Razi Journal of Medical Sciences

fa رابطه‌ی ترس از تصویر بدن و مشکلات بین فردی با میانجیگری تنظیم شناختی هیجان در بیماران ویتیلیگو The Relationship between Fear of Body Image and Interpersonal Problems Mediated by Cognitive Emotion Regulation in Patients with Vitiligo روانشناسی بالینی Clinical Psychiatry پژوهشي Research زمینه و هدف: پوست با تبعات روانشناختی در روابط تاثیرگذار است. پژوهش حاضر با هدف بررسی نقش میانجیگرانه راهبردهای شناختی هیجان در رابطه ترس از تصویر بدن با مشکلات بین فردی در بیماران ویتیلیگو انجام شد. روش‌کار: طرح پژوهش حاضر، توصیفی از نوع همبستگی بود. آزمودنیها 281 نفر از مبتلایان به ویتیلیگو جزو اعضای گروه انجمن ویتیلیگو ایران در فروردین سال 1399 بودند که به‌صورت نمونهگیری هدفمند انتخاب و به پرسشنامههای مشکلات بین فردی، تنظیم شناختی هیجان و  نگرانی از تصویر بدنی داوطلبانه پاسخ دادند. دادهها از طریق همبستگی پیرسون، فن معادلات ساختاری نسخه 24 نرم افزار SPSS، AMOS و روش بوت استرپ در برنامه MACRO پریچر و هایز (2008) جهت آزمودن روابط میانجیگرانه استفاده شد. یافته‌ها: بین ترس از تصویر بدن با مشکلات بین فردی و راهبردهای سازشنایافته تنظیم هیجان، رابطه‌ مستقیم و معنیدار و بین ترس از تصویر بدن با راهبردهای شناختی سازشیافته تنظیم هیجان رابطه‌ معکوس و معنیدار مشاهده شد. تحلیل‌های میانجی نشان داد که راهبردهای سازش نایافته اثر ترس از تصویر بدن را بر مشکلات بین فردی شدت میبخشد (0007/0p=) و همچنین اثر غیرمستقیم ترس از تصویر بدن بر مشکلات بین فردی از طریق راهبردهای سازش یافته معنیدار بود (0315/0p=). نتیجه‌گیری: برای کاهش مشکلات بین فردی در بیماران ویتیلیگو میتوان از طریق کاستن از ترس از تصویر بدن و تصحیح راهبردهای سازشنایافته و تقویت راهبردهای سازشیافته اقدام کرد؛ ترس از تصویر بدن ممکن است از طریق راه اندازی سازوکارهای سازش نایافته به مشکلات بین فردی دامن بزند. <div> <table align="left" hspace="0" vspace="0"> <tbody> <tr> <td align="left" style="padding-top:0in; padding-right:12px; padding-bottom:0in; padding-left:12px" valign="top">Background & Aims: Vitiligo is one of the most common skin pigmentation disorders which afflicting 0.5-2% of the world population. Its main clinical symptoms include the emergence and expansion of melanocytes (3). Its onset is usually before the age of 30, and its prevalence is almost the same for the two sexes (5). Vitiligo can have destructive psychosocial effects on patients because there is a relationship between the body and the mind (6). Although vitiligo is not physically debilitating, due to the outward changes associated with it, most patients have a negative body image and may feel shame, which eventually disrupts their social life, marriage, sexual relations, psychological well-being, and emotion regulation (10). Sensitivity to vitiligo is exacerbated through defective emotion regulation or a reduced ability to cope with stress (10). Cognitive strategies for emotion regulation deal with people’s way of thinking after a negative experience or damaging event. Therefore, these strategies can play an effective role in determining mental health and successful social interactions (12). Thus, the treatment of patients with vitiligo seems to require psychosocial support (13). The present study examined the mediating role of cognitive emotion regulation strategies in the relationship between fear of body image and interpersonal problems in patients with Vitiligo. Methods: The statistical population comprised all the patients with vitiligo who had been registered at the Vitiligo Association of Iran and had joined the associations’ group, channel, and page on social media in March-April 2020. The participants were selected using purposive sampling, following which 390 people initially took part, but 281 remained in the study based on the inclusion and exclusion criteria. The inclusion criteria were: age range of 20-40 years (Several studies have mentioned marriage and sexual relations among the problems faced by these patients, and this motivated the selection of this age range), having basic literacy skills to answer the questionnaires, having at least one form of email or ID on the cyberspace, having vitiligo on visible body parts such as hands, legs, head, neck, and face, and providing informed consent for participation. The exclusion criteria were: failing to complete one of the questionnaires, and withdrawal from the study. The data were collected via an online demographic questionnaire, the Inventory of Interpersonal Problems (IIP-32), the Body Image Concern Inventory (BICI), and the Cognitive Emotion Regulation Questionnaire (CERQ-P). The links to these questionnaires were shared on the Telegram channel and Instagram page of the Vitiligo Association of Iran. The data were analyzed via Pearson’s correlation and structural equations modeling in SPPS, AMOS-24, and by Preacher and Hayes (2008) bootstrap approach in MACRO to test the mediating relations. Results: The results of the online survey showed that, from among 281 participants, 177 had had vitiligo for >10 years; the severity of vitiligo was >5% in 128 participants; and 149 participants had >1% vitiligo on visible body parts. A significant positive relationship was found between fear of body image and interpersonal problems (p = 0.0001) and maladaptive emotion regulation strategies (p = 0.002), and a significant negative relationship was observed between fear of body image and adaptive strategies (p = 0.0001). The mediation analyses revealed that maladaptive strategies exacerbate the effect of body image on interpersonal problems (p = 0.0007). Also, the indirect effect of fear of body image on interpersonal problems through adaptive strategies was significant (p = 0.0315). However, no significant relationship was found between adaptive emotion regulation strategies and interpersonal problems in these patients (p = 0.092). These results indicate that, to mitigate the interpersonal problems of patients with vitiligo, interventions can focus on reducing fear of body image, correcting maladaptive strategies, and strengthening adaptive strategies. Moreover, based on the findings, fear of body image may lead to interpersonal problems by triggering maladaptive mechanisms. Conclusion: In line with previous studies (31), a damage to the behavioral component of body image in vitiligo may disrupt interpersonal relations. A defect in one's appearance reduces self-esteem and leads to stress, anxiety, and fear of being judged by others. Therefore, vitiligo has a destructive effect on patients’ daily life and mental health. Patients with vitiligo catastrophize this disease due to their negative mental image resulting from excessive rumination and continuous mental obsession with this disease and its effects on their lives. They first blame themselves and then others, and thus form a negative self-evaluation. Previous studies have shown that vitiligo has an obvious potential for causing mental pressure; however, this relationship is not unilateral, and stress can cause or exacerbate vitiligo as well (28). There is no effective treatment for vitiligo, and there are many psychological disorders associated with it. It has recently been reported that to improve the quality of life of these patients, several psychological interventions can be included in the treatment program of different skin diseases (29). Therefore, to help these patients, it is important to examine the related psychological factors and determine the mediators.  Based on the results of the present study, the presence of maladaptive strategies is more destructive and damaging than the absence of adaptive strategies. Furthermore, the absence of adaptive strategies can negatively impact psychological well-being. Thus, if we can mitigate fear of body image in these patients, their interpersonal problems can be minimized. The results of this study demonstrated that from among the two mediating variables, the promotion of adaptive emotion regulation strategies has little effect on reducing interpersonal problems. On the other hand, psychological interventions to identify and reduce maladaptive emotion regulation strategies significantly decrease interpersonal problems. Because vitiligo requires a multifaceted team treatment, it is suggested that dermatologists pay special attention to the psychological aspect of this disease in addition to offering different treatments, and seek the help of mental health specialists and health psychologists for offering individually or group psychological interventions to improve emotion regulation skills. </td> </tr> </tbody> </table> </div> نارضایتی از تصویر بدن, تنظیم هیجان, بین فردی, ویتیلیگو Body Image Dissatisfaction, Emotion Regulation, Interpersonal, Vitiligo 138 152 http://rjms.iums.ac.ir/browse.php?a_code=A-10-5358-1&slc_lang=fa&sid=1 Neda Seyfi Pur ندا سیفی پور m.nedaseyfi@gmail.com 3900319475328460083646 3900319475328460083646 No MA in General Psychology, Department of Psychology, Faculty of Literature and Humanities, University of Guilan, Rasht, Iran کارشناس ارشد روانشناسی عمومی، گروه روان‌شناسی، دانشکده ادبیات و علوم انسانی، دانشگاه گیلان، رشت، ایران Azra Zebardast عذرا زبردست zebardast@guilan.ac.ir 3900319475328460083647 3900319475328460083647 Yes Assistant Professor, Department of Psychology, Faculty of Literature and Humanities, University of Guilan, Rasht, Iran استادیار روانشناسی سلامت، گروه روان‌شناسی، دانشکده ادبیات و علوم انسانی، دانشگاه گیلان، رشت، ایران Sajjad Rezaei سجاد رضائی rezaei_psy@hotmail.com 3900319475328460083648 3900319475328460083648 No Assistant Professor, Department of Psychology, Faculty of Literature and Humanities, University of Guilan, Rasht, Iran استادیار روانشناسی عمومی، گروه روانشناسی، دانشکده ادبیات و علوم انسانی، دانشگاه گیلان، رشت، ایران