Volume 31, Issue 1 (3-2024)
RJMS 2024, 31(1): 1-12 |
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Ethics code: IR.IAU.SRB.REC.1403.070
Clinical trials code: 0
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Nassiri L, Ghahremani M, Dargahi S. The Structural Model of Psychological Vulnerability Based on Childhood Trauma and Unstable Self-Esteem with Regard to the Mediating Role of Internalized Shame in People Applying for Cosmetic Surgery. RJMS 2024; 31 (1) :1-12
URL: http://rjms.iums.ac.ir/article-1-8737-en.html
URL: http://rjms.iums.ac.ir/article-1-8737-en.html
Assistant Professor, Department of Psychology, Ashtian Branch, Islamic Azad University, Ashtian, Iran , maryam_ghahremani@yahoo.com
Abstract: (413 Views)
Background & Aims: Today, cosmetic surgery is considered one of the most common forms of surgery in the world, and its usage has become widespread. The main and fundamental goal of cosmetic surgery is to improve the physical appearance of a person who has an abnormal appearance. When people realize that their appearance is not by the standards and norms of society, they may suffer and consider surgery the final solution. Studies that have used psychological scales to evaluate psychopathology have mentioned significant psychopathology in patients applying for cosmetic surgery. The results of a study in this field indicate that more than 70% of cosmetic surgery applicants have been diagnosed with a psychiatric disorder, the most common of which include depression, anxiety, neuroticism, and passive-aggressive personality disorder. The results of the conducted research indicate that people who were interested in cosmetic surgery had more psychological vulnerability than those who were not interested in cosmetic surgery. One of the major problems of cosmetic surgery applicants is high psychological vulnerability, including symptoms of anxiety, depression, and depression. Psychological vulnerability can be defined as sensitivity to the creation of a disorder, uncertainty, feeling of danger in facing certain conditions, and being exposed to the risk of psychological problems. Psychological vulnerability is effective in all cognitive and behavioral dimensions of people. Psychological vulnerability is presented as a pattern of psychological symptoms or behavior that occurs in a person, and this pattern or symptoms reflects an underlying psychological dysfunction and its consequences include disability or clinically significant distress. These symptoms are a predictable response to a general stressor or the lack of a culturally approved response to a specific event, and they can be caused by a neurological role. The purpose of the research was to test the structural model of psychological vulnerability based on childhood trauma and unstable self-esteem, considering the mediating role of internalized shame in people applying for cosmetic surgeries.
Methods: This research was fundamental and quantitative in terms of objective and semi-quasi correlation and structural equation modeling. The statistical population of the present study included all people applying for cosmetic surgery living in Tehran and referring to cosmetic clinics in 2022-2023. A sample of 304 people, who volunteered to cooperate, were included in the research from among the aforementioned population. Drugatis Psychological Vulnerability Questionnaire (2001), Bernstein's Childhood Trauma (2003), Chabrol, Rocio and Callahan's Unstable Self Esteem (2006), and Cook's Internalized Shame (1993) were used to collect information. Data were analyzed by correlation matrix method and structural equation modeling.
Results: The results of data analysis showed that the indicators of the proposed model have an acceptable fit. The path of unstable self-esteem to psychological vulnerability (β = 0.343, P = 0.000), the path of unstable self-esteem to internalized shame (β = 0.435, P = 0.000), the path of internalized shame to psychological vulnerability (β = 0.549, P = 0.000), the path of childhood trauma to psychological vulnerability (β = 0.147, P = 0.000), the path of childhood trauma to internalized shame (P = 0.000, 431/ β = 0) is reported. Also, the mediating role of internalized shame was confirmed at the confidence level of 0.95.
Conclusion: Self-report questionnaires were used to collect data. Therefore, the results of the present study, due to the use of questionnaires and self-report scales, may have encouraged the subjects to use methods based on obtaining social approval and avoiding stigma related to individual inadequacy instead of actual behavior. As a result, caution should be observed in the interpretation of the obtained findings. The high volume of questions in the research questionnaires, which could include the possibility of fatigue of the subjects, was one of the other limitations of this research. Also, the results of other people or cultures should be done with caution. Considering the ethnic and cultural diversity in Iran, the model of the present study as well as other psychological elements should be investigated in volunteers and non-volunteers of cosmetic surgery in other ethnic groups. It is suggested to use a large community of women and men in future studies to increase the generalizability of the research results. It is also suggested to investigate and compare the two genders in future studies. It is recommended to pay attention to the important role of psychological factors affecting mental vulnerability and in the tendency to this type of surgery before undergoing cosmetic surgery, and since psychologists have expertise in the diagnosis and treatment of psychological and personality issues, this should be considered. Specialized psychological counseling should be done by them before cosmetic surgery. The present study was conducted with the aim of testing the nose model of the psychological vulnerability of people applying for cosmetic surgeries based on childhood trauma and unstable self-respect, considering the mediator role of internalized shame in Tehran. According to the results obtained in the present study, the main hypothesis was confirmed. This result generally indicates that the model of psychological vulnerability based on childhood trauma and unstable self-esteem has a good fit with regard to the mediating role of internalized shame in people applying for cosmetic surgeries. Therefore, it is recommended that the contribution of the above variables in the assessment, diagnosis and treatment is considered important and related organizations should consider possible preventive programs.
Methods: This research was fundamental and quantitative in terms of objective and semi-quasi correlation and structural equation modeling. The statistical population of the present study included all people applying for cosmetic surgery living in Tehran and referring to cosmetic clinics in 2022-2023. A sample of 304 people, who volunteered to cooperate, were included in the research from among the aforementioned population. Drugatis Psychological Vulnerability Questionnaire (2001), Bernstein's Childhood Trauma (2003), Chabrol, Rocio and Callahan's Unstable Self Esteem (2006), and Cook's Internalized Shame (1993) were used to collect information. Data were analyzed by correlation matrix method and structural equation modeling.
Results: The results of data analysis showed that the indicators of the proposed model have an acceptable fit. The path of unstable self-esteem to psychological vulnerability (β = 0.343, P = 0.000), the path of unstable self-esteem to internalized shame (β = 0.435, P = 0.000), the path of internalized shame to psychological vulnerability (β = 0.549, P = 0.000), the path of childhood trauma to psychological vulnerability (β = 0.147, P = 0.000), the path of childhood trauma to internalized shame (P = 0.000, 431/ β = 0) is reported. Also, the mediating role of internalized shame was confirmed at the confidence level of 0.95.
Conclusion: Self-report questionnaires were used to collect data. Therefore, the results of the present study, due to the use of questionnaires and self-report scales, may have encouraged the subjects to use methods based on obtaining social approval and avoiding stigma related to individual inadequacy instead of actual behavior. As a result, caution should be observed in the interpretation of the obtained findings. The high volume of questions in the research questionnaires, which could include the possibility of fatigue of the subjects, was one of the other limitations of this research. Also, the results of other people or cultures should be done with caution. Considering the ethnic and cultural diversity in Iran, the model of the present study as well as other psychological elements should be investigated in volunteers and non-volunteers of cosmetic surgery in other ethnic groups. It is suggested to use a large community of women and men in future studies to increase the generalizability of the research results. It is also suggested to investigate and compare the two genders in future studies. It is recommended to pay attention to the important role of psychological factors affecting mental vulnerability and in the tendency to this type of surgery before undergoing cosmetic surgery, and since psychologists have expertise in the diagnosis and treatment of psychological and personality issues, this should be considered. Specialized psychological counseling should be done by them before cosmetic surgery. The present study was conducted with the aim of testing the nose model of the psychological vulnerability of people applying for cosmetic surgeries based on childhood trauma and unstable self-respect, considering the mediator role of internalized shame in Tehran. According to the results obtained in the present study, the main hypothesis was confirmed. This result generally indicates that the model of psychological vulnerability based on childhood trauma and unstable self-esteem has a good fit with regard to the mediating role of internalized shame in people applying for cosmetic surgeries. Therefore, it is recommended that the contribution of the above variables in the assessment, diagnosis and treatment is considered important and related organizations should consider possible preventive programs.
Keywords: Psychological Vulnerability, Childhood Trauma, Unstable Self-Esteem, Internalized Shame, Cosmetic Surgery
Type of Study: Research |
Subject:
Clinical Psychiatry
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