نوع مقاله : مقاله پژوهشی
نویسندگان
1 دانشجوی دکتری مشاوره، گروه مشاوره، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران
2 دانشیار گروه مشاوره، واحد ابهر، دانشگاه آزاد اسلامی، ابهر، ایران
3 استاد،گروه مشاوره، دانشگاه الزهرا، تهران، ایران
چکیده
زمینه و هدف: اختلالات بی‌اشتهایی عصبی یکی از شایع‌ترین اختلالات خوردن در میان نوجوانان است. پژوهش حاضر با هـدف تعیین اثربخشی درمان مبتنی بر پذیرش و تعهد بر تصویر بدنی و سبک‌های هویت دانش‌آموزان دختر مبتلا به بی‌اشتهایی عصبی انجـام گرفـت.
مواد و روشها: پـژوهش حاضر از نـوع نیمـه‌تجربـی، با طرح پیش‌آزمـون و پس‌آزمون و پیگیری همراه با گروه کنترل بود. جامعه آماری، شامل نوجوانان دختر مبتلا به بی‌اشتهایی در سال تحصیلی 99-1400 شهر کرج بودند. بهمنظور انجام پژوهش، 30 نفر از دانش‌آموزان با نمونه‌گیری تصـادفی در گروه آزمـایشی و گروه کنتـرل قرار گرفتند. گروه آزمایش در 10 جلسه مداخله درمان مبتنی بر خانواده را دریافـت کردند و گروه کنترل مداخله‌ای دریافت نکردند. ابزارهای مورداستفاده، پرسش‌نامه نگرش‌های خوردن گارنر و گرفینگل (1982)، پرسش‌نامه سبک‌های هویت برزونسکی (1989) و پرسش‌نامه تصویر بدنی (کش و پروزینسکی، 1990) بـود. داده‌هـا بـا تحلیل کواریانس چندمتغیره و تحلیل واریانس آمیخته بررسی شدند.
یافتهها: نتایج نشان داد درمان مبتنی بر پذیرش و تعهد، منجر به پیدایش تصویر بدنی مثبت و کسب هویت متعهدانه در دانش‌آموزان می‌شود (0/01<p ). همچنین نتایج مرحله پیگیری نشان داد که اثربخشی مداخله، ماندگار است. نتیجه‌گیری: با توجه به یافتهها می‌توان گفت درمان مبتنی بر پذیرش و تعهد، منجر به پیدایش تصویر بدنی مثبت و سبک هویت متعهدانه در نوجوانان دختر می‌شود. بنابراین روان‌شناسان و مشاوران می‌توانند از این درمان در دانش‌آموزان دختر مبتلا به بی‌اشتهایی عصبی استفاده کنند.
کلیدواژه‌ها
موضوعات
عنوان مقاله [English]
The effectiveness of acceptance and commitment therapy on body image and identity styles of female students with anorexia nervosa
نویسندگان [English]
- marzieh babaee Heydarabadi 1
- mohammad ghamari 2
- simin Hosenian 3
1 PhD student, Department of Counseling, Science & Research Branch, Islamic Azad University, Tehran, Iran
2 Associate Professor, Department of Counseling, Abhar Branch, Islamic Azad University, Abhar, Iran.
3 Professor of the counseling group, Al-Zahra University, Tehran, Iran.
چکیده [English]
Introduction: It seems eating disorder is increasing in adolescent. The aim of this study was to determine the effectiveness of acceptance and commitment-based therapy on body image and identity styles of female students with anorexia nervosa.
Materials and Methods: The research design was quasi-experimental, pre-test and post-test and control group. The statistical population was adolescent girls with anorexia in the academic year 2020-2021 Karaj. At least 30 students were randomly assigned to experimental and control groups. In 10 treatment sessions, the experimental group received treatment, and the control group did not benefit from this intervention. The instruments used were Garner and Garfingel (1982) Eating Attitudes Questionnaire, Brzonsky Identity Styles Questionnaire (1989) and Imaging Physics Questionnaire (Kash & Prozinski, 1990). Data were analyzed by multivariate analysis of covariance and mixed analysis of variance.
Results: The results showed that acceptance and commitment-based therapy leads to the emergence of a positive body image and the acquisition of a committed identity in students (p <0.01). Follow-up also showed that the effectiveness of the intervention is lasting.
Conclusion: According to the findings, it can be concluded that the method of Acceptance and Commitment Therapy leads to the positive body image and committed identity style in female adolescent. Therefore, psychologists and counselors can use this treatment for female students with anorexia.
کلیدواژه‌ها [English]
- Anorexia nervosa
- Body image
- Acceptance and commitment therapy
- Identity
- Dobrescu SR, Dinkler L, Gillberg C, Råstam M, Gillberg C, Wentz E. Anorexia nervosa: 30-year outcome. The British Journal of Psychiatry. 2020; 216(2):97-104. https://doi.org/10.1192/bjp.2019.113
- Peterson K, Fuller R. Anorexia nervosa in adolescents: An overview. Nursing2021. 2019; 49(10):24-30. doi: 10.1097/01.NURSE.0000580640.43071.15.
- Dakanalis A, Timko CA, Colmegna F, Riva G, Clerici M. Evaluation of the DSM-5 severity ratings for anorexia nervosa in a clinical sample. Psychiatry research. 2018; 262:124-128. https://doi.org/10.1016/j.psychres.2018.02.009
- Chew CS, Kelly S, Tay EE, Baeg A, Khaider KB, Oh JY, Rajasegaran K, Saffari SE, Davis C. Implementation of family‐based treatment for Asian adolescents with anorexia nervosa: A consecutive cohort examination of outcomes. International Journal of Eating Disorders. 2021; 54(1):107-116. doi/abs/10.1002/eat.23429
- Shafiei, M., Basharpoor, S., zabihiniagardoridabadi, E., Heidarirad, H. Role of response inhibition, negative urgency and body image concerns in anticipation of eating disorders in girl Students University of Medical Sciences. Journal of Psychological Studies, 2018; 14(1): 91-107. https://doi.org/10.22051/psy.2017.14162.1349
- Palmeroni N, Luyckx K, Verschueren M, Claes L. Body dissatisfaction as a mediator between identity formation and eating disorder symptomatology in adolescents and emerging adults. Psychologica Belgica.2020; 60(1):328-346. https://doi.org/10.5334/pb.564
- Stein KF, Lee CK, Corte C, Steffen A. The influence of identity on the prevalence and persistence of disordered eating and weight control behaviors in Mexican American college women. Appetite. 2019; 140:180-189. https://doi.org/10.1016/j.appet.2019.05.008
- Verschueren M, Luyckx K, Kaufman EA, Vansteenkiste M, Moons P, Sleuwaegen E, Berens A, Schoevaerts K, Claes L. Identity processes and statuses in patients with and without eating disorders. European Eating Disorders Review. 2017; 25(1):26-35. https://doi.org/10.1002/erv.2487
- Bartolo MG, Palermiti AL, Servidio R, Musso P, Tenuta F, Amendola MF, Costabile A, Inguglia C. The relationship between parental monitoring, peer pressure, and motivations for responsible drinking among Italian adolescents: the mediating role of positive alcohol expectancies. The Journal of Genetic Psychology. 2022;17(1):1-9. https://doi.org/10.1080/00221325.2022.2113026
- Fernando AN, Sharp G. Genital self-image in adolescent girls: the effectiveness of a brief educational video. Body Image.2020; 35(1):75-83. https://doi.org/10.1016/j.bodyim.2020.08.007
- Ansari S, Asgari P, Makvandi B, Heidari A, Seraj Khorrami N. Effectiveness of schema therapy in psychological distress, body image, and eating disorder beliefs in patients with anorexia nervosa. Avicenna Journal of Neuro Psycho Physiology.2020; 7(3):184-189. http://dx.doi.org/10.32592/ajnpp.2020.7.3.107
- Abbasi, Ghadmpour, Ezatollah, & Hojjati. The effect of cognitive reconstruction training on body image, social anxiety and suicidal ideation in students with negative body image. Scientific Journal of Education and Evaluation (Quarterly).2020; 13 (51), 73-94. [In Persian]
- Bai Z, Luo S, Zhang L, Wu S, Chi I. Acceptance and commitment therapy (ACT) to reduce depression: A systematic review and meta-analysis. Journal of Affective Disorders. 2020; 260:728-737. https://doi.org/10.1016/j.jad.2019.09.040
- Sewart AR, Niles AN, Burklund LJ, Saxbe DE, Lieberman MD, Craske MG. Examining positive and negative affect as outcomes and moderators of cognitive-behavioral therapy and acceptance and commitment therapy for social anxiety disorder. Behavior therapy.2019; 50(6):1112-1124. https://doi.org/10.1016/j.beth.2019.07.001
- Vilardaga R, Estévez A, Levin ME, Hayes SC. Deictic relational responding, empathy, and experiential avoidance as predictors of social anhedonia: Further contributions from relational frame theory. The Psychological Record.2012; 62(3):409-32. DOI: 10.1007/BF03395811
- Juarascio AS, Schumacher LM, Shaw J, Forman EM, Herbert JD. Acceptance-based treatment and quality of life among patients with an eating disorder. Journal of Contextual Behavioral Science.2015; 4(1):42-7. https://doi.org/10.1016/j.jcbs.2014.11.002
- Pears S, Sutton S. Effectiveness of Acceptance and Commitment Therapy (ACT) interventions for promoting physical activity: a systematic review and meta-analysis. Health Psychology Review.2021; 15(1):159-84. doi: 10.1080/17437199.2020.1727759
- Roche L, Dawson DL, Moghaddam NG, Abey A, Gresswell DM. An Acceptance and Commitment Therapy (ACT) intervention for Chronic Fatigue Syndrome (CFS): a case series approach. Journal of Contextual Behavioral Science.2017; 6(2):178-86. https://doi.org/10.1016/j.jcbs.2017.04.007
- Forman EM, Butryn ML. A new look at the science of weight control: how acceptance and commitment strategies can address the challenge of self-regulation. Appetite.2015; 84(1): 171-80. https://doi.org/10.1016/j.appet.2014.10.004
- Garner DM, Garfinkel PE. The Eating Attitudes Test: An index of the symptoms of anorexia nervosa. Psychological medicine.1982; 9(2):273-279. https://doi.org/10.1017/S0033291700030762
- Azimzadeh B, Razavieh A, Moharrari MR. Investigation of Relationship between Disordered Eatings and Body Checking Behaviors in the Students of Islamic Azad University of Arsanjan. Knowledge & Research in Applied Psychology.2009; 42(1): 124-48.
- Berzonsky MD. Identity style: Conceptualization and measurement. Journal of adolescent research.1989; 4(3):268-282.DOI: 1177/074355488943002
- Ghazanfari A. Validation and standardization of 6G-ISI style identity questionnaire. Studies of education and psychology:2021; 5(1):81-94
- Cash TF, Melnyk SE, Hrabosky JI. The assessment of body image investment: An extensive revision of the Appearance Schemas Inventory. International Journal of eating disorders.2004; 35(3):305-316. https://doi.org/10.1002/eat.10264
- Shemshadi H, Shams A, Sahaf R, Shamsipour Dehkordi P, Zareian H, Moslem AR. Psychometric properties of Persian version of the Multidimensional Body-Self Relations Questionnaire (MBSRQ) among Iranian elderly. Iranian Journal of Ageing.2020; 15(3):298-311. http://dx.doi.org/10.32598/sija.15.3.61.13
- Hill, M. L., Masuda, A., Melcher, H., Morgan, J. R., & Twohig, M. P. Acceptance and commitment therapy for women diagnosed with binge eating disorder: A case-series study. Cognitive and behavioral practice.2015; 22(3), 367-378. https://doi.org/10.1016/j.cbpra.2014.02.005
- Pearson AN, Follette VM, Hayes SC. A pilot study of acceptance and commitment therapy as a workshop intervention for body dissatisfaction and disordered eating attitudes. Cognitive and Behavioral Practice.2012; 19(1):181-97. https://doi.org/10.1016/j.cbpra.2011.03.001
- Fogelkvist M, Parling T, Kjellin L, Gustafsson SA. A qualitative analysis of participants’ reflections on body image during participation in a randomized controlled trial of acceptance and commitment therapy. Journal of eating disorders. 2016; 4(1):1-9.DOI; 10.1186/s40337-016-0120-4
- Rezaeisharif A, Cheraghian H, Naeim M. Effectiveness of Acceptance and Commitment Therapy on Reducing Body Image Disorders in Adolescent Girls. Addictive Disorders & Their Treatment.2021; 20(4):336-341.
- Juarascio, A. S., Schumacher, L. M., Shaw, J., Forman, E. M., & Herbert, J. D. Acceptance-based treatment and quality of life among patients with an eating disorder. Journal of Contextual Behavioral Science. 2015;.4(1), 42-47. https://doi.org/10.1016/j.jcbs.2014.11.002
- Stockton D, Kellett S, Berrios R, Sirois F, Wilkinson N, Miles G. Identifying the underlying mechanisms of change during acceptance and commitment therapy (ACT): A systematic review of contemporary mediation studies. Behavioural and cognitive psychotherapy.2019; 47(3):332-362. https://doi.org/10.1017/S1352465818000553
- Stein KF, Lee CK, Corte C, Steffen A. The influence of identity on the prevalence and persistence of disordered eating and weight control behaviors in Mexican American college women. Appetite.2019; 140(1):180-189. https://doi.org/10.1016/j.appet.2019.05.008
)