نقش تشخیصی ترس از ارزیابی مثبت و منفی، کمال گرایی و توجه معطوف به خود در افراد مبتلا به اضطراب اجتماعی، پرخوری عصبی و افراد بهنجار

نوع مقاله: مقاله پژوهشی

نویسندگان

1 کارشناسی رشد روانشناسی بالینی دانشگاه خوارزمی،تهران، ایران

2 دانشیار، گروه روانشناسی بالینی دانشگاه خوارزمی، تهران، ایران

چکیده

مقدمه: مطالعات انجام شده بر روی افراد مبتلا به اضطراب اجتماعی و پرخوری عصبی طیف وسیعی از متغیرها را که در این دو اختلال نقش دارند، شناسایی کرده­اند. پژوهش حاضر با هدف بررسی نقش تشخیصی مؤلفه­های ترس از ارزیابی مثبت و منفی، کمال­گرایی مثبت و منفی و توجه معطوف به خود میان افراد با اختلال بولیمیا، دچار اضطراب اجتماعی و عادی انجام شد.
روش: در قالب یک طرح علّی­مقایسه­ای90 نفر(30 نفر مبتلا به پرخوری عصبی، 30 نفر مبتلا به اضطراب اجتماعی، 30 نفر بهنجار) در دامنه سنی 40-20 به شیوه­ی نمونه­گیری در دسترس انتخاب و پرسشنامه­های هراس اجتماعی، نگرش خوردن، ترس از ارزیابی مثبت و منفی، کمال­گرایی مثبت و منفی و توجه معطوف به خود را تکمیل کردند. داده­ها با روش تحلیل تشخیص مورد تجزیه و تحلیل قرار گرفت.
یافته­ ها: نتایج نشان داد میانگین نمرات گروه بهنجار و پرخوری عصبی در مؤلفه­ی کمال­گرایی مثبت بالاتر از گروه اضطراب اجتماعی است و میانگین نمرات گروه اضطراب اجتماعی غیر از کمال­گرایی مثبت در بقیه­ی مؤلفه­ها از گروه بهنجار و پرخوری عصبی بالاتر است. همچنین نتایج تحلیل تشخیص نشان داد این تفاوت در ترکیبی از متغیرهای پژوهش برحسب اهمیت­شان به­ترتیب ترس از ارزیابی منفی، کمال­گرایی منفی، توجه درونی، ترس از ارزیابی مثبت و توجه بیرونی، سه­گروه را از هم متمایز می­کند.
نتیجه­ گیری: با توجه به نتایج پژوهش می­توان گفت مؤلفه­های ترس از ارزیابی منفی، کمال­گرایی منفی، توجه معطوف به خود و ترس از ارزیابی مثبت می­تواند وقوع یا عدم وقوع اضطراب اجتماعی و پرخوری عصبی را متمایز ­کند؛ از این رو مداخلات درمانی باید به این عوامل بپردازند.

کلیدواژه‌ها


عنوان مقاله [English]

Discriminative Role of the Fear of Positive and Negative Evaluation, Perfectionism and Self-focused Attention in Social Anxiety Disorder, Bulimia Nervosa Disorder and Normal Individuals

نویسندگان [English]

  • S Ghadampour, 1
  • Sh Mohammadkhani, 2
  • j. Hasani, 2
چکیده [English]

Introduction: Research examining social anxiety and bulimia nervosa disorder has shown the role of various variables about them. The goal of current study was to assess the discriminative role of the fear of positive and negative evaluation, positive and negative perfectionism and self-focused attention between bulimia nervosa disorder, social anxiety disorder and normal individuals.
Method: Using an expose-facto design, 90 subjects (30 bulimia nervosa, 30 social anxiety and 30 normal individuals) were selected by available sampling method and completed the Social Phobia Inventory (SPIN),  Eating Attitude Test (EAT-26), Fear of Positive  Evaluation Scale (FPES), Fear of Negative Evaluation   Scales(FNES-B), Positive and Negative Perfectionism(PNP) and Self-focused Attention Questionnaire(FAQ). Data were analyzed using a Diagnostic Analysis.
Results:  The results showed higher mean scores of the positive perfectionism in normal group and bulimia nervosa compared with the mean scores in social anxiety group. The mean scores in the Social Anxiety group in all of the variables except Positive Perfectionism was higher than the normal group and bulimia nervosa as well. Results of the diagnostic analysis showed a compound of significant variables respectively for fear of negative evaluation, negative perfectionism, internal attention, fear of positive evaluation and external attention which make a discrimination among three groups.
Conclusion:  It could be concluded that the fear of negative evaluation, negative perfectionism, self-focused attention and fear of positive evaluation could distinct occurrence of social anxiety and bulimia nervosa disorders; thus the ttreatment interventions should address these factors.

کلیدواژه‌ها [English]

  • Social Anxiety
  • Bulimia Nervosa
  • Evaluation
  • Perfectionism
  • Self-Focused Attention

1- Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub. 2013.

2- Kring AM, Johnson SL, Davison GC, Neale JM. Abnormal psychology: John Wiley & Sons. 2012.

3- Egan SJ, Wade TD, Shafran R. Perfectionism as a transdiagnostic process: A clinical review. Clinical psychology review. 2011; 31(2): 203-12.

4- Weeks JW, Rodebaugh TL, Heimberg RG, Norton PJ, Jakatdar TA. “To avoid evaluation, withdraw”: Fears of evaluation and depressive cognitions lead to social anxiety and submissive withdrawal. Cognitive Therapy and Research. 2009; 33(4): 375-89.

5- Weeks JW, Heimberg RG, Rodebaugh TL, Norton PJ. Exploring the relationship between fear of positive evaluation and social anxiety. Journal of Anxiety Disorders. 2008; 22(3): 386-400.

6- Leary MR. A brief version of the Fear of Negative Evaluation Scale. Personality and Social Psychology Bulletin. 1983; 9(3): 371-5.

7- Gilbert N, Meyer C. Social anxiety and social comparison: Differential links with restrictive and bulimic attitudes among nonclinical women. Eating Behaviors. 2003; 4(3): 257-64.

8- Gilbert N, Meyer C. Fear of negative evaluation and the development of eating psychopathology: A longitudinal study among nonclinical women. International Journal of Eating Disorders. 2005; 37(4): 307-12.

9- Vander Wal JS, Gibbons JL, del Pilar Grazioso M. The sociocultural model of eating disorder

 

development: Application to a Guatemalan sample. Eating Behaviors. 2008; 9(3): 277-84.

10- Lundgren JD, Anderson DA, Thompson JK. Fear of negative appearance evaluation: Development and evaluation of a new construct for risk factor work in the field of eating disorders. Eating behaviors. 2004; 5(1): 75-84.

11- Adams CE, Myers VH, Barbera BL, Brantley PJ. The role of fear of negative evaluation in predicting depression and quality of life four years after Bariatric surgery in women. Psychology. 2011; 2(03): 150.

12- Weeks JW, Heimberg RG, Rodebaugh TL. The Fear of Positive Evaluation Scale: Assessing a proposed cognitive component of social anxiety. Journal of anxiety disorders. 2008; 22(1): 44-55.

13- Levinson CA, Rodebaugh TL. Social anxiety and eating disorder comorbidity: The role of negative social evaluation fears. Eating behaviors. 2012; 13(1): 27-35.

14- Khani S, Abdi H, Norhbezare D. A comparison of adaptive and maladaptive perfectionists and non-perfectionists. European Journal of Experimental Biology. 2013; 3(2): 608-12.

15- Egan S, Wade T, Shafran R. The transdiagnostic process of perfectionism. Revista de Psicopatología y Psicología Clínica. 2012; 17(3): 279-94.

16- Silgado J, Timpano KR, Buckner JD, Schmidt NB. Social anxiety and bulimic behaviors: The moderating role of perfectionism. Cognitive Therapy and Research. 2010; 34(5): 487-92.

17- Levinson CA, Rodebaugh TL, White EK, Menatti AR, Weeks JW, Iacovino JM, et al. Social appearance anxiety, perfectionism, and fear of negative evaluation. Distinct or shared risk factors for social anxiety and eating disorders? Appetite. 2013; 67: 125-33.

18- Vassilopoulos SP. Social anxiety and ruminative self-focus. Journal of Anxiety Disorders. 2008; 22(5): 860-7.

19- Zou JB, Hudson JL, Rapee RM. The effect of attentional focus on social anxiety. Behaviour Research and Therapy. 2007; 45(10): 2326-33.

20- Vassilopoulos SP, Watkins ER. Adaptive and maladaptive self-focus: a pilot extension study with individuals high and low in fear of negative evaluation. Behavior therapy. 2009; 40(2): 181-9.

21- McManus F, Sacadura C, Clark DM. Why social anxiety persists: An experimental investigation of the role of safety behaviours as a maintaining factor. Journal of behavior therapy and experimental psychiatry. 2008; 39(2): 147-61.

22- Mor N, Winquist J. Self-focused attention and negative affect: a meta-analysis. American Psychological Association. 2002.

23- Grabhorn R, Stenner H, Stangier U, Kaufhold J. Social anxiety in anorexia and bulimia nervosa: The mediating role of shame. Clinical Psychology & Psychotherapy. 2006; 13(1): 12-9.

24- Egan SJ, Watson HJ, Kane RT, McEvoy P, Fursland A, Nathan PR. Anxiety as a mediator between perfectionism and eating disorders. Cognitive Therapy and Research. 2013; 37(5): 905-13.

25- Sharifi V, Asadi S, Mohammadi M, AMINI H, Kaviani H, Semnani Y, et al. Reliability and feasibility of the Persian version of the structured diagnostic interview for DSM-IV (SCID). 2004.

26- Connor KM, Davidson JR, Churchill LE, Sherwood A, Weisler RH, FOA E. Psychometric properties of the social phobia inventory (SPIN). The British Journal of Psychiatry. 2000; 176(4): 379-86.

27- Zanjani Z, Goudarzi MA, Taghavi MR, Molazade J. Comparing the body sensation and social skills of shyness, social phobia and normal individuals. 2009.

28- Shokri O, Geravand F, Naghsh Z, Ali Tarkhan R, Paeezi M. The psychometric properties of the brief fear of negative evaluation scale. Iranian Journal of Psychiatry and Clinical Psychology. 2008; 14(3): 316-25.

29- Nobakht M, Dezhkam M. An epidemiological study of eating disorders in Iran. International Journal of Eating Disorders. 2000; 28(3): 265-71.

30- nikooi f. perfectionism and Fear of evaluation in social anxiety. Educ Psycol Stud. 2010; 7(12): 93-112.

31- Rezaei Dogaheh E, Mohammadkhani P, Dolatshahi B. The Comparison of Group Versus Individual Format of Cognitive-Behavior Therapy on Fear of Positive Evaluation. Journal of Rehabilitation. 2012; 13(1): 58-65.

32- Hasel KM, Besharat MA, Abdolhoseini A, Nasab SA, Niknam S. Relationships of personality factors to perceived stress, depression, and oral lichen planus severity. International journal of behavioral medicine. 2013; 20(2): 286-92.

33- Sheykhan R, Mohamadkhani S, Hasanabadi H. Self-Focused Attention in Treatment of Social Anxiety: A Controlled Clinical Trial. Journal of Mazandaran University of Medical Sciences. 2013; 23(106): 120-8.

34- DeBoer LB, Medina JL, Davis ML, Presnell KE, Powers MB, Smits JA. Associations between fear of negative evaluation and eating pathology during intervention and 12-month follow-up. Cognitive therapy and research. 2013; 37(5): 941-52.

35- Jain M, Sudhir PM. Dimensions of perfectionism and perfectionistic self-presentation in social phobia. Asian Journal of Psychiatry. 2010; 3(4): 216-21.

36- Haikal M, Hong RY. The effects of social evaluation and looming threat on self-attentional biases and social anxiety. Journal of anxiety disorders. 2010; 24(3): 345-52.

37- Utschig AC, Presnell K, Madeley MC, Smits JA. An investigation of the relationship between fear of negative evaluation and bulimic psychopathology. Eating behaviors. 2010; 11(4): 231-8.

38- Franco‐Paredes K, Mancilla‐Díaz JM, Vázquez‐Arévalo R, López‐Aguilar X, Álvarez‐Rayón G. Perfectionism and eating disorders: A review of the literature. European eating disorders review. 2005; 13(1): 61-70.

39- Walter RC. Self-focus, Perfectionism, and Memory for Emotion in Social Anxiety: ProQuest; 2006.

40- Mackinnon SP, Battista SR, Sherry SB, Stewart SH. Perfectionistic self-presentation predicts social anxiety using daily diary methods. Personality and Individual Differences. 2014; 56: 143-8.

41- Marsero S, Ruggiero G, Scarone S, Bertelli S, Sassaroli S. The relationship between alexithymia and maladaptive perfectionism in eating disorders: a mediation moderation analysis methodology. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity. 2011; 16(3): e182-e7.

42- Stice E. Risk and maintenance factors for eating pathology: a meta-analytic review. Psychological bulletin. 2002; 128(5): 825.

43- Mohammadzadeh A, Najafi M, Rezaei A. Comparing the Explanatory Role of Perfectionism in Obsessive Compulsive Features and Pathological Eating Attitudes. journal of clinical psycology. 2013; 5(1): 69-79.

44- Ram A. The relationship of positive and negative perfectionism to academic achievement, achievement motivation, and well-being in tertiary students. 2005.

45- Spurr JM, Stopa L. Self-focused attention in social phobia and social anxiety. Clinical psychology review. 2002; 22(7): 947-75.

46- Sawaoka T, Barnes RD, Blomquist KK, Masheb RM, Grilo CM. Social anxiety and self-consciousness in binge eating disorder: associations with eating disorder psychopathology. Comprehensive psychiatry. 2012; 53(6): 740-5.

47- Hashemi-Nosratabad T, Mahmoud-Alilou M , Gholizadeh A.The Effectiveness of Cognitive Behavioral Therapy based on Hofmann’s Model on Fear of Negative Evaluation and Self- Focused Attention in Social Anxiety Disorder. journal of clinical psycology. 2017; 9(1): 101-10.

48- Weeks JW, Howell AN. The bivalent fear of evaluation model of social anxiety: further integrating findings on fears of positive and negative evaluation. Cognitive Behaviour Therapy. 2012; 41(2): 83-95.

49- Lipton MF, Augenstein TM, Weeks JW, De Los Reyes A. A multi-informant approach to assessing fear of positive evaluation in socially anxious adolescents. Journal of Child and Family Studies. 2014; 23(7): 1247-57.

50- Davoudi I, Salahian A, Veisy F. Fear of Positive Evaluation and Social Anxiety. Journal of Mazandaran University of Medical Sciences. 2013; 22(96): 79-87.