Assessing Efficacy of Emotional Regulation Techniques on Alexithymia among Students Who Suffer From Dyscalculia

Background: Dyscalculia tends to debilitating for children with respect to their social interactions and learning process. Although it can cause so many problematic consequences in developmental stages of children, by implementing precise and in time therapeutic intervention, it can be mitigated. Current paper examines the efficacy of emotional regulation techniques among students who suffer from dyscalculia. Materials and Methods: This study was experimental study with pre-test and post-test and control group. Statistical Society of this study included all students (4th, 5th, 6th grader), who suffered from dyscalculia in Bileh town (Urumieh Province/Iran) during 2013-2014(N=76). This study consisted 34 students, who suffered from dyscalculia. These students were chosen via systematic random sampling. Data were collected using Raven IQ test, Shalev mathematical Test, Alexithymia Scale, Psychological wellbeing questionnaire. Regarding analyzing data, MANOVA was used. Results: The results of multivariate analysis of covariance show that between case group and control, significant difference in components of alexithymia and psychological wellbeing were noticed. Hence, it can be inferred that emotional regulation strategies improves component of alexithymia and psychological well being of students with dyscalculia. Conclusion: According to results, teaching emotion regulation strategies to students considered to be effective in promoting awareness and positive attitudes. Thus, it is plausible that implementing these strategies tend to play major role as an intervention among students with

transfer deficit among alexithymics may be one the hypothesis regarding pathogenesis of this disorder; that is, the emotional information from the right hemisphere is not being properly transferred to the language regions in the left hemisphere , as can be caused by a decreased corpus callosum. Another hypothesis which can be discusses is limbic malfunctioning (Madadi & Ghaedi, 2003).The core characteristics of alexithymia are evident dysfunction in emotional awareness, social attachment, and interpersonal relating. Moreover, individuals suffering from alexithymia also have difficulty in distinguishing and appreciating the emotions of others, which is thought to lead to unempathic and ineffective emotional responding (Besharat, 2007).Considerable data indicate that students with learning problems tend to have less consistent emotion and they have problem regarding regulating their emotions. This phenomon is less seen in normal population and these individuals tend to demonstrate more dramatic reactions when faced a normal situations (Bauminger et al., 2005). Results of former study suggest that students with learning disorders have problems in indentifying, describing and concrete thinking compared to normal students. In this context, they demonstrate inappropriate animosity, impulsive attitude, aggression, excessive self-assurance, envy and dissociability. It appears plausible that due to specific psychological attributes, behavioral problems, mood states and other psychological impairments, proper prophylaxis/interventional procedure should be facilitated regarding this group of people. According to Wagaman(2008), there is no effective medications for this group of children; though with following suitable procedures a child may be able to cope with associated problems. One of the effective methods regarding psychological wellbeing of students with dyscalculia which have not been mentioned by scholars, are Emotional Regulation Training. Emotional Regulation reffers to ability of understanding, modulating the experience and expressing the emotions (Feldman- Barrett et al., 2001;Gross, 2001.Adaptive emotional regulation tend to share a relationship with adaptation, psychological wellbeing and positive social interaction (Gross, 2002;Saarni, 1990) and elevating rate of positive experiences will lead to effective confrontation with traumatic situation (Gross, 2002) and additionally it will impact necessary actions in social interactions (Tugade & Frederickson, 2002). Reviewing literature and psychological researches demonstrate that emotional regulation is a prominent factor regarding psychological wellbeing and social interactions and flawed process of them may cause internal disorders ( e.g. depression, anxiety and social isolation) and external disorders( e.g. crime activities, behavioral aggression). According to Jill(2002) and Schnitzer and Colleagues(2007), cognitive intervention may be effective regarding boosting intellectual ability of students with dyscalculia regarding hypothesizing and understanding humor in social interactions (Diefendorff, Richard & Yang, 2008). Furthermore, group emotional intervention maintain a positive effect on reducing self harm attitude and reducing depression signs, anxiety and stress (Gratz K & Gunderson, 2006).According to aforementioned necessities, current study is trying to answer to this question: Is teaching emotional regulation techniques is effective regarding elevating psychological wellbeing and reducing alexithymia in students with dyscalculia?   Barahmand et al., 2007) and it was used vastly with respect to diagnosing dyscalculia. It contains three sections: 1. Numerical understanding: Consisted of 8 subtests about counting, understanding, matching, reading numbers, writing numbers alphabetically or as numbers' symbols, comparing numbers, using mathematical symbols; 2. This section is about producing numbers and it is consisted of subtests, which examines simple(one digit) summation, subtraction, division and multiplying. 3. This section is about numerical calculation. Total score of this subtest is 100. Validity of this test estimated 0.92 among 703 individuals as sample (Shalev et al., 2005).In Iran, Barahmand and Colleauges (2005) estimated validity coefficient of this test via chronbach's alfa as 0.95. Criterion score regarding diagnosing dyscalculia in students (6 th grade) was 34/68 ((quoted by Barahmand et al., 2007).

Raven IQ Test:
The tests were originally developed by John C. Raven in 1936 in the UK in order to assess IQ between 9-18 years old. It is consisted of 5 items (each items have 12 questions). Internal consistency coefficient and retest validity coefficient assessed as mean of mean of 0.90 and 0.82 respectively. Correlation of this test with Wechsler, Goodenough test, StanforD-Binet and Proteus maze estimated to be in a range of 0.40 to 0.75. Correlation of this test announced to be more with nonverbal test. In this study, individuals with IQ higher than 90 were chosen (Raven et al., 2003).

The Ryff Scales of Psychological Well-Being:
Ryff designed this test (1989) in Medical School of Wisconsin University and it was revised in 2002 (Hosser and Colleagues).The Ryff inventory consists of either 84 questions (long form) or 54 questions (medium form). There is also a short form, but it is statistically unreliable and therefore should not be used for assessment. Both the long and medium forms consist of a series of statements reflecting the six areas of psychological wellbeing: autonomy, environmental mastery, personal growth, positive relations with others, and purpose in life, and self-acceptance.
Respondents rate statements on a scale of 1 to 6, with 1 indicating strong disagreement and 6 indicating strong agreement. Ryff (1989), estimated internal consistency coefficient of this test as 0.91. Validity of this questionnaire claimed to be 0.81 in Michaeeli (2009) study. In current study, internal consistency coefficient is 0.87.

Toronto Alexithymia Scale 20(TAS-20):
TAS (Bagby et al., 1994) is compromised of 20 questions and it assesses three subscales of 1 DIF (Difficulty Identifying Feeling), which has 7 questions, 2 DDF (Difficulty Describing Feelings), which has 5 questions, 3 EOT(Externally Oriented Thinking), which has 5 questions. Items are rated using 5-point Likert scale whereby 1=Strongly disagree and 5=Strongly agree. The total Alexithymia score is sum of all responses to all 20 items (Bagby et al., 1994). In Farsi version of TAS-20 (Besharat, 2007), Cronbach's alpha regarding total score of Alexithymia and 3 subscales (DIF, DDF, EOT) estimated as 0.85, 0.82, 0.75, and 0.72 respectively, which showed proper internal consistency of this scale. Retest validity of this scale in a sample of 67 individuals in period of 2 weeks was confirmed as r=0.80 and r=0.87 regarding total score of Alexithymia and subscales respectively. Synchronic Reliability based on Pearson correlation coefficient between Alexithymia and emotional quotient, Alexithymia and psychological wellbeing, Alexithymia and  Procedure: After getting acceptance of authorities, we referred to primary school located in Bileh town (Urumieh Province/Iran). Although, teachers of the school confirmed dyscalculia of students, for reassurance we conducted Shalev Math test, raven IQ test and Toronto Alexithymia scale. Then, via systematic random sampling method and with mentioning distribution frequency of boy and girls and their educational stage, sample was chosen. In next step, tools of gathering data were conducted as pretest and after that, 8 interventional sessions were hold in case group and 8 normal sessions (included routine conversation) were hold in control group. By the end of sessions, posttest was conducted among both case and control groups. At last, all gathered data were analyzed with SPSS16 and via MANCOVA.

Analyzing data procedure:
In current study, in additional to implementing descriptive statistical tests ( e.g. Frequency, mean and SD), MANCOVA was used. Additionally, with respect to noticing pre-hypotheses of MANCOVA; one-sample Kolmogorov Smirnov test was used and for assessing the equality of variances, levene's test was used and BOX tests were used for assessing congruity of covariance.

Table-No1 Mean and SD of Alexithymia's components in Pretest and Posttest stages
According

Table-No2 Mean and SD of psychological wellbeing's components in Pretest and Posttest level
As it can be seen in Table-No2, mean and (SD) of post-test in case-group is as mentioned below: 1.Autonomy: 29/43(3.11); 2.Environmental Mastery: 36.56(2.44); 3. Personal Growth: 26.56(3.09); 4. Positive relations with others: 26.43(2.42); 5.Purpose in Life: 23.43(3.11); 6.Selfacceptance: 26.65(2.44) In order to assess the similarity of variances, Levene's test was implemented and results showed that level of (F) is not meaningful for any components of current study (P≥0.005); so it is plausible that variance error of these variables between case-group and control-group does not differ. Furthermore, regarding assessing similarity of covariance, BOX test was conducted and results showed that difference is not meaningful (P=442, F=0.

Components of Current study
According to

DISCUSSION AND CONCLUSION
Main purpose of current study was to assess the efficacy of teaching emotional regulation techniques on alexithymia and psychological wellbeing of students with dyscalculia. According to MANCOVA results, there was meaningful difference with regard to three levels of alexithymia (DOF, DDF and EOT), between case-group and control-group. Hence, its plausible that teaching emotional regulation technique is efficient in reducing alexithymia among students diagnosed with alexithymia. These results are consistent with the results of the study conducted by Gratz and Gondersoon, 2006;Skinters et al., 2007;Dayfanr of et al., 2008;Martini and Bosseri, 2010). As Dayfanrof's (2008) shows that emotional regulation techniques has a positive correlation with decrease in negative emotions and focusing of positive emotional regulation techniques will elevate understanding of individuals in managing their emotions. Furthermore, it can be helpful in identifying aggression, fear, humility and sadness and accordingly regulating the emotions (Yoo et al., 2006). Additionally, group intervention may provide positive impact on self-harm attitudes, borderline personality disorder, depressive symptoms, anxiety and stress (Gratz and Gondersoon, 2006). Jill (2002), Skinters et al., 2007and Andrise and laber (2007 claimed in their studies that cognitive interventions maintain a positive influence regarding elevating understanding, modifying difficult attitudes of children with dyscalculia. They believe that these interventions are prominent factors in boosting thinking power of students regarding hypothesizing and understanding humor in social interactions. Study conducted by Martini & Busseri (2010) suggests that negative emotional regulation techniques are predictive of negative emotion, low satisfaction and vice versa.
Furthermore, regarding second dependent variable, results of MANCOVA showed that among students with dyscalculia in both case and control groups; there is meaningful difference regarding autonomy, environmental mastery, personal growth, positive relations with others, purpose in life and self acceptance. As introducing emotional regulation techniques cause positive effects among psychological wellbeing's components in case group comparing to control. Hence, second hypothesis of this study is confirmed. Current results are consistent with the results of the study conducted by Gross & John (2003); Quoidbach and Colleagues (2010); Nykliček and Colleagues (2011);Sylvester (2012). Quoidbach and Colleagues studied effect of emotional regulation techniques on psychological wellbeing (reducing distress, life satisfaction) and they demonstrated that telling someone (sharing positive event with someone) will lead to life satisfaction and involvement with positive rumination will lead to distress reduction. Sylvester (2012) showed that positive effects on psychological wellbeing will lead to improvement in physical wellbeing. Gross & John(2003) claimed that different approach to emotional regulation will lead to difference psychological, emotional and social states among individuals.
In confirming the results of current study, it can be inferred that emotional regulation is process of modulating one or various aspects of experiences with specific emotional responses . Emotional regulation plays a major role in psychological wellbeing (Nykliček et al., 2011). Emotional regulation considered being prominent factor in proper functioning and implementing maladaptive methods would lead to negative consequences such as low psychological wellbeing (Gross & Muñoz, 1997) and even somatic problems (Gross & John, 2003;Denollet et al, 2008). Emotional regulation and psychological wellbeing are concepts, which are connected and entangled in various ways. Same brain regions are aroused with respect to aforementioned concepts, which play major role in interaction with other individuals. These two concepts cause dramatic impacts on psychopathology, social isolation and somatic symptoms (Nykliček et al., 2011).
In some forms of psychopathology such as emotional disorder or personality disorders, role of emotional regulation has been highlighted (Gross & Muñoz, 1997). Furthermore, psychological interventions such as CBT and DBT have been used regarding emotional regulation and they have founded to be effective in reducing problematic symptoms (Linehan, 1993).
Nevertheless, current study examined which approach to emotional regulation is effective and some studies showed that some of the emotional regulation techniques are effective with respect to psychological wellbeing (Nykliček et al., 2011). One the methods which was used in current study was emotional inhibition which is intentional inhibition of an emotion by the time of emotional arousal . In clear sense, this method can be used in different societies in social interactions. In contrast, some studies discuss role of emotional inhibition in decreasing positive emotions (Gross & Levenson, 2007), impaired interpersonal function (Butler et al., 2003) and decreased psychological wellbeing (Gross & John, 2003). In addition, this method may boost rumination about negative emotions (Gross & John, 2003). Although, rumination and worrying may cause a distraction regarding emotional experience (Roemer et al., 2009). Some evidences suggest that there is close relationship between emotional inhibition and activating sympathetic nervous system which may led to Cardio vascular diseases (Butler et al., 2003). In this sense, mentioning one exception seem to be vital, both expressing and inhibition of anger in excessive way may lead to cardio vascular diseases (Nyklíček, I., 2011).
One of the limitations, which can be discussed regarding this study, is that no interview was conducted regarding diagnosis of dyscalculia among students. Another limitation was not controlling educational and financial status of parents. Another limitation worth mentioning is ADHD as common comorbid situation with LD.
It is advised to hold follow up sessions regarding long-term assessment of emotional regulation training procedure. Due to substantial effects of dyscalculia on various aspects of students' life, interventional programs should be facilitated and they should be followed precisely by authorities.