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Volume 24, Issue 4 (Winter 2023)
Advances in Cognitive Sciences 2023, 24(4): 88-101 |
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Ethics code: EE/1401.2.24101797 /SCU.AC.IR
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Peymannia B, Javanmard M, Mehrabizadeh Honarmand M. Effectiveness of cognitive rehabilitation based on recognition of emotion and memory on visual working memory and facial emotion processing in children with Attention Deficit/Hyperactivity Disorder. Advances in Cognitive Sciences 2023; 24 (4) :88-101
URL: http://icssjournal.ir/article-1-1446-en.html
URL: http://icssjournal.ir/article-1-1446-en.html
1- Assistant Professor, Department of Psychology, Faculty of Educational Sciences and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran
2- MA in Clinical Psychology, Department of Psychology, Faculty of Educational Sciences and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran
3- Professor, Department of Psychology, Faculty of Educational Sciences and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran
2- MA in Clinical Psychology, Department of Psychology, Faculty of Educational Sciences and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran
3- Professor, Department of Psychology, Faculty of Educational Sciences and Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran
Abstract: (766 Views)
Introduction
Research evidence shows that children with attention deficit hyperactivity disorder (ADHD) have defects in identifying emotions and adapting faces to situations, recognizing the emotion of anger, and generally, the speed of emotion processing compared to normal peers. Since facial expressions are the most crucial method of communicating non-verbal information to each other, it seems that some of these children's impulsive and inattentive behaviors are caused by insufficiencies in facial emotion processing.
On the other hand, research evidence shows that working memory is related to emotional processing, and children and adults with facial ADHD also suffer from failure in working memory. It must be said that faces take the first place among social-emotional stimuli, and the way of coding, remembering, and facial expressions are the fundamental axis of visual working memory. Emotions also significantly affect what one perceives, pays attention to, and remembers in everyday life.
According to the mentioned research literature, based on the role of visual working memory in the emotional state of the face, from one side to the other, there is a lack of such research that investigates cognitive rehabilitation based on emotional recognition of visual working memory and emotional processing of the face of a child with a disorder. Regarding ADHD, the question is whether cognitive rehabilitation based on emotion recognition and memory is effective in visual working memory and facial emotion processing in children with ADHD symptoms.
Methods
The current research is a semi-experimental study with a pre-test and post-test design with an experimental group. The statistical database included all students aged 8-12 years in primary school in the city of Selsele in the academic year 2021-2022. In the first step, considering the peak of 7-8% prevalence rate of hyperactivity in the country, 500 child screening questionnaires were completed by the families virtually. Then, 40 students who met the ADHD criteria in the screening questionnaire according to the child behavior checklist (CBCL) form were selected as the first sample. In the second step, the students were subjected to a clinical interview regarding the Diagnostic and Statistical Manual of Psychological Disorders, 5th edition. After the screening, 34 people were selected as the final sample and randomly divided into two experimental and control groups of 17 people. Then, the experimental group participated in 50-minute sessions of cognitive rehabilitation intervention based on emotional healing for 13 weeks. Significantly, both experimental and control groups intervened before the beginning of the sessions, and after the end of the sessions, they responded to the low scales of visual working memory and facial emotion processing of the CANTAB (2014) instrument.
The inclusion criteria in this study are: 1) The presenting symptoms of attention deficit hyperactivity disorder based on the child scale and the structured interview of disorders based on DSM-5, 2) Minimum age of eight and a maximum of 12 years, 3) Informed consent of the person to participate in the research after signing the written consent, and 4) The absence of co-occurring disorders such as learning disorders, in addition to these, the features of exit are: 1) The presence of visual and hearing problems and 2) Not attending more than two sessions of the participants are in the treatment stages. This research was carried out with the informed written consent of the family, students, and the observance of the ethical principles of the American Psychiatric Association in clinical research, as a result of maintaining the physical and mental health of the participants. In the first step, frequency, mean, and standard deviation have been used for description. Furthermore, to compare the two test groups and use statistics indices (Kolmogorov-Smirnov test) to determine the reason for the spread of scores, Levene's test to check the homogeneity of variances, homogeneity of regression coefficients, and multivariate analysis of covariance test has been used.
Results
The results of the research in Table 1 revealed the mean and standard deviation of the visual working memory and facial emotion processing of the experimental group in the post-test; (mean: 88.2, standard deviation: 6.5, mean: 66.6, standard deviation: 7.1) in comparison with the control group; (mean: 42.6, standard deviation: 10.5, mean: 77.5, standard deviation: 12.1), increased and these changes are not observed in the control group.
Notably, despite not confirming the assumption of normality of the visual working memory variable in the rest of the visual defaults assumptions of the covariance analysis, such as Levene's test to check the homogeneity of the variance of the research variables, respectively, for visual working memory; (P>0.180 and F=1.88) and emotion processing (P>0.118 and F=2.58) were calculated and confirmed. Moreover, the homogeneity of regression slope is the most important assumption of covariance analysis in experimental and control groups for visual working memory. (P>0.496 and F=42.11) and emotion processing (P>0.923 and F=6.4) were confirmed. In addition, the results of the multivariate analysis of variance show the significance of the linear combination of variables in the experimental and control groups.
Altogether, the research results showed a significant difference between the experimental and control groups in terms of visual working memory and facial emotion processing in the post-test. According to the mentioned variables, cognitive rehabilitation based on emotion processing has been effective in improving visual working memory by 47 percent and facial emotion processing by 30 percent.
Conclusion
The present study was conducted to investigate cognitive rehabilitation based on emotion recognition and memory on visual working memory and facial emotion processing of children with symptoms of ADHD. The findings of the research showed that there is a statistically significant difference between the mean of the experimental group and the control group in the visual working memory and facial emotion processing in the post-test, and the use of cognitive rehabilitation based on emotion recognition improves the visual working memory and emotion processing of the experimental group compared to the control group.
In sum, in explaining the findings of the current research, it can be said that based on the principle of brain flexibility, cognitive rehabilitation intervention based on emotion processing with repetition and continuous exercises provides a platform for improving working memory capacity and facial emotion processing in children with symptoms of ADHD. As a result of improving the capacity of visual working memory becomes the basis for encoding neutral information along with other emotional information and will prevent biased encoding of part of the information.
Ethical considerations
Compliance with ethical guidelines
This article is extracted from the master's thesis of clinical psychology of the current research in compliance with ethical principles, including obtaining written consent in order to participate in the research, respecting the principle of confidentiality of participants, providing adequate information about how to research to all participants and being free to exit the research process. This research was approved by the Ethics Committee of the Shahid Chamran University of Ahvaz with Ethics Code EE/1401.2.24101797/SCU.ac.ir.
Authors' contributions
Bahram Peymannia and Mozhdeh Javanmard: Defined the concepts in choosing the subject and designing the study. Mozhdeh Javanmard: Collected and analyzed data. Bahram Peymannia: Writing and drafting. Finally, under the supervision of Mahnaz Mehrabizadeh Honarmand, the research team discussed the results and participated in editing the final version of the article.
Funding
The research received nofunding from commercial, public or nonprofit financing organizations.
Acknowledgments
The authors would like to express their gratitude to all the teachers, parents, and students who participated in this research.
Conflict of interest
According to the authors, there is no conflict of interest.
Research evidence shows that children with attention deficit hyperactivity disorder (ADHD) have defects in identifying emotions and adapting faces to situations, recognizing the emotion of anger, and generally, the speed of emotion processing compared to normal peers. Since facial expressions are the most crucial method of communicating non-verbal information to each other, it seems that some of these children's impulsive and inattentive behaviors are caused by insufficiencies in facial emotion processing.
On the other hand, research evidence shows that working memory is related to emotional processing, and children and adults with facial ADHD also suffer from failure in working memory. It must be said that faces take the first place among social-emotional stimuli, and the way of coding, remembering, and facial expressions are the fundamental axis of visual working memory. Emotions also significantly affect what one perceives, pays attention to, and remembers in everyday life.
According to the mentioned research literature, based on the role of visual working memory in the emotional state of the face, from one side to the other, there is a lack of such research that investigates cognitive rehabilitation based on emotional recognition of visual working memory and emotional processing of the face of a child with a disorder. Regarding ADHD, the question is whether cognitive rehabilitation based on emotion recognition and memory is effective in visual working memory and facial emotion processing in children with ADHD symptoms.
Methods
The current research is a semi-experimental study with a pre-test and post-test design with an experimental group. The statistical database included all students aged 8-12 years in primary school in the city of Selsele in the academic year 2021-2022. In the first step, considering the peak of 7-8% prevalence rate of hyperactivity in the country, 500 child screening questionnaires were completed by the families virtually. Then, 40 students who met the ADHD criteria in the screening questionnaire according to the child behavior checklist (CBCL) form were selected as the first sample. In the second step, the students were subjected to a clinical interview regarding the Diagnostic and Statistical Manual of Psychological Disorders, 5th edition. After the screening, 34 people were selected as the final sample and randomly divided into two experimental and control groups of 17 people. Then, the experimental group participated in 50-minute sessions of cognitive rehabilitation intervention based on emotional healing for 13 weeks. Significantly, both experimental and control groups intervened before the beginning of the sessions, and after the end of the sessions, they responded to the low scales of visual working memory and facial emotion processing of the CANTAB (2014) instrument.
The inclusion criteria in this study are: 1) The presenting symptoms of attention deficit hyperactivity disorder based on the child scale and the structured interview of disorders based on DSM-5, 2) Minimum age of eight and a maximum of 12 years, 3) Informed consent of the person to participate in the research after signing the written consent, and 4) The absence of co-occurring disorders such as learning disorders, in addition to these, the features of exit are: 1) The presence of visual and hearing problems and 2) Not attending more than two sessions of the participants are in the treatment stages. This research was carried out with the informed written consent of the family, students, and the observance of the ethical principles of the American Psychiatric Association in clinical research, as a result of maintaining the physical and mental health of the participants. In the first step, frequency, mean, and standard deviation have been used for description. Furthermore, to compare the two test groups and use statistics indices (Kolmogorov-Smirnov test) to determine the reason for the spread of scores, Levene's test to check the homogeneity of variances, homogeneity of regression coefficients, and multivariate analysis of covariance test has been used.
Results
The results of the research in Table 1 revealed the mean and standard deviation of the visual working memory and facial emotion processing of the experimental group in the post-test; (mean: 88.2, standard deviation: 6.5, mean: 66.6, standard deviation: 7.1) in comparison with the control group; (mean: 42.6, standard deviation: 10.5, mean: 77.5, standard deviation: 12.1), increased and these changes are not observed in the control group.
Notably, despite not confirming the assumption of normality of the visual working memory variable in the rest of the visual defaults assumptions of the covariance analysis, such as Levene's test to check the homogeneity of the variance of the research variables, respectively, for visual working memory; (P>0.180 and F=1.88) and emotion processing (P>0.118 and F=2.58) were calculated and confirmed. Moreover, the homogeneity of regression slope is the most important assumption of covariance analysis in experimental and control groups for visual working memory. (P>0.496 and F=42.11) and emotion processing (P>0.923 and F=6.4) were confirmed. In addition, the results of the multivariate analysis of variance show the significance of the linear combination of variables in the experimental and control groups.
Altogether, the research results showed a significant difference between the experimental and control groups in terms of visual working memory and facial emotion processing in the post-test. According to the mentioned variables, cognitive rehabilitation based on emotion processing has been effective in improving visual working memory by 47 percent and facial emotion processing by 30 percent.
Conclusion
The present study was conducted to investigate cognitive rehabilitation based on emotion recognition and memory on visual working memory and facial emotion processing of children with symptoms of ADHD. The findings of the research showed that there is a statistically significant difference between the mean of the experimental group and the control group in the visual working memory and facial emotion processing in the post-test, and the use of cognitive rehabilitation based on emotion recognition improves the visual working memory and emotion processing of the experimental group compared to the control group.
In sum, in explaining the findings of the current research, it can be said that based on the principle of brain flexibility, cognitive rehabilitation intervention based on emotion processing with repetition and continuous exercises provides a platform for improving working memory capacity and facial emotion processing in children with symptoms of ADHD. As a result of improving the capacity of visual working memory becomes the basis for encoding neutral information along with other emotional information and will prevent biased encoding of part of the information.
Ethical considerations
Compliance with ethical guidelines
This article is extracted from the master's thesis of clinical psychology of the current research in compliance with ethical principles, including obtaining written consent in order to participate in the research, respecting the principle of confidentiality of participants, providing adequate information about how to research to all participants and being free to exit the research process. This research was approved by the Ethics Committee of the Shahid Chamran University of Ahvaz with Ethics Code EE/1401.2.24101797/SCU.ac.ir.
Authors' contributions
Bahram Peymannia and Mozhdeh Javanmard: Defined the concepts in choosing the subject and designing the study. Mozhdeh Javanmard: Collected and analyzed data. Bahram Peymannia: Writing and drafting. Finally, under the supervision of Mahnaz Mehrabizadeh Honarmand, the research team discussed the results and participated in editing the final version of the article.
Funding
The research received nofunding from commercial, public or nonprofit financing organizations.
Acknowledgments
The authors would like to express their gratitude to all the teachers, parents, and students who participated in this research.
Conflict of interest
According to the authors, there is no conflict of interest.
Keywords: Visual working memory, Emotion processing, Facial, Attention Deficit/Hyperactivity Disorder
Type of Study: Research |
Received: 2022/07/29 | Accepted: 2023/01/2 | Published: 2023/02/19
Received: 2022/07/29 | Accepted: 2023/01/2 | Published: 2023/02/19
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