Razi Journal of Medical Sciences

fa بررسی رابطه شرم از بدن و رفتارهای خود آزاری در نوجوانان با میانجی‌گری تعاملات والد-فرزند Investigating the Relationship between Body Shame and Self-Harming Behaviors in Adolescents with the Mediating Role of Parent-Child Interactions روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;"><a name="_Hlk184301929">زمینه و هدف:</a> رفتارهای خودآزاری در نوجوانان به‌عنوان یک چالش مهم در سلامت روان شناخته می‌شود. شرم از بدن، به‌ویژه در دختران نوجوان، یکی از عوامل مؤثر در شکل‌گیری این رفتارهاست. با این حال، نقش تعاملات والد-فرزند در تبیین این رابطه کمتر بررسی شده است. هدف پژوهش حاضر بررسی نقش میانجی تعاملات والد-فرزند در رابطه بین شرم از بدن و رفتارهای خودآزاری است. روش کار: این پژوهش با رویکرد میدانی، طرح توصیفی-همبستگی و مدل‌یابی معادلات ساختاری انجام شد. جامعه آماری دانش‌آموزان دختر مقطع متوسطه دوم نظری و دولتی در منطقه 5 تهران بود. نمونه‌گیری هدفمند انجام شد و داده‌های 365 نفر تحلیل شد. ابزارهای استفاده شده شامل پرسش نامه‌های شرم از بدن، آسیب به خود، و ارزیابی رابطه والد-فرزند بود. داده‌ها با استفاده از تحلیل مسیر و نرم‌افزارهای SPSS و LISREL تجزیه و تحلیل شدند. یافته‌ها: نتایج نشان داد که شرم بیرونی و درونی تأثیر مستقیم و غیرمستقیم بر رفتارهای خودآزاری دارند. همچنین، تعاملات والد-فرزند نقش میانجی معناداری در این رابطه ایفا می‌کند. شرم درونی با اثر کل 49/0 بیشترین تأثیر را بر رفتارهای خودآزاری داشت. نتیجه‌گیری: یافته‌های پژوهش نشان داد که شرم بدنی، به‌ویژه در شکل درونی‌شده آن، نقش پیش‌بینی‌کننده‌ای قوی در بروز رفتارهای خودآزارگرانه در نوجوانان دارد. با این حال، تعاملات والد-فرزند به‌عنوان یک عامل میانجی مؤثر، می‌تواند شدت این اثرات منفی را کاهش داده و نقش محافظتی ایفا کند. این نتایج بر اهمیت کیفیت روابط خانوادگی در پیشگیری از آسیب‌های روانی-رفتاری نوجوانان تأکید دارند. </div> <div style="text-align: justify;">Background & Aim: Adolescence represents a critical developmental stage during which body image concerns and identity formation become particularly salient. Among the most detrimental experiences in this period is body shame, a complex emotional response resulting from internalized self-criticism and perceived external judgment related to physical appearance. Numerous studies have identified body shame as a significant predictor of maladaptive outcomes such as anxiety, depression, eating disorders, and more notably, self-harming behaviors. Despite the growing body of evidence supporting this association, the underlying mechanisms that modulate this relationship—particularly familial dynamics—remain underexplored. Parent-child interactions, characterized by emotional warmth, communication, and role modeling, play a pivotal role in adolescents’ psychosocial development. Dysfunctional parent-child interactions may intensify the emotional consequences of body shame, whereas supportive interactions might serve a buffering function. Therefore, this study aims to investigate the relationship between body shame and self-harming behaviors in adolescent girls, with a specific emphasis on the mediating role of parent-child interactions. Methods: This descriptive-correlational research was conducted using a path analysis framework. The study population included adolescent girls aged 15 to 18 years who were enrolled in public and theoretical high schools in Tehran during the 2023–2024 academic year. A purposive sampling method was employed to select 330 participants who met inclusion criteria such as willingness to participate, absence of diagnosed psychiatric disorders, and informed consent from guardians. Data were collected using four standardized instruments: a demographic questionnaire, the Body Image Shame Scale (BISS), the Self-Harm Inventory (SHI), and the Parent-Child Relationship Scale (PCRS-24). All instruments demonstrated acceptable levels of reliability and validity in previous research. The data were analyzed using SPSS version 26 and LISREL 8.8 software to perform structural equation modeling. Normality, multicollinearity, and fit indices were evaluated to ensure model adequacy. Results: Descriptive analysis indicated that all participants were female, predominantly tenth graders, with an average age of 16.7 years. Socioeconomic status was mostly reported as "good" or "moderate." Both internal and external body shame showed significant correlations with self-harming behaviors. Structural path analysis revealed that internal body shame had the strongest direct effect on self-harming behaviors (β = 0.36, p < 0.01), while external shame also had a significant direct effect (β = 0.28, p < 0.01). Indirect effects via parent-child interactions were significant for both internal (β = 0.13) and external shame (β = 0.17), indicating partial mediation. Furthermore, internal shame negatively influenced positive affect and increased role confusion. The model demonstrated good fit indices (RMSEA = 0.042, CFI = 0.94, SRMR = 0.041), confirming its robustness. These findings emphasize the role of emotional and relational variables in the etiology of self-harming behaviors among adolescent girls. Conclusion: This study provides empirical support for the hypothesis that body shame—both internal and external—significantly predicts self-harming behaviors in adolescent girls, and that this relationship is partially mediated by the quality of parent-child interactions. The results highlight the necessity of family-based preventive and therapeutic interventions. Poor communication, emotional neglect, and inconsistent parenting may exacerbate feelings of inadequacy and shame, increasing the likelihood of self-injury. Conversely, emotionally supportive and communicative parent-child relationships can mitigate these risks. These findings align with previous research by Ren et al. and others that demonstrate the direct impact of body shame on adolescents’ maladaptive behaviors. From a theoretical standpoint, the study supports frameworks of affect regulation and socialization, indicating that shame management is a relationally mediated process. Given the strong link between family dynamics and adolescent mental health, practitioners are advised to incorporate parent-training modules in intervention programs targeting self-harming behaviors. School psychologists and counselors should also be trained to identify signs of body shame and poor family communication early. Future research should consider longitudinal designs and include adolescent boys and other sociocultural groups for broader generalizability. Moreover, integrating qualitative approaches could enrich the understanding of adolescents’ lived experiences of shame and familial interaction. The study is limited by its cross-sectional design, which precludes causal inference. Additionally, the reliance on self-report measures may introduce social desirability bias. Cultural and gender-specific factors were not fully addressed, limiting the generalizability of the findings.</div> شرم از بدن, رفتارهای خودآزاری,‌ تعامل والد-فرزند, نوجوان Body Shame, Self-Harming Behaviors, Parent-Child Interaction, Adolescent, Mediation Model, Path Analysis 1 20 http://rjms.iums.ac.ir/browse.php?a_code=A-10-8314-1&slc_lang=fa&sid=1 Maryam Heidari مریم حیدری maryamheidari532@gmail.com 3900319475328460088081 0009-0007-3079-5229 Yes Master's Student in Clinical Psychology, Faculty of Medical Sciences and Technologies, Islamic Azad University, Science and Research Branch, Tehran, Iran دانشجوی کارشناسی ارشد روانشناسی بالینی، دانشکده علوم و فناوری‌های پزشکی، دانشگاه آزاد اسلامی واحد علوم و تحقیقات تهران، ایران Seyyedeh Atefeh Mahdavi سیده عاطفه مهدوی 3900319475328460088082 3900319475328460088082 No Assistant Professor of Psychology, Faculty of Medical Sciences and Technologies, Islamic Azad University, Science and Research Branch, Tehran, Iran استادیار روانشناسی،‌ دانشکده علوم و فناوری‌های پزشکی، دانشگاه آزاد اسلامی واحد علوم و تحقیقات تهران، ایران