نوع مقاله : مقاله پژوهشی

نویسندگان

• مجتبی احمدی فارسانی ¹
• ایران داودی ²
• مهناز مهرابی زاده هنرمند ³

¹ گروه روانشناسی، دانشکده علوم تربیتی و روانشناسی، دانشگاه شهید چمران اهواز، اهواز، ایران.

² استادیار، گروه روان‌شناسی، دانشگاه شهید چمران اهواز، اهواز، ایران

³  استاد، گروه روان‌شناسی، دانشگاه شهید چمران اهواز، اهواز، ایران

چکیده

هدف پژوهش حاضر مقایسه اثربخشی توانبخشی شناختی با و بدون تحریک الکتریکی مستقیم فرا جمجمه‌ای بر بهبود کنترل مهاری، انعطاف‌پذیری شناختی و علائم وسواسی-جبری در نوجوانان مبتلابه اختلال وسواسی-جبری بود. روش پژوهش حاضر ‌آزمایشی با طرح پیش‌آزمون-پس‌آزمون و پیگیری و تخصیص تصادفی آزمودنی‌ها بود. جامعه آماری پژوهش عبارت بود از نوجوانان دختر و پسر مبتلابه اختلال وسواسی- جبری شهر اهواز در سال 1401-1400 که از این میان 30 نفر که ملاک‌های ورود به مطالعه را داشتند به روش نمونه‌گیری هدفمند انتخاب و در 2 گروه آزمایش 1و 2 (هر گروه 15 نفر) به‌صورت تصادفی تخصیص داده شدند. افراد گروه آزمایش 1، درمان توانبخشی شناختی و افراد گروه آزمایش 2، حین انجام تکالیف توانبخشی شناختی تحریک الکتریکی مستقیم فرا جمجمه‌ای را نیز دریافت کردند. برای جمع‌آوری اطلاعات از آزمون برو/نرو، آزمون دسته‌بندی کارت‌های ویسکانسین و مقیاس وسواس- بی‌اختیاری ییل‌براون استفاده شد. نتایج تحلیل کوواریانس چند‌متغیری و تک‌متغیری نشان داد که درمان توانبخشی شناختی همراه با تحریک الکتریکی مستقیم فرا جمجمه‌ای اثربخشی بیشتر و معنی‌داری در بهبود کنترل مهاری، انعطاف‌پذیری شناختی و کاهش شدت علائم وسواسی-جبری دارد (05/0>P). نتایج پژوهش حاضر نشان داد تحریک الکتریکی مستقیم فرا جمجمه‌ای منجر به افزایش اثربخشی تکالیف توانبخشی شناختی می شود.

کلیدواژه‌ها

• اختلال وسواسی-جبری
• انعطاف‌پذیری شناختی
• توانبخشی شناختی
• تحریک الکتریکی مستقیم فرا جمجمه‌ای
• کنترل مهاری

موضوعات

• روان‌شناسی شناختی

عنوان مقاله [English]

Comparison of the Efficacy of Cognitive Rehabilitation Therapy with and without Transcranial Direct Current Stimulation in Inhibitory Control, Cognitive Flexibility, and Obsessive-Compulsive Symptoms of Adolescents with Obsessive-Compulsive Disorder

نویسندگان [English]

• mojtaba ahmadi farsani ¹
• Iran Davoudi ²
• Mahnaz Mehrabi Zadeh Honarmand ³

¹ Department of psychology, College of Education and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran.

² Assistant Professor, Department of Psychology, Faculty of Educational Science and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran.

³  Professor, Department of Psychology, Faculty of Educational Science and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran

چکیده [English]

Introduction
Obsessive-compulsive disorder (OCD) is a condition currently defined by the American Psychiatric Association as a disorder characterized by obsessive thoughts or compulsions. These symptoms significantly affect the quality of life of sufferers and are often associated with other neurodevelopmental or psychiatric conditions. Several factors contribute to the development of OCD, among which cognitive deficits are considered one of the most significant. Various studies have shown that individuals with obsessive-compulsive disorder exhibit physiological and cognitive impairments, particularly in inhibitory control and cognitive flexibility. On the other hand, various research findings have led to the hypothesis that individuals with obsessive-compulsive disorder (OCD) may have physiological defects or failures, particularly abnormalities or malfunctions in different areas of the brain. These areas include the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), and striatum, which may experience dysfunction. Furthermore, numerous studies have demonstrated deficits in the dorsolateral prefrontal cortex (DLPFC) among individuals with obsessive-compulsive disorder. These deficits in the DLPFC have been found to be associated with impairments in executive functions. This study aimed to compare the efficacy of cognitive rehabilitation therapy with and without transcranial direct current stimulation in improving inhibitory control and cognitive flexibility and reducing the intensity of obsessive-compulsive symptoms in adolescents with obsessive-compulsive disorder.

Method
The current study is a experimental research using a pre-test-post-test and a 3-month follow-up. Thirty male and female individuals aged 14 to 18 years old who had been diagnosed with obsessive-compulsive disorder and were seeking treatment at counseling and psychological services centers in Ahvaz participated in the study. Participants met the inclusion criteria were selected using an purposive sampling and randomly assigned to either the experimental 1 or 2. Before the intervention, participants were evaluated using appropriate instruments, including the Go/No Go Test, Wisconsin Card Sorting Test, and Yale-Brown Obsessive-Compulsive Scale. After the evaluation, the participants in the experimentals group underwent 12 sessions of cognitive rehabilitation therapy with and without transcranial direct current stimulation. Participants were re-evaluated immediately after completing the intervention sessions and again three months later.

Results
MANCOVA showed that there is a significant difference between the mean scores of the research groups in the post-test phase and the follow-up, compared to the pre-test, in terms of inhibitory control, cognitive flexibility, and obsessive-compulsive symptoms (p <0.05). The separated ANCOVA revealed that cognitive rehabilitation treatment with transcranial direct current stimulation was significantly more effective than cognitive rehabilitation treatment without transcranial direct current stimulation in enhancing inhibitory control and cognitive flexibility and reducing the intensity of obsessive-compulsive symptoms during the post-test and follow-up phases (p <0.05).

Discussion
Based on the findings of the present study, it can be concluded that transcranial direct current stimulation enhances the effectiveness of cognitive rehabilitation tasks. In explaining this finding, it can be said that when transcranial direct electrical stimulation (anode on the F3 area and cathode on the Fp2 area) is combined with a suprathreshold stimulus such as cognitive tasks, it can increase synaptic transmission. Therefore, transcranial direct electrical stimulation can enhance synaptic strength in neural pathways activated by cognitive rehabilitation tasks and improve training effects.

کلیدواژه‌ها [English]

• Obsessive-compulsive Disorder
• Cognitive Flexibility
• Cognitive Rehabilitation
• Transcranial Direct Current Stimulation
• Inhibitory Control