تاثیر آموزش والدگری مبتنی بر ذهن‌آگاهی به مادران کودکان با اختلال نارسایی توجه/بیش-فعالی بر بهبود مشکلات درونی‌شده مادران و کاهش رفتارهای برونی‌سازی‌شده فرزندانشان

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناسی ارشد روانشناسی، گروه روانشناسی، دانشگاه زنجان، زنجان، ایران

2 استادیار گروه روانشناسی، دانشگاه زنجان، زنجان، ایران

چکیده

مقدمه و اهداف
با توجه به شیوع بالای اختلال نارسایی توجه/بیش‌فعالی در کودکان و مشکلات روانشناختی که به­ واسطه ویژگی­ های رفتاری این کودکان برای والدین و به ­ویژه مادرانشان ایجاد می‌شود، پژوهش حاضر به بررسی تاثیر آموزش والدگری مبتنی بر ذهن‌آگاهی بر بهبود رفتارهای درونی‌سازی­شده مادران (اضطراب و افسردگی) و رفتارهای برونی‌سازی­شده (رفتارهای قانون‌شکنانه و پرخاشگرانه) فرزندان با نارسایی توجه/ بیش‌فعالی پرداخته است.
مواد و روش­ ها
در مطالعه حاضر از روش پژوهش نیمه­آزمایشی با طرح پیش ­آزمون-پس‌ آزمون با گروه کنترل استفاده شد. تعداد 30 نفر از مادرانی که فرزندان‌شان به ­واسطه‌ی نظر معلمان، پرسشنامه مرضی کودکان فرم والدین و مصاحبه تشخیصی مبتلا به این اختلال تشخیص داده شده بودند، به­ صورت نمونه‌گیری در دسترس انتخاب و در دو گروه آزمایش و کنترل ب ه­صورت تصادفی جایگزین شدند. به منظور سنجش رفتارهای برونی‌سازی­شده کودکان و مشکلات درونی‌سازی­ شده مادرانشان به ­ترتیب از فهرست رفتاری کودکان CBCL و مقیاس بیمارستانی اضطراب و افسردگی HADS استفاد شد. سپس گروه آزمایش طی هشت جلسه سه ساعته تحت آموزش والدگری مبتنی بر ذهن ­آگاهی قرار گرفتند. پس از اتمام جلسات پس ­آزمون گرفته شد. داده‌های به­ دست ­آمده از پژوهش حاضر با استفاده از آزمون آماری تحلیل کوواریانس و به کمک نرم ­افزار آماری SPSS21 تحلیل شد.
یافته­  ها
یافته­ ها نشان داد که میزان اضطراب و افسردگی مادران شرکت­کننده در گروه آزمایش به­طور معناداری کاهش یافته است (0/05<p). همچنین بر اساس گزارش مادران میزان رفتارهای برونی­سازی­شده کودکان در گروه آزمایش نسبت به گروه شاهد کاهش بیشتری یافته بود که با 0/05
 
نتیجه­ گیری
با توجه به یافته‌های حاصل از پژوهش حاضر می‌توان گفت سبک والدگری مبتنی بر ذهن‌آگاهی باعث کاهش میزان اضطراب و افسردگی مادران می‌شود و همچنین به کاهش رفتارهای برونی­ سازی­ شده کودکان‌شان می‌انجامد.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Effectiveness of Mindful Parenting Training to Mothers of Children with Attention Deficit- Hyperactivity Disorder to Improve the Internalized Problems of Mothers and Reduce the Externalized Problems of Their Children

نویسندگان [English]

  • Leila Merajifar 1
  • Mohsen Amiri 2
  • Loghman Ebrahimi 2
1 MSc in Psychology. Department of Psychology, University of Zanjan, Zanjan, Iran
2 PhD, Assistant Professor, Department of psychology, University of Zanjan, Zanjan, Iran
چکیده [English]

Background and Aims: Considering the prevalence of Attention Deficit/Hyperactivity Disorder (ADHD) in children and its respective psychological problems for their parents and in particular their mothers, the present study investigated the effectiveness of training mindful parenting on improving internalizing behaviors of mothers (e.g. Depression and Anxiety) and externalizing behaviors (Rule Breaking Behavior, Aggressive Behavior) of their kids.  
Materials and Methods: A quasi-experimental study with pre-test and post-test design and control group was carried out on 30 mothers whose children were diagnosed with ADHD chosen through convenient sampling and randomly divided into experimental and control groups. Depending on the exit criteria for absence in more than one session, the group experienced a decline and the results were analyzed for 24 mothers. The research instruments were CSI-4 (1994), the child behavior check list (CBCL) for Parents (1991), and hospital anxiety and depression questionnaire (1983). Training mothers with mindfulness approach was accomplished in eight 3-hour sessions. At the end, both control and experimental groups completed the above-mentioned questionnaires as post-test. The collected data were analyzed using covariance, added scores, and independent samples t-test.
Results: The results revealed the effectiveness of mindful parenting methods on decreasing mother’s anxiety and depression (P<0/05) and also the effectiveness of the method on decreasing children’s externalizing problem (P<0/05) in the experimental group in comparison with the control group.
Conclusion: Generally, findings showed that mindful parenting method will decrease the mother’s internalizing problems (Depression and Anxiety) and children’s externalizing problem (Rule Breaking Behavior, Aggressive Behavior).

کلیدواژه‌ها [English]

  • Mindful parenting
  • Attention Deficit/Hyperactivity Disorder (ADHD)
  • Externalizing behaviors
  • Internalizing behaviors
1.             Association A.P. Diagnostic and statistical manual of mental disorders (DSM-5®)2013: American Psychiatric Pub.##
2.             Thomas R, et al. Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics. 2015;135(4): 994-1001. ##
3.             Frodl T, Skokauskas N. Meta‐analysis of structural MRI studies in children and adults with attention deficit hyperactivity disorder indicates treatment effects. Acta Psychiatrica Scandinavica. 2012;125(2):114-126. ##
4.             Capusan  A.J, et al. Childhood maltreatment and attention deficit hyperactivity disorder symptoms in adults: a large twin study. Psychological medicine. 2016; 46(12):2637-2646. ##
5.             Davison G.C, Neale J.M. Abnormal Psychology New York: John Willey and Sons 1994. ##
6.             Theule J, Wiener J, Rogers M.A, Marton I. Predicting parenting stress in families of children with ADHD: Parent and contextual factors. Journal of child and family studies. 2010;20(5):640-647##
7.             Barkley R.A. Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment2014: Guilford Publications. ##
8.             Thijssen J. Children with externalizing behavior problems: risk factors and preventive efforts 2016. ##
9.             Kuja‐Halkola R, et al. Codevelopment of ADHD and externalizing behavior from childhood to adulthood. Journal of Child Psychology and Psychiatry. 2015;56(6):640-647. ##
10.          Mustillo S, et al. Obesity and psychiatric disorder: developmental trajectories. Pediatrics. 2003;111(4): 851-859. ##
11.          Cunningham C.E, Boyle M.H. Preschoolers at risk for attention-deficit hyperactivity disorder and oppositional defiant disorder: Family, parenting, and behavioral correlates. Journal of abnormal child psychology. 2002; 30(6):555-569. ##
12.          Aunola K, Nurmi J.E. The role of parenting styles in children's problem behavior. Child development, 2005; 76(6):1144-1159. ##
13.          Huber J.S. The mediating effect of sibling warmth on parental stress in families with children who have attention deficit hyperactivity disorder. Florida State University 2010. ##
14.          Johnston C, Mash E.J. Families of children with attention-deficit/hyperactivity disorder: review and recommendations for future research. Clinical child and family psychology review.2001; 4(3): 183-207. ##
15.          Willis T, Lovaas I. A behavioral approach to treating hyperactive children: The parent’s role. Learning disabilities and related disorders. 1977; 19-140. ##
16.          Lundahl B, Risser H.J., Lovejoy M.C. A meta-analysis of parent training: Moderators and follow-up effects. Clinical psychology review. 2006; 26(1): 86-104. ##
17.          Bögels S. Restifo K. Mindful parenting: A guide for mental health practitioners2013: Springer. ##
18.          Geurtzen N, et al. Association between mindful parenting and adolescents’ internalizing problems: non-judgmental acceptance of parenting as core element. Journal of Child and Family Studies. 2015; 24(4): 1117-1128. ##
19.          Kabat‐Zinn J. Mindfulness‐based interventions in context: past, present, and future. Clinical psychology: Science and practice. 2003;10(2):144-156. ##
20.          Freeman W.S., Johnston C, Barth F.M. Parent attributions for inattentive-overactive, oppositional-defiant, and prosocial behaviours in children with attention deficit hyperactivity disorder. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement.1997; 29(4):239. ##
21.          Duncan L.G., Bardacke N. Mindfulness-based childbirth and parenting education: promoting family mindfulness during the perinatal period. Journal of Child and Family Studies. 2010;19(2):190-202. ##
22.          Williams K.L., Wahler R.G. Are mindful parents more authoritative and less authoritarian? An analysis of clinic-referred mothers. Journal of Child and Family Studies. 2010;19(2):230-235. ##
23.          de Bruin E.I., et al. Mindful parenting assessed further: Psychometric properties of the Dutch version of the Interpersonal Mindfulness in Parenting Scale (IM-P). Mindfulness. 2014; 5(2): 200-212. ##
24.          Bögels S.M., Lehtonen A, Restifo K. Mindful parenting in mental health care. Mindfulness. 2010;1(2): 107-120. ##
25.          Miller-Lewis L.R., et al. Early childhood externalising behaviour problems: Child, parenting, and family-related predictors over time. Journal of abnormal child psychology. 2006; 34(6):886-901. ##
26.          Latendresse G. Mindful Birthing: Training The Mind, Body And Heart For Childbirth And Beyond. Journal of Midwifery & Women’s Health. 2013; 58(3):351-351. ##
27.          Germer C. The mindful path to self-compassion: Freeing yourself from destructive thoughts and emotions 2009: Guilford Press. ##
28.          Neff K. Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and identity. 2003; 2(2):85-101. ##
29.          Segal Z.V., Williams J.M.G., Teasdale J.D. Mindfulness-based cognitive therapy for depression.2012: Guilford Press. ##
30.          Gadow K, Sprafkin J. Child symptom inventories manual (CSI: parent checklist and CSI: teacher checklist): Screening instruments for childhood emotional and behavioral disorders, 1994: Stony Brook, NY: Checkmate Plus. ##
31.          Gadow K.D., Sprafkin J. ADHD Symptom Checklist-4 (ADHD-SC4)1997: Stony Brook, NY: Checkmate Plus. ##
32.          Satoorian S.A, Ahmadi M.R. T.K. The role of parenting Dimensions and Child-Parent Relationship in Children's Internalized and Externalized Behavioral Problems. family research. 2017;12(4): 683-705. ##
33.          Glosser R. Examination of the relationship between the child behavior checklist/6-18 and the social responsiveness scale parent forms using individuals with high functioning autism 2011. ##
34.          Zigmond A.S. Snaith R.P. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica. 1983; 67(6):361-370. ##
35.          Härter M, Reuter K, Gross-Hardt, Bengel J, Screening for anxiety, depressive and somatoform disorders in rehabilitation. Disability and Rehabilitation. 2001; 23(16):737-744. ##
36.          Meppelink, R., et al. Mindful parenting training in child psychiatric settings: heightened parental mindfulness reduces parents’ and children’s psychopathology. Mindfulness, 2016. 7(3): p. 680-689. ##
37.          Potharst, E.S., et al., Mindful with your baby: Feasibility, acceptability, and effects of a mindful parenting group training for mothers and their babies in a mental health context. Mindfulness. 2017;8(5):1236-1250. ##
38.          Miller C.J., Brooker B. Mindfulness programming for parents and teachers of children with ADHD. Complementary therapies in clinical practice.2017; 28:108-115. ##
39.          Bögels S.M., et al. Mindful parenting in mental health care: effects on parental and child psychopathology, parental stress, parenting, coparenting, and marital functioning. Mindfulness. 2014;5(5):536-551. ##
40.          Corthorn C. Milicic N. Mindfulness and parenting: A correlational study of non-meditating mothers of preschool children. Journal of Child and Family Studies. 2016;25(5):1672-1683. ##
41.          Van der Oord S., Bögels S.M., 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(1):139-147. ##
42.          Moreira H., Canavarro M.C. Psychometric properties of the Interpersonal Mindfulness in Parenting Scale in a sample of Portuguese mothers. Mindfulness. 2017; 8(3): 691-706. ##
43.          Beer M., Ward L, Moar K. The relationship between mindful parenting and distress in parents of children with an autism spectrum disorder. Mindfulness. 2013; 4(2):102-112. ##
44.          Coatsworth J.D., et al. Integrating mindfulness with parent training: Effects of the mindfulness-enhanced strengthening families program. Developmental Psychology. 2015;51(1):26. ##
45.          Moradiyani Gizeh Rod SK, HosseiniRamaghani NS., Merabi M. Aggression of mothers with children suffering from oppositional defiant disorder. Armaghane-danesh. 2016; 21(6):576-590. ##
46.          Ghazanfari F, Moradiyani Gizeh Rod S.Kh, Mehrabi M, Panahi H. The effectiveness of mindfulness-based parenting program on the general health of mothers who have children with oppositional defiant disorder. Urmia University of medical Sciences. 2016;27(7):1027-3727. ##
47.          Modinos G., Ormel J, Aleman A. Individual differences in dispositional mindfulness and brain activity involved in reappraisal of emotion. Social cognitive and affective neuroscience. 2010; 5(4):369-377. ##
48.          Keng S.-L., Smoski M.J., Robins C.J. Effects of mindfulness on psychological health: A review of empirical studies. Clinical psychology review. 2011; 31(6):1041-1056. ##
49.          Richardson C.M. Emotion regulation in the context of daily stress: Impact on daily affect. Personality and Individual Differences. 2017;112:150-156. ##
50.          Emmons R.A. Stern R. Gratitude as a psychotherapeutic intervention. Journal of clinical psychology.2013; 69(8):846-855. ##
51.          Krieger T., et al. Self-compassion in depression: Associations with depressive symptoms, rumination, and avoidance in depressed outpatients. Behavior Therapy.2013; 44(3):501-513. ##
52.          Westphal M., et al. Self-compassion and emotional invalidation mediate the effects of parental indifference on psychopathology. Psychiatry research. 2016; 242:186-191. ##
53.          Elices M., et al. Compassion and self-compassion: Construct and measurement. Mindfulness & Compassion, 2017; 2(1):34-40. ##
54.          Singh N.N., et al. Mindfulness training for parents and their children with ADHD increases the children’s compliance. Journal of Child and Family Studies. 2010; 19(2):157-166. ##
55.          Bögels S., et al. Mindfulness training for adolescents with externalizing disorders and their parents. Behavioural and cognitive psychotherapy. 2008; 36(2):193-209. ##
56.          Singh N.N., et al. Mindful parenting decreases aggression and increases social behavior in children with developmental disabilities. Behavior Modification. 2007; 31(6):749-771. ##
57.          Parent J., et al. Mindfulness in parenting and coparenting. Mindfulness.2016;7(2):504-513. ##
58.          Behbahani M Z.F.Effectiveness of Mindful Parenting Training on Clinical Symptoms and Self-Efficacy in children with Attention Deficit Hyperactivity Disorder. Isfahan Medical School. 2017;35(429):511-7. ##
59.          Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. University of Massachusetts Medical Center/Worcester.(1991). ##
60.          Ingoldsby E.M., et al. Neighborhood disadvantage, parent–child conflict, neighborhood peer relationships, and early antisocial behavior problem trajectories. Journal of abnormal child psychology.2006;34(3):293-309. ##
61.          O'leary S.G., Vidair H.B. Marital adjustment, child-rearing disagreements, and overreactive parenting: predicting child behavior problems. Journal of Family Psychology. 2005;19(2):208. ##
62.          Burke C.A. 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(2):133-144. ##