Clinical Research Of Naikan Cognitive Therapy On Oppositional Defiant Disorder

Objective:To explore the efficacy of NaiKan Cognitive Therapy(NCT) on improving Oppsitional Defiant Disorder(ODD) children’s the clinical symptoms, self-awareness, acceptance of others, comprehension of social support, and provides the new interventions the oretical basis for ODD clinical treatment.Methods:From July2010to August2012, in Child and Adolescent Psychology Department of Tianjin Anding Hospital,87ODD patients who met the inclusion criteria and exclusion criteria as research subjects were randomly divided into two groups:study group (n=43)was treated with NCT, the control group (n=44) participated in the conventional group counseling and the distribution of symptoms before and after the intervention was determined by investigator; The Achenbach Children’s Behavior Questionnaires (CBCL) were filled by parents or cares; SCL-90, Piers-Harris Children’s Self-Concept Scale (PHCSS), to Accommodate Others Scale (AOS), Perceived Social Support Scale (PSSS) were finished by children themselves.Results:76patients completed the study.37cases in Study group and39cases in Control group continued into result analysis. No significant difference in general and evaluation items was found in former two intervened groups.①Before and after the intervention, the constituent ratio of ODD symptoms items were checked, the effect of the ODD clinical symptoms improvement in study group were significantly better than that in control group.②Before the intervention, the two groups of SCL-90in human relationships, hostility, paranoid factor scores were greater than2;hostile factor improvement in the control group after the intervention(P<0.05); Scores of interpersonal relationships, hostile and paranoid in the study group were significantly lower(P<0.01). Scores of the above factors were lower than the control group(P<0.05,P<0.01).③After intervention, the scores of CBCL aggressive behavior in control group were reduced (P<0.05); and the school skills scores were improved (P<0.05). Scores of factors about retractility, anxiety/depression, social problems, discipline problems, aggressive behavior, introversion, extraversion were significantly reduced (P<0.01) in study group; activity, social skills, school, social competence scores were significantly increased (P<0.01); The above factors in study group after the intervention were lower than those in control group (P<0.01), scores of all the skills were higher than those in control group(P<0.05,P<0.01).④After the intervention, PHCSS total score and the scores of behavior factor, happiness-satisfaction factor, anxiety factor, social factor were increased than before(P<0.05,P<0.01); The above factors in study group after the intervention were higher than control group(P<0.05,P<0.01).⑤Scores of AOS accommodate factor in study group after intervention was significantly higher than before intervention(P<0.01) and was significantly increased than control group (Pp<0.01).⑥Scores of PSSS factor about family support, friend support, and other support in study group after intervention were significantly higher than before (P<0.01)and were significantly increased than those of control group (P<0.01).Conclusion:①NCT can effectively improve the clinical symptoms of oppositional defiant disorder patients;②NCT can effectively improve the oppositional defiant disorder in patients with core symptoms.③NCT can not only effectively reduce behavioral problems like children withdrawal, anxiety/depression, social problems, discipline problems, aggressive behavior, introverted problem, outgoing problems, but also increase the social competence, school capacity, social competence of ODD patients;④NCT can fully effectively improve self-awareness of ODD patients, and then reduce the behavioral disinhibition and expression of ODD persistent defiance, hostility, antagonism, provocation and vandalism, in order to achieve prevention and treatment.⑤NCT can improve the ability of ODD to accommodate others, and let them know how to get along with others.⑥NCT let ODD children actually increase the Sense of solidarity and trust with others, improve the interpersonal relationships including parent-child relationship, and then they can better comprehend the existence of help from family, friends, and truly appreciate the social support system⑦As a new psychological therapy, NCT has good application prospect for the prognosis of patients with ODD.