نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناس ارشد روانشناسی، گروه روانشناسی عمومی، دانشکده ادبیات و علوم انسانی، دانشگاه لرستان

2 استادیار گروه روانشناسی عمومی، دانشکده ادبیات و علوم انسانی، دانشگاه لرستان، خرم آباد.

3 استادیار گروه روانشناسی عمومی، دانشکده ادبیات و علوم انسانی، دانشگاه لرستان، خرم آباد

چکیده

چکیده
ن
ﻫﺪف ﻛﻠﻲ در پژوهش حاضر، تعیین اثربخشی درمان شناختی مبتنی بر ذهن­آگاهی بر افسردگی و اضطراب مادران کودکان اختلال طیف اتیسم بود. طرح پژوهش به صورت نیمه­آزمایشی از نوع پیش­آزمون­ـ پس­آزمون و پیگیری با گروه گواه بود، جامعه مورد مطالعه به روش نمونه­گیری در دسترس و از مادران مراجعه­کننده به خیریه اتیسم حضرت زینب اصفهان انتخاب شد که از میان آنها تعداد20 نفر به طور تصادفی، به دو گروه10 نفری آزمایشی و گواه تقسیم شدند. در مرحله پیش­آزمون، پس­آزمون و پیگیری یک ماهه به منظور سنجش میزان افسردگی و اضطراب مادران وهمچنین برای گرد­آوری داده­ها از پرسشنامه اضطراب بک و افسردگی بکII استفاده شد. گروه آزمایشی تحت درمان گروهی شناخت درمانی مبتنی بر ذهن­آگاهی، طی 8 جلسه 120 دقیقه ای قرار گرفت و گروه گواه هیچ­گونه درمانی دریافت نکرد. برای تجزیه و تحلیل داده­ها از تحلیل کوواریانس چند متغیره استفاده شد. نتایج پژوهش نشان داد که در مرحله پس­آزمون وپیگیری نمره‌های افسردگی و اضطراب در افراد گروه آزمایشی بعد از مداخله به طور معنی­داری کاهش یافته­ است. بنابراین، نتایج این پژوهش بر اهمیت کاربرد این مداخله دردرمان افسردگی و اضطراب مادران کودکان اختلال طیف اتیسم و ارائه افق­های جدید در مداخلات بالینی این افراد تاکید دارد.

کلیدواژه‌ها

عنوان مقاله [English]

The Effectiveness of Mind fullness-based Cognitive Group Therapy on Depression & Anxiety in Mothers of Children with Autism Spectrum Disorder

نویسندگان [English]

  • shahnaz adibi sede 1
  • mohammadali sepahvandi 2
  • simin gholamrezaei 3

1 Master student, Department of General Psychology ,Persian Literature and Humanities Faculty, University of Lorestan.

2 Assistant Professor, Department of General Psychology, Faculty of Persian Literature and Humanities, University of Lorestan.

3 Assistant Professor, Department of General Psychology, Persian Literature and Humanities faculty, University of Lorestan

چکیده [English]

Introduction
Indeed, many notable parameters such as difficult and late diagnosis, occurrence of symptoms after a natural and normal course of growth, lack of effective treatment of autism spectrum disorder and special care which is needed by autism children, can affect the mental health of parents, and in particular mothers. In psychotherapy research, mindfulness is considered as one of the new therapies in the field of relapse prevention and an enhanced state of self-awarness thought in order to improve the depression and anxiety. Considering the existence of mood disorders and anxiety in mothers of children with autism spectrum disorder, the overall aim of this study was to determine the effectives of mindfullness-based cognitive therapy on depression and anxiety in mothers of children with autism spectrum disorder.
 
Method:
This research, which Is a quasi-experimental study, compromised of per-test, post-test and follow-up study with the control group. The sample group was selected by available sampling method from mothers referred to the Isfahan “Hazrat Zainab” autism charity. Therefore, 20 subjects were chosen randomly and assigned to two control and experimental groups (each with 10 subjects). In order to assess the severity of depression and anxiety in mothers, Beck Depression Inventory-II and Beck Anxiety Inventory were used in pre-test, post-test and one month follow-up phases. The experimental group recieved the mindfulness-based cognitive group therapy for eight 2-hours sessions each week and the control group did not receive any treatment. Analysis of MANCOVA was used to analyze the data.
 
Results
The results of the research revealed that at the post-test stage, depression and anxiety scores decreased significantly in the experimental group after the intervention. Moreover, the experimental group was followed up for one month after the treatment, which no changes were observed in the mentioned scores, compared to the post-test phase. It is worth mentioning that the conditions for the control group were almost the same and no changes were occurred.
 
Conclusions
Therefore, mindfulness-based cognitive therapy   has been effective in the treatment of depression and anxiety in autistic children's mothers. The results emphasized the importance ofusing thisintervention in treating depression and anxiety in mothers of children with autism spectrum disorder and presenting new insights in clinical interventions. This research showed that using this treatment, reduce psychological problems of mothers of autistic spectrum children, such as their depression and anxiety were reduced, which ultimately lead to prominent results such as the life expectancy increase, adapting to the conditions of the child's illness, better relations with others, having more social activities and reduction of depression and anxiety problems.

کلیدواژه‌ها [English]

  • mindfulness-based cognitive therapy
  • Anxiety
  • Depression
  • mothers of children with autism spectrum disorder
Allen, N. B., & Knight, W. E. J. (2005). Mindfulness, compassion for self, and compassion for other: Implication for psychopathology and treatment of depression. In P. Gilbert (Ed), compassion: Conceptualizations, research and use in psychotherapy. (239-262). New York: Psychology Press.
Aalto, A. M., Elovainio, M., Kivimäki, M., Uutela, A., & Pirkola, S., (2012). The Beck Depression Inventory and General Health Questionnaire as measures of depression in the general population: A validation study using the Composite International Diagnostic Interview as the gold standard. Psychiatry Research, 197 (1), 163-171.
American Psychiatric Association. (2013). Diagnostic & statistical manual of mental disorders(5th ed). Arlington, VA: American Psychiatric Publishing.
Azadyekta, M. (2013). Effectiveness of Coping Strategies in Reducing Anxiety in Mothers of Children with Autism Spectrum Disorder, Quarteriy Journal of Family and Research, 10 (3) ,119-130. [Persian].
Beyrami, M., Movahedi, Y., Mohammadzadegan, R., Movahedi, M &Vakili, S. (2013). The Effectiveness of Group-Based Cognitive Therapy Based on Mindfulness in Reducing Anxiety and Depression in High School Students. Journal of Psychological Achievements, 20 (2), 1-18. [Persian].
Beyrami, M., Hashemi, T., Bakhshipour, A., Ali Lou, M. M., & Eghbali, A. (2014).Comparison of the effect of emotional education and cognitive therapy based on mindfulness on psychological distress and cognitive strategies of emotional regulation of mothers of mentally retarded children. Quarterly Journal of Advanced Psychological Research, 9 (33), 43-60. [Persian].
Beck, A. T., & Steer, R. A. (1990). Beck Anxiety Inventory Manual. San Anto: Psychological Corporation.
Beck, A. T., Steer, R. A.,&  Brown, G. K. (1996). Manual for the Beck Depression Inventory. 2nd ed. San Antonio: TX: The Psychological Corporation.
Beidel, D. C., Frueh, B. C., & Hersen, M. (2014). Adult Psychopathology & Diagnosis. Published by John wiley & Sons, Inc, Hoboken, New Jersey.
Berjis, M., Hakim Javadi, M., Taher, M., Lavasani, Gh. M. & Hossein Khanzadeh, A. A. (2013). A comparison of the amount of worry, hope and meaning of life in the mothers of deaf children, children with autism, and children with learning disability, Journal of Learning Disabilities,3(1), 148-155. [Persian]
Carney, C. E., Moss, T. G., Harris, A. L., Edinger, J. D., & Krystal, A. D. (2011). Should we be anxious when assessing anxiety using the Beck Anxiety Inventory in clinical insomnia patients? Journal of Psychiatric Research, 45, 1243-1249.
Center for Disease Control. New data on Autism: Five Important Facts to Know. Autism Spectrum Disorder. (2014). Retrieved from http://www. cdc.gov/ncbddd/autism/date.html.(6/2/2017).
Conner, M. C., & White, S. W. (2014). Stress in mothers of children with autism: Trait mindfulness as a Protective factor. Research in Autism Spectrum Disorders, 8, 617-624.
Dabson, K., & Mohammad Khani, P. (2007). Psychometric characteristics of the Beck Depression Inventory(2) in patients with MDD in partial remission. Journal Rehabil, (8), 80-86. [Persian].
De Bruin, E. I., Blom, R., Smit., F. M., Steensel, V., & Bogels, S. M. (2014).
My mind: Mindfuiness training for youngsters with ASD and their parents. Autism, 1-9.
Dimidjian, S., Goodman, S. H., Felder, J. N., Gallop, R., Brown, A. P., & Beck, A. (2015). An open trial of mindfulness-based cognitive therapy for the Prevention of perinatal depressive relapse/re currence. Arch Womens Ment Health, 18 (1), 85-94.
Egede, L. E., & Hernandez– Tejada, M. A., (2013). Effect of comorbid depression on quality of life in adults with type 2 diabetes. Review Information Health Care, 13 (1), 83-91.
Glanz, B. I., Degano, I. R., Rintell, D. J., Chitnis, T., weiner, H. L., & Healy, B. C. (2012). Work productivity in relapsing multiple sclerosis: associations with depression, fatigue, anxiety, cognition & health – relatedquality of life. Value in Health, 15 (8), 1029 – 1035.
Gray, D. E. (2010). High functioning autistic children and the construction of “normal family life”. Journal of Social & Medicine, 44 (8), 1097-1106.
Hayes, S. C., & Strosahl, K. D. (2010). Apractical Guide to Acceptance & Commitment Therapy. New York: Springer Science & Business Media Inc.
Hobart, H. M., & Smith, W. (2014). Autism and family in the People’s Republic of China: Learning from parents' perspectives. Research & Practice for Persons with Severe Disabilities, 33 (1-2), 37-47.
Hofman, S. G., Sawyer, A. T., With, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Journal of Consulting Clinical Psychology, 78 (2), 69-83.
Kaviyani, H., & Mosavi, A. (2008). Psychometric properties of the Beck anxiety inventory in population age and sex classes. Journal Sch Med, 66(2), 136-140. [Persian].
Khaleghipour, Sh; Zargar, F. (2014). Effect of mindfulness-based cognitive therapy on depression and life expectancy in mothers of children with Intellectual disabilities. Journal Research Behaver Science, 12(2), 44-53. [Persian].
Khormayi, E. (2011). The Effectiveness of Group-Based Cognitive-Behavioral Therapy on the Depression of Mothers of Autistic Children. Master's Degree of Consultation, Allameh Tabataba'i University. [Persian].
Kim, I., Ekas, V. N., & Hock, R. (2016). Associations between child behavior problems, family management & depressive symptoms for mothers of children with autism spectrum disorder. Research in Autism Spectrum Disorders, (26), 80-90.
Mace, C. (2006). Long-term impact of mindfulness practice on well-being: New finding from qualitative research. In A. Delle five(Ed), Dimension of well-being, research and intervention, (455-469). Milan: Franco Angeli.
Mami, Sh., & Amirian, K. (2015). Effect of cognitive-behavioral group therapy on mental health and irrational beliefs of mothers with autistic children. Journal of Women and Family Studies, 8 (30), 69-82. [Persian].
Munshi, K., Eisendrath, S., & Delucchi, K. (2013). Preliminary long-term follow-up of Mindfulness-based cognitive therapy-induce remission of depression. Mindfulness (NY), 4 (4), 354-361.
Ogeston, P. L., Mackintosh, V. H., & Myer B. J. (2011). Hope and worry in mothers of children with an autism spectrum disorder or Down syndrome.Research in Autism Spectrum Disorders, 5 (4), 1378-1384.
Omidi, A., & Mohammad Khani, P. (2008). Train mental presence as a clinical intervention. Quarterly Journal of Mental Health, 1 (1), 29-38. [Persian].
Patten, S. B., Williams, J. V., lavarato, D. H., Koch, M., & Metz, L. M. (2013).  Depression as a predictor of occupational transition in a multiple sclerosis cohort.Functional Neurology, 28 (4), 275-280.
Rafiei, M., & Seifi, A.( 2013). An investigation into the reliability and validity of Beck Anxiety Inventory among the university students. Journal of Thought & Behavior in Clinical Psychology, 7(27), 43-50. [Persian].
Rafiei, H. (2012). Autism: Evaluation and treatment, 92-187. [Persian]. Tehran University Press.
Rahimi, CH. (2014). Using Beck Depression Inventory for Iranian students, Clinical Psy., & Personality Journal, 21(10), 173-188. [Persian].
Rajabi, S., & Yazdkhasti, F. (2014).The effectiveness of acceptance and commitment group therapy on anxiety and depression in women with MS who referred to the MS association. Journal of Clinical Psychology,6(1), 29-39. [Persian].
Saltzman, A., & Goldin, P.(2008). Mindfulness- based stress reduction for school-age children. In L. A. Greco & S. C. Hayes (Eds). Mindfulness and Acceptance for children and adolescents (pp, 139-161). Oakland, CA: New York
Seif, F., Rahimi, Ch., & Mohammadi, N. (2016).The effectiveness of  individual and group cognitive-behavioral therapies on depression      decrease and ejection fraction increase in coronary heart disease. Journal of Psychology Achievements, 4(23)(1), 1-22. [Persian].
Sharma, M. P., Mao, A., & Sudhir, P. M. (2012). Mindfulness-Based Cognitive Behavior Therapy in Patients with Anxiety Disorders: A Case Series.Indian J Psychol Med, 34 (3), 263-269.
Shu, B. C., Lung, F., W., & Chang, Y. Y. (2000). The mental health in mothers with autistic children: A care- control study in southern Taiwan, Kaohsiung. Journal of Medical Science, 16 (6), 308-334.
Taheri, P., Garmarudi, GH., Azadbakht, M., Fakrizadeh, Z., Hamidi, R., Fathizadeh, SH., & Ghisvandi, A. (2015). Evaluation of validity and reliability of second version of Beck Depression Questionnaire in Iranian elderly (BDI-II). Journal of Medical Science, 22(1), 189-198. [Persian].
Teasdale, J. D., Williams, J. M. G., Segal, Z. V., Ridgeway, V.A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse recurrence in major depression by mindfulness based cognitive therapy. Journal of Consulting and Clinical Psychology,(68), 615-623.
World Health Organization. .(2012). Depression. Retrieved October. From http://www.who.int