The effect of relaxation training on people with behaviour disorders in Kuwait.
With the beginning of the 21st century there emerged the age of nervous stress. Over-loaded by new technological developments and the associated responsibilities of scientific progress, human beings have become more and more subject to different degrees of nervous tension, stress and behavioral disorders--the matter that negatively entailed serious damages of human consciousness, feeling and performance. Suffering from different kinds of psychological illness and neuropathic symptoms--including behavior disorders--has turned into a common trait of our age.
Given the fact that behaviour disorders have been about to prevail as a common case among sectors of children, in specific, and many adolescents, in general; many experts and speciafists of the field are excited to explore the phenomenon of disturbances and disorders of behaviour. In this concern, studies indicate that disorders are usually available by the age of 3, growing with the prepatory school age stage and reaching climax between 8 and 10. However, symptoms may disappear completely by the puberty stagy (Mustafa, H. : 2001, 229) (Hammouda, M.: 1991, 198).
Koffman classifies behaviour disorders as including: motor hyperactivity, subversion, impulsiveness, aggressiveness, withdrawal, problematic moral development and deviation. For most cases, behaviourally disordered children are marked by motor hyperactivity and aggressive behaviour as the most common traits. Aggression, here, may be targeted at others or the self. It may be either physical or verbal and differs according to age considerations (In early childhood aggression may take the form of others' annoyance, harassment and hegemony tendencies; while elderly children may reveal aggression toward teachers and the school. In later stages, aggression may be directed toward society and embodied in behavlouts such as homicide, theft and illegal assault) (Http://www.shefaa.org/frum/sho wthread.php? t=7105).
For most psychologists, behaviour disorders accompanied by motor hyperactivity and aggressive behavior represent a major concern. Bearing in mind the 10% ratio of the disease among children in the United states (Kandoll: 2000, 110), The US "National Institute for Health" (1988) underlines motor hyperactivity disorders as a serious developmental case that accounts for several negative drawbacks and damaging impacts on children, fami lies, schools and the society in general (Abd Allah, A.: 2002, 308).
Grounded on the damage motor hyperactivity-based behaviour disorders may produce in a child's behaviour; and the subsequent troubles usually faced by teachers and parents of the disordered child, dysfunctional techniques and ways of education may be used in attempts to bound the phenomenon and to minimize undesired effects--a step that leads to more and more aggravation of the problem (Abdul Rahman, A. & Hashim, S. : 2002, 89-90)
For another hand, and classified as an outside--targeted behaviour as well as a conduct disorder, aggressive behaviour stands as the most critical social trait that commonly characterizes behaviourally disordered children.
Aggression, here, may take the form of verbal assault, physical assault, expressing outrage, crying and screaming in the presence of others, hassling, obstinacy, teasing and tugging at others, motor hyperactivity, self- abuse and self-provocation. (Sesalam, K. S.: 2002, 23).
The aggressive behaviour phenomenon has developed, recently, toward more complicated forms; perhaps, to the extent of being a serious threat to safety and security in several societies.
In this regard, Afaf Mohammad (1991, 48) highlights the problem of prevailing aggressive behaviours among children from all age stages as the most salient among different problems and troubles of behaviour disorder. The problem is also more noticeable among children of social care institutions due to contexts of suffering and discouraging circumstances faced by children like these.
Research importance & thesis:
As a chief technique for countering nervous tension, stress, anxiety and similar causes of behaviour disorders, relaxation exercises have long attracted the interest of several experts and psychological researchers. Indeed, relaxation training has been tried and practiced by many peoples of the world throughout the years; though, in a variety of forms. Yet most recent forms of relaxation practice as a technique are based on a host of simplified exercises and practices that aim to provide both physical comfort and spiritual relief. Most relaxation techniques are dependent upon methods such as deep respiration; body loosening, slackening; and the removing of muscle tonus, contraction or strain. For the most part, relaxation training is adopted as either an independent therapeutic technique or accompanying contrary inhibition as a therapeutic method based on creating a counter response for nervous anxiety and tension.
In fact, Jacobson (1938) was the first one to suggest muscle relaxation as a method involving successive tightening and slackening of certain muscle series and, then, helping the trainees differentiate between cases of tension and relax. Jacobson added that the matter helped the trainees reach the utmost possible levels of relax. Relaxation is, furthermore, treated as a special skill that needs both regulated and intensified deals of training (A1-Khatib, G: 2003, 37).
Below are three major factors mentioned by Bittle as determinants of the extent beneficiary of relaxation training:
Individuals should be motivated enough to learn about and practise the relaxation techniques and methods. Upon good motivation of the trainees, high degrees of relaxation are expected to be easily achieved.
Individuals should be fully aware of the reasons driving them to be involved in the practice, its utility and groundings.
Engagement in the training process should be done regularly and continuously through daily periods of time assigned, specifically, to the practice activities.
Different ways and techniques could be used in attaining the state of relaxation. Most popular of these techniques are concerned with deep respiration, muscle laxity and mental relaxation.
Both muscle and mental types of respiration share the involvement of respiration exercises as the way most influential in controlling aggressive behaviours and motor hyperactivity. Apparently, types of respiration differ between cases of relaxation and anxiety: states of tranquility are; usually, accompanied by long, deep breathing while nervous tension and states of stress are marked by short, quick respiration.
The research problem originated, thus, in the researcher's observations of some clientele of two psychiatric institutions in Kuwait: Al-Rashed and Al-Sulighat Institutions for psychiatry. Making interviews with the parents of these clientele, the researcher came to realize that a number of those people suffered from behaviour disorders related to motor hyperactivity and aggressive behaviour. The researcher, then, felt the importance of employing relaxation training in the attempt to reduce such levels of motor hyperactivity and aggressive behaviour. The research is specifically important considering the relative inadequacy and deficiency of both Arabic and foreign literature concerning the effects of relaxation training on reducing motor hyperactivity and aggressive behavior.
1) The study of Klorad & Spring (1991) which aimed to identify the effects of relaxation techniques on competitive anxiety. The researchers used the experimental method for a sample of (26) swimmers. Results illustrated that the swimmers who were trained on relaxation showed negative hormone response less than swimmers who were not trained.
2) The study of Ranklin, Eugene et al. (1993) entitled "Efficacy of progressive muscle relaxation for reducing state anxiety among elderly adults on memory tasks perceptual and motor skills". The study sample included (30) elderly adults living together in the same district and suffering from symptoms of insomnia and anxiety. Mean age of subjects was (74). Results indicated that reduced anxiety levels were obtained much more with subjects who were involved in the relaxation training.
3) The study of Abdul-Mon'em, N. M. (2001) entitled: "the effect of a suggested program for relaxation training on anxiety level as a state with elderly adults and on anxiety level as a trait with elderly adults". The experimental method was applied to a sample of (30) elderly adults divided into two groups: experimental (15) and control (15). The results showed that the suggested program for relaxation training had a positive effect on anxiety level as a state with the research sample.
4) The study of Jensen, Peter S. et al. (2001). The aim was to reduce Attention Disorder with Motor hyperactivity Degree (ADHD) for children using the Psychodrama of role playing and role inversion techniques. The study sample was made up of (8) children aged between (6-12). Most important results revolved around the efficacy of the psychodrama program and the role playing technique in reducing ADHD via developing and focusing attention, reducing impulsiveness degree and minimizing motor hyperactivity levels.
5) The study of Hartman (2003) that aimed to reduce (ADHD) through the psychodrama therapeutic intervention. The study was applied to a sample of (16) children aged bet (7-10). Results demonstrated the efficiency of the psychodrama therapeutic program in reducing ADHD.
6) The study of AL-Degwy, R.A. (2005) that aimed to identify the effects of relaxation training and respiration exercises on reducing nervous tension of pregnant women. The experimental method was used with the one-group pre-post test design. The study sample was made up of (11) pregnant women who were selected randomly and aged bet (20-35). The results stressed the positive effect of the relaxation training program on reducing the degree of nervous tension among pregnant women.
Research Aims / Objectives
The current research is intended to identify the effect of relaxation training on certain symptoms of behavioural disorders by means of attaining the following:
1-The reduction of aggressive behaviour and motor hyperactivity.
2-Identifying improvement ratios with respect to the reduction of aggressive behaviour and motor hyperactivity.
Research Hypotheses :
1-Statistically significant differences are to be found bet. Pre / and post-tests of the research sample with regard to the reduction of aggressive behaviour and motor hyperactivity in favour of post-measurement.
2-Increment is to be found in ratios of improvement with regard to the reduction of aggressive behaviour and motor hyperactivity in favour of post--measurement.
The researcher used the experimental method with one of its experimental designs : the one-group pre / and post-test.
Population & Sample
The research was applied to a sample of (20) persons with behavioural disorders from a normal population aged bet. (9-12) years and selected, randomly, from two psychiatric institutions in Kuwait: AL-Rashed center at AL-Hawly town and AL-Sulighat Psychiatric center. The two institutions were favoured due to the avail ability of the research sample and needed place and equipment. Within the basic sample, (15) subjects were randomly assigned to conducting the basic study ; where as, (5) others were utilized in administering the scientific treatment and processing of the tests under study.
Data Collection Instruments:
The researcher made use of the following instruments, equipment and tests :
A) Aged Participants' birth certificates were reviewed and age was approximated to the nearest month.
B) Length: The researcher used the scale of length (rest meter) and length was approximated to the nearest cm.
C) Weight: The researcher used the medical scale and weight was approximated to the nearest Kg.
2-Socio-Economic Status Scale-D:
Prepared By : Abdul--Aziz AL-Shaghs (2006)-included (1).
3-The Draw--a Person Scale:
(for Intelligence) : Prepared by : Judd Enff, Standardized by : Fatema Helmi (1983)--included (2).
4-Aggressive Behavior Scale:
Prepared By : Amal AL-Meligy (1992)--included (3).
5-Motor Hyperactivity Scale:
Prepared By : Mohammad AL-Nubi (2004)--included (4).
Research Sample Homogeneity:
The 15--subject sample of the research was homogenized in terms of the variables of (age, length, weight, intelligence, socio--economic status, motor hyperactivity tests and aggressive behaviour levels).
Table (1) shows skewness coefficients for the variables of (age, length, weight, intelligence, socio--economic status, motor hyperactivity tests and aggressive behaviour level). Coefficients of skewness range between (- 1.03 : 1.55) with values / estimations restricted to ([+ or -] 3) and which fall under the normal curve--an indication of the research sample homogeneity.
Scientific Treatment of Data Collection Instruments :
The researcher applied the test-retest method regarding tests of motor hyperactivity and aggressive behaviour level to a sample of (5) subjects. First application took place on Sunday 17/9/2006 while the second test was applied after 15 days from first application to the same sample and under same conditions.
Pearson's correlation coefficient was used by the researcher to identify correlation between findings of both tests (first & second) with the purpose of examining and deciding reliability of the tests under study and research. Correlation was proved between first and second applications with regard to the tests of motor hyperactivity and aggressive behaviour levels. The coefficient of correlation ranged bet. (0,76 : 0.89) in an indication of the reliability of the tests under study and research.
The researcher made use of differential validity (the contrasted groups) in applying the motor hyperactivity and aggressive behaviour level tests to a random sample of (5) subjects from among the research population of behaviourally disordered individuals (non-differentiated group). In addition, (5) subjects from the same age level, but with no behavioural disorders (differentiated group), were exposed to the same tests with the purpose of identifying validity and comparing between the arithmetic means of the two groups using the (t-test). The researcher found statistically significant differences between the two groups (differentiated ver. non-differentiated) with regard to the tests of motor hyperactivity and aggressive behaviour levels. Estimated (t) value was higher than scheduled (t) value at the significance level (0.05)--which indicates the validity of the tests under study and research.
Basic Study of the Research:
For the purpose of designing the relaxation exercises most appropriate for the basic sample of the research, the researcher made a review of several references and the related literature and, accordingly, established the proper content in accordance with the opinions of experts.
The aim of relaxation exercises:
To develop the ability to reduce aggressive behaviour making use of relaxation training as applied to the basic sample of the research.
To develop the ability to reduce motor hyperactivity making use of relaxation training as applied to the basic sample of the research.
Grounds for selecting the exercises:
The researcher made use of the relaxation exercises that fulfilled the following requirements :
--To accord with the traits and characteristics of a sample of behaviourally disordered subjects.
--To provide a facility for mobility and consider all factors of health, safety and security of subjects when implementing the training unit.
--To provide contextual convenience of surroundings and circumstances.
--To provide diversity of usage regarding the employed tools and instruments (sofas, chairs, music, focused versus reduced lightening, etc.)
--To provide balance between exercises within each training unit.
--to Avoid exhaustion or tiredness of the trainees and assigning intervals for rest and vacation.
Components of the relaxation exercises:
The program included the following set of major elements:
a) Slow-motion walking.
b) Relaxation practice (muscle/mental)
c) Respiration practice.
Duration of the exercises:
(12) weeks as a total period distributed over (24) training units, averaging (2) units a week. 30 minutes are devoted to each training unit at a total of (720) minutes for the program as a whole.
Domains of the exercises:
The relaxation exercises selected were based on the following main domains:
First Dimension: Deep respiration
Respiration is commonly conceived as a mechanical process controlled by the nervous system, and which has its starts with the very beginning of the human life. Respiration is greatly affected by one's state of mind and inner psychological states to the extent that one's tension, anxiety or depression could be mirrored, obviously, in the way he / she breathes. Accordingly, speedy ways of breathing to which people may resort under circumstances of tension, anxiety or depression may reduce the amount of Oxygen they are supposed to acquire through breathing and, therefore, badly affect the respiration system.
No doubt that deep respiration practices may allow for the acquisition of the amount of Oxygen suitable enough for the human body in addition to wasting great amounts of Carbon dioxide. As a result, human body and mind are engaged into a state of full relaxation in addition to the improvement of abdominal blood circulation (Counseling and Guidance in Jiddah Schools: 1424 A.H, 64).
Second Dimension: Muscle relaxation
Reciprocal contraction and extension of any muscle of the human body are accompanied by the production of a feeling of pain resulting from the flow of electro charges transmitted to the Hypothalamus; which is, the part of the human brain being responsible for providing the appropriate psychological or behavioural response to all types of stress. The transmission of the electro charges by the physiological systems to the Hypothalamus causes the latter to reach utmost levels of tension. Here, comes the role of relaxation training with a remarkable ability to reduce one's successive electro charges and return the Hypothalamus to the state of psychological balance. In such a way, relaxation acts as a means of encountering daily situations of stress.
For the relaxation process to act effectively, it requires the provision of the following conditions:
Muscle relaxation achieves its best in conditions where practice is conducted twice-a day with an 8-hour break. Practice should be, ideally, avoided at times such as immediately after eating or before falling asleep. Three hours, at least, before sleeping are advised.
Calmness and tranquility of place are extremely favoured with regard to situations of practice. Avoiding interruption by any source of disturbance; such as-a child or a family member or whoever, is highly important for the success of the relaxation practice.
3) Body state / Position:
Two positions of the body are acceptable for the success and effectiveness of deep muscle relaxation training: First, lying down on the floor or a comfortable bed on condition that the body be in a flat position. Sitting down on a comfortable seat is also acceptable, though armchairs with high backs are more fitting and favourable. In the case of lying down on the floor, the trainee may make use of an under-neck pillow for supporting the head. All causes of body tension must be avoided entirely while shutting one's eyes and beginning with deep breathing are so recommendable. (Hussein AL-Fayed: 2001, 39).
Third Dimension: Mental Relaxation
Among the different types of relaxation training, mental relaxation is the oldest one being known, familiarized and distinguished by different peoples throughout history and from the very beginning of mankind. Long ago, the Japanese knew the yoga sport as one way of achieving mental laxity, and so did the Chinese and other similar peoples. Sufi people also knew and practised that kind of worship that may fall under techniques of mental relaxation. Likewise, praise of God is, in itself, a relaxation technique that does well with the human mind and spirit. With all types of mental relaxation the predominant act is to segregate your mind from all aspects of the outside world; concentrate only on a definite shape, picture, or word in your imagination and make it all your concern through thinking in nothing ever than it. 15 minutes at least are required for implementation of this task; and, more time allowed will be more helpful. (Gamal AL-Khatib: 2003,55).
Both tests of the aggressive behaviour and motor hyper activity were subjected to measurement before applying to the research basic sample on 3/5/2007
Applying the relaxation exercises:
The relaxation exercises were conducted with the research sample in the time from 5/5/2007 through to 24/7/2007 coveting a period of (12) weeks distributed over (2) units a week. 30 minutes were assigned for each training unit in conformity with the research program. Saturdays and Wednesdays only were allocated to the training units along the time from 9 O'clock AM. to 11 A.M.
Both tests of the aggressive behaviour and motor hyper activity were applied to the research sample after engagement in the training program. Measurement took place on 25/7/2007 through to Monday 26/7/2007.
The researcher made use of the following statistical treatments as most appropriate for the current research: (Arithmetic mean, standard deviation, median, correlation coefficient, one-group t-tests & Significance level at 0.05.
1) Statistically significant differences are found bet. Pre / and Post-measurement of aggressive behaviour and motor hyperactivity applying the Wilcoxson non-Parametric test to the experimental group.
Table (2) Shows the existence of statistically significant differences in pre/ and post-measurement of the long-term average intensity group with regard to aggressive behaviour and motor hyperactivity and applying the Wilcoxson non-parametric test to the research sample. Significance level ranged between (0.003: 0.012)--lower than the significance level (0.05) that the researcher decided as a condition for accepting differences. Accordingly, the significance of differences was accepted by the researcher in favour of post-measurement.
2) Differences in improvement ratios of controlled and experimental groups with regard to tests of aggressive behavior and motor hyperactivity.
Table (3) Demonstrates differences in the improvement ratios of the research sample as related to the aggressive behaviour level--ranging bet. (11.34%: 40.01%), while showing an improvement ratio of the motor hyperactivity test reaching (25.69%).
[FIGURE 1 OMITTED]
The following Figure Illustrates differences in improvement ratios between pre/post measurements.
Tables (2) and (3) indicate the existence of statistically significant differences between pre & post measurements of the long- term average intensity group mattering the aggressive behaviour and motor hyperactivity on usage of Wilcoxson nonparametric test as applied to the research sample.
Results are in favour of post-measurement. Differences are also found in improvement ratios of the research sample concerning level of aggressive behaviour with a range of (11.34%: 40.00%), while attaining an improvement ratio in the motor hyperactivity test reaching (25.69%).
The researcher attributes these results to the effectiveness of the proposed relaxation training program with the included dimensions of muscle, mental and imaginative relaxation. The program is utilized, successfully, to reach aggressive behaviour and motor hyperactivity levels much more lower than levels before applying the exercises to the research sample.
The researcher also accounts for the reduction of aggressive behaviour and
motor hyperactivity levels in light of the diversity of the relaxation exercises being used . Added to this is the usage of a sequence of muscle relaxation techniques that focuses on the successive contraction and extension of the whole body muscle series until reaching the point of enabling all muscles of the body to achieve the relaxation level most fitting and appropriate for decreasing and countering aggressive behaviour and motor hyperactivity.
In addition, mental relaxation has participated positively and effectively with muscle relaxation to achieve integration and full mastery of the relaxation process in a way that leads to final reduction of aggressive behaviour and motor hyperactivity levels.
The results of the current research match the findings from other studies (e.g. Malek, H. M, 1999; Klorad & spring, 1991; Ranklin, Eugene, et al. 1993; Abdul-Mon'em, N. M. 2001; Jensen, Peter S. et al. 2001; Hartman, 2003 and Al-Degwy, R. A., 2005). The results also agree with the assurance of Shamo'on (2002: 170) that "relaxation leads to minimizing one's response to nervous stress when it is used immediately after situations of stress and, @@thereby, helps replace any produced increment of tension. Shamo'on adds that imaginative relaxation acts as the most distinctive feature of the human mind that gives the individual a chance to imaginarily change the unpleasant aspects of stressful situations in compensation for failure to change them in reality.
Relaxation, thus, helps increase concentration and enables the individual to get rid of aspects of aggressive behaviour and motor hyperactivity. Moreover, it develops and activates the ability to work for longer periods of time as well as controlling all organs of the body in a way that guarantees the diminishing and prevention of aggressive behaviour and motor hyperactivity.
Conclusions & Recommendations
In light of the research objectives, hypotheses and methods; and considering the research sample and findings, the following points are concluded:
1. Relaxation exercises had positive effects on reducing aggressive behaviour and motor hyperactivity.
2. Improvement ratios between pre/and post-tests regarding aggressive behaviour level ranged bet. (11.34%: 40.00).
3. Improvement ratios between pre/and post-tests regarding motor hyperactivity reached (25.69%).
Guided by the results and based on the research conclusions, the researcher recommends the following:
1. The necessity of applying all dimensions of relaxation training (including muscle relaxation, mental relaxation and respiration control) to people with behavioural disorders (aggressive behaviour and motor hyperactivity) on the grounds of the proven effectiveness and positive role of the relaxation training in handling the problems of aggressive behaviour and motor hyperactivity.
2. The necessity of acquainting people with the proper knowledge about the efficacy and importance of activating relaxation training practices as a means of reducing aggressive behaviour and motor hyperactivity among people with behaviour disorders.
3. Assuring the importance of muscle relaxation through regular training of the whole muscle series.
4. Providing staffs qualified enough to deal with behaviourally disordered individuals.
5. Organizing training sessions and programs for qualifying people in charge of working in the field of behaviour disorders.
6. Mass communication participation through programs oriented to specifically display the importance and utility of relaxation training for the behaviourally disordered individuals.
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DR. MASOOMA ALMUTAIRI
Department of Education Psychology
Table (1) Description of equivalence variables : (Chronological age, length, weight, intelligence, socio--economic status, hyper activity & aggressive behaviour level) of the research sample. N=15 Variables Measure Arithmetic Standard Median Skew unit mean deviation ness Chronological age Year 10.14 1.34 10.10 0.09 Length cm. 130.02 3.82 130 0.02 Weight Kg. 32.53 5.83 32 0.27 Intelligence score 88.98 7.47 90 -0.40 Socio--economic score 151.87 7.49 148 1.55 status Aggressive behavior score 43.66 4.99 44 0.20 Direct/Physical Aggressive behavior score 45.34 5.27 45 0.19 Direct/Verbal Aggressive behavior score 46.11 3.24 45 -1.03 indirect Aggressive behavior score 135.11 7.22 133 0.88 Sum Motor hyperactivity score 44.27 4.73 43 0.81 Table (2) Significance of differences in pre/post measurement of the research sample regarding aggressive behaviour and motor hyperactivity using the Wilcoxson non-parametric test for the experimental group. [N.sub.1]=[N.sub.2]=15 Tests/Treatments Signal Rank Rank Rank Value Signifi- cance Number Mean Sum Z Level P Aggressive - 9 4.00 36.00 - behaviour 0.012 + 6 3.00 18.00 2.80 * Direct/Physical Aggressive - 10 3.25 35.00 - behaviour 0.009 + 5 2.00 10.00 2.29 * Direct/Verbal Aggressive - 12 2.50 30.00 - behaviour 0.011 + 3 1.00 3.00 2.54 * Indirect Aggressive - 11 5.50 55.00 - behaviour 0.005 + 4 1.00 4.00 2.34 * Sum Motor - 10 2.50 25.00 - 0.003 hyperactivity + 5 1.00 5.00 2.32 * Table (3): Differences in improvement ratios of the research sample mattering the aggressive behaviour and motor hyperactivity. Tests/measurements Experimental Group Pre- Post- Ratio Aggressive behaviour 43.52 30.23 13.29% Direct/Physical Aggressive behaviour 45.90 34.56 11.34% Direct/Verbal Aggressive behaviour 46.89 31.51 15.38% Indirect Aggressive behaviour 136.31 96.30 40.01% Sum Motor hyperactivity 43.75 32.51 25.69%
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|Date:||Jun 22, 2011|
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