@2024 Afarand., IRAN
ISSN: 2252-0805 The Horizon of Medical Sciences 2017;23(3):215-221
ISSN: 2252-0805 The Horizon of Medical Sciences 2017;23(3):215-221
Effectiveness of Mindfulness-Based Parenting Educational Program on the Anxiety, Parent-Child Conflict and Parent Self-Agency in Mothers with Oppositional Defiant Disorder Children
ARTICLE INFO
Article Type
Original ResearchAuthors
Ghazanfari F. (1)Hosseini Ramaghani N. (* )
Moradiyani Gizeh Rod S.Kh. (1)
Panahi H. (1)
(* ) Psychology Department, Literature & Humanities Faculty, University of Lorestan, Khorramabad, Iran
(1) Psychology Department, Literature & Humanities Faculty, University of Lorestan, Khorramabad, Iran
Correspondence
Address: Literature & Humanities Faculty, Lorestan University, 5th Kilometer of Tehran Highway, Lorestan Province, Khorramabad, Iran. Postal Code: 68151-44316Phone: +98 (66) 33120097
Fax: +98 (66) 33120106
nasrin.ramaghani@gmail.com
Article History
Received: August 22, 2016Accepted: May 2, 2017
ePublished: July 22, 2017
BRIEF TEXT
Disobedience is the stage of natural growth in children. The most visible coping behaviors is between the age of 12 and 20 months, and reaches its peak at age 3, then declines in preschool years [1]. … [2-23]. An effective approach to improve the psychological adjustment of parents and reducing behavioral problems in child and adolescents is mindfulness-based approaches [24, 25]. This approach promotes healthy parenting and physical health of mother and child as well as the child's emotional development [26]. … [27-34].
The purpose of the present study was to determine the effect of mindfulness-based parenting on reduction of anxiety and parent-child anxiety, as well as the increase of self-efficacy of parenting in mothers with oppositional and disobedient disorder.
The present study is a quasi-experimental study with pretest and posttest with control group.
This study was performed among all mothers of the first to sixth grade of primary school students (6-12 year old) in Noorabad City in the academic year 2015-2016.
Targeted cluster sampling was used and 34 mothers of children with oppositional-disobedience disorder were selected to participate in the study.
The following tools were used to perform the research: 1. Child Behavioral Checking List (CBCL) and Teacher Report Form (TRF): Child Behavioral Checklist and Teacher Report Form are two forms of the Astenbach Baseline Assessment System, which are completed by parent and teacher, according to the child's status in the last 6 months. In these questionnaires, DSM-IV-TR disorder scales have been set. The results have shown that the coefficients of coefficients of DSM-IV-TR syndrome scales were satisfactory and ranged from 0.64 to 0.81 for CBLC and 0.62 to 0.92 for TRF respectively [35]. 2. Beck Anxiety Questionnaire (BAI): This questionnaire contains 21 items that include common symptoms of anxiety (physical, emotional, and cognitive symptoms). The score of the person can range from zero to 63. According to Beck et al. [36], the score of 0 to 7, 8-15 and 16-25 indicate slight anxiety, moderate anxiety, and severe anxiety respectively. The internal consistency of this test in Iran has been reported 92% using Cronbach's alpha [37]. 3. Conflict Strategies Questionnaire (CT): This questionnaire contains 15 questions that measure three conflict resolution strategies including reasoning, verbal aggression and physical aggression and has been provided by Moori-E- Strauss. High scores on the whole indicate a higher conflict. The questionnaire questions are scored on a Likert scale of five degree (from very low to very high). Several researchers in Iran have confirmed the internal consistency of the subscales and the whole scale. The reliability of the questionnaire was 0.78 and 0.72 using Cronbach's alpha and test-retest method respectively [38]. 4. Parenting self-Agency Measure (PSAM): This was first used by Domek et al. to evaluate the parental self-agency. This scale measures the overall sense of parental confidence in parenthood. Talei, has reported the Cronbach's Alpha of the Persian version of this questionnaire 0.70 and its suitable face validity [39]. Then, mothers were randomly assigned into two experimental and control groups and a pretest was performed on them. In the next step, the mothers of the experimental group participated in a mindfulness-based parenting education that was conducted weekly and for two months in the two days on the basis of mindfulness, and then both groups took the posttest (Table 1). Statistical analysis: The collected data were analyzed by SPSS 23 software and analyzed by multivariate analysis of covariance. To use the covariance analysis test, first the assumption of the normal distribution of data was investigated using Kolmogorov-Smirnov test. Equivalence assumption for variance was investigated by Levene test, and homogeneity of variance/covariance matrices was studied using Mbox test; homogeneity of regression, also, was investigated.
The means of age of mothers in the experimental and control group were 29.45±1.06 and 28.98±1.15 years respectively. Also, in the experimental group, 11 and 6 participants had over diploma and diploma education respectively, and in the control group, 10 and 7 participants had over diploma and diploma education respectively. In the post-test, the experimental group improved in the mean total score of anxiety, parent-child conflict and parental self-agency. After controlling the effect of the pretest scores, there was a significant difference between the two groups in terms of the mean of the total scores of anxiety, parent-child conflict, and parenting self-agency (p<0.001). Therefore the effect sizes of mindfulness-based parenting educational training on the reduction of total anxiety score and parent-child conflict were 0.5 and 0.38 respectively, and the effect size of increasing parenting self-agency was 0.4 (Table 2).
According to the results of this study, a mindfulness-based parenting could reduce the symptoms of anxiety, reduction in parent-child conflict and increase the self-efficacy of parenting in mothers with children with oppositional—disobedience disorder. The results of this study is in line with the findings of previous studies [14, 24, 25, 28, and 32]. … [40-44].
It is suggested that in future studies, the effectiveness of mindfulness-based parenting education on problems of children with abnormalities such as stress and perceived child-rearing practices, and their aggressive and copying behaviors be considered.
Of the limitations of this study, limitation of the number of samples of mothers with daughters with oppositional-disobedience disorder and lack of follow-up stage can be mentioned.
Mindfulness-based parenting program can reduce anxiety, parent-child conflict and increase of self-efficacy in mothers with a child with obesity-disobedience disorder.
The authors of this study thank and appreciate the sincere cooperation of the honorable authorities of the education and schools of the city of Noorabad, as well as the mothers of the participants.
Non-declared
This research is ethically confirmed in the research council of the psychiatric department of Lorestan University.
The cost of this study has been provided by the authors.
TABLES and CHARTS
Show attach fileCITIATION LINKS
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[2]Tremblay RE. Developmental origins of disruptive behaviour problems: the ‘original sin’hypothesis, epigenetics and their consequences for prevention. J Child Psychol Psychiatry. 2010;51(4):341-67.
[3]Munkvold LH, Lundervold AJ, Manger T. Oppositional defiant disorder-gender differences in co-occurring symptoms of mental health problems in a general population of children. J Abnorm Child Psychol. 2011;39(4):577-87.
[4]American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th edition. Washington, DC: American Psychiatric Association; 2013.
[5]Tseng WL, Kawabata Y, Gau SS. Social adjustment among Taiwanese children with symptoms of ADHD, ODD, and ADHD comorbid with ODD. Child Psychiatry Hum Dev. 2011;42(2):134-51.
[6]Hamilton SS, Armando J. Oppositional defiant disorder. Am Fam Phys. 2008;78(7):861-6.
[7]Marmorstein NR. Relationships between anxiety and externalizing disorders in youth: the influences of age and gender. J Anxiety Disord. 2007;21(3):420-32.
[8]Ghosh A, Malhotra S, Basu D. Oppositional defiant disorder (ODD), the forerunner of alcohol dependence: A controlled study. Asian J Psychiatry. 2014;11:8-12.
[9]Dick DM, Viken RJ, Kaprio J, Pulkkinen L, Rose RJ. Understanding the covariation among childhood externalizing symptoms: Genetic and environmental influences on conduct disorder, attention deficit hyperactivity disorder, and oppositional defiant disorder symptoms. J Abnorm Child Psychol. 2005;33(2):219-29.
[10]Sohrabi F, Asadzadeh H, Arabzadeh Z. Effectiveness of Barkley’s parental education program in reducing the symptoms of oppositional defiant disorder on preschool children. J Sch Psychol. 2014;3(2):253-66. [Persian]
[11]Lin X, Li L, Chi P, Wang Z, Heath MA, Du H, et al. Child maltreatment and interpersonal relationship among Chinese children with oppositional defiant disorder. Child Abuse Negl. 2016;51:192-202.
[12]Bayrami M. The effect of the parent management training to mothers of school-boys with externalizing disorders on their general health and parenting styles. J Fundam Ment Health. 2009;11(2):105-14. [Persian]
[13]Cunningham CE, Boyle MH. Preschoolers at risk for attention-deficit hyperactivity disorder and oppositional defiant disorder: Family, parenting, and behavioral correlates. J Abnorm Child Psychol. 2002;30(6):555-69.
[14]Haydicky J, Shecter C, Wiener J, Ducharme JM. Evaluation of MBCT for adolescents with ADHD and their parents: Impact on individual and family functioning. J Child Fam Stud. 2015;24(1):76-94.
[15]Maughan B, Rowe R, Messer J, Goodman R. Conduct disorder and oppositional defiant disorder in a national sample: Developmental epidemiology. J Child Psycol Psychiatry. 2004;45(3):609-21.
[16]Edwards G, Barkley RA, Laneri M, Fletcher K, Metevia L. Parent–adolescent conflict in teenagers with ADHD and ODD. J Abnorm Child Psychol. 2001;29(6):557-72.
[17]Craig F, Operto FF, De Giacomo A, Margari L, Frolli A, Conson M, et al. Parenting stress among parents of children with neurodevelopmental disorders. Psychiatry Res. 2016;242:121-9.
[18]Bondy EM, Mash EJ. Parenting efficacy, perceived control over caregiving failure, and mothers' reactions to preschool children's misbehavior. Child Study J. 1999;29(3):157-73.
[19]Hayes L, Matthews J, Copley A, Welsh D. A randomized controlled trial of a mother–infant or toddler parenting program: Demonstrating effectiveness in practice. J Pediatr psychol. 2008;33(5):473-86.
[20]Siu AF, Ma Y, Chui FW. Maternal Mindfulness and Child Social Behavior: the Mediating Role of the Mother-Child Relationship. Mindfulness. 2016;7(3):577-83.
[21]Van der Oord S, Bögels SM, Peijnenburg D. The effectiveness of mindfulness training for children with ADHD and mindful parenting for their parents. J Child Fam Stud. 2012;21(1):139-47.
[22]Jiang Y, Gurm M, Johnston C. Child impairment and parenting self-efficacy in relation to mothers’ views of ADHD treatments. J Atten Disord. 2014;18(6):532-41.
[23]Dean C, Myers K, Evants E. Communicating-wide implementation of parenting program: The south east Sydney positive parenting project. Aust J Advancement Ment Health. 2003;2(3):1-12.
[24]Coatsworth JD, Duncan LG, Greenberg MT, Nix RL. Changing parent’s mindfulness, child management skills and relationship quality with their youth: Results from a randomized pilot intervention trial. J Child Fam Stud. 2010;19(2):203-17.
[25]Turpyn CC, Chaplin TM. Mindful parenting and parents’ emotion expression: Effects on adolescent risk behaviors. Mindfulness. 2016;7(1):246-54.
[26]Duncan LG, Baradacke N. Mindfulness-based childbirth and parenting education: Promoting family mindfulness during the perinatal period. J Child Fam Stud. 2010;19(2):190-202.
[27]Orzech KM, Shapiro SL, Brown KW, McKay M. Intensive mindfulness training-related changes in cognitive and emotional experience. J Posit Psychol. 2009;4(3):212-22.
[28]Perez-Blasco J, Viguer P, Rodrigo MF. Effects of a mindfulness-based intervention on psychological distress, well-being, and maternal self-efficacy in breast-feeding mothers: results of a pilot study. Arch Womens Mental Health. 2013;16(3):227-36.
[29]Bögels S, Restifo K. Mindful parenting: A guide for mental health practitioners. New York: Springer; 2014.
[30]Davis TS. Mindfulness-Based Approaches and their potential for educational psychology practice. Educ Psychol Pract. 2012;28(1):31-46.
[31]Duncan LG, Coatsworth JD, Greenberg MT. A model of mindful parenting: Implications for parent–child relationships and prevention research. Clin Child Fam Psychol Rev. 2009;12(3):255-70
[32]Costin J, Lichte C, Hill-Smith A, Vance A, Luk E. Parent group treatments for children with oppositional defiant disorder. Aust J Advancement Ment Health. 2004;3(1):36-43.
[33]Burnett-Zeigler IE, Satyshur MD, Hong S, Yang A, Moskowitz JT, Wisner KL. Mindfulness based stress reduction adapted for depressed disadvantaged women in an urban Federally Qualified Health Center. Complement Ther Clin Pract. 2016;25:59-67.
[34]Bamber MD, Schneider JK. Mindfulness-based meditation to decrease stress and anxiety in college students: A narrative synthesis of the research. Educ Res Rev. 2016;18:1-32.
[35]Minaee A. Adaptation and standardization of child behavior checklist, youth self-report, and teacher’s report forms. J Except Child. 2006;6(1):529-58. [Persian]
[36]Beck AT, Steer RA. Relationship between the Beck anxiety inventory and the Hamilton anxiety rating scale with anxious outpatients. J Anxiety Disord. 1991;5(3):213-23.
[37]Kaviani H, Seyfourian H, Sharifi V, Ebrahimkhani N. Reliability and validity of Anxiety and Depression Hospital Scales (HADS): Iranian patients with anxiety and depression disorders. Tehran Univ Med J. 2009;67(5):379-85.
[38]Askari P, Safarzadeh S. The relationship of emotional adjustment and religious beliefs with strategies for resolving conflict with parents among the students of Ahwaz Azad Islamic University. Ravanshenasi va Din. 2014;7(1):81-95. [Persian]
[39]- Talei A, Tahmasian K, Vafai N. Effectiveness of positive parenting program training on mothers’ parental self-efficacy. J Fam Res. 2011;7(3):311-23. [Persian]
[40]Teasdale JD, Segal ZV, Williams JM, Ridgeway VA, Soulsby JM, Lau MA. Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. J Consult Clin Psychol. 2000;68(4):615-23.
[41]Raphiphatthana B, Jose PE, Kielpikowski M. How do the facets of mindfulness predict the constructs of depression and anxiety as seen through the lens of the tripartite theory?. Personal Individ Differ. 2016;93:104–11.
[42]Grossman P, Niemann L, Schmidt S, Walach H. Mindfulness-based stress reduction and health benefits: A meta-analysis. J Psychosom Res. 2004;57(1):35-43.
[43]Brown KW, Ryan RM, Creswell JD. Mindfulness: Theoretical foundations and evidence for its salutary effects. Psychol Inq. 2007;18(4):211-37.
[44]Stahl B, Goldstein E. A mindfulness-based stress reduction workbook. Oakland, California: New Harbinger Publications; 2010.
[2]Tremblay RE. Developmental origins of disruptive behaviour problems: the ‘original sin’hypothesis, epigenetics and their consequences for prevention. J Child Psychol Psychiatry. 2010;51(4):341-67.
[3]Munkvold LH, Lundervold AJ, Manger T. Oppositional defiant disorder-gender differences in co-occurring symptoms of mental health problems in a general population of children. J Abnorm Child Psychol. 2011;39(4):577-87.
[4]American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th edition. Washington, DC: American Psychiatric Association; 2013.
[5]Tseng WL, Kawabata Y, Gau SS. Social adjustment among Taiwanese children with symptoms of ADHD, ODD, and ADHD comorbid with ODD. Child Psychiatry Hum Dev. 2011;42(2):134-51.
[6]Hamilton SS, Armando J. Oppositional defiant disorder. Am Fam Phys. 2008;78(7):861-6.
[7]Marmorstein NR. Relationships between anxiety and externalizing disorders in youth: the influences of age and gender. J Anxiety Disord. 2007;21(3):420-32.
[8]Ghosh A, Malhotra S, Basu D. Oppositional defiant disorder (ODD), the forerunner of alcohol dependence: A controlled study. Asian J Psychiatry. 2014;11:8-12.
[9]Dick DM, Viken RJ, Kaprio J, Pulkkinen L, Rose RJ. Understanding the covariation among childhood externalizing symptoms: Genetic and environmental influences on conduct disorder, attention deficit hyperactivity disorder, and oppositional defiant disorder symptoms. J Abnorm Child Psychol. 2005;33(2):219-29.
[10]Sohrabi F, Asadzadeh H, Arabzadeh Z. Effectiveness of Barkley’s parental education program in reducing the symptoms of oppositional defiant disorder on preschool children. J Sch Psychol. 2014;3(2):253-66. [Persian]
[11]Lin X, Li L, Chi P, Wang Z, Heath MA, Du H, et al. Child maltreatment and interpersonal relationship among Chinese children with oppositional defiant disorder. Child Abuse Negl. 2016;51:192-202.
[12]Bayrami M. The effect of the parent management training to mothers of school-boys with externalizing disorders on their general health and parenting styles. J Fundam Ment Health. 2009;11(2):105-14. [Persian]
[13]Cunningham CE, Boyle MH. Preschoolers at risk for attention-deficit hyperactivity disorder and oppositional defiant disorder: Family, parenting, and behavioral correlates. J Abnorm Child Psychol. 2002;30(6):555-69.
[14]Haydicky J, Shecter C, Wiener J, Ducharme JM. Evaluation of MBCT for adolescents with ADHD and their parents: Impact on individual and family functioning. J Child Fam Stud. 2015;24(1):76-94.
[15]Maughan B, Rowe R, Messer J, Goodman R. Conduct disorder and oppositional defiant disorder in a national sample: Developmental epidemiology. J Child Psycol Psychiatry. 2004;45(3):609-21.
[16]Edwards G, Barkley RA, Laneri M, Fletcher K, Metevia L. Parent–adolescent conflict in teenagers with ADHD and ODD. J Abnorm Child Psychol. 2001;29(6):557-72.
[17]Craig F, Operto FF, De Giacomo A, Margari L, Frolli A, Conson M, et al. Parenting stress among parents of children with neurodevelopmental disorders. Psychiatry Res. 2016;242:121-9.
[18]Bondy EM, Mash EJ. Parenting efficacy, perceived control over caregiving failure, and mothers' reactions to preschool children's misbehavior. Child Study J. 1999;29(3):157-73.
[19]Hayes L, Matthews J, Copley A, Welsh D. A randomized controlled trial of a mother–infant or toddler parenting program: Demonstrating effectiveness in practice. J Pediatr psychol. 2008;33(5):473-86.
[20]Siu AF, Ma Y, Chui FW. Maternal Mindfulness and Child Social Behavior: the Mediating Role of the Mother-Child Relationship. Mindfulness. 2016;7(3):577-83.
[21]Van der Oord S, Bögels SM, Peijnenburg D. The effectiveness of mindfulness training for children with ADHD and mindful parenting for their parents. J Child Fam Stud. 2012;21(1):139-47.
[22]Jiang Y, Gurm M, Johnston C. Child impairment and parenting self-efficacy in relation to mothers’ views of ADHD treatments. J Atten Disord. 2014;18(6):532-41.
[23]Dean C, Myers K, Evants E. Communicating-wide implementation of parenting program: The south east Sydney positive parenting project. Aust J Advancement Ment Health. 2003;2(3):1-12.
[24]Coatsworth JD, Duncan LG, Greenberg MT, Nix RL. Changing parent’s mindfulness, child management skills and relationship quality with their youth: Results from a randomized pilot intervention trial. J Child Fam Stud. 2010;19(2):203-17.
[25]Turpyn CC, Chaplin TM. Mindful parenting and parents’ emotion expression: Effects on adolescent risk behaviors. Mindfulness. 2016;7(1):246-54.
[26]Duncan LG, Baradacke N. Mindfulness-based childbirth and parenting education: Promoting family mindfulness during the perinatal period. J Child Fam Stud. 2010;19(2):190-202.
[27]Orzech KM, Shapiro SL, Brown KW, McKay M. Intensive mindfulness training-related changes in cognitive and emotional experience. J Posit Psychol. 2009;4(3):212-22.
[28]Perez-Blasco J, Viguer P, Rodrigo MF. Effects of a mindfulness-based intervention on psychological distress, well-being, and maternal self-efficacy in breast-feeding mothers: results of a pilot study. Arch Womens Mental Health. 2013;16(3):227-36.
[29]Bögels S, Restifo K. Mindful parenting: A guide for mental health practitioners. New York: Springer; 2014.
[30]Davis TS. Mindfulness-Based Approaches and their potential for educational psychology practice. Educ Psychol Pract. 2012;28(1):31-46.
[31]Duncan LG, Coatsworth JD, Greenberg MT. A model of mindful parenting: Implications for parent–child relationships and prevention research. Clin Child Fam Psychol Rev. 2009;12(3):255-70
[32]Costin J, Lichte C, Hill-Smith A, Vance A, Luk E. Parent group treatments for children with oppositional defiant disorder. Aust J Advancement Ment Health. 2004;3(1):36-43.
[33]Burnett-Zeigler IE, Satyshur MD, Hong S, Yang A, Moskowitz JT, Wisner KL. Mindfulness based stress reduction adapted for depressed disadvantaged women in an urban Federally Qualified Health Center. Complement Ther Clin Pract. 2016;25:59-67.
[34]Bamber MD, Schneider JK. Mindfulness-based meditation to decrease stress and anxiety in college students: A narrative synthesis of the research. Educ Res Rev. 2016;18:1-32.
[35]Minaee A. Adaptation and standardization of child behavior checklist, youth self-report, and teacher’s report forms. J Except Child. 2006;6(1):529-58. [Persian]
[36]Beck AT, Steer RA. Relationship between the Beck anxiety inventory and the Hamilton anxiety rating scale with anxious outpatients. J Anxiety Disord. 1991;5(3):213-23.
[37]Kaviani H, Seyfourian H, Sharifi V, Ebrahimkhani N. Reliability and validity of Anxiety and Depression Hospital Scales (HADS): Iranian patients with anxiety and depression disorders. Tehran Univ Med J. 2009;67(5):379-85.
[38]Askari P, Safarzadeh S. The relationship of emotional adjustment and religious beliefs with strategies for resolving conflict with parents among the students of Ahwaz Azad Islamic University. Ravanshenasi va Din. 2014;7(1):81-95. [Persian]
[39]- Talei A, Tahmasian K, Vafai N. Effectiveness of positive parenting program training on mothers’ parental self-efficacy. J Fam Res. 2011;7(3):311-23. [Persian]
[40]Teasdale JD, Segal ZV, Williams JM, Ridgeway VA, Soulsby JM, Lau MA. Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. J Consult Clin Psychol. 2000;68(4):615-23.
[41]Raphiphatthana B, Jose PE, Kielpikowski M. How do the facets of mindfulness predict the constructs of depression and anxiety as seen through the lens of the tripartite theory?. Personal Individ Differ. 2016;93:104–11.
[42]Grossman P, Niemann L, Schmidt S, Walach H. Mindfulness-based stress reduction and health benefits: A meta-analysis. J Psychosom Res. 2004;57(1):35-43.
[43]Brown KW, Ryan RM, Creswell JD. Mindfulness: Theoretical foundations and evidence for its salutary effects. Psychol Inq. 2007;18(4):211-37.
[44]Stahl B, Goldstein E. A mindfulness-based stress reduction workbook. Oakland, California: New Harbinger Publications; 2010.