The effects of cognitive behavioral therapy-based psychoeducation on quality of life, anxiety, and depression in children with attention deficit hyperactivity disorder

认知行为疗法心理教育对注意力缺陷多动障碍儿童生活质量、焦虑和抑郁的影响

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Abstract

BACKGROUND: Attention deficit hyperactivity disorder is a prevalent neurodevelopmental condition in childhood, associated not only with difficulties in attention and impulsivity but also with increased internalizing symptoms, such as anxiety and depression, and a marked reduction in quality of life. Although pharmacological treatments play a central role in the management of attention deficit hyperactivity disorder, there is a growing need for psychosocial interventions that target these emotional difficulties and quality of life outcomes while actively involving families. This study is novel in its evaluation of the effectiveness of a structured cognitive behavioral therapy based psychoeducational program involving both children and their parents in reducing anxiety and depressive symptoms and improving quality of life in children diagnosed with attention deficit hyperactivity disorder. METHOD: A quasi-experimental controlled pretest-posttest design was employed. The intervention group comprised thirty-seven children aged eight to twelve years diagnosed with attention deficit hyperactivity disorder and their parents, while the control group included thirty-six age- and gender-matched children with the same diagnosis and their parents. The intervention consisted of an eight-session cognitive behavioral therapy based psychoeducational program integrating emotional regulation, adaptive coping strategies, and parent-focused guidance. Data were collected at baseline and after the intervention using a sociodemographic information form, the Quality of Life Inventory, and the Revised Children's Anxiety and Depression Scale. RESULTS: The intervention and control groups were similar in terms of demographic characteristics. The mean age of children in the intervention group was 10.35 ± 1.40 years, while the mean age of children in the control group was 10.47 ± 1.28 years (p = 0.751). Regarding gender distribution, the intervention group consisted of 11 girls (29.7%) and 26 boys (70.3%), while the control group consisted of 18 girls (50.0%) and 18 boys (50.0%) (p = 0.077). Children participating in the cognitive behavioral therapy -based psycho-educational program showed a statistically significant improvement in quality of life and a significant decrease in anxiety and depressive symptoms between the pre-test and post-test. No significant changes were observed in the same outcome measures in the control group. CONCLUSION: These findings provide robust evidence that cognitive behavioral therapy based psychoeducational interventions incorporating family participation are effective in improving psychological well-being and quality of life in children with attention deficit hyperactivity disorder. From both psychiatric and nursing perspectives, such programs represent a valuable, non-pharmacological adjunct to standard care, supporting holistic and family-centered approaches in the multidisciplinary management of childhood attention deficit hyperactivity disorder. CLINICAL TRIAL REGISTRATION: This study was registered under Clinical Trial Number: NCT06624527 on September 25, 2023. URL: https://clinicaltrials.gov/study/NCT06624527?term=NCT06624527&rank=1 .

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