اثربخشی درمان شناختی-رفتاری خانواده محور بر سازش خانواده کودکان دارای اختلال وسواسی-جبری

دانش و پژوهش در روان شناسی کاربردی

دوره 24، شماره 3 - شماره پیاپی 93، آذر 1402، صفحه 25-37   

نوع مقاله: مقاله پژوهشی

شناسه دیجیتال (DOI): 10.30486/jsrp.2021.1918841.2774

نویسندگان

زیور آریاصدر^{* 1}؛ ایران داوودی²؛ عبدالکاظم نیسی³؛ مهناز مهرابی زاده³

¹دکترای روانشناسی، دانشگاه شهید چمران اهواز، اهواز، ایران

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

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

چکیده

اختلال وسواس-جبری یک بیماری روانی شدید و طولانی مدت که با رنج قابل ملاحظه و افت عملکرد همراه است. هدف پژوهش اثربخشی درمان شناختی-رفتاری خانواده محور بر سازش خانواده کودکان دارای اختلال وسواسی-جبری بود. طرح پژوهش از نوع روش نیمه­آزمایشی طرح تک­موردی (تک­آزمودنی) بود. جامعه­آماری این پژوهش، کلیه کودکان دارای اختلال در محدوده سنی 7 تا 12سال مراجعه کننده به مراکز مشاوره و کلینیک­های روانپزشکی شهر اهواز در زمستان 1398 (مراحل پیگیری فروردین1399) بودند. نمونه­ها به روش نمونه­گیری در دسترس چهارکودک (و مادران­شان) انتخاب و تحت مداخله درمانی شناختی- رفتاری خانواده­-محور در 12 جلسه قرارگرفتند. در این پژوهش از مقیاس­های وسواس-اجباری ییل براون کودک (Cahil & et al, 1997) و مقیاس سازش وتاثیر خانواده کودک (Calvocoressi & et al, 1999) استفاده شد. برای تجزیه و تحلیل داده­ها از روش­های ترسیم دیداری یا تحلیل نمودار گرافیکی، شاخص تغییر پایا و درصد بهبودی استفاده شد. نتایج به دست آمده نشان داد شاخص پایا در مرحله درمان و پیگیری برای سازش خانواده معنی­دار می­باشد (05/0p<). درصد بهبودی کلی نیز نشان داد اثربخشی درمان شناختی-رفتاری خانواده­­-­محور بر سازش خانواده درکودکان دارای اختلال بر اساس طبقه­بندی بلانچارد برای چهار­کودک در مرحله درمان و پیگیری، در طبقه درمان موفق قرارگرفت. پس این درمان می­تواند بر سازش خانواده کودکان دارای اختلال وسواسی- جبری سودمند و کارآمد باشد.

کلیدواژه‌ها

درمان شناختی–رفتاری خانواده-‌محور؛ سازش خانواده؛ کودکان دارای اختلال وسواس- جبری

مراجع

 Alatiq,Y., & Alrshoud, H. (2018). Family-based cognitive behavioural therapy for obsessive compulsive disorder with family accommodation: case report from Saudi Arabia. Journal of the American Academy of Child & Adolescent Psychiatry  Volume 11 . 2018, e14.

Baruah, U. R.,  Pandian, D. K.,  Narayanaswamy, J., Math, S. B.,  Kandavel, T.,  Reddy, Y. C. J. (2018). A randomized controlled study of brief family-based intervention in obsessive compulsive disorder. Journal of Affective Disorders Volume 225, 1 January 2018, Pages 137-146

 Brakoulias, V., Perkes, I. E.,  Tsalamanios, E. (2017). A call for prevention and early intervention in obsessive‐compulsive disorder. Early Intervention in Psychiatry, 12(4), December 2017, 572-577. 

Cancilliere, M. K., Freeman, J., Garcia, A., Benito, K.,  Sapyta, J.,  Franklin, M. (2018). Assessing Acute Secondary Treatment Outcomes in Early-Onset Obsessive–Compulsive Disorder. Child Psychiatry & Human Development.

Chorpita B. (2016). Cognitive-Behaviral Therapy for Childhood Anxiety Disorders. Traslated, Helmi, k.Tehran: Arjmand; 2016. [Persian]

Decloedt, E. H., & Stein, D. J. (2010). Current trends in drug treatment of obsessive – compulsive disorder. Neuropsychiatry Dis treat, Vol 6 , May  2010 : 233-242.

Dekel, I., Ilan, SH. D., Lang. D., David, E .B., Zilka, H., Shilton, T., Lebowitz, E., R.Gothelf, D. (2020). The Feasibility of a Parent Group Treatment for Youth with Anxiety Disorders and Obsessive Compulsive Disorder. Child Psychiatry & Human Development.

Flessner, C.A., Freeman, J. B.,  Sapyta, J., Garcia, A., Franklin, M.E., March, J. S.,  Foa, E. (2011). Predictors of Parental Accommodation in Pediatric Obsessive-Compulsive Disorder: Findings from the Pediatric Obsessive-Compulsive Disorder Treatment Study (POTS) Trial. Journal of the American Academy of Child & Adolescent Psychiatry Volume 50, Issue 7, July 2011, Pages 716-725.

Foa,  E., Yadin, E.,  Lichner, T. (2018).  Exposure and Response (Ritual) Prevention for Obsessive-Compulsive Disorder. Traslated, Karimi, J., Shiralinia, KH., Imai, M. Tehran: Arjmand; 2017. [Persian]

Freeman, J., & Garcia, A. (2016). Family-Based Treatment for Young Children with OCD. Traslated, Dalir, M., & Rasaneh, F. Tehran: Arjmand; 2016. [Persian]

Ganji, M.  (2015). Abnormal Psychology; DSM-5. Tehran: Savalan; 2015. [Persian]

Ginsburg, G. S., Burstein, M., Becker, K. D., Drakek, L. (2011). Treatment of Obsessive Compulsive Disorder in Young Children: An Intervention Model and Case Series. Child & Family Behavior Therapy, 33:97–122, 2011.

Guzick, A. G., Cooke, D., Keller, M., Gage, N.,  McNamara, P. H. (2018). CBT-Plus: A meta-analysis of cognitive behavioral therapy augmentation strategies for obsessive-compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders Volume 19, October 2018, Pages 6-14.

Hamidpour H. (2010). The Importance of Methodology in Cognitive Behavioral Research.Tehran: Baztab Danesh; 2010.P49-56. [Persian]

 Hybel, K. A., Mortensen, E .L., Lambek, R., Hojgaard, D. R. M. A., Thomsen, P. H. (2017). Executive function predicts cognitive-behavioral therapy response in childhood obsessive-compulsive disorder. Behaviour Research and Therapy Volume 99, December 2017, Pages11-18.

Hyman, B., & Pedrick, C. (2016). The OCD Workbook Your Guide to Breaking Free from Obsessive-Compulsive Disorder. Traslated, Ghassemzadeh, H. Tehran: Arjmand; 2016. [Persian]

jaspers-Fayer, F., Yaolin, S., Belschner, L., Mah, J., Chan, E., Bleakley, C. Ellwyn, R. Simpson, A.,  McKenney, K., & Stewart, E. (2018). A  case-control study of sleep disturbances in pediatric obsessive-compulsive disorder. Journal of Anxiety Disorders Volume 55, April 2018, Pages1-7

Lewin,  A. B., ParkbAnna, J. M., Erika, J. A., Alessandro, J. N.,  Elysse, M., Arnold, B., Murphy, T. K., Storch, E. A. (2014). Behaviour Research and Therapy Family-based exposure and response prevention therapy for preschool-aged children with obsessive-compulsive disorder: A pilot randomized controlled trial. Behaviour Research and Therapy Volume 56, May 2014, Pages 30-38.

Mataix-Cols, D. (2015). Obsessive compulsive and related disorders in childrenand adolescents: innovation and consolidation. Abstracts  of the 16th International Congress of ESCAP European Society for Child and Adolescent Psychiatry.

Mathieu, SH. L., Conlon, E. G., Waters, A. M., Farrell, L. J. (2020). Perceived Parental Rearing in Paediatric Obsessive–Compulsive Disorder: Examining the Factor Structure of the EMBU Child and Parent Versions and Associations with OCD Symptoms. Child  Psychiatry & Human Development.

 Miyawaki, Dai., Goto, A., Iwakura, Y., Hirai, K., Miki, Y., Asada, N., Terakawa, H., Inoue, K.. (2018). Preschool-onset obsessive-compulsive disorder with complete remission. Neuropsychiatr Dis Treat. 2018; 14: 1747–1753.

Monzan, B., Vidal-Ribas, B., Turner, C., Krebs, G., Stokes, C., Heyman, I., Mataix-Cols, D., Stringaris, A.  (2020). The Role of Paternal Accommodation of Paediatric OCD Symptoms :Patterns and Implications for Treatment Outcomes . Journal of Abnormal Child Psychology.

Peris, T. S., Bergman, R. L., Langley, A., Chang, S., Mccracken, J. T., Piacentini, J. (2008). Correlates of Accommodation of Pediatric Obsessive - Compulsiv Disorder: Parent, Child, and Family Characteristics. Journal of the American Academy of Child & Adolescent Psychiatry Volume 47, Issue 10, October 2008, Pages 1173-1181.

Piacentini, J., Bergman, L., Chang, S., Langley, A., Peris, T., Wood, J., McCracken, J. (2011). Controlled Comparison of Family Cognitive Behavioral Therapy and Psychoeducation /Relaxation Training for Child Obsessive-Compulsive Disorder. Journal of the American Academy of Child & Adolescent Psychiatry  Volume 50, Issue 11, November 2011, Pages 1149-1161.

Piacentini, J., Langley, A., Roblek, T. (2018). Cognitive-Behavioral Treatment of Childhood OCD. Traslated, Habibi, N., Shahrivar, Z. Tehran: Arjmand; 2018.  [Persian]

Pietrabissa, G., Manzoni, G. M., Gibson, P., Boardman, D., Gori, A., nuovo, G. C. (2015). Brief strategic therapy for obsessive– compulsive disorder: a clinical and research protocol of a one-group observational study. BMJ Open, 2016 Mar 24, e 009118.

Peterson, B. D., Eifert, G. H., Feingold, T., Davidson, S. (2009). Using of acceptance and commitment therapy to treat distressed couples: A case study with two couples. Cognitive and Behavioral Practice, 16, 430-442.

Rosa-Alcazara, A., Rosa-Alcazar, A., Olivares-Olivaresb, P., Parada-Navasc, J., Rosa-Alcazarb, E., Sanchez-Meca, J. (2019).Family involvementand treatment for young children with Obsessive-Compulsive Disorder: Randomized control study. Internation a Journal of Clinical and Health Psychology, 19, 218-227.

Riise, E. N.,  Kvale, G., Öst, L. G., Skjold, S. H., Hansen. B. (2019). Does Family Accommodation Predict Outcome of Concentrated Exposure and Response Prevention for Adolescents? Child Psychiatry & Human Development.

Sanchez-Mecaa, J. Rosa-Alcazara, A. Iniesta-Sepulvedab, M. Rosa-Alcazar, A. (2014). Differential efficacy of cognitive-behavioral therapy and pharmacological treatments for pediatric obsessive–compulsive disorder: Ameta-analysis. Journal of Anxiety Disorders, 28, 31-44.

 Selles, R. R., Belschner, L., Negreiros, J., Lin, S., Schuberth, D., McKenney, K.., Gregorowski, N.,  Simpson, A., Bliss, A., Stewart, S. E. (2018). Group family-based cognitive behavioral therapy for pediatric obsessive compulsive disorder: Global outcomes and predictors of improvement. Psychiatry research Volume 260, February 2018, Pages 116-122.

Selles, R. R., Frankli, M., Sapyta,  J.,  Compton, S. N., Tommet,  N., Jones, R. N., Garcia, A., Freeman, J. (2017). Children’s and Parents’ Ability to Tolerate Child Distress: Impact on Cognitive Behavioral Therapy for Pediatric Obsessive Compulsive Disorder .Child Psychiatry Hum Dev.

Skarphedinsson, G., Weidle, B., Thomsen, P. H., Dahl, K., Torp, N. CH., Nissen, J. B., Melin, K., Hybel, K., Valderhaug, R., Wentzel-Larsen, T., Compton, S. N., Ivar, T. (2014). Continued cognitive-behavior therapy versus sertraline for children and adolescents with obsessive–compulsive disorderthat were non-responders to cognitive-behavior therapy: a randomized controlled trial. Eur Child Adolesc Psychiatry.

Storch, E .A., Geffken,G. R., Merlo, L. G., Emann, G., Duke, D., Munson, M., Adkins, J., Grabill, K., Murphy,T., Goodman, W. (2007). Family-Based Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder: Comparison of Intensive and Weekly Approaches. Journal of the American Academy of Child & Adolescent Psychiatry  Volume 46, Issue 4, April 2007, Pages 469-478.

Strauss, C., Hale, L., Stobie, B.  (2015). A meta-analytic review of the relationship between family accommodation and OCD symptom severity. Journal of Anxiety Disorders  Volume 33, June 2015, Pages 95-102.

Waite, P., Williams, T. (2014). Obsessive Compulsive Disorder. Traslated, Soltanmohamadloo, S., Sheybani, A., Ghapanchi, A. Tehran: Arjmand; 2014. [Persian]

Wheaton, M. G., Chen, S. R. (2020). Homework Completion in Treating Obsessive–Compulsive Disorder with Exposure and Ritual Prevention: A Review of the Empirical Literature. Cognitive Therapy and Research.

Wu, M. S., Geller, D. A., Schneider, S. C., Small, B. J., Murphy, T. K., Wilhelm, S., Storch. E. A. (2019).Comorbid Psychopathology and the Clinical Profile of Family Accommodation in Pediatric OCD. Child Psychiatry & Human Development.

Wu, M. S., McGuire, J. F., Martino, C., Phares ,V., Selles, R. R., Storch, E. A. (2016). A meta-analysis of family accommodation and ocd  symptom severity. Clinical Psychology Review, Volume 45, April 2016, Pages 34-44.