اثربخشی برنامه از کمرویی‌ به جرئت‌مندی بر علائم بالینی کودکان مبتلا به اختلال اضطراب جدایی و همراهی خانوادگی والدین آنها

نوع مقاله : مقاله پژوهشی

نویسندگان

1 استادیار گروه روان‌شناسی، دانشگاه گلستان،گرگان، ایران.

2 استادیار گروه روان‌شناسی، واحد بندر گز، دانشگاه آزاد اسلامی، بندر گز، ایران.

چکیده

مقدمه: هدف این پژوهش، بررسی اثربخشی برنامه از کمرویی‌ به جرئت‌مندی بر علائم بالینی کودکان مبتلا به اختلال اضطراب جدایی و همراهی خانوادگی والدین آنها بود.
روش: این پژوهش نیمه‌تجربی با طرح پیش‌آزمون – پس‌آزمون و پیگیری همراه با گروه کنترل بود. جامعة آماری تحقیق، کودکان مبتلا به اضطراب شهرستان گرگان و مادران آنها بودند که از بین آنها، 36 کودک با روش نمونه‌گیری هدفمند به عنوان نمونة پژوهش انتخاب و به دو گروه آزمایش و کنترل اختصاص داده شدند. برنامه از کمرویی به جرئت‌مندی در 10 جلسه برای برای والدین گروه آزمایش انجام شد. به منظور بررسی تأثیر مداخله در ابتدا و انتهای درمان و مرحله پیگیری، مقیاس‌های اضطراب کودکان اسپنس و همراهی خانوادگی بر روی مادران تمام کودکان اجرا شد. در نهایت از تحلیل کوواریانس و فرمول درصد بهبودی برای تجزیه و تحلیل داده‌ها استفاده شد.
نتایج: نتایج کاهش معنادار در اضطراب کودکان و همراهی خانوادگی والدین گروه آزمایش نسبت به گروه کنترل در پس‌آزمون و پیگیری نشان داد(05/0P<). نتایج معناداری بالینی هم نشان داد، اضطراب کودکان و همراهی خانوادگی والدین گروه آزمایش نسبت به گروه کنترل در مرحله پس‌آزمون و پیگیری، به طور معناداری بهبود یافت.
بحث و نتیجه‌گیری: برنامه از کمرویی‌ به جرئت‌مندی در بهبود علایم کودکان مبتلا به اضطراب و همراهی خانوادگی والدینشان مؤثر است. نتیجة این پژوهش و پژوهش‌های مشابه می‌تواند در حوزه‌های تشخیصی و درمانی اختلالات اضطرابی در کودکان مورد استفاده قرار گیرد.

کلیدواژه‌ها

عنوان مقاله [English]

Effectiveness of From Timid To Tiger Program on Clinical Symptoms of Children with Separation Anxiety Disorder and Family Accomadation of Their Parents

نویسندگان [English]

  • Mohsen Jalali 1
  • Elnaz Pourahmadi Esfastani 2
1 Assistant Professor of Clinical Psychology, Faculty of Humanities and Social Sciences, Golestan University, Gorgan, Iran.
2 Assistant Professor of Neuroscience, Department of clinical psychology, Bandargaz Branch,Islamic Aazad University, Bandargaz, Iran.
چکیده [English]

Introductin:The aim of this study was to evaluate the effectiveness of the  to Tiger program on the clinical symptoms of children with Separation Anxiety Disorder (SAD) and the family accommodation of their parents.
Method: This study employed a semi-experimental research design that included pretests, post-tests, and follow-up assessments with a control group. The statistical population of the research consisted of children with anxiety in Gorgan and their mothers. Thirty-six children were selected using purposive sampling as the research sample and were randomly allocated into experimental and control groups. The Timid to Tiger Program was conducted in 10 sessions for parents in the experimental group. To evaluate the effect of the intervention, the Spence Anxiety Scale and the Family Accommodation Scale were administered to the mothers of all participating children at the beginning, the end of treatment, and during the follow-up stage. Finally, analysis of covariance and the improvement percentage formula were utilized to analyze the data.
Results: The results indicated a significant reduction in anxiety among children and improved family accommodation among parents in the experimental group compared to the control group, as observed in both the post-test and follow-up (P < 0.05). The results of clinical significance indicated that the anxiety levels of children and the family accommodation of parents in the experimental group significantly improved compared to the control group in both the post-test and follow-up assessments.
Discussion and Conclusion: The FormTimid to Tiger Program is effective in reducing anxiety in children with Separation Anxiety Disorder and in enhancing parental accommodation. The results of this research, along with similar studies, can be applied in the fields of diagnosis and therapy for anxiety disorders in children.

کلیدواژه‌ها [English]

  • Child
  • Separation anxiety disorder
  • From Timid to tiger Program

مراجع

  1. Canals J, Voltas N, Hernández-Martínez C, Cosi S, Arija V. Prevalence of DSM-5 anxiety disorders, comorbidity, and persistence of symptoms in Spanish early adolescents. Eur Child Adolesc Psychiatry. 2019; 28: 131–143. https://doi.org/10.1007/s00787-018-1207-z
  2. Ghandour RM, Sherman LJ, Vladutiu CJ, Ali MM, Lynch SE, Bitsko RH, et al. Prevalence and treatment of depression, anxiety, and conduct problems in US children. J Pediatr. 2019; 206: 256–267. https://doi.org/10.1016/j.jpeds.2018.09.021. Epub 2018 Oct 12
  1. Curry JF, March JS. “Comorbidity of childhood and adolescent anxiety disorders,” in Phobic and Anxiety Disorders in Children and Adolescents: A Clinician’s Guide to Effective Psychosocial and Pharmacological Interventions, eds T. H. Ollendick and J. S. March (Oxford: Oxford University Press). 2004: 116–140. https://doi.org/10.1093/med:psych/9780195135947.003.0005
  2. Beidel DC, Turner SM. Shy Children, Phobic Adults: Nature and Treatment of Social Anxiety Disorder, 2nd Edn. Washington, DC: American Psychological Association, 2007. https://doi.org/10.1037/11533-000
  3. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSMIV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005; 62: 593–602. https://doi.org/10.1001/archpsyc.62.6.593
  4. World Health Organization. Health for the World’S Adolescents: A Second Chance in the Second Decade. Retrieved from: https://apps.who.int/ adolescent/second decade/files/1612_MNCAH_HWA_Executive_Summary. 2014. https://iris.who.int/handle/10665/112750
  5. In-Albon T, Meyer AH, Schneider S. Separation Anxiety Avoidance Inventory-Child and Parent Version: Psychometric Properties and Clinical Utility in a Clinical and School Sample. Child Psychiatry Hum Dev. 2013; 44: 689–697. https://doi.org/10.1007/s10578-013-0364-z
  6. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author; 2013. https://doi/book/10.1176/appi.books.9780890425596
  7. Espada JP, Mendez X, Orgiles M. Psychometric properties and ability of the separation anxiety scale for children. Eur Child Adolesc Psychiatry. 2008; 17: 365-372. https://doi.org/10.1007/s00787-008-0678-8. Epub 2008 Apr 21.
  8. Biederman J, Petty C, Faraone S, Hirshfeld-Becker DR, Henin A, Rauf A, et al. Childhood antecedents to panic disorder in referred and non referred adults. J Child Adolesc Psychopharmacol. 2005; 15: 549–562. ‌ https://doi.org/10.1089/cap.2005.15.549
  9. Kendall PC, Compton SN, Walkup JT, Birmaher B, AlbanoAM, Sherill A. Clinical Characteristics of anxiety disorderes youth. J Anxiety Disord. 2010; 24: 360-365‌.‌ https://doi.org/10.1016/j.janxdis.2010.01.009. Epub 2010 Feb 6
  10. Ceyhan A, Ceyhan E. Relationship between early separation anxiety and depressive symptoms: The mediating role of locus of control and problem-solving skills. Pakistan Journal of Social and Clinical Psychology. 2009; 7(1): 3–17. https://www.gcu.edu.pk/pages/gcupress/pjscp/volumes/pjscp2009-1.pdf
  11. Schneider S, Blatter-Meunier J, Herren, C, Adornetto C, In-Albon T, Lavallee K. Disorder-specific cognitive-behavioral therapy for separation anxiety disorder in young children: A randomized waiting-list-controlled trial. Psychother Psychosom. 2011; 80(4): 206-215. https://doi.org/10.1159/000323444
  12. Breinholst S, Esbjorn BH, Reinholdt-Dunne ML, Stallard P. CBT for the treatment of child anxiety disorders: A review of why parental involvement has not enhanced outcomes. J Anxiety Disord. 2012; 26: 416–424. https://doi.org/10.1016/j.janxdis.2011.12.014
  13. Lewinsohn PM, Holm-Denoma JM, Small JW, Seeley JR, Joiner TE. Separation anxiety disorder in childhood as a risk factor for future mental illness. J Am Acad Child Adolesc Psychiatry. 2008; 47(5): 549-556. https://doi.org/10.1097/CHI.0b013e31816765e7
  14. Silverman WK, Pina AA, Viswesvaran C. Evidence-based psychosocial treatments for phobic and anxiety disorders in children and adolescents. J Clin Child Adolesc Psychol. 2008; 37: 105–130. https://doi.org/10.1080/15374410701817907
  15. Cobham VE, Dadds MR, Spence SH, McDermott B. Parental anxiety in the treatment of childhood anxiety: A different story three years later. J Clin Child Adolesc Psychol. 2010; 39: 410–420. https://doi.org/10.1080/15374411003691719
  16. Micco JA, Henin A, Mick E, Kim S, Hopkins CA, Biederman J. Anxiety and depressive disorders in offspring at high risk for anxiety: a metaanalysis. J Anxiety Disord. 2009; 23(8): 1158-1164. https://doi.org/10.1016/j.janxdis.2009.07.021
  17. Suveg C, Sood E, Comer JS, Kendall PC. Changes in emotion regulation following cognitive-behavioral therapy for anxious youth. J Clin Child Adolesc Psychol. 2009; 38. https://doi.org/10.1080/15374410902851721
  18. Cooper-Vince CE, Pincus DB, Comer JS. Maternal intrusiveness,family financial means, and anxiety across childhood in a large multiphase sam-ple of community youth. J Abnorm Child Psychol. 2014; 42(3): 429–438. https://doi.org/10.1007/s10802-013-9790-4
  19. Lebowitz ER, PanzaKE, Su J, Bloch MH. Family accommodationin obsessive–compulsive disorder. Expert Rev Neurother. 2013; 12(2): 229–238. https://doi.org/10.1586/ern.11.200
  20. Lebowitz ER, Woolston J, Bar-Haim Y, Calvocoressi L, Dauser C, Warnick E, et al. Family accommodation in pediatric anxiety disorders. Depress Anxiety. 2013; 30: 47–54. https://doi.org/10.1002/da.21998
  21. Caporino N, Morgan J, Beckstead J, Phares V, Murphy T, Storch EA. A structural equation analysis of family accommodation in pediatricobsessive–compulsive disorder. J Abnorm Child Psychol. 2012; 40(1): 133–143. https://doi.org/10.1007/s10802-011-9549-8
  22. McLeod BD, Wood JJ, Weisz JR. Examining the association between parenting and childhood anxiety: a meta-analysis. Clin Psychol Rev. 2007; 27(2): 155–172. https://doi.org/10.1016/j.cpr.2006.09.002
  23. Flessner CA, Sapyta J, Garcia A, Freeman JB, Franklin ME, Foa E, et al. Examining the psychometric properties of the Family Accommodation Scale-Parent-Report (FAS-PR). J Psychopathol Behav Assess. 2011; 33(1)‌: 38–46. https://doi.org/10.1007/s10862-010-9196-3
  24. Ginsburg GS, Siqueland L, Masia-Warner C, Hedtke KA. Anxiety disorders in children: family matters. Cogn Behav Pract. 2004; 11(1): 28–43. https://doi.org/10.1016/S1077-7229(04)80005-1
  25. Lebowitz ER,Omer H,Hermes H, Scahill L. Parent Training for Childhood Anxiety Disorders: The SPACE Program. Cogn Behav Pract. 2014; 21: 456-469. https://doi.org/‌10.1016/j.cbpra.2013.10.004
  26. Peters TE, Connolly S. Psychopharmacologic Treatment for Pediatric Anxiety Disorders. Child Adolesc Psychiatr Clin N Am. 2012; 21: 789–806. https://doi.org/10.1016/j.chc.2012.07.007
  27.  Kodish I, Rockhill C, Varley C. Pharmacotherapy for anxiety disorders in children and adolescentsDialogues Clin Neurosci. 2012; 13(4): 439–452. https://doi.org/10.31887/DCNS.2011.13.4/ikodish
  28. Eisen AR, & Toffey KL. Separation anxiety disorder. In B. O. Olatunji (Ed.), The Cambridge handbook of anxiety and related disorders. Cambridge University Press; 2019. 550-575. https://doi.org/10.1017/9781108140416.020
  29. Eisen AR, Sussman JM, Schmidt T, Mason L, Hausler LA, Hashim R. Separation anxiety disorder. In McKay, D. & Storch, E. A. (ed.), Handbook of Child and Adolescent Anxiety Disorders, Part 4. New‌York: NY: Springer Science + Business Media; 2011. 245-259. https://doi.org/10.1007/978-1-4419-7784-7_17
  30. Comer JS, Puliafico AC, Aschenbrand SG, McKnight K, Robin JA, Goldfine ME, Albano A. M. A pilot feasibility evaluation of the CALM Program for anxiety disorders in early childhood. J Anxiety Disord. 2012; 26(1): 40–49. https://doi.org/10.1016/j.janxdis.2011.08.011. Epub 2011 Aug 25.
  31. Möller EL, Nikolić M, MajdandŽić M, Bögels SM. Associations between maternal and paternal parenting behaviors, anxiety and its precursors in early childhood: a meta-analysis. Clin Psychol Rev. 2016; 45: 17–33. https://doi.org/10.1016/j.cpr.2016.03.002
  32. Cartwright-Hatton S, Roberts C, Chitasbesan P, Fothergill C, Harrington R. Systematic review of the efficacy of cognitive behaviour therapies for childhood and adolescent anxiety disorders. Br J Clin Psychol. 2004; 43, 4: 1–436. https://doi.org/10.1348/0144665042388928
  33. Kennedy SJ, Rapee RM, Edwards SL. A selective intervention program for inhibited preschool-aged children of parents with an anxiety disorder: Effects on current anxiety disorders and temperament. J Am Acad Child Adolesc Psychiatry. 2009; 48: 602–609. https://doi.org/10.1097/CHI.0b013e31819f6fa9
  34. Hirshfeld-Becker DR, Masek B, Henin A, Blakely LR, Pollock-Wurman RA, McQuade J, Biederman J. Cognitive behavioral therapy for 4- to 7-year-old children with anxiety disorders: A randomized clinical trial. J Consult Clin Psychol. 2010; 78: 498–510. https://doi.org/10.1037/a0019055
  35. Eisen AR, Raleigh H, Neuhoff CC. Parent-Child Interaction Therapy for Treatment of Separation Anxiety Disorder in Young Children: A Pil the Unique Impact of Parent Training for Separation Anxiety Disorder in Children. Behav Ther. 2008; 39: 195–206. https://doi.org/10.1016/j.beth.2007.07.004
  36. Lau EX, Rapee RM, Coplan RJ. Combining child social skills training with a parent early intervention program for inhibited preschool children. J Anxiety Disord. 2017; 51: 32–8. https://doi.org/10.1016/j.janxdis.2017.08.007
  37. Havighurst SS, Wilson KR, Harley AE, Kehoe CE. Dads “Tuning in to Kids”: a randomized controlled trial of an emotion socialization parenting program for fathers. Soc Dev. 2019; 28: 979–97. https://doi.org/10.1111/sode.12375
  38. Thienemann,M., Moore, P., & Tompkins, K. A parent-only group intervention for children with anxiety disorders: pilot study. J Am Acad Child Adolesc Psychiatry. 2006; 45: 37–46. https://doi.org/10.1097/01.chi.0000186404.90217.02
  39. Cartwright-Hatton, S. From timid to tiger. Chichester, UK: Wiley-Blackwell,2010. https://books.google.com/books/about/From_Timid_To_Tiger.html?id=eP8deUQbsU0C
  40. Cartwright-Hatton S, McNally D, Field AP, Rust S, Laskey B, Dixon C, Woodham A. A new parenting-based group intervention for young anxious children: Results of a randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2011; 50: 242–251. https://doi.org/10.1016/j.jaac.2010.12.015
  41. Merry SN. 'Timid to Tiger' group parenting training reduces anxiety diagnoses in 3-9-year-olds. Evid Based Ment Health. 2011; 14, 74. https://doi.org/10.1136/ebmh.14.3.74
  42. بازرگان ع، سرمد ز، حجازی ا. روش تحقیق در علوم رفتاری. تهران: نشر آگاه؛ 1402.  
  43. دلاور ع. روش تحقیق در روان‌شناسی و علوم رفتاری(ویراست پنجم). تهران: انتشارات ویرایش؛ 1401.
  44. Gadow KD, Sprafkin J. Child symptom inventories manual. Stony brook, Ny: Checkmate Plus, 1994. https://search.worldcat.org/title/Child-symptom-inventory-4-:-screening-and-norms manual/oclc/175006479
  45. Spence SH. A measure of anxiety symptoms among children. Behav Res Ther. 1998; 36: 545–566. https://doi.org/‌10.1016/s0005-7967(98)00034-5
  46. Kaufman J, Birmaher B, Brent D, Rao UMA, Flynn C, Moreci P, et al. Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J. Am. Acad. Child Adolesc. Psychiatry. 1997; 36: 980–988. https://doi.org/10.1097/00004583-199707000-00021
  47. Whiteside SP, Brown AM. Exploring the Utility of the Spence Children’s Anxiety Scales Parent- and Child-Report Forms in a North American Sample. J Anxiety Disord. 2008; 22: 1440-1446. https://doi.org/ 10.1016/j.janxdis.2008.02.006
  48. Nauta MH, Scholing A, Rapee RM, Abbott M, Spence SH, Waters A. A parent-report measure of children’s anxiety: psychometric properties and comparison with child-report in a clinic and normal sample. Behav Res Ther. 2004; 42: 813–839. https://doi.org/10.1016/S0005-7967(03)00200-6
  49. Jalali Mohsen, Mahmoodi H, Pourahmadi Esfestani E. Spence children’s anxiety scale through parent report: Psychometric properties in a community sample of Iranian children. Journal of Research in Psychopathology. 2020; 1(2): 48-40. https://doi.org/10.22098/jrp.2020.1087 [In Persian]
  50. محمداسماعیل ا، پور احمد ع‌. بررسی اعتبار روایی و نقاط برش اختلال‌های پرسشنامه علائم مرضی کودکان 4 CSI-بر روی دانش‌آموزان شش تا 14 ساله مدارس ابتدایی و راهنمایی شهر تهران. پژوهش در حیطه کودکان استثنایی، 1383؛ 2(3): 239-254. 20120327152725-4003-24.pdf
  51. زمانی م، جلالی م، پوراحمدی ا. نقش همراهی خانوادگی با علایم کودک، شیوه‌های فرزندپروری و استرس والدگری در پیش‌بینی شدت اختلالات اضطرابی در کودکان 6 تا 10 ساله در استان گلستان. مجله دانشگاه علوم پزشکی گرگان، 1398؛ 21(‌2): 88-98. http://goums.ac.ir/journal/article-1-3268-fa.html
  52. Shahrivar, Z, Kousha, M, Moallemi, S, Tehrani-Doost, M, Alaghband-Rad, J . The Reliability and Validity of Kiddie-Schedule for Affective Disorders and Schizophrenia - Present and Life-time Version - Persian Version. child and Adolescent Mental Health. 2010; 15: 97–102. https://doi.org/10.1111/j.1475-3588.2008.00518.x
  53. Ogles BM, Lunnen KM, Bonesteel K. Clinical Significance: History, Application, and Current Practice. Clin Psychol Rev. 2010; 21(3): 421-446. https://doi.org/10.1016/s0272-7358(99)00058-6
  54. Pincus DB, Chase R, Chow CW, Weiner CL, Cooper-Vince C, Eyberg SM. Efficacy of modified Parent-Child Interaction Therapy for young children with separation anxiety disorder. Paper presented at the the 44th annual meeting of the Association for Behavioral and Cognitive Therapies, San Francisco: CA; 2010. https://doi.org/10.1007/s10567-014-0172-4
  55. Sanders M, Calam R, Durand M, Liversidge T, Carmont SA. Does self-directed and web-based support for parents enhance the effects of viewing a reality television series based on the Triple P—Positive Parenting Programme? J Child Psychol Psychiatry. 2011; 49: 924–932. https://psycnet.apa.org/doi/10.1111/j.1469-7610.2008.01901.x
  56. Rapee RM. Family factors in the development and management of anxiety disorders. Clin Child Fam Psychol Rev. 2012; 15(1): 69-80. https://doi.org/10.1007/s10567-011-0106-3
  57. Wheatcroft R, Creswell C. Parental cognitions and expectations of their preschool children: the contribution of parental anxiety and child anxiety. Br J Dev Psychol. 2007; 25(3): 435-441. https://doi.org/10.1348/026151006x173288
  58. Herren C, In-Alban T, Schneider S. Beliefs regarding child anxiety and parenting competence in parents of children with separation anxiety disorder. J Behav Ther Exp Psychiatry. 2012; 44(1): 53-60. https://doi.org/10.1016/j.jbtep.2012.07.005

 

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