اثربخشی درمان خودشفقت ورزی بر افسردگی، اضطراب و تنیدگی مادران کودکان با اختلال نارسایی توجه/ فزون کنشی (مقاله علمی وزارت علوم)
درجه علمی: نشریه علمی (وزارت علوم)
آرشیو
چکیده
این پژوهش با هدف بررسی اثربخشی درمان خودشفقت ورزی بر افسردگی، اضطراب و تنیدگی مادران کودکان با اختلال نارسایی توجه/ فزون کنشی بود. در این پژوهش از روش شبه تجربی با طرح پیش آزمون – پس آزمون با گروه گواه، همراه با دوره پیگیری استفاده شد. نمونه شامل 28 مادر از مادران کودکان 5 تا 11 ساله پسر و دختر مبتلا به اختلال نارسایی توجه/ فزون کنشی شهر رشت در سال 1400-1399 بود که به روش نمونه گیری دردسترس، انتخاب و در دو گروه آزمایش و گواه به شیوه تصادفی جای دهی شدند. گروه آزمایش به مدت 8 جلسه هفتگی در دوره آموزشی درمانی خودشفقت ورزی به صورت گروهی شرکت داده شدند و گروه گواه پس از پایان مطالعه، خلاصه ای از درمان را به طور فشرده دریافت کردند. هر دو گروه در سه مرحله پیش آزمون و پس آزمون و پیگیری با پرسشنامه افسردگی، اضطراب و تنیدگی ارزیابی شدند. برای تحلیل داده ها از آزمون تحلیل واریانس با اندازه گیری مکرر استفاده شد. یافته های پژوهش نیز نشان دادند درمان خودشفقت ورزی اثر معناداری بر نمره افسردگی، اضطراب و تنیدگی دارد؛ بدین ترتیب که نمرات افسردگی، اضطراب و تنیدگی در مرحله پس آزمون نسبت به پیش آزمون، به طور معناداری کاهش یافته است؛ این کاهش معنادار در دوره پیگیری نیز پایدار بود. نتایج نشان دادند آموزش خودشفقت ورزی نتایج بسیار مفیدی برای مادران، به ویژه برای کاهش افسردگی، اضطراب و تنیدگی آنها دارد و می تواند به منزله یکی از آموزش های برتر در مقایسه با سایر آموزش ها اجرا شود.Attention-Deficit / Hyperactivity Disorder, mothers, psychological distress, self-compassion
This study aimed to investigate the effectiveness of self-compassion therapy on depression, anxiety, and stress among mothers of children with attention-deficit/hyperactivity disorder. A quasi-experimental method with a pretest-posttest-follow-up design with a control group was used. The sample consisted of 28 mothers of 5 to 11-year-olds boys and girls with attention deficit/hyperactivity disorder in Rasht in 2020-2021. They were selected by convenience sampling and randomly assigned to experimental and control groups. The experimental group participated in the compassion self-treatment training group for eight weekly sessions, and the control group received a concise summary of the treatment after the end of the study. Both groups were administered a questionnaire on depression, anxiety, and stress three times for pre-test, post-test, and follow-up. The analysis of variance with repeated measures was used to analyze the data. Findings showed that self-compassion treatment significantly affected depression, anxiety, and stress scores. In the post-test stage, depression, anxiety, and stress scores were significantly lower as compared to the pre-test. Moreover, this significant decrease in the follow-up was also stable. The results showed that self-compassion training could benefit mothers, significantly reducing depression, anxiety, and stress. Therefore, it can be implemented as one training compared to other training.
Introduction
Attention-Deficit / Hyperactivity Disorder (ADHD) is characterized by ADHD, Impulsivity, and Hyperactivity Disorder. The disorder has three categories: inattentive, hyperactive/impulsive, and combined. The prevalence of this disorder in the United States is about 7% and internationally reported between 2 and 21% (By Toft et al., 2017). Based on psychological theories and studies, the effects of children with ADHD on other family members, especially the mother, have been accepted (Sussman et al., 2022). Since the mother is the first caregiver of the child and the first stages of development have an undeniable effect on human personality, and because many psychological problems are rooted in this interaction, the relationship between mother and child has been of particular interest (Theule et al., 2013). Because this connection is so close and intertwined that any change in one or the other is subject to change and transformation. In this regard, the mother, who has the most contact and closeness with the child, can be more at risk of such problems (Lertxundi et al., 2022).
Having a child with special needs can cause many psychological, economic, and social problems and pressures for families. If left unchecked, it can lead to high levels of psychological distress (Aszaslan & Yıldırım, 2021). Studies indicate the vital role of personal characteristics and environmental and cognitive factors in the severity of depression, stress, and anxiety of parents (Beaton et al., 2020; Si et al., 2020). In this regard, Narconam et al. (2014) examined the prevalence of stress among parents of children with ADHD. According to the results of this study, 69.7% of parents reported high levels of stress and those mothers had more problems than fathers. There was also a significant relationship between the severity of the child's disorder and parental stress.
One of the positive therapies is self-compassion, which has been less addressed concerning parents of children with ADHD (Navab et al., 2019). Self-compassion therapy is a popular, comprehensive, integrated approach to a meta-diagnostic treatment. Research on its effectiveness and acceptability has also increased over the past ten years as treatment progresses and is more effective than other individual and self-help interventions (Craig et al., 2020). Due to the importance of investigating this issue, the present study aimed to investigate self-compassion training on depression, anxiety, and stress in mothers of children with ADHD.
Method
Research method, statistical population, and sample: The present study was an applied research study that employed a quasi-experimental study with a pre-test, post-test, and follow-up design. The statistical population of the study included all mothers of children with ADHD. The participants were selected from among those who were referred to the Comprehensive Rehabilitation Center for Children and Adolescents of Gil and the specialized pediatric clinic of Shafa Hospital in Rasht in 2020-2021.
Short form of Depression, Anxiety, and Stress Questionnaire: This questionnaire was prepared by Lovibond and Lovibond (1995). This scale has two forms. The main form includes 42 terms. One hundred forty-four different terms evaluate depression, anxiety, and stress. The short form contains 21 terms that measure each of the seven terms of a psychological factor or structure. Each subscale consists of 7 questions scored on a Likert scale from zero to three. In addition, the participants were asked to rate the extent to which they experienced each state in the past week using a 4-point intensity/frequency scale. The range of scores obtained for each subscale is from 0 to 21: the higher scores indicate higher psychological distress.
Results
This study examined 28 mothers of children with ADHD in two groups of 14, including self-compassion training and control. The mean age of children in the experimental group (8.14 79 1.79) years and in the control group (7.92 7 1.43) years and the age range of 5-11 years. Most mothers were between 30-39 years old, nine people (64.3%) were in the experimental group, and ten people (71.4%) were in the control group. The majority of mothers in the experimental group were 12 (85.7%) and in the control group were 10 (71.4%) without physical or psychological disorders.
Table 1. Results of analysis of variance with repeated measurement of experimental and control groups in the research stages
Source
SS
df
MS
F
P
Eta
OP
Time
68/786
2
32/893
19/617
0/001
0/430
0/936
Depression
Group
144/048
1
144/048
4/409
0/046
0/145
0/855
Time * Group
69/024
2
32/512
20/583
0/001
0/442
0/912
Time
56/024
2
28/012
9/082
0/001
0/259
0/861
Anxiety
Group
189
1
189
4/473
0/044
0/147
0/877
Time * Group
90/929
2
45/464
14/741
0/001
0/362
0/905
Time
219/310
2
109/655
38/232
0/001
0/595
0/956
Stress
Group
855/048
1
855/048
47/358
0/001
0/646
0/983
Time * Group
328/881
2
164/440
57/334
0/001
0/688
0/973
The results in Table 1 show that the effect of the group on the variables of depression, anxiety, and stress is significant. Therefore, it can be said that there was a significant difference between the mean scores mentioned between the experimental and control groups. The effect of time on all variables of depression, anxiety, and stress was significant. Therefore, regardless of the group, there was a significant difference between the mean scores in the three stages. The interaction effect between time and group was also significant for all depression, anxiety, and stress variables. Therefore, it can be said that the difference in the mean scores of the variables of depression, anxiety, and stress at different times varies according to the variable levels of the group.
Conclusion
This study aimed to investigate the effectiveness of self-compassion therapy on depression, anxiety, and stress in mothers of children with ADHD. The study results showed a significant difference between the experimental and control groups regarding depression, anxiety, and stress. In addition, the findings indicate that mothers who received self-compassion training were less depressed, anxious, and stressed than mothers who did not receive training. These findings are in line with the results of Nawab et al. (2019), Anderson and Guitar (2015), Chronis et al. (2006), and Beaton et al. (2020).
Self-compassion produces inner awareness, unconditional acceptance, empathy, and constant attention to inner feelings. Therefore, it increases problem-solving ability, self-control, belief in a bright future, staying calm under pressure, flexibility in dealing with obstacles, avoiding boring strategies, and positive emotions in challenging times (Neff, 2003). Because compassion translates more negative emotions about itself into positive emotions, thereby reducing depression, anxiety, and depression in mothers of children with ADHD (Inwood & Ferrari, 2018). Research findings also confirm the relationship between self-compassion and mental health and well-being indicators, including reducing depression and anxiety and increasing self-esteem, happiness, and optimism, improving marital relationships, and, consequently, the durability of marriages. Therefore, it is vital to address the research that examines the components that affect the positive functioning of the family (Wilson et al., 2019).
Ethical Consideration
Compliance with Ethical Guidelines
The participants participated in the current research with written consent and all the rights of the participants to participate in the research have been respected.
Authors’ Contributions
All authors contributed to the study. The first author participated in writing, ideation, background collection, and editing. The second author participated in the data analysis and interpretation of the results. The third author participated in coordinating with the hospital to conduct the course and research samples. The fourth author provided recommendations in the discussion and conclusions, and the fifth author was in charge of implementing the protocol.
Conflict of Interest
Conducting this research has not resulted in any conflict of interest for the authors and its results have been reported in a completely transparent and unbiased manner.
Funding
The current research was done without any financial support from any particular organization.
Acknowledgment
The authors thank all participants in the study.
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