Sadra Medical Journal

The Effectiveness of Trauma-Focused Cognitive Behavioral Therapy on Emotion and Academic Self-Regulation in Adolescent Girls in Zahedan City with Clinical Symptoms of Post-Traumatic Stress Disorder

Document Type : Original Article

Authors

Roksana Tarighi 1
Hossein Jenaabadi 2
Vali Mehdinezhad 3

1 PhD student in Educational Psychology, Department of Psychology, Zahedan Branch, Islamic Azad University, Zahedan, Iran

2 Professor of Psychology, University of Sistan and Baluchestan, Zahedan, lran

3 Associate Professor, Department of Educational Sciences, University of Sistan and Baluchistan, Zahedan, Iran

https://doi.org/10.30476/smsj.2023.97433.1380
Abstract
Introduction: Adolescents with post-traumatic stress disorder (PTSD) exhibit heightened sensitivity to environmental hazards, and face difficulties in emotion regulation and academic self-regulation. The present study aimed to investigate the effectiveness of trauma-focused cognitive-behavioral therapy on emotion regulation and academic self-regulation in adolescent girls with clinical symptoms of post-traumatic stress disorder following a traumatic event.
Methods: The research method in this study was a quasi-experimental design with pre-test and post-test measures, including a control group. A total of 20 female students from the high school in Zahedan in the year 2021 were purposefully selected and assigned to two groups: the experimental group (10 participants) and the control group (10 participants). Trauma-focused cognitive-behavioral therapy was administered to the experimental group over 11 ninety-minute sessions. The data collection tools included the Pekran et al. (2002) Academic Emotion Questionnaire, the Kiano et al. (1987) Post-Traumatic Stress Disorder (PTSD) Questionnaire, and the Zimmerman and Martinez-Pons (1986) Academic Self-Regulation Questionnaire. Data analysis involved the use of both univariate and multivariate analysis of covariance (ANCOVA).
Results: The findings indicated a significant difference between the mean scores of academic emotions and academic self-regulation in the experimental and control groups at the post-test phase, with a 95% confidence level (P<0.05). The effect size of trauma-focused cognitive-behavioral therapy on positive academic emotions was 0.76, on negative academic emotions was 0.65, and on academic self-regulation was 0.78.
Conclusion: To address the psychological problems of adolescents with clinical symptoms of post-traumatic stress disorder (PTSD), trauma-focused cognitive-behavioral therapy can be utilized.

Keywords

Cognitive Behavioral Therapy
Covid-19
Emotions
Post-traumatic Stress Disorder
Self-Regulation
  1. Morozov, A.; Nirca, V.; Victorova, A.; Poppert, S.; Frickmann, H.; Yamada, C.; Kacena, M.A.; Rata, S.; Movila, A. SARS-CoV-2 from COVID-19 Patients in the Republic of Moldova: Whole-Genome Sequencing Results. Viruses 2022, 14, 2310. https://doi.org/10.3390/ v14102310.
  2. Shahyad, S; Mohammadi, M. The psychological effects of the spread of covid-19 on the mental health of the community: a review study, Journal of Military Medicine, 2019; 22 (2): 184-192. (Persian)
  3. Mirilović N, Janković J, Latas M. The impact of the COVID-19 epidemic on students’ mental health: A cross-sectional study. PLoS ONE. 2022. 17(9): e0275167. https://doi.org/10.1371/journal. pone.0275167
  4. Selçuk, E; Demir, A; Erbay, L; Özcan, Q; Gürer, H; Dönmez, Y. Anxiety, depression and post-traumatic stress disorder symptoms in adolescents during the COVID-19 outbreak and associated factors, The international Journal of Clinical Practice, 3; 149: 1742-1757.
  5. Chang, MC; Park, D. Incidence of Post-Traumatic Stress Disorder After Coronavirus Disease, Healthcare (Basel). 2020 Sep 30;8(4):373. doi: 10.3390/healthcare8040373.
  6. Aronu AE, Chinawa AT, Ossai EN, Chinawa JM, Odinka PC, Odinka JI, et al. Posttraumatic stress disorder among secondary school students during the COVID-19 lockdown in Enugu. Niger J Med 2022;31:249-54.
  7. Wathelet, M; Fove, T; Jousset, A; Duhem, S; Habran, E; Horn, M & etal. Prevalence of and factors associated with post- traumatic stress disorder among French university students 1 month after the COVID-19 lockdown. Translational Psychiatry, 2021, 11:327.
  8. Benjamin J, Sadok VA, Pedro R. Psychiatry Summary; Behavioral Sciences [Rezaei F. Persian trans.]. Tehran: Arjmand Publication, 2018.
  9. Cameron P; Allison A & Campbell E. Emotion regulation in posttraumatic stress disorder (PTSD): Rumination accounts for the association between emotion regulation difficulties and PTSD severity, Journal Of Clinical Psychology. 2019; 3 (2): 21- 34.
  10. Shen L, Wu X, Zhen R and Zhou X. Post-Traumatic Stress Disorder, Mobile Phone Dependence, and Academic Boredom in Adolescents During the COVID-19 Pandemic. Front. Psychol. 2021; 12:724732.
  11. Sayed MH, Hegazi MA, El-Baz MS, Alahmadi TS, Zubairi NA, Altuwiriqi MA, et al. COVID-19 related posttraumatic stress disorder in children and adolescents in Saudi Arabia. PLoS ONE 2021, 16(8): e0255440.
  12. Pekrun, R. The control-value theory of achievement emotions: Assumptions, corollaries, and implications for educational research and practice. Educational Psychology Review. 2006; 18, 315-341.
  13. Pekrun, R. Elliot, A. J. Maier, M. A. Achievement Goals and Achievement Emotions: Testing a Model of Their Joint Relations With Academic Performance. Educational Psychology. 2009; 101(1), 115-135.
  14. Mohammadi Siah-Kamri F; Khalundi Fard Z. The relationship between academic excitement and academic conflict, Tehran: Farzangan. 2019. (Persian)
  15. Rezapour Mirsaleh; Behjat Manesh A; Tolai and The role of secondary post-traumatic stress disorder and resilience in the motivation and academic progress of students who are children of veterans, Tab Jhanbaz Journal, 2016; 6 (8): 227-236. (Persian)
  16. Tomaszek, K & Muchacka-Cymerman, A. Student Burnout and PTSD Symptoms: The Role of Existential Anxiety and Academic Fears on Students during the COVID 19 Pandemic, Depression Research and Treatment, 2022; 3 (3): 1-9.
  17. Jian, Y; Hu, T; Zong, Y; Tang, W. Relationship between post-traumatic disorder and posttraumatic growth in COVID-19 home-confined adolescents: The moderating role of self-efficacy. Current Psychology, 2022, 3 (4): 1-10.
  18. Tavasolinia S. Investigating the effectiveness of the contact process with procrastination methods on students’ self-management and academic self-efficacy, master’s thesis, Allameh Tabatabai University. 2016. (Persian)
  19. Karimi H. Investigating the relationship between self-management and students’ academic vitality, the third conference of knowledge and technology of psychology, educational sciences and sociology of Iran, Tehran: University of Tehran. 2019. (Persian(
  20. American Psychological Association. Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. Washington, DC: Author. 2017.
  21. Straud C. L. Siev, J. Messer, S. & Zalta, A. K. Examining Military Population and Trauma Type as Moderators of Treatment Outcome for First-Line Psychotherapies for PTSD: A Meta- Analysis. Journal of Anxiety Disorders. 2019; 1- 12. doi:10.1016/j.janxdis.2019.102133.
  22. Cohen, J. A. Greenberg, T. Padlo, S. Shipley, C. Mannarino, A. P. Deblinger, E& etal. Cognitive Behavioral Therapy forTraumatic Bereavement in Children Treatment Manual. Center for Traumatic Stress in Children and Adolescents. Department of Psychiatry Allegheny General Hospital Pittsburgh, PA. 2001.
  23. Enrique, A; Eilert, N; Wogan, R; Earley, C; Duffy, D & Palacios, J (2021). Are Changes in Beliefs About Rumination and in Emotion Regulation Skills Mediators of the Effects of Internet‑Delivered Cognitive‑Behavioral Therapy for Depression and Anxiety? Results from a Randomized Controlled Trial, Cognitive Therapy and Research; 45:805–816
  24. Ghazizadeh S; Mashhadhi A; Tabibi Z; Soltanifar A; Arfa A. The effectiveness of trauma-focused cognitive behavioral therapy on improving self-blame in children suffering from sexual abuse: a single case study, the second national psychology congress of Iran, Tehran. 2015. (Persian)
  25. Deblinger, E; Pollio, E; Cooper, B & Steer, R. Disseminating Trauma‑Focused Cognitive Behavioral Therapy with a Systematic Self‑care Approach to Addressing Secondary Traumatic Stress: PRACTICE What You Preach, Community Mental Health Journal. 2020; 56:1531–1543
  26. Wamser-Nanney R, Steinzor CE. Factors related to attrition from trauma-focused cognitive behavioral therapy. Child Abuse Negl. 2017; 66:73-83. DOI: 10.1016/j.chiabu.2016.11.031 PMID: 28024712.
  27. Cohen L, Manion L, Morrison K. Research Methods in Behavioral Sciences. Routledge; 2018: 202-226
  28. Keane, T.M; Wolfe, J & Taylor, K.L. PTSD: Evidence for diagnostic Validity and Methods of Psychological assessment. Journal Of Ctinical Psychology. 1987; 43, 32-43.
  29. Nirimani M, Zahid A, Beshrpour S. Prevalence of posttraumatic stress disorder in hospital emergency nurses and fire department workers in uremia city. RBS 2010; 8 (1): 23- 36. (Persian)
  30. Goodarzi MA. [Evaluating reliability and validity of the Mississipi scale for post traumatic stress disorder in Shiraz city]. Journal of psychology 2003; 2: 153-78. (Persian)
  31. Zimmerman, B.J. & Matinez – pons.N. (2016). Student Differences in self-regulated learning: relation grade, sex and giftedness to.
  32. Hosseini-Rad F. Causal relationship between future perspective and self-efficacy with academic achievement with the mediation of self-regulated learning strategies in male high school students of Ahvaz city. Master’s thesis of Shahid Chamran University of Ahvaz. 2013. (Persian)
  33. Pekrun R. Goatz T. Perry RP... Achievement Emotions Questionnaire (AEQ), User, s. Mannal; Mannal Version. 2005.
  34. Kadivar P; Kausian J; Farzad and; Nikdel F. Validation of Pakran’s academic emotions questionnaire. Quarterly magazine of educational innovations. 2009; 32(8), 34-45. (Persian)
  35. Ghanad, S. Causal relationship between the emotions of progress and academic motivation with academic engagement with the mediation of academic persistence in female high school students of Dezful city. Master’s thesis. Chamran martyr of Ahwaz University. 2013. (Persian)
  36. Hadadranjabr S; Saadipour A; Dartaj F; Delavar A. Ebrahimi Qawam p. The effectiveness of the educational program based on the cognitive-behavioral approach on the academic emotions of students with self-destructive academic behaviors, Journal of Education Strategies in Medical Sciences. 2018; 1 (11): 109-119. (Persian(
  37. Unterhitzenberger J, Wintersohl S, Lang M, Konig J, Rosner R. Providing manualized individual truma-focused CBT to unaccompanied refugee minors with uncertain residence status: a pilot study. Child and Adolescent Psychialtry and Mental Health 2019; 13(1): 22
  38. Hendrik A; Cohen J; Mannarino A, Deblinger A. Cognitive behavioral therapy workbook focused on trauma. Translated by Sara Jahani, Tehran: Ayrink. 2019. (Persian)
  39. Salemi p. Naomi A. goldsmith Davodi A. Effectiveness of trauma-focused behavioral cognitive methodology on post-traumatic growth in abused children, Journal of Psychiatric Nursing. 2017; 5 (1): 13-25. (Persian(
  40. Enrique A; Eilert N; Wogan R; Earley C; Duffy D; Palacios J. Are Changes in Beliefs About Rumination and in Emotion Regulation Skills Mediators of the Effects of Internet‑Delivered Cognitive‑Behavioral Therapy for Depression and Anxiety? Results from a Randomized Controlled Trial, Cognitive Therapy and Research. 2021; 45:805–816
  41. Cohen J. A; Mannarino A. P; Staron,V. A pilot study of modified cognitive behavioral therapy for childhood traumatic grief (CBT-CTG). Journal of the American Academy of Child & Adolescent Psychiatry. 2016; 45(12), 1465-1473.
  42. Mousavi J. The effectiveness of trauma-focused cognitive behavioral therapy on traumatic symptoms and psychological well-being of earthquake-affected students with post-traumatic stress disorder in West Islamabad city, Master’s thesis, Payam Noor University, Kermanshah province. 2019.
  43. Dalgleish T; Goodall B; Chadwick I; Werner-Seidler A; McKinnon A; Morant N & etal. Trauma-focused cognitive behaviour therapy versus treatment as usual for post traumatic stress disorder (PTSD) in young children aged 3 to 8 years: study protocol for a randomized controlled trial, J Trials. 2015; 13; 16:116.
Sadra Medical Journal
Volume 11, Issue 4
Autumn 2023
Pages 417-429

Article View 135,613
PDF Download 177,207

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