مقایسه‌ پردازش اطلاعات اجتماعی بر اساس مدل شناختی اجتماعی کریک و داج در کودکان با و بدون اختلال بی‌نظمی خُلق اخلالگر مقالة

خلاصة:

مقدمه: هدف این پژوهش بررسی و مقایسه پردازش اطلاعات اجتماعی در کودکان مبتلا به اختلال بی نظمی خلق اخلالگر و کودکان عادی بر اساس مدل شناختی اجتماعی کریک و داج (1994) بود. این اختلال اخیراً در مبحث اختلالات خلقی در نسخه پنجم راهنمای تشخیصی و آماری اختلال‌های روانی گنجانیده شده است و دارای دو نشانۀ اصلی خشم و تحریک پذیری می‌باشد. روش کار: در این پژوهش علی- مقایسه ای، تعداد 57 کودک پسر دارای اختلال و 167 کودک پسر عادی 9 تا 12 سال به روش خوشه‌ای تصادفی و با استفاده از پرسش‌نامه خشم و تحریک‌ پذیری و مصاحبه بالینی انتخاب و سپس به‌وسیله مقیاس ارزیابی کودکان از روابط اجتماعی روزمره مقایسه شدند. یافته ها: تحلیل واریانس چند متغییری نشان داد که بین دو گروه کودکان در مراحل تفسیر و اسناددهی به نشانه‌ها (5/5f= و001/.p=) تولید و روشنگری اهداف (65/6f= و001/.p=)، پردازش هیجانی (01/4f= و004/.p=) و تولید پاسخ (02/7f= و001/.p=) تفاوت معنی‌داری وجود دارد. نتیجه گیری: نتایج این پژوهش نشان داد که کودکان مبتلا به اختلال بی نظمی خلق اخلالگر در مقایسه با کودکان عادی در یک موقعیت اجتماعی مبهم هنگام پردازش اطلاعات بیشتر دچار سوگیری شده و عملکرد مناسبی ندارند در نتیجه بیشتر رفتارهای خصمانه از خود نشان می‌دهند. پیشنهاد می‌شود در پژوهش‌های بعدی اثربخشی پروتکل‌های مداخله‌ای بر اساس مدل داج جهت درمان و کاهش نشانه‌های اختلال بی‌نظمی اخلالگر بررسی شود.

خلاصة:

Introduction Social maladjustment, including aggression, is the main problem in childhood and later stages of life. Crick and Dodge developed a social information processing model to explain children’s aggression (1). Accordingly, children engage in the following six mental stages before behaving properly when they face a social situation: 1- Encoding of external and internal cues, 2- interpretation and mental representation of those cues, 3- clarification or selection of a goal, 4- response access or construction, 5- response decision, and 6- behavioral enactment. During steps 1 and 2, encoding and interpretation of social cues, it is hypothesized that children selectively attend to particular situational and internal cues, encode those cues, and then interpret them. During step 3, after interpreting the situation, it is proposed that children select a goal or desired outcome for the situation or continue with a preexisting goal. Next, in step 4, it is hypothesized that children access from possible memory responses to the situation, or, if the situation is novel, they may construct new behaviors in response to immediate social cues. In step 5, it is hypothesized that children evaluate the previously accessed (or constructed) responses and select the most positively evaluated response for enactment. In step 6, the selected response is behaviorally enacted. According to the previous studies, children’s aggression can affect all six steps of the social information processing model. Studies demonstrate that emotional and behavioral problems are affected by biased social information processing (1, 4). Children with disruptive mood dysregulation disorder (DMDD) are intensely affected by aggressive behavior and negative emotions. DMDD is recently included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a mood disorder. It is characterized by two main symptoms, namely anger and irritability. These individuals face an obstacle to misinterpret other people’s intentions, which worsens aggression. These children find it much more challenging to experience sensory processing and perceptual behavior than normal children. Characterized by the aggressive behavioral component, children with DMDD pay too much attention to negative emotional stimuli such as anger (21). In addition, children with chronic irritability experience more problems processing emotional stimuli and regulating emotions (24). So far, no study has been conducted on social information processing in Iranian children based on Dodge’s social cognition model. Therefore, this study aims to evaluate and compare early stages of social information processing in children with disruptive mood dysregulation disorder (DMDD) and normal children based on the social cognitive model of Crick and Dodge. Methods This research was conducted with a causal-comparative method on 58 children with DMDD and 167 normal Boys studying at elementary school in Bushehr. In this study, the mean age was 10.62 years (1.25) in children with DMDD and 10.70 years (1.28) in normal children. Of these, 43, 51, 61, and 69 children studied at grades 3, 4, 5, and 6 of elementary school, respectively. The participants were randomly selected using a cluster sampling technique, Anger and Irritability Questionnaire (AIQ), and clinical interview based on DSM-5 (Nusbaum, 2013) (27). They were then compared using the Children's Evaluation of Everyday Social Encounters Questionnaire. Data were analyzed using descriptive and inferential statistical methods such as mean, variance, and multivariable analyze of variance (MANOVA) test by SPSS-19 software. Results The results obtained from the multivariate analysis of variance (Wilks' Lambda) showed a significant difference between the group in the steps of interpretation of social cues (F=5.5, P=0.001, Partial Eta Squared=0.128), clarification or selection of a goal (F=6.65, P=0.001, Partial Eta Squared=0.159), emotional processing (4.01, P=0.004, Partial Eta Squared=0.07), response access or construction (P=7.02, P=0.001, Partial Eta Squared=0.115). In all the stages of the study, to evaluate the characteristics of the data, the homogeneity of the variance-covariance matrices of the vector of dependent variables was examined; the results of Box’s M test (P>0.05) indicated that this statistical assumption held., Bartlett’s test of sphericity (P The tests of between-subjects effects indicated a significant difference between the group in the stages of interpretation of social cues (Positive internal, F=16.38, P=0.0001; positive external, F=13.45, P=0.0001, negative internal, F=0.109, P=0.7, negative external, F=.239 P=0.6, positive causal attributions, F=8.81, P=0.003 and negative causal attributions F=7.80, P=0.006), clarification or selection of a goal (Task-focused, F=11.78, P=0.0001, avoidant, F=21.12, P=0.001; face-saving, F=3.92, P=0.04; affect management, F=0.08, P=0.7; distress expression, F=13.99, P=0.001 and relationship focused, F=12.05, P=0.001), emotional processing (Concern-based processing, F=6.82, P=0.01; anger-based processing, F=9.11, P=0.003; grief-based processing, F=10.11, P=0.002 and happy processing, F=5.65, P=0.01), response access or Construction (Prosocial response, F=25.36, P=0.0001; passive avoidant response, F=0.799, P=0.3; active avoidant response, F=4.14, P=0.04 and hostile response, P=4.74, P=0.03). According to the mean scores in the significant components, children with disruptive mood dysregulation disorder had lower performance. Conclusion The present study results showed that children with DMDD were more biased in an ambiguous social situation in the early steps of social information processing. They were also significantly less competent than their normal peers in internal positive causal attribution, external positive causal attribution (positive attribution to others’ behaviors), and positive interpretation of others' intentions in a social situation. Children with DMDD were also more biased than their normal peers in their negative interpretation of others’ intentions. However, there was no significant difference between them in interpreting the causes of events in external negative attribution and internal negative attribution in ambiguous social situations. DMDD children exhibited tremendous anger, worried or nervous, and sad or down in emotional processing and provided less happy processing. Regarding goal formation/clarification, children with DMDD mainly preferred anger-and avoidance-based goals, and were less involved in the relationship-and dignity-centered goals. Moreover, children with DMDD produced fewer social responses and were more willing to provide anger-based and active-avoidance responses, compared to their normal peers. Various studies demonstrated that maladaptive social information processing could justify behavioral-emotional maladjustment in most children. Therefore, it is recommended to evaluate the effectiveness of interventional protocols based on the Crick and Dodge model in future studies to treat and mitigate the symptoms of disruptive dysregulation disorder. The most important limitation of this study was that it specifically focused on the male population; therefore, the results cannot be generalized to the female population. Ethical Considerations Compliance with ethical guidelines The Ethics Committee of the University of Isfahan (IR.UI.REC.1398.063) has granted requisite ethical approvals. A written informed consent was obtained from the children and their parents. They were informed about the confidentiality of the information and their voluntariness in participation in the study. Authors’ contributions Khatoon Pourmaveddat was involved in the study design, data collection, analysis, review and correction, and article writing. Hamid Taher Neshat Doost, Mohammad Bagher Kajbaf, and Hooshang Talebi were involved in the study design, analysis, and article writing. All authors read and approved the final manuscript. Funding No financial support has been received for this research. Acknowledgment We would like to thank the Bushehr Education Organization and the students who collaborated with the researchers in this study. Conflict of interest This study has no conflict of interest with any organization.