نوع مقاله : علمی- پژوهشی

نویسندگان

• رقیه عسگرنژاد ¹
• عاطفه حجتی ²

¹ گروه روانشناسی بالینی، دانشگاه آزاد اسلامی، واحد علوم پزشکی قم، قم، ایران.

² گروه روانشناسی بالینی، دانشگاه آزاد اسلامی، واحد علوم پزشکی قم، قم، ایران

چکیده

مقدمه: پژوهش حاضر با هدف اصلی مدل‌یابی معادلات ساختاری علائم جسمانی سازی بر اساس سازمان شخصیت با توجه به نقش واسطه‌ای احساس گرفتاری در زنان مبتلا به سرطان پستان انجام شد.
روش: این پژوهش توصیفی-همبستگی از نوع مدلیابی معادلات ساختاری بود. جامعه آماری شامل تمام زنان مبتلا به سرطان پستان دارای پرونده در بیمارستان شهدای تجریش شهر تهران در سال 1402-1403 بود. از میان جامعه آماری نمونه‌ای به تعداد 200 نفر در نظر گرفته شد که به شیوه نمونه گیری هدفمند به پژوهش وارد شدند. سپس چک لیست نشانگان استرس (SSC) چنگ و حامید (1996)، پرسشنامه سازمان شخصیت (POQ) کرنبرگ (2002) و پرسشنامه احساس گرفتاری (EQ) گیلبرت و آلن (1998) میان شرکت کنندگان توزیع شد. بعد از تکمیل پرسشنامه‌ها، برای توصیف داده‌ها از روش‌های آمار توصیفی و برای آزمون فرضیات از آزمون معادلات ساختاری به شیوه تحلیل مسیر از طریق نرم افزارهای SPSS و AMOS استفاده شد.
یافته‌ها: نتایج نشان داد که سازمان شخصیت با ضریب استاندارد 473/0 و احساس گرفتاری با ضریب استاندارد بتا 263/0 اثر مثبت و معناداری در سطح 05/0 بر علائم جسمانی‌سازی داشته است. همچنین متغیر سازمان شخصیت با ضریب استاندارد 156/0 اثر غیر مستقیم و معناداری بر علائم جسمانی سازی با میانجی‌گری احساس گرفتاری داشته است. در نهایت متغیر سازمان شخصیت با ضریب استاندارد 593/0 اثر مثبت و مستقیمی در سطح 05/0 بر احساس گرفتاری داشته است.
نتیجه‌گیری: بر این اساس می‌توان نتیجه گرفت سازمان شخصیت به‌طور مستقیم و از طریق نقش میانجی احساس گرفتاری، تأثیر معناداری بر علائم جسمانی‌سازی در زنان مبتلا به سرطان پستان دارد.

کلیدواژه‌ها

• احساس گرفتاری
• سازمان شخصیت
• سرطان پستان
• علائم جسمانی

موضوعات

• بیماریهای مزمن مانند سرطان،دیابت،ایدز، قلبی-عروقی ، ام اس و ....

عنوان مقاله [English]

Equation Modeling of Somatization Symptoms Based on Personality Organization Considering the Mediating Role of Entrapment in Women with Breast Cancer

نویسندگان [English]

• Roghayeh Asgarnejad ¹
• Atefeh Hojjati ²

¹ Department of Clinical Psychology, Qom Medical Sciences Branch, Islamic Azad University, Qom, Iran

² Department Of Clinical Psychology, Qom Medical Sciences Branch, Islamic Azad University, Qom, Iran.

چکیده [English]

Objective: Breast cancer is the most prevalent malignancy among women worldwide, and its experience significantly elevates the likelihood of developing somatization symptoms, thereby imposing substantial healthcare costs (Arnold et al., 2022; Moran et al., 2023). Identifying factors influencing these symptoms is therefore imperative. Personality organization, as a foundational psychological construct, plays a pivotal role in psychosomatic responses to stress, with specific personality traits demonstrably linked to mental health outcomes and adaptation processes in cancer patients (Kovács et al., 2021; Cerezo et al., 2020). Conversely, somatization frequently stems from an inability to directly express negative emotions, a process exacerbated by "entrapment", a psychological state commonly observed in cancer populations and associated with particular personality dimensions such as neuroticism (Çetin & Varma, 2021; Chen et al., 2022). Despite existing evidence, prior research has predominantly focused on direct relationships between Five-Factor Model personality traits and psychosomatic outcomes, exhibiting two critical limitations: first, neglecting the comprehensive theoretical framework of "personality organization," and second, failing to examine the mediating role of entrapment as a key mechanism in chronic cancer-related stress responses. This research gap is particularly pronounced among Iranian women with breast cancer, who face unique cultural challenges (Hosseini et al., 2023). Consequently, the present study employs structural equation modeling to investigate the relationship between personality organization and somatization symptoms, incorporating entrapment as a mediating variable. The primary objective is to determine whether these variables collectively predict somatization symptoms in this population. Method: This fundamental research utilized a descriptive-correlational design. The statistical population comprised all women diagnosed with breast cancer attending Shahid Tajrish Hospital in Tehran during the Iranian calendar years 1402–1403 (2023–2024). Adhering to structural equation modeling principles (Kline, 2012), a sample size of 200 participants was determined and selected via purposive sampling based on predefined inclusion and exclusion criteria. Assessment instruments included the Stress Symptom Checklist (Cheng & Hamid, 1996) for measuring somatization, the Personality Organization Questionnaire (Kernberg, 2002), and the Entrapment Questionnaire (Gilbert & Allan, 1998). The validity and reliability of these tools have been established in both international and Persian-language studies (Shaker, 2018; Ghamarani et al., 2013; Cheng & Hamid, 1995). Following informed consent acquisition, data were collected through self-report questionnaires. Data analysis employed descriptive and inferential statistical methods, specifically path analysis within a structural equation modeling framework using SPSS and AMOS software. This analytical approach enabled examination of direct and indirect relationships among personality organization, entrapment, and somatization symptoms within a cohesive theoretical model. Results: Personality organization demonstrated a significant positive direct effect on entrapment (standardized coefficient β = 0.593, p <.001). Both entrapment (β=0.264, p=.005) and personality organization (β=0.473, p<.001) exhibited significant direct effects on somatization symptoms. Bootstrap testing (Table 1) revealed a significant indirect effect of personality organization on somatization symptoms through entrapment (β=0.156, p=.014), confirming that diminished personality organization intensifies entrapment, subsequently amplifying somatization symptoms at the 5 percent significance level.Conclusion: This study demonstrates that deficits in personality organization predict somatization symptoms in women with breast cancer both directly and indirectly through the mediating role of entrapment. These findings suggest that individuals with maladaptive personality structures lack effective emotion regulation and stress-processing mechanisms, leading them to suppress psychological distress related to their illness and unconsciously manifest it as physical pain or fatigue (Lipowski, 1988). Within this pathway, entrapment functions as a critical missing link: personality disorganization fosters perceptions of helplessness and being trapped by the disease (O'Connor & Portzky, 2018), thereby intensifying the conversion of psychological suffering into physical symptoms. Consistent with prior research (Hosseini et al., 2023; Kang et al., 2023), these results underscore the necessity of transcending purely biological perspectives on cancer. Practically, therapeutic interventions should extend beyond physical symptom management to address personality structure reconstruction and reduction of entrapment feelings. Approaches such as Emotion-Focused Therapy or Cognitive-Behavioral Therapy may disrupt the vicious cycle of somatization by facilitating direct emotional expression and restoring perceived control (Çetin & Varma, 2021). Although limitations exist, including the cross-sectional design and uncontrolled clinical variables, this model provides a valuable framework for developing integrated psychosomatic care protocols tailored to the Iranian cultural context, where direct expression of psychological distress often encounters social barriers.

کلیدواژه‌ها [English]

• breast cancer
• entrapment
• personality organization
• somatization symptoms