practice of mindful change (2 edition). New York: The Guilford Press, 2012. ##
  27. Scent CL, & Boes SR. Acceptance and commitment training: a brief intervention to reduce procrastination among college students. Journal of College Student Psychotherapy. 2014; 28(2): 144-156. ##
  28. Fathi AA, Fathi Azar E, Badri R, Mirnasab M. Effectivness of academic procrastination reduction strategy training on academic procrastination of Tabriz high scholl students. Journal of Instraction and evaluation. 2015; 30 (8):45-57. [In Persian] ##
  29. Mohammad Esmail E. Validity and Reliability of CSI-F. Journal of Research in Exceptional Children. 2002; 2 (3):241-254. [In Persian] ##
  30. Harris R. ACT with love, Oakland: New Horbinger publication, 2009. ##
  31. Mitchell JT, McIntyre EM, English JS, Dennis MF, Beckham JC, & Kollins SH. A pilot trial of mindfulness meditation training for ADHD in adulthood: impact on core symptoms, executive functioning, and emotion dysregulation. Journal of attention disorders. 2017; 21(13):1105-1120. ##
  32. Hölzel BK, Lazar SW, Gard T, Schuman-Olivier Z, Vago DR, & Ott U. How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science. 2011; 6:537-559. ##
  33. Britton WB, Shahar B, Szepsenwol O, & Jacobs WJ. Mindfulness-based cognitive therapy improves emotional reactivity to social stress: Results from a randomized controlled trial. Behavior Therapy. 2012; 43:365-380. ##
  34. Keng SL, Smoski MJ, & Robins CJ. Effects of mindfulness on psychological health: A review of empirical studies. Clinical Psychology Review. 2011; 31:1041-1056. ##
  35. Shapiro SL, Carlson LE, Astin JA, & Freedman B. Mechanisms of mindfulness. Journal of Attention Disorders. 2006; 62:373-386. ##
  36. Smalley SL, Loo SK, Hale TS, Shrestha A, McGough J, Flook L, & et al. Mindfulness and Attention Deficit Hyperactivity Disorder. Journal of Clinical Psychology. 2009; 65(10):1087-1098. ##
  37. Wang S, Zhou Y, Yu S, Ran L, Liu X, Chen Y. Acceptance and Commitment Therapy and Cognitive-Behavioral Therapy as Treatments for Academic Procrastination: A Randomized Controlled Group Session. Research on Social Work Practice. 2015: 27 (1):1-11. ##
  38. Wohl MJA, Pychyl TA, Bennett SH. I forgive myself, now I can study: How self-forgiveness for procrastinating can reduce future procrastination. Personality and Individual Differences. 2010; 48: 803-808.
  39. Tice DM, & Bratslavsky E. Giving in to feel good: The place of emotion regulation in the context of general self-control. Psychological Inquiry. 2000; 11:149–159. ##
  40. Ecker M., Ebert DD, Lehr D, Sieland B, Berking M. Overcome procrastination: Enhancing emotion regulation skills reduce procrastination. Learning and Individual Differences. 2016; 52:10-18. ##
Volume 8, Issue 2
July 2019
Pages 106-118
  • Receive Date: 19 May 2018
  • Revise Date: 13 June 2018
  • Accept Date: 10 September 2018
  • First Publish Date: 22 June 2019