نارسایی‌های الگوهای ارتباطی و کنش وری خانواده نوجوانان مبتلا به اختلال خلقی دو قطبی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری روان شناسی، گروه روان شناسی، دانشگاه فردوسی مشهد، مشهد، ایران.

2 استادگروه روان شناسی، دانشکده علوم تربیتی و روان شناسی، دانشگاه فردوسی مشهد، مشهد، ایران.

3 مرکز تحقیقات روان‌پزشکی و علوم رفتاری، بیمارستان ابن‌سینا، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد

10.22067/tpccp.2024.81679.1478

چکیده

هدف: هدف از پژوهش حاضر بررسی الگوهای ارتباطی و کنش‌وری‌های خانوادگی در نوجوانان مبتلا به اختلال خلقی دو قطبی بود.

روش: مطالعه حاضر از نوع توصیفی و با روش علی مقایسه‌ای دوگروهی بود. جامعه آماری مطالعه حاضر کلیه نوجوانان مبتلا به اختلال خلقی دوقطبی بودند. تعداد 52 نوجوان مبتلا به اختلال خلقی دو قطبی بستری در بیمارستان روان‌پزشکی ابن سینا مشهد از طریق نمونه‌گیری در دسترس انتخاب شدند. 52 نوجوان داوطلب سالم نیز جهت مقایسه داده‌ها، مورد ارزیابی قرار گرفتند. داده‌ها از طریق اجرای دو پرسش‌نامه‌ی عملکرد خانواده (FDA) و الگوهای ارتباطی خانواده (FCP)جمع‌آوری شد. برای تحلیل داده‌ها، روش آماری تحلیل واریانس چند متغیری مورد استفاده قرار گرفت. تمامی فرایند تجزیه‌ و تحلیل داده‌ها با استفاده از نرم‌افزار آماری «SPSS 26» صورت گرفت.

یافته‌ها: نتایج نشان داد که بین دو گروه نوجوانان (مبتلا به اختلال دوقطبی و سالم) در مؤلفه‌های پرسشنامه عملکرد خانواده (حل مشکل، ارتباط، نقش‌ها، همراهی عاطفی، آمیزش عاطفی، کنترل رفتار، عملکرد کلی) و مؤلفه‌های پرسشنامه الگوهای ارتباطی خانواده (گفت و شنود، هم‌نوایی) تفاوت معناداری وجود دارد (01/0>p). وجود کنش‌وری‌های خانوادگی مختل در اختلال خلقی دو قطبی نوجوانان باید به عنوان عاملی مهم در درمان و مداخلات مورد توجه ویژه قرار گیرد.

کلیدواژه‌ها

موضوعات


Algorta, G. P., MacPherson, H. A., Youngstrom, E. A., Belt, C., , Arnold, L., Frazier, T. W., Taylor, H. G., Birmaher,B.,, Horwitz, S., Findling, R., & Fristad, M. A. (2017). Parenting Stress Among Caregivers of Children With Bipolar Spectrum Disorders. Journal of Clinical Child & Adolescent Psychology. https://doi.org/DOI:10.1080/15374416.2017.1280805
Algorta, G. P., Youngstrom, E. A., Frazier, T. W., Freeman, A. J., Youngstrom, J. K., & Findling, R. L. (2011). Suicidality in pediatric bipolar disorder: predictor or outcome of family processes and mixed mood presentation? Bipolar Disord, 13(1), 76-86. https://doi.org/10.1111/j.1399-5618.2010.00886.x
Association, A. p. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed).
Brigde, J. A., Goldstirn, T. R., &, & Brent, D. A. (2006). Adolescent suicide and suicidal behavior. Journal of Child Psychology and Psychiatry, 47, 372–394. https://doi.org/10.1111/j.1469-7610.2006.01615.x
Carvalho, A. F., Firth, J., & Vieta, E. (2020). Bipolar Disorder. N Engl J Med, 383(1), 58-66. https://doi.org/10.1056/NEJMra1906193
De Abreu, L. N., Nery, F. G., Harkavy-Friedman, J. M., de Almeida, K. M., Gomes, B. C., Oquendo, M. A., & Lafer, B. (2012). Suicide attempts are associated with worse quality of life in patients with bipolar disorder type I. Compr Psychiatry, 53(2), 125-129. https://doi.org/10.1016/j.comppsych.2011.03.003
Dou, W., Yu, X., Fang, H., Lu, D., Cai, L., Zhu, C., Zong, K., Zheng, Y., & Lin, X. (2021). Family and Psychosocial Functioning in Bipolar Disorder: The Mediating Effects of Social Support, Resilience and Suicidal Ideation. Front Psychol, 12, 807546. https://doi.org/10.3389/fpsyg.2021.807546
Duffy, A., Alda, M., Hajek, T., Sherry, S. B., & Grof, P. (2010). Early stages in the development of bipolar disorder. J Affect Disord, 121(1-2), 127-135. https://doi.org/10.1016/j.jad.2009.05.022
Fristad, M. A., Wolfson, H., & Algorta, G. P. (2016). Disruptive mood dysregulation disorder and bipolar disorder not otherwise specified: fraternal or identical twins? . Journaal of Child and Adolescnt Psychopharmacol, 26, 138‐146. DOI: 10.1089/cap.2015.0062
Geller, B., Tillman, R., Bolhofner, K., & Zimerman, B. (2008). Child bipolar I disorder: prospective continuity with adult bipolar I disorder; characteristics of second and third episodes; predictors of 8-year outcome. Arch Gen Psychiatry, 65(10), 1125-1133. https://doi.org/10.1001/archpsyc.65.10.1125
Goldstein, B. I., & Birmaher, B. (2012). Prevalence, clinical presentation and differential diagnosis of pediatric bipolar disorder. Isr J Psychiatry Relat Sci, 49(1), 3-14. https://www.ncbi.nlm.nih.gov/pubmed/22652925
Gomes, B. C., Kleinman, A., Carvalho, A. F., Pereira, T. C., Gurgel, A. P., Lafer, B., Busatto, G. F., Caetano, S. C., & de Almeida Rocca, C. C. (2016). Quality of life in youth with bipolar disorder and unaffected offspring of parents with bipolar disorder. J Affect Disord, 202, 53-57. https://doi.org/10.1016/j.jad.2016.05.041
Guerrero-Jimenez, M., Gutierrez, B., & Cervilla, J. A. (2022). Psychotic symptoms associate inversely with social support, social autonomy and psychosocial functioning: A community-based study. Int J Soc Psychiatry, 68(4), 898-907. https://doi.org/10.1177/00207640211011198
Keenan-Miller, D., Peris, T., Axelson, D., Kowatch, R. A., & Miklowitz, D. J. (2012). Family functioning, social impairment, and symptoms among adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry, 51(10), 1085-1094. https://doi.org/10.1016/j.jaac.2012.08.005
Koroshnia, M., & Latifian, M. (2008). An Investigation on Validity and Reliability of Revised Family Communication Patterns Instrument. Journal of Family Research, 3(4), 855-875. (In Persian) https://sid.ir/paper/122282/en
Luo, X., Zhu, Y., Lu, D., Zong, K., & Lin, X. (2020). Subjective cognitive dysfunction in patients with bipolar disorder: The prevalence, related factors and effects on predicting psychosocial functioning and suicidal ideation. Psychiatry Res, 284, 112669. https://doi.org/10.1016/j.psychres.2019.112669
MacPherson, H. A., Ruggieri, A. L., Christensen, R. E., Schettini, E., Kim, K. L., Thomas, S. A., & Dickstein, D. P. (2018). Developmental evaluation of family functioning deficits in youths and young adults with childhood-onset bipolar disorder. J Affect Disord, 235, 574-582. https://doi.org/10.1016/j.jad.2018.04.078
MacPherson, H. A., Weinstein, S. M., Henry, D. B., & West, A. E. (2016). Mediators in the randomized trial of Child- and Family-Focused Cognitive-Behavioral Therapy for pediatric bipolar disorder. Behav Res Ther, 85, 60-71. https://doi.org/10.1016/j.brat.2016.08.014
Miklowitz, D. J., Peris, T. S., & Lord, C. (2020). Helping Families to Understand and Cope With Psychiatric Disorders in Childhood-Beyond Basic Facts. JAMA Psychiatry, 77(4), 433-434. https://doi.org/10.1001/jamapsychiatry.2019.4812
Miklowitz, D. J., Schneck., C. D., & Walshaw, P. D. (2017). Early intervention for youth at high risk for bipolar disorder: A multisite randomized trial of family-focused treatment. Early Intervention in Psychiatry, 0, 1–9. https:// doi.org/10.1111/eip.12463
Millman, Z. B., Weintraub, M. J., & Miklowitz, D. J. (2018). Expressed emotion, emotional distress, and individual and familial history of affective disorder among parents of adolescents with bipolar disorder. Psychiatry Res, 270, 656-660. https://doi.org/10.1016/j.psychres.2018.10.054
Mohammadzade, S., Mohammadi, M. R., Ahmadi, N., Hooshyari, Z., Tahazade, s., Yousefi, F., Maleki, B., & hamidi, s. (2019). Epidemiology of psychiatric disorders in children and adolescents 6 -18 yearsold in Kurdistan province in 2016 [Original Research]. Scientific Journal of Kurdistan University of Medical Sciences, 23(6), 115-127. https://doi.org/10.52547/sjku.23.6.115 (In Persian) 
O'Donnell, L. A., Weintraub, M. J., Ellis, A. J., Axelson, D. A., Kowatch, R. A., Schneck, C. D., & Miklowitz, D. J. (2020). A Randomized Comparison of Two Psychosocial Interventions on Family Functioning in Adolescents with Bipolar Disorder. Fam Process, 59(2), 376-389. https://doi.org/10.1111/famp.12521
Reinares, M., Bonnin, C. M., Hidalgo-Mazzei, D., Colom, F., Sole, B., Jimenez, E., Torrent, C., Comes, M., Martinez-Aran, A., Sanchez-Moreno, J., & Vieta, E. (2016). Family functioning in bipolar disorder: characteristics, congruity between patients and relatives, and clinical correlates. Psychiatry Res, 245, 66–73. https://doi.org/10.1016/j.psychres.2016.08.010
Shahrivar, Z., Kousha, M., Moallemi, S., Tehrani-Doost, M., & Alaghband-Rad, J. (2010). The Reliability and Validity of Kiddie-Schedule for Affective Disorders and Schizophrenia - Present and Life-time Version - Persian Version. Child Adolesc Ment Health, 15(2. 97-102) https://doi.org/10.1111/j.1475-3588.2008.00518.x (In Persian) 
Shalev, A., Merranko, J., Goldstein, T., Miklowitz, D. J., Axelson, D., Goldstein, B. I., Brent, D., Monk, K., Hickey, M. B., Hafeman, D. M., Sakolsky, D., Diler, R., & Birmaher, B. (2019). A Longitudinal Study of Family Functioning in Offspring of Parents Diagnosed With Bipolar Disorder. J Am Acad Child Adolesc Psychiatry, 58(10), 961-970. https://doi.org/10.1016/j.jaac.2018.10.011
Siegel, R. S., Hoeppner, B., Yen, S., Stout, R. L., Weinstock, L. M., Hower, H. M., Birmaher, B., Goldstein, T. R., Goldstein, B. I., Hunt, J. I., Strober, M., Axelson, D. A., Gill, M. K., & Keller, M. B. (2015). Longitudinal Associations Between Interpersonal Relationship Functioning and Mood Episode Severity in Youth With Bipolar Disorder. The Journal of Nervous and Mental Disease, 203(3). https://journals.lww.com/jonmd/Fulltext/2015/03000/Longitudinal_Associations_Between_Interpersonal.8.aspx
Sullivan, A. E., Judd, C. M., Axelson, D. A., & Miklowitz, D. J. (2012). Family functioning and the course of adolescent bipolar disorder. Behav Ther, 43(4), 837-847. https://doi.org/10.1016/j.beth.2012.04.005
Weinstein, S. M., Cruz, R. A., Isaia, A. R., Peters, A. T., & West, A. E. (2018). Child- and Family-Focused Cognitive Behavioral Therapy for Pediatric Bipolar Disorder: Applications for Suicide Prevention. Suicide Life Threat Behav, 48(6), 797-811. https://doi.org/10.1111/sltb.12416
West, A. E., & Cosgrove, V. E. (2019). Editorial: The Impact of Parental Psychopathology on Family Functioning: Prioritizing Transdiagnostic Interventions With Parents and Families. J Am Acad Child Adolesc Psychiatry, 58(10), 940-942. https://doi.org/10.1016/j.jaac.2019.04.005
Wilcox, H. C., Fullerton, J. M., Glowinski, A. L., Benke, K., Kamali, M., Hulvershorn, L. A., Stapp, E. K., Edenberg, H. J., Roberts, G. M. P., Ghaziuddin, N., Fisher, C., Brucksch, C., Frankland, A., Toma, C., Shaw, A. D., Kastelic, E., Miller, L., McInnis, M. G., Mitchell, P. B., & Nurnberger, J. I., Jr. (2017). Traumatic Stress Interacts With Bipolar Disorder Genetic Risk to Increase Risk for Suicide Attempts. J Am Acad Child Adolesc Psychiatry, 56(12), 1073-1080. https://doi.org/10.1016/j.jaac.2017.09.428
Yousefi, N. (2012). An Investigation of the Psychometric Properties of the McMaster Clinical Rating Scale (MCRS). Quarterly of Educational Measurement, 2(17), 91-120. https://jem.atu.ac.ir/article_5626.html?lang=en (In Persian) 
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