اثربخشی درمان شناختی رفتاری متمرکز بر تروما بر نشانگان اختلال تنیدگی پس از سانحه در کودکان با تجربه سوءاستفاده جنسی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 گروه روانشناسی-دانشکده علوم تربیتی و روانشناسی دانشگاه محقق اردبیلی- اردبیل -ایران

2 گروه روان‌شناسی دانشگاه فردوسی مشهد، مشهد، ایران.

3 گروه روانشناسی دانشگاه فردوسی مشهد، مشهد، ایران

4 گروه روانپزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

چکیده

مقدمه: هدف پژوهش حاضر تعیین اثربخشی درمان شناختی رفتاری متمرکز بر تروما بر بهبود نشانگان اختلال تنیدگی پس از سانحه در کودکان با تجربه سوءاستفاده جنسی بود.
روش پژوهش: این پژوهش شبه آزمایشی از نوع مورد منفرد A-B-Aبا طرح خط پایه چندگانه و با پیگیری بود. جامعه آماری پژوهش کلیه کودکان با تجربه سوءاستفاده جنسی 9 تا 12 سال مشهد بودند که به مراکز معاینات بالینی پزشکی قانونی در سال 1395 مراجعه کردند و دو نفر به‌صورت نمونه‌گیری هدفمند انتخاب شدند. شرکت‌کنندگان پژوهش در موقعیت‌های خط پایه، جلسات 4-8-12-16 مداخله و یک، دو و سه ماه، یک و دو سال بعد از مداخله، به پرسشنامه نشانگان تنیدگی پس از سانحه، مقیاس گزارش والدین از نشانگان تنیدگی پس از سانحه کودکان، پاسخ دادند. درمان به‌صورت انفرادی در 16 جلسه اجرا شد. تحلیل داده‌ها با استفاده از روش تحلیل دیداری نمودار، درصد بهبودی، اندازه اثر و درصد داده‌های غیر همپوش (PND) انجام شد.
یافته‌ها: نتایج نشان داد درمان به‌طور معناداری منجر به بهبودی و کاهش شدت نشانگان PTSD هم در پایان و هم در مراحل پیگیری شده است.
نتیجه‌گیری: بنابراین می‌توان بیان کرد که این درمان در بهبود PTSD کودکان با تجربه سوءاستفاده جنسی مؤثر است و این کودکان آسیب‌پذیر نیازمند توجه متخصصان هستند.

کلیدواژه‌ها

عنوان مقاله [English]

The Effectiveness of Trauma-Focused Cognitive-Behavioral Therapy on Symptoms of Post-Traumatic Stress Disorder in Children with Sexual Abuse Experiences

نویسندگان [English]

  • Sepideh Ghazizadeh 1
  • Ali Mashhadi 2
  • Zahra Tabibi 3
  • Atefeh Soltanifar 4
1 Department of psychology-Faculty of Education and Psychology- Ferdowsi University of Mashhad-Iran
2 Department of psychology, Ferdowsi university of Mashhad, Mashhad, Iran.
3 Department of psychology, Ferdowsi university of Mashhad, Mashhad, Iran.
4 Department of Psychiatry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
چکیده [English]

Abstract
Introduction: This study aimed to determine the effectiveness of TF-CBT on improving symptoms of PTSD in sexually abused children.
Methods: This quasi-experimental research was a single-subject research design with multiple baselines with follow-up. The statistical population consisted of all children of 9-12 years old, who have been sexually abused that referred to the Center of Clinical Tests of Forensic Medicine in 2016. In this study, sampling was purposeful, and 2 children were selected. The participants in situations of baseline, even sessions of intervention and one, two, three months and one, two years after intervention responded to the child post-traumatic symptom scale, the parent report of post-traumatic symptoms. Sixteen treatment sessions were administrated for each subject. Data analysis by using visual analysis chart, percentage of recovery, Effect size and PND was done.
Results: The results showed that TF-CBT significantly improved symptoms of PTSD in clients at the end and in the process has been followed.
Conclusion: It could be concluded that TF-CBT is effectively improving symptoms of PTSD in sexually abused children and vulnerable children need specialists.

کلیدواژه‌ها [English]

  • Post-traumatic stress disorder
  • Sexual abuse
  • Trauma-Focused Cognitive Behavioural Therapy

مراجع

منابع
1. Gil E. Helping abused and traumatized children: Integrating directive and nondirective approaches: Guilford Press; 2006.
2. Goodyear-Brown P. Handbook of Child Sexual Abuse. Edition F, editor. New Jersey: John Wiley & Sons; 2012.
3. Hillberg T, Hamilton-Giachritsis C, Dixon L. Review of meta-analyses on the association between child sexual abuse and adult mental health difficulties: A systematic approach. Trauma, Violence, & Abuse. 2011;12(1):38-49.
4. Fergusson DM, Boden JM, Horwood LJ. Childhood self-control and adult outcomes: results from a 30-year longitudinal study. Journal of the American Academy of Child & Adolescent Psychiatry. 2013;52(7):709-17.
5. Hébert M, Langevin R, Oussaïd E. Cumulative childhood trauma, emotion regulation, dissociation, and behavior problems in school-aged sexual abuse victims. Journal of affective disorders. 2018;225:306-12.
6. Sadock BJ, & Sadock, V. A., Ruiz, P. Kaplan and Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry. 11th, editor: Lippincott Williams & Wilkins; 2015.
7. Pereda N, Guilera G, Forns M, Gómez-Benito J. The prevalence of child sexual abuse in community and student samples: A meta-analysis. Clinical psychology review. 2009;29(4):328-38.
8. Pifalo T. Jogging the cogs: Trauma-focused art therapy and cognitive behavioral therapy with sexually abused children. Art Therapy. 2007;24(4):170-5.
9. Stoltenborgh M, Van Ijzendoorn MH, Euser EM, Bakermans-Kranenburg MJ. A global perspective on child sexual abuse: meta-analysis of prevalence around the world. Child maltreatment. 2011;16(2):79-101.
10. Goodman R, Scott S. Child and adolescent psychiatry: John Wiley & Sons; 2012.
11. Melville JD, Kellogg ND, Perez N, Lukefahr JL. Assessment for self-blame and trauma symptoms during the medical evaluation of suspected sexual abuse. Child abuse & neglect. 2014;38(5):851-7.
12. Bigfoot DS, Schmidt SR. Honoring children, mending the circle: cultural adaptation of trauma‐focused cognitive‐behavioral therapy for American Indian and Alaska Native children. Journal of Clinical Psychology. 2010;66(8):847-56.
13. Deblinger E, Lippmann J, Steer R. Sexually abused children suffering posttraumatic stress symptoms: Initial treatment outcome findings. Child Maltreatment. 1996;1(4):310-321.
14. Deblinger E, Pollio E, Dorsey S. Applying trauma-focused cognitive–behavioral therapy in group format. Child maltreatment. 2016;21(1):59-73.
15. Silverstone P, Greenspan F, Silverstone M, Sawa H, Linder J. A complex multimodal 4-week residential treatment program significantly reduces PTSD symptoms in child sexual abuse victims: The Be Brave Ranch. J Child Adolesc Behav. 2016;4:275-80.
16. Kameoka S, Yagi J, Arai Y, Nosaka S, Saito A, Miyake W, et al. Feasibility of trauma-focused cognitive behavioral therapy for traumatized children in Japan: a Pilot Study. International journal of mental health systems. 2015;9(1):26-31.
17. Feather JS, Ronan KR. Cognitive behavioural therapy for child trauma and abuse: A step-by-step approach: Jessica Kingsley Publishers; 2010.
18. Cohen JA, Mannarino AP, Berliner L, Deblinger E. Trauma-focused cognitive behavioral therapy for children and adolescents: An empirical update. Journal of Interpersonal Violence. 2000;15(11):1202-23.
19. Feather JS. Trauma-focused cognitive behavioural therapy for abused children with posttraumatic stress disorder: development and evaluation of manualised treatment programme: Massey University, Albany, New Zealand; 2007.
20. Foa EB, Johnson KM, Feeny NC, Treadwell KR. The Child PTSD Symptom Scale: A preliminary examination of its psychometric properties. Journal of clinical child psychology. 2001;30(3):376-84.
21. Motlagh M, Alaghbandrad J, Shahrivar Z, Arabgol F, Sahebi M. Symptom Profile and Risk Factors of Posttraumatic Stress Disorder in Earthquake-Stricken Children and Adolescents of Bam. Advances in Cognitive Sciences. 2005;7(3):65-70.
22. Greenwald R, Rubin A .Assessment of posttraumatic symptoms in children: Development and preliminary validation of parent and child scales. Research on Social Work Practice. 1999;9(1):61-75.
23. Jaber Gaderi N, Babaie A, Nori K, Zadmir N, Nori R, Kazemi MA, Hosseini LE, Sharifi VI, Moradi MA. Frequency of Life Traumatic Events and their Psychological Impacts in 7-15 Years Old Urban Students of Kermanshah City in 2006. Journal of Kermanshah University of Medical Sciences. 2008;12(2).190-201. [Persian] 
24. Naseri E, Sohrabi F, Borjali A, Falsafinejad Mr. The Effectiveness of Dual Focus Schema Therapy in Treatment of Heroine Dependency comorbid with Antisocial Personality Disorder. Clinical Psychology Studies. 2015;5(18):75-97. [Persian]
25. Rice ME, Harris GT. Comparing effect sizes in follow-up studies: ROC Area, Cohen's d, and r. Law and human behavior. 2005;29(5):615-20.
26. Alresheed F, Hott BL, Bano C. Single Subject Research: A Synthesis of Analytic Methods. Journal of Special Education Apprenticeship. 2013;2(1):1-18.
27. Pernicano, P. Family-focused trauma intervention: Guilford Press; C2010.
28. Jensen TK, Holt T, Ormhaug SM, Egeland K, Granly L, Hoaas LC, et al. A randomized effectiveness study comparing trauma-focused cognitive behavioral therapy with therapy as usual for youth. Journal of Clinical Child & Adolescent Psychology. 2014;43(3):356-69.
29. Daigneault I, Dion J, Hébert M, Bourgeois C. Mindfulness as mediator and moderator of post-traumatic symptomatology in adolescence following childhood sexual abuse or assault. Mindfulness. 2016;7(6):1306-15.

فایل ها

سابقه مقاله

  • تاریخ دریافت: 02 دی 1398
  • تاریخ بازنگری: 11 بهمن 1399
  • تاریخ پذیرش: 16 اسفند 1399

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