Razi Journal of Medical Sciences

fa مدل ساختاری آسیب‌پذیری روان‌شناختی بر اساس تروما دوران کودکی و حرمت خود‌ناپایدار با توجه به نقش میانجی شرم درونی‌شده افراد متقاضی جراحی‌های زیبایی 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 روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: هدف اصلی و اساسی عمل جراحی زیبایی، بهبود ظاهر فیزیکی فردی است که دارای ظاهری نابهنجار است. هدف از پژوهش حاضر آزمون مدل ساختاری آسیبپذیری روانشناختی بر اساس تروما دوران کودکی و حرمت خودناپایدار با توجه به نقش میانجی شرم درونیشده افراد متقاضی جراحیهای زیبایی بود. روش کار: این پژوهش از لحاظ هدف بنیادین و کمی و از نوع توصیفی همبستگی و مدلیابی معادلات ساختاری بود. جامعه آماری پژوهش حاضر، شامل کلیه افراد متقاضی جراحی زیبایی ساکن شهر تهران و مراجعهکننده به کلینکهای زیبایی در سال 1403-1402 بود. از میان جامعه مذکور نمونهای برابر با 304 فرد به روش نمونه‌گیری خوشه‌ای تصادفی به پژوهش وارد شدند. از پرسشنامه آسیبپذیری روانشناختی دروگاتیس (2001)، تروما دوران کودکی برنشتاین (2003)، حرمت خودناپایدار چابرول (2006)،  شرم درونیشده کوک (1993) جهت جمعآوری اطلاعات استفاده شد. دادهها به روش ماتریس همبستگی و مدلیابی معادلات ساختاری مورد تحلیل قرار گرفتند. یافته ها: نتایج تحلیل دادهها نشان داد که شاخصهای مدل پیشنهادی از برازش قابل قبولی برخوردار هستند. مسیر حرمت خودناپایدار به آسیبپذیری روانشناختی (343/0 β =)، مسیر حرمت خود ناپایدار به شرم درونیشده (435/0 = β)، مسیر شرم درونیشده به آسیبپذیری روانشناختی (549/0 = β)، مسیر تروما دوران کودکی به آسیبپذیری روانشناختی (147/0 = β)، مسیر تروما دوران کودکی به شرم درونیشده (431/0 = β) گزارش میشود. همچنین نقش میانجی شرم درونیشده در سطح 95/0 اطمینان مورد تایید قرار گرفت.  نتیجه گیری: با توجه به نتایج به دست آمده در پژوهش حاضر، مدل آسیبپذیری روانشناختی بر اساس ترومای دوران کودکی و حرمت خودناپایدار با توجه به نقش میانجی شرم درونی‌شده در افراد متقاضی جراحی‌های زیبایی برازش مطلوب دارد.  </div> <div style="text-align: justify;">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.</div> آسیب‌پذیری روان‌شناختی, تروما دوران کودکی, حرمت خود ناپایدار, شرم درونی‌شده, جراحی زیبایی Psychological Vulnerability, Childhood Trauma, Unstable Self-Esteem, Internalized Shame, Cosmetic Surgery 1 12 http://rjms.iums.ac.ir/browse.php?a_code=A-10-8233-1&slc_lang=fa&sid=1 Ladan Nassiri لادن نصیری 3900319475328460090187 3900319475328460090187 No PhD Student, Department of Counseling, Science and Research Branch, Islamic Azad University, Tehran, Iran دانشجوی دکتری، گروه مشاوره، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران Maryam Ghahremani مریم قهرمانی maryam_ghahremani@yahoo.com 3900319475328460090188 3900319475328460090188 Yes Assistant Professor, Department of Psychology, Ashtian Branch, Islamic Azad University, Ashtian, Iran استادیار، گروه روانشناسی، واحد آشتیان، دانشگاه آزاد اسلامی، آشتیان، ایران Shahriar Dargahi شهریار درگاهی Shahriardargahi@cfu.ac.ir 3900319475328460090189 3900319475328460090189 No Professor, Department of Psychology and Counseling, Farhangian University, Tehran, Iran استاد، گروه آموزش روانشناسی و مشاوره، دانشگاه فرهنگیان، تهران، ایران