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MohammadReza Tamannaeifar; Mahboobe Esmikhani
Abstract
Objective: Body dysmorphic disorder is a perceptual disorder in which a person is preoccupied with one or more parts of their body that they perceive as particularly ugly or misshapen. Women with body dysmorphic disorder are intensely concerned with their breasts, buttocks, thighs, and overall weight. ...
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Objective: Body dysmorphic disorder is a perceptual disorder in which a person is preoccupied with one or more parts of their body that they perceive as particularly ugly or misshapen. Women with body dysmorphic disorder are intensely concerned with their breasts, buttocks, thighs, and overall weight. The obsessive nature of body dysmorphic disorder can cause a person to experience repeated negative feelings and discomfort about their appearance and how others perceive them, and an overall decrease in psychological and social functioning. For example, people with body dysmorphic disorder may engage in self-checking activities, such as repeatedly looking at themselves in the mirror to assess the area(s) of concern and comparing their appearance to that of others. Body dysmorphic disorder concerns (or symptoms related to body dysmorphic disorder) are distressing and can cause significant suffering and are influenced by various factors, one of which is primary maladaptive schemas. Early maladaptive schemas serve as a framework for interpreting reality that provides a stable and coherent sense of self and the world. It is clear that early maladaptive schemas are associated with body dysmorphic disorder, but what could be important is to discover and examine the role of mediating variables in the relationship between early maladaptive schemas and body dysmorphic disorder, which in this study examined the mediating role of self-esteem, because self-esteem, in addition to being affected by the antecedents of this study, namely early maladaptive schemas, can affect dysmorphic disorder. For this reason, and based on research precedents, self-esteem can be an appropriate mediating variable in the relationshis between the variables in this study. The purpose of the present study was to investigate structural equation modeling of the body dysmorphic disorder based on early maladaptive schemas with mediating role of self-esteem in women with breast cancer. Method: The method of the present research is applied in terms of its purpose and descriptive in terms of survey type, which is considered quantitative research. The statistical population of the study was women with breast cancer referral to the oncology center of Imam Khomeini and Imam Hussein Hospital of Tehran city in autumn year 2024. The sample size was selected based on Klein's model (2023) and with subjectivw sampling of 300 women. Data collection tools include the body dysmorphic disorder scale (BDDS) of Hanley and et al (2020), Young schema questionnaire – short form version 3 (YSQ-S3) of Young (2005) and self-esteem scale (RSEs) of Rosenberg (1989). The inclusion criteria for the study were diagnosis of breast cancer, being in the radiotherapy treatment phase, having a minimum level of literacy, full consent to participate in the study, the right to withdraw from the study, having sufficient time to answer the questionnaires, and not receiving psychiatric treatment. Failure to fully answer the questionnaire questions and not having the necessary cooperation to participate in the study were exclusion criteria. For descriptive data analysis, mean and standard deviation were used; for inferential data analysis, Pearson correlation coefficient and structural equation modeling were used. Data analysis software was SPSS and AMOS version 28. Results: The number of respondents was 300, and no outliers or outliers were identified in this study. The mean age and standard deviation were 37.33 and 2.92, respectively. The results showed direct effect of early maladaptive schemas and self-esteem on body dysmorphic disorder is significant. The results also showed that self-esteem has a significant mediating role in the relationship between early maladaptive schemas with body dysmorphic disorder. Also, the final research model had a good fit (RMSEA=0.07, SRMR=0.05, p<0.05) and 84% of the variance of body dysmorphic disorder is explained. Conclusion: In explaining the mediating role of self-esteem in the relationship between early maladaptive schemas and dysmorphic disorder, it can be said that when a person experiences changes in their appearance and body due to illness and considers these changes to be a kind of defect in them, they judge their body and appearance based on this perceived defect. Therefore, it is possible that the emotions and cognitions present in the schemas of self-regulation and impaired functioning react to signs of defect and show sensitivity to appearance. Given that the activity of self-regulation and impaired functioning schemas is, to some extent, accompanied by negative judgments about themselves and the experience of feelings of failure and helplessness, this feeling of failure and helplessness can lower the self-esteem of women with breast cancer, leading them to exhibit weaker self-esteem than other women. Consequently, when women with breast cancer do not have sufficient self-esteem, they feel inadequate due to the removal of the breast and the defect in the breast area, and they believe that they have a serious and major defect in their body. In such cases, they are more likely to experience body dysmorphic disorder. It can be concluded that body dysmorphic disorder in women with breast cancer can be improved with schema therapy and self-esteem training. The present study had several limitations. First, this study was a cross-sectional design. Therefore, future studies could adopt experimental or longitudinal designs to explore the relationship between variables. Data were collected using self-report questionnaires only. Although the validity and reliability of these questionnaires have been well established, response bias or socially desirable responses may have existed in the present study. The participants in this study were a sample from Tehran, so the cross-cultural applicability of the results is limited. Given that this study was conducted among women with breast cancer, future studies could also collect data from different groups of women with other chronic physical illnesses to gain more insight into the factors affecting dysmorphic disorder. The results of the present study have theoretical and practical implications. Theoretically, this study using a mediation model may help to understand the mechanisms involved and affecting dysmorphic disorder. Also, the results of the present study showed that early maladaptive schemas and self-esteem are key factors for predicting body dysmorphic disorder. Therefore, it can be concluded that body dysmorphic disorder can be improved in women with breast cancer with schema therapy and self-esteem training.
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Fatemeh Abdoli Arani; MohammadReza Tamannaeifar
Abstract
Objective: The growing trend of diseases such as type 2 diabetes, high blood pressure, as well as the increase in the obese and elderly population in different countries caused the growth rate of chronic kidney diseases globally to be higher than the annual growth rate of the world population. It is ...
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Objective: The growing trend of diseases such as type 2 diabetes, high blood pressure, as well as the increase in the obese and elderly population in different countries caused the growth rate of chronic kidney diseases globally to be higher than the annual growth rate of the world population. It is estimated that more than 850 million people worldwide are affected by this disease. If kidney diseases are not diagnosed on time and treated appropriately, it leads to end-stage kidney disease. The purpose of the present study was to investigate developing relationship model quality of life, mindfulness and self-compassion with mediating role self-care behaviors among dialysis patients. This was descriptive-correlation research. Method: The statistical population of the study was dialysis patient’s Kashan city in March to July of year 2024. The sample size was selected based on Klein's model (2023) and with subjectivw sampling of 300 dialysis patient’s. Data collection tools include the quality of life-BRIEF of World Health Organization (2004), Freiburg mindfulness inventory of Walach and et al (2006), short form of the self‐compassion scale of Raes and et al (2011) and exercise of self‐care agency scale of Kearney and Fleischer (1979). Data were analyzed using Pearson correlation and structural equations modeling. Data analysis software was SPSS and AMOS version 28. Results: Te results showed direct effect of mindfulness (β=0.51 and sig=0.001) and self-compassion (β=0.54 and sig=0.001) were significant on quality of life. Also, the results showed that self-care behaviors had a mediating role in relationship between mindfulness (β=0.61 and sig=0.001) and self-compassion (β=0.52 and sig=0.001) with quality of life. Also, the final research model had a good fit (RMSEA=0.03, p<0.05). Conclusion: In explaining the mediating role of self-care behaviors in the relationship between mindfulness and quality of life, it can be said that a dialysis person with mindfulness can help himself to experience more peace and relaxation, this peace and relaxation has helped him to Adhere to self-care and fulfill medical and pharmaceutical orders, and this adherence to self-care in dialysis patients makes them experience a better quality of life. Also, In explaining the mediating role of self-care behaviors in the relationship between self-compassion and quality of life, it can be said that self-compassion can lead to an increase in the level of self-care behaviors and a person can take better and more effective care of him and therefore follow up on his treatment process. slow and adheres to medical and medication orders, as a result, it shows a higher recovery rate, which makes the quality of life of patients better than other dialysis patients. According to the findings of this research and the importance of the role of the mindfulness and self-compassion in quality of life of dialysis patients, it is suggested to experts in this field to use the training of mindfulness and self-compassion to improve quality of life in dialysis patients.
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MohammadReza Tamannaeifar; Azam Mansourinik; Freshteh Malekzadeh Kashani
Abstract
Objective: Chronic pain as a common problem may effect on the physical health, well-being and quality of life in patients. The aim of this study was to examine the mediating role of alexithymia and moderating resilience in the relationship between insecure attachment styles and the quality of life in ...
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Objective: Chronic pain as a common problem may effect on the physical health, well-being and quality of life in patients. The aim of this study was to examine the mediating role of alexithymia and moderating resilience in the relationship between insecure attachment styles and the quality of life in chronic pain patients. Method: This study is a structural equation modeling. Among the chronic patients referred to Kashan therapeutic clinics in 2022, 188 patients were recruited through convenience sampling. In order to collect information, Revised Adult Attachment Scale (Collins & Reid, 1989), Toronto Alexithymia Scale (1992), Connor-Davidson Resilience Scale (2003) and Quality of Life Scale (WHOQOL- BREF) were used. Data were analyzed using SPSS and AMOS 24 software. Results: The results of correlation coefficients showed that there are significant negative correlation between the quality of life with anxious insecure attachment, dependency insecure attachment and alexithymia, while there are significant positive correlation between resilience and quality of life (P<0.01). The results showed that the proposed model of the present study has a good fit (x2/df=2.748, p<0.001, CFI= 0.91, RMSEA=0.06). In addition, the results showed that the direct effect of anxious attachment on alexithymia (β= 0.549, P<0.05) and the direct effect of alexithymia on quality of life is significant (β= -0.632, P<0.01). When alexithymia are included as mediator in the relationship between anxious attachment and quality of life, the indirect effect of anxious attachment on quality of life is -0.347, and this indirect effect is significant (P<0.01). Also, the direct effect of dependency attachment on alexithymia is significant (β= 0.297, P<0.05). When alexithymia are included as mediator in the relationship between dependency attachment and quality of life, the indirect effect of dependency attachment on quality of life is -0.188, and this indirect effect is significant (P<0.05). Therefore, The results showed that alexithymia mediates the relationship between anxious insecure attachment and quality of life (β=-0.347, p<0.01) and dependency insecure attachment and quality of life (β=-0.188, p<0.05) in chronic pain patients. Resilience also moderates the relationship between alexithymia and quality of life (β=-0.121, p<0.05). Conclusion: The insecure attachment may effect on quality of life through alexithymia and resilience can be a protective factor against the negative impact of this effect in chronic pain patients. These results have important implications for clinicians and researcher in the field of health psychology. Psycho-educational interventions to identify emotions and describe them and reduce alexithymia can help patients manage their emotions better and improve different aspects of their quality of life. Also, interventions based on resilience can lead to improving the quality of life in chronic pain patients.
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Mohammad Reza Tamannaifar; Azam Mansourinik; Shiva Ahmadpoursamani
Abstract
Objectives: Quality of life in patients with heart failure can be affected by several factors. The present study aimed to examine the relationship between personality traits and quality of life in heart failure patients mediated by self-care behaviors. Method: This study is a structural equation modeling. ...
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Objectives: Quality of life in patients with heart failure can be affected by several factors. The present study aimed to examine the relationship between personality traits and quality of life in heart failure patients mediated by self-care behaviors. Method: This study is a structural equation modeling. Among the heart failure patients referred to Tehran Heart Hospitals, 300 patients referred to Jam Hospital and Bustan Cardiovascular Clinic were recruited through convenient sampling. In order to collect information, NEO-FFI (Costa & McCrae, 1992), MOS (Ware & Sherbourne, 1992) and EHFSCB (Jarsma et al., 2003) were used. Data were analyzed using SPSS and AMOS 24 software. Results: The results of correlation coefficients showed that there are significant negative correlation between the personality traits of neuroticism and agreeableness with quality of life, while there are significant positive correlation between extroversion and quality of life (P<0.01). Also, there are significant negative correlation between self-care behaviors and quality of life (P<0.01). According to the results the proposed model has a good fit (x2/df=2.786, p<0.001, CFI= 0.92, RMSEA=0.07). In addition, the direct effect of neuroticism, extroversion and agreeableness on quality of life is significant (P<0.01). When self-care behaviors are included as mediators in the relationship between personality traits and quality of life, the indirect effect of neuroticism and conscientiousness on quality of life is 0.09 and 0.049 respectively, and these indirect effects are significant (P<0.01). Therefore, self-care behaviors mediate the relationship between personality traits of neuroticism and conscientiousness with quality of life.Conclusion: These results have important implications for clinical practice and research in the field of cardiac health psychology and indicate the need to develop approaches and better management of these patients in self- care behaviors. Considering the widespread prevalence of heart diseases as a chronic disease and the high costs of treatment, the results of this research have many practical implications for health psychologists, doctors and nurses. Interventions aimed at changing personality characteristics (especially reducing neuroticism and increasing conscientiousness) in order to improve the quality of life of heart patients is a complex and time-consuming task. Therefore, one of the effective interventions to increase these patients’ quality of life can be focusing on increasing self-care behaviors. Hence, educating patients about the importance of this issue can play an important role in improving these patients’ quality of life.
