Middle Eastern Journal of Disability Studies
مجله مطالعات ناتوانی
MEJDS
Medical Sciences
http://jdisabilstud.org
1
admin
2322-2840
2322-2840
10.29252/mejds
14
8888
13
fa
jalali
1399
12
1
gregorian
2021
3
1
11
Articles-1400
online
1
fulltext
fa
اثربخشی مداخلهٔ مبتنیبر الگوی گفتمان مادر-کودک بر کاهش مشکلات برونیسازی و بازنمایی ذهنی منفی از مادر و افزایش انسجام روایتی کودکان دارای مشکلات برونیسازی
The Effects of Mother-Child Discourse in Externalizing Problems, the Negative Mental Representation of Mother and Child, and the Narrative Coherence of Children With Externalizing Problems
روانشناسی
Psychology
مقاله پژوهشی اصیل
Original Research Article
<p style="font-style: normal; text-align: justify;"><span style="font-size:12px;"><span style="font-family:Tahoma;"><strong>زمینه و هدف:</strong> در رابطهٔ مادر-کودک، ارتباط گفتمانی در شکلگیری یا کاهش مشکلات کودکان مؤثر تشخیص داده شده است. هدف پژوهش حاضر بررسی اثربخشی مداخلهٔ مبتنیبر الگوی گفتمان مادر-کودک تدوینشده، بر کاهش مشکلات برونیسازی، کاهش بازنمایی ذهنی منفی از مادر و افزایش انسجام روایتی کودکان دارای مشکلات برونیسازی بود.<br>
<strong>روشبررسی:</strong> پژوهش حاضر نیمهآزمایشی و از نوع طرحهای پیشآزمون، پسآزمون و پیگیری با گروه گواه بود. جامعهٔ آماری را ۲۶ زوج مادر-کودک، دارای کودکان ۴تا۶ سال با مشکلات برونیسازی در مهدکودکهای سازمان بهزیستی شهر تهران در سال ۱۳۹۷ تشکیل دادند که بهطور دردسترس انتخاب شدند. بعد از همگنکردن براساس متغیرهای جمعیتشناختی، شرکتکنندگان بهطور تصادفی در یکگروه ۱۴نفرهٔ آزمایشی و یکگروه ۱۲نفرهٔ گواه قرار گرفتند. گروهها بهوسیلهٔ فهرست رفتاری کودک (آخنباخ و رکسورلا، ۲۰۰۱) و مجموعهٔ داستانهای مکآرتور (امد و همکاران، ۲۰۰۳) ارزیابی شدند.<span style="color:windowtext;"> عنوان بستهٔ آموزشی مداخلهٔ تدوینشده در این پژوهش «مداخلهٔ مبتنیبر </span>الگوی <span style="color:windowtext;">گفتمان مادر-کودک» بود که اعتبار آن به تأیید پنج نفر از متخصصان دارای دکتری تخصصی روان</span><span dir="LTR"><span style="color:windowtext;"></span></span><span style="color:windowtext;">شناسی رسید. </span>جلسات مداخله در ۷ جلسهٔ دوساعته و بهصورت هفتگی برای گروه آزمایش اجرا شد. <span style="color:windowtext;">در تحلیل آماری از تحلیل واریانس با اندازهگیری مکرر و آزمون </span>تعقیبی بونفرونی<span style="color:windowtext;"> در نرمافزار </span><span dir="LTR"><span style="color:windowtext;">SPSS</span></span><span style="color:windowtext;"> نسخۀ ۲۲ </span><span style="color:windowtext;">استفاده شد. سطح معناداری آزمونها ۰٫۰۵ درنظر گرفته شد. </span><br>
<strong>یافتهها:</strong> اثرات تعاملی زمان و گروه نشان داد مداخله برای هر سه متغیر مشکلات برونیسازی (۰٫۰۰۱><em><span dir="LTR">p</span></em>)، بازنمایی ذهنی منفی از مادر (۰٫۰۰۱><em><span dir="LTR">p</span></em>) و انسجام روایتی کودک (۰٫۰۲۰=<em><span dir="LTR">p</span></em>) معنادار بود. در سه متغیر ذکرشده تفاوت بین مراحل پیشآزمون و پسآزمون (۰٫۰۵><em><span dir="LTR">p</span></em>) و پیشآزمون و پیگیری (۰٫۰۵><em><span dir="LTR">p</span></em>) معنادار بود؛ اما بین مراحل پسآزمون و پیگیری معنادار نبود که نشاندهندهٔ ماندگاری تأثیر مداخله است.<span style="color:windowtext;"><span style="font-size:8.0pt;"></span></span><br>
<strong>نتیجهگیری:</strong> بستهٔ مداخلهای مبتنیبر الگوی گفتمان مادر-کودک که در این پژوهش تدوین شده است، منجربه کاهش مشکلات برونیسازی، کاهش بازنمایی ذهنی منفی از مادر و افزایش انسجام روایتی کودکان دارای مشکلات برونیسازی میشود. </span></span></p>
<div style="text-align: justify;"><strong>Background & Objectives</strong>: Externalizing problems are associated with numerous unpleasant consequences, i.e., among the most frequent reasons for children’s referral to mental healthcare centers. Various factors were proposed respecting this issue’s etiology, ranging from genetic to environmental and familial features. However, mother-child interactions, and especially the mother-child discourse during preschool can impact the formation or reduction of numerous problems in such children. As per different theories, the components of the mother-child discourse are related to the child’s mental representations of attachment as well as the child’s narrative coherence ability. However, few interventions focusing on children’s behavioral problems have particularly addressed the significance of mother-child discourse. Therefore, the present study aimed to investigate the effects of a formulated intervention based on the mother-child discourse model on reducing externalizing problems by reducing negative mental representations and increasing the narrative coherence of children with externalizing problems.<br>
<strong>Methods</strong>: This was a quasi-experimental study with a pretest-posttest-follow-up and a control group design. The statistical population of the study consisted of 4- to 6-year-old children with externalizing problems in the kindergartens of the Welfare Organization of Tehran City, Iran, and their mothers in 2018. Twenty-six mother-child couples whose children had externalizing problems were selected using the convenience sampling method. After homogenization based on demographic variables (children’s age & gender, and the educational level & occupation of the mothers), they were randomly divided into two groups; 15 couples were assigned per group. At the end of the study, 3 couples in the experimental group (n=12 couples<span dir="RTL">(</span> and 4 couples in the control group <span dir="RTL">)</span>n=11 couples<span dir="RTL">(</span> were excluded. The inclusion criteria of the research for the mothers included having a diploma and the lack of anxiety disorders and depression based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5); for children, the same was an age range of 4 to 6 years, receiving a score within the range of externalizing problems (65-69) according to the Child Behavior Checklist (CBC; Achenbach & Rescorla, 2001), and not taking psychiatric drugs. Then, the children were assessed by the CBC concerning externalizing problems. Moreover, the MacArthur Story Stem Battery (Emde et al., 2003) was applied to examine the negative mental representations of attachment and narrative coherence in them. Furthermore, the intervention sessions were entitled "intervention based on mother-child discourse", i.e., a short-term approach to reduce externalizing problems in children. This package was prepared under the supervision of child psychologists; the content validity method was used to validate the package. The study was conducted in seven 2-hour weekly sessions with 4 sessions for mothers and 3 sessions for the mothers and children. Repeated-measures Analysis of Variance (ANOVA) and Bonferroni posthoc test were used for data analysis in SPSS at the significance level of 0.05.<br>
<strong>Results</strong>: The repeated-measures ANOVA data revealed that the main effect of time was significant on externalizing problems (<em>p</em><0.001), the negative mental representation of attachment to the mother (<em>p</em><0.001), and the child’s narrative coherence (<em>p</em>=0.020). Moreover, the main effect of intergroup was significant on externalizing problems (<em>p</em>=0.040) and the negative mental representation of attachment to the mother (<em>p</em><0.001). Accordingly, the mean scores of the experimental and control groups were significantly different; however, children's narrative coherence was not significantly different between the two groups, suggesting that the change over time was the same for both study groups. Besides, the intervention for externalizing problems (F<sub>1.22</sub>=116.89, <em>p</em><0.001, Ƞ=0.84), the negative mental representation of attachment to the mother (F<sub>1.22</sub>=165.00, <em>p</em><0.001, Ƞ=0.82), and the child’s narrative coherence (F<sub>1.22</sub>=5.90, <em>p</em><0.020, Ƞ=0.21) were significant. In terms of externalizing problems, the difference between pretest and posttest stages (<em>p</em><0.001), and pretest and follow-up steps (<em>p</em><0.001) was significant; however, there was no significant difference between the posttest and follow-up stages, indicating the persistence of the intervention (<em>p</em>=0.460). Respecting negative mental representation, the difference between pretest and posttest stages (<em>p</em><0.001) and pretest and follow-up steps (<em>p</em><0.001) was significant; however, there was no significant difference between the posttest and follow-up stages, reflecting the persistence of the intervention effects (<em>p</em>=0.170). There was a significant difference between pretest and posttest (<em>p</em>=0.010) and pretest and follow-up stages (<em>p</em>=0.040) in narrative coherence; however, there was no significant difference between the posttest and follow-up stages, demonstrating the persistence of the intervention effects (<em>p</em>=0.560).<br>
<strong>Conclusion</strong>: According to the present research results, the intervention based on the mother-child discourse model was useful for reducing externalizing problems, reducing negative mental representations, and increasing the narrative coherence of children with externalizing problems.</div>
بازنمایی ذهنی منفی از مادر, انسجام روایتی, تعامل والد-کودک, مشکلات برونیسازی, کودکان.
Negative mental representation of the mother, Narrative coherence, Parent-Child discourse, Externalizing problems, Children.
4
4
http://jdisabilstud.org/browse.php?a_code=A-10-1744-1&slc_lang=fa&sid=1
Fateme
Matin Khah
فاطمه
متین خواه
e.matinkhah@gmail.com
100319475328460051674
100319475328460051674
No
Department of Psychology, University of Isfahan
گروه روانشناسی، دانشگاه اصفهان
Shole
Amiri
شعله
امیری
s.amiri@edu.ui.ac.ir
100319475328460051675
100319475328460051675
Yes
Department of Psychology, University of Isfahan
گروه روانشناسی، دانشگاه اصفهان
Mohammad Ali
Mazaheri
محمد علی
مظاهری
m-mazaheri@sbu.ac.ir
100319475328460051676
100319475328460051676
No
Department of Psychology, Shaheed Beheshti University
گروه روانشناسی، دانشگاه شهید بهشتی
Saeed
Ghanbari
سعید
قنبری
s_ghanbari@sbu.ac.ir
100319475328460051677
100319475328460051677
No
Department of Psychology, Shaheed Beheshti University
گروه روانشناسی، دانشگاه شهید بهشتی