اثربخشی درمان مبتنی‌بر آموزش حل مسئله بر نشانه‌های رفتاری برونی‌سازی‌شده

زمینه و هدف: در سال‌های اخیر توجه به مسائل و مشکلات رفتاری کودکان به‌عنوان یکی از موضوعات عمدهٔ روان‌شناسی و روان‌پزشکی افزایش یافته است. پژوهش حاضر با هدف بررسی اثربخشی درمان مبتنی‌بر آموزش حل مسئله بر نشانه‌های اختلالات رفتاری برونی‌سازی‌شده صورت گرفت.روش‌بررسی: طرح پژوهش نیمه‌آزمایشی از نوع پیش‌آزمون و پس‌آزمون با گروه گواه بود. جامعهٔ آماری پژوهش را تمامی دانش‌آموزان پسر دارای نشانه‌های رفتاری برونی‌سازی‌شده تشکیل دادند که در سال تحصیلی 99-1398 در مدارس دورهٔ اول دبیرستان شهرستان تبریز مشغول به تحصیل بودند. از میان آن‌ها 30 نفر به‌عنوان داوطلب واجد شرایط انتخاب شدند و به‌صورت تصادفی در دو گروه آزمایش و گواه تخصیص یافتند. مقیاس اختلالات رفتار ایذایی پلهام و ناژی (1992) به‌عنوان پیش‌آزمون و پس‌آزمون بر هر دو گروه اجرا شد. گروه آزمایش به‌مدت هشت جلسهٔ 60‌دقیقه‌ای، درمان مبتنی‌بر آموزش حل مسئله را دریافت کرد. گروه گواه هیچ‌گونه آموزش درمانی ویژه‌ای دریافت نکرد. درنهایت داده‌ها با استفاده از روش تحلیل کوواریانس چندمتغیره و نرم‌افزار spss نسخهٔ 20 تحلیل شدند. سطح معناداری آزمون‌ها در این مطالعه برابر با 0٫05 در نظر گرفته شد.یافته‌ها: نتایج نشان داد که با کنترل پیش‌آزمون، بین گروه‌های آزمایش و گواه در اختلالات نقص ‌توجه/بیش‌فعالی (0٫001>p)، نافرمانی مقابله‌ای (0٫049=p)، سلوک (0٫003=p)، نشانه‌های نقص‌ توجه (0٫008=p)، بیش‌فعالی (0٫001>p) و دزدی و فریب (0٫004=p) تفاوت معنا‌داری وجود دارد؛ به‌طوری‌که این نشانه‌ها در گروه آزمایش کمتر از گروه گواه بوده است.نتیجه‌گیری: براساس یافته‌های پژوهش می‌توان نتیجه گرفت درمان مبتنی‌بر آموزش حل مسئله بر کاهش نشانه‌های رفتاری برونی‌سازی‌شده اثربخش خواهد بود.

Treatment Based on Problem-Solving Training on Externalized Behavioral Symptoms

Background & Objectives: The health status of each society’s members are of particular importance. Accordingly, paying attention to their mental health helps to improve their bio psychological health and their social functioning. However, in every community, some individuals encounter some problems that affect their bio psychological health. Recently, the behavioral issues of children, as a significant subject of psychology and psychiatry, have attracted much attention. Furthermore, they constitute a considerable part of the population of every society. Besides, numerous children experience emotional and behavioral problems, i.e., not only challenging to be resolved but also may continue into adulthood. Given the wide range of behavioral problems, there are several approaches to classifying them. The most common method of categorizing behavioral issues, introduced by Achenbach in 1991, concerns children’s behavioral problems in two broad categories; internalized behaviors (e.g., withdrawal, obsession, sadness, shyness, fear, & delusion) and externalized behaviors (e.g., behaviors against others and the environment, including aggression, contention, & the destruction of property). The present study aimed to investigate the effectiveness of treatment based on problem–solving training on externalized behavioral symptoms.Methods: This was a quasi–experimental study with a pretest–posttest and a control group design. The statistical population of this study was all middle school students of Tabriz City, Iran, in the 2018–2019 academic year. Of them, 30 students were chosen by convenience sampling technique and were randomly divided into the experimental and control groups. The inclusion criteria were age range of 12–15 years, no learning disorders, no mental disability, no visual, auditory or motor impairments, as well as no medical conditions, such as diabetes, epilepsy, or heart disease that may influence the research process. First, Pelham and Gnagy’s Disruptive Behaviors Rating Scale (DBRS) (1992) was administered to both study groups. The experimental group then received 8 sessions of 60–minute treatment based on problem–solving training. Next, both groups were evaluated using DBRS. Finally, the obtained data were analyzed using Multivariate Analysis of Covariance (MANCOVA) in SPSS.Results: is the collected data suggested significant differences between the experimental and control groups in Attention–Deficit/Hyperactivity Disorder (ADHD) (p<0.001), oppositional defiant disorder (p=0.049), conduct disorder (p=0.003), attention deficit (p=0.008), hyperactivity (p<0.001), and deceitfulness or theft (p=0.004) symptoms. The mean value of attention deficit, hyperactivity, ADHD, oppositional defiant disorder, deceitfulness or theft, and conduct disorder were lower in the experimental group than the controls. In addition, the calculated eta coefficient indicated that 95% of individual differences in the posttest scores of behavioral disorders belonged to the effectiveness of the provided treatment. However, there was no significant difference between the experimental and control groups in terms of aggression, the destruction of property, and serious violations of rules.Conclusion: Based on the present study findings, providing treatment based on problem–solving training is effective in reducing externalized behavioral symptoms among individuals.