مقایسه اثربخشی آموزش مدیریت والدین (pmt) و آموزش مبتنی بر رابطه والد-کودک (cprt)بر کاهش مجموع نشانگان مرضی کودکان با اختلال نافرمانی مقابله‌ای

زمینه و هدف: اختلال نافرمان مقابله‏ای از شایع‌ترین اختلالات روانشناختی دوران کودکی می‌باشد که تاثیر بدی در تعاملات خانواده دارد و همچنین دارای پیش آگهی نامناسب همچون ابتلا به اختلالات روانشناختی در بزرگسالی، اعتیاد، مشکلات بین فردی، تحصیلی می‌شود . لذا هدف از پژوهش حاضر مقایسه اثربخشی آموزش مدیریت والدین (pmt) با آموزش مبتنی بر رابطه والد-کودک  (cprt) بر کاهش مجموع نشانگان مرضی کودکان دارای اختلال نافرمانی مقابله‏ای می باشد. روش کار: پژوهش حاضر یک کارآزمایی بالینی نیمه تجربی به صورت پیش آزمون - پس آزمون با گروه کنترل بود.  جامعه‌ی پژوهش حاضر را کلیه والدین کودکان 5-11 ساله مبتلا به اختلال نافرمانی مقابله ای (odd) مراجعه کننده به درمانگاه‏ها و مراکز روان شناختی و روان پزشکی شهر تهران می‏باشد. نمونه پژوهش شامل 45 والد بود که با نمونه گیری در دسترس انتخاب و به صورت تصادفی در سه گروه آزمایش 15 نفره قرارگرفتند. ابزارهای مورد استفاده در این پژوهش شامل پرسشنامه علائم رفتاری کودکان (csi-4) و پرسشنامه snap-iv بود.یافته ها: نتایج مربوط به آزمون تحلیل کوواریانس برای نمرات نشانگان مرضی کودکان نشان داد که  آماره f برای نمرات مرضی کودکان نافرمان (34/ 75) در سطح 001/ 0 معنی‏دار است؛ بین گروه‌ها در نمرات مرضی کودکان نافرمان تفاوت معنی‌دار وجود دارد. نتایج مقایسه میانگین‏ها نشان داد که میانگین گروه آزمایش (pmt) 81/7 و میانگین گروه آزمایشی (cprt) 10/9 می‏باشد که با توجه به نتایج مقایسه زوجی در سطح 001/ 0 معنی دار است.نتیجه گیری: روش pmt و روش cprt هر دو بر بهبود نشانگان مرضی کودکان با اختلال نافرمانی مقابله ای موثر هستند. از میان دو رویکرد درمانی روش pmt از روش cprt در کاهش نشانگان مرضی موثرتر بود.

comparison of the effectiveness of parental management education (pmt) with parent-child relationship education (cprt) on reducing the total morbidity of children with coping disobedience disorder

background & aims: oppositional defiant disorder (odd) the most common clinical disorders in children and adolescents those in the class of disruptive behavior disorders are the largest group of disorders in children and adolescents referred to mental health clinics. according to diagnostic and statistical manual 5 (dsm5) the prevalence of this disorder ranges from 1 to 11% with an average prevalence estimated at about 3.3%. these children have an angry and irritable temperament, they often become angry, they are quick-tempered, angry, or easily offended they have an argumentative and confrontational behavior pattern, often arguing with authorities, actively opposing or refusing to follow rules, they mostly intentionally upset others, often blaming others for their mistakes or misconduct, and engaging in vindictive or retaliatory behaviors.in finding the cause, we can refer to a set of genetic and biological characteristics and tendencies, including inefficient parenting. the prognosis of oppositional defiant disorder is unfavorable as well as chronic. patients with it are prone to psychiatric disorders in adulthood, such as antisocial personality disorder, calcium, addiction, and interpersonal, academic, and psychological problems.therefore, due to the adverse consequences of disobedient disobedience disorder and the wide-ranging impact it has on individual and social life requires fundamental steps to be taken to treat children with the disorder. including treatments for oppositional defiant disorder drug therapy, as well as part of the treatment of individual interventions and the rest of the family interventions, focused. among the various therapeutic approaches, treatment for children in addition to medication, is parent management training. the basis of pmt is based on the view that childrenchr('39')s behavioral disorders arise and persist as a result of incorrect interactions between child and parent. on the other hand, parental therapy is a unique approach used by trained play therapy professionals to teach parents to be part of their childrenchr('39')s healing or healing factors. one of these new methods is child-parent relationship training (cprt), which is one of the most effective methods in the treatment of oppositional defiant disorder that focuses on the participation of families in the treatment of children. since the effectiveness of these treatments and the comparison of these two treatments on these children had not been done so far, the aim of the present study was to compare the effectiveness of parent management training (pmt) with child-parent relationship training (cprt) on total reduction. childrenchr('39')s morbid syndrome has an oppositional defiant disorder.methods: the present study was applied according to the purpose and was a quasi-experimental clinical trial in the form of a pretest-posttest design with a control group. the population of the present study was all parents of children aged 11-5 years with confrontational disobedience disorder who referred to clinics and psychological and psychiatric centers in tehran. the study sample consisted of 45 participants who were selected by available sampling and randomly divided into three groups of 15 people. after selecting the sample members, the snap questionnaire was completed by the parents. then, the parents of the cprt experimental group participated in 10 2-hour group sessions for 10 weeks and the parents of the pmt experimental group participated in 9 2-hour group sessions for 9 weeks, and the control group received only medication. at the end of the course, the snap questionnaire was again given to the parents of the experimental and control groups by a psychologist. the data were then analyzed using spss software and the statistical method of analysis of covariance.results: the results of the analysis of covariance test for pediatric morbidity syndrome scores showed that the f-statistic for morbid scores of disobedient children (75.34) was significant at the level of 0.001. these findings indicate that there is a significant difference between the groups in the morbid scores of disobedient children. the results show the effectiveness of parent management training (pmt) and child-parent relationship training (cprt) in reducing the symptoms of children with oppositional defiant disorder. in order to examine the changes in scores more accurately, tukey test was used. the results of comparison of means showed that the mean of the total corrected experimental group was pmt (7.81) and the mean of experimental group was cprt (10.9). it is significant to the results of pairwise comparison at the level of 0.001. this means that both trainings are effective and the reduction of morbid symptoms has occurred in both of them. parents are considered as the strongest influence on the interactive patterns of the family. they can provide the best and most effective way of socializing and building a proper upbringing by creating healthy and constructive emotional relationships, expressing love, accepting the right interactions and appropriate treatment methods. bring. on the other hand, the root of many abnormalities should be sought in the relationships of family members and parenting methods. most childrenchr('39')s behavioral problems reflect the complex interpersonal conditions of family members, especially parents. in other words, the creation or exacerbation of behavioral problems the child can also be a defective relationship between family members and related to the wrong parenting training methods and their defective interactions with children. in order to reduce these problems and improve those parent participation training programs (such as pmt and cprt) that a unique perspective is used, that is, how parents can be a good alternative to therapists and become therapists or therapeutic agents by teaching some therapeutic skills to treat their childrenchr('39')s problems and disorders at home.conclusion: both of pmt and cprt has been shown to be effective in reducing odd in children. between these methods, pmt was more effective than cprt.