Cognitive Avoidance and Self-differentiation: Predicting Body Deformity Symptoms in Women Visiting Beauty Clinics

Document Type : Original Article

Authors

1 M.Sc., Training and Counseling Department, Central Tehran Branch, Islamic Azad University, Tehran, Iran

2 Assistant Professor, Training and Counseling Department, Central Tehran Branch, Islamic Azad University, Tehran, Iran

3 Assistant Professor, Psychological Department, Central Tehran Branch, Islamic Azad University, Tehran, Iran

Abstract

Background: Body dysmorphic disorder is a psychological condition in which an individual is convinced that there is an imperfection in their physical appearance, causing them significant distress and prompting repetitive actions.
 
Objectives: The current study aimed to predict body deformity symptoms in women visiting beauty clinics by analyzing cognitive avoidance and self-differentiation. 
 
Methods: The study was conducted based on a correlational descriptive approach. The statistical population included females who attended beauty clinics in District 3 of Tehran in 2023. Convenient sampling was utilized as the sampling method. The required data were gathered using the Differentiation of Self Inventory-Short Form and Revised Yale-Brown Obsessive-Compulsive Scale. The data analysis technique involved Pearson's correlation coefficient and multiple regression. The collected data were analyzed in IBM SPSS version 26. 
 
Results: The findings showed a clear negative relationship between the total self-differentiation score (r=-0.47) and its elements, such as personal identity (r=-0.19), relationships with others (r=-0.39), and emotional reactivity (r=-0.37), and symptoms of body deformity in women seeking beauty treatments.
 
Conclusion: According to the research results, it can be inferred that cognitive avoidance and self-differentiation play a crucial role in alleviating symptoms of body deformity among women undergoing beauty treatments. Therefore, this information can be used as a basis for developing therapeutic and educational initiatives aimed at addressing these concerns.  

Keywords


Acknowledgments: The study followed ethical guidelines and received approval from the appropriate authorities. This research was approved by the Ethics Committee of the Central Tehran branch of the Islamic University under the Ethics Code IR.IAU.CTB.REC.1402.126. Ethical principles were closely followed throughout the study to safeguard the confidentiality and privacy of participant information.

 

Availability of data and materials: The data used in the research can be obtained by reaching out to the author before or after the study is published.

 

Conflicts of interests: The authors stated that they have no conflicting interests

 

Consent for publication: By signing the Consent to Publish form and submitting it to the Publisher, the authors authorize publication of the work.

 

Ethics approval and consent to participate: This research was approved by the Ethics Committee of the Central Tehran branch of the Islamic University under the Ethics Code IR.IAU.CTB.REC.1402.126. Ethical principles were closely followed throughout the study to safeguard the confidentiality and privacy of participant information.This study was conducted following the principles of the Declaration of Helsinki.

 

Financial disclosure: The research project did not receive any financial support.

 

Author contributions: M.I.: Contributed to the conception of the work, revising the draft, approving the final version of the manuscript, and agreeing on all aspects of the work; Z.S.A.: Contributed to the data analysis and interpretation, critical revision, and approval of the final version of the manuscript; M.I.: Contributed to acquiring data, drafting the manuscript, and approving the final version; Z.S.A  and M.S.A.: Contributed to the conception and design of the study, critical revision, and approval of the manuscript's final version; M.I.: Contributed to the conception and design of the study, data interpretation, drafting of the manuscript and critical revision, and approval of final version.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

1. Hermans, A.-M., et al., Oops I did it (again): Patient experiences of complications after non-invasive cosmetic procedures. Social Science & Medicine, 2024: p. 116685.
https://doi.org/10.1016/j.socscimed.2024.116685
PMid:38359524
 
2. Sarwer, D.B., Body image, cosmetic surgery, and minimally invasive treatments. Body image, 2019. 31: p. 302-308.. Epub 2019 Jan 28. PMID: 30704847.
https://doi.org/10.1016/j.bodyim.2019.01.009
PMid:30704847  
 
3. Loghmani, S., et al., Demographic characteristics of patients undergoing rhinoplasty: a single center two-time-period comparison. World Journal of Plastic Surgery, 2017. 6(3): p. 275. PMID: 29218274; PMCID: PMC5714970  
 
4. de Brito, M.J.A., et al., Prevalence of body dysmorphic disorder symptoms and body weight concerns in patients seeking abdominoplasty. Aesthetic surgery journal, 2016. 36(3): p. 324-332 PMID: 26851144; PMCID: PMC5127455.
https://doi.org/10.1093/asj/sjv213
PMid:26851144 PMCid:PMC5127455  
 
5. Niya, N.M., et al., Iranians' perspective to cosmetic surgery: a thematic content analysis for the reasons. World journal of plastic surgery, 2019. 8(1): p. 69.. PMID: 30873365; PMCID: PMC6409151.
https://doi.org/10.29252/wjps.8.1.69
PMid:30873365 PMCid:PMC6409151  
 
6. Raeissosadati, N.S., et al., Comparison of frequency of body dysmorphic disorder in applicants of abdominoplasty with applicants of other cosmetic surgeries. World Journal of Plastic Surgery, 2022. 11(2): p. 101. PMID: 36117888; PMCID: PMC9446113.
https://doi.org/10.52547/wjps.11.2.95  
 
7. Boychuk, A.V., et al., PrEGNaNt woMEN witH Covid-19 aNd PlaCENta aNGioGENESiS. Polski Merkuriusz Lekarski, 2023. 3(6): p. 441. PMID: 38069843.
https://doi.org/10.36740/Merkur202305101
PMid:38069843  
 
8. Albert, U., et al., Suicide in obsessive-compulsive related disorders: prevalence rates and psychopathological risk factors. Journal of Psychopathology, 2019. 25(3): p. 139-148.  
 
9. Angelakis, I., P.A. Gooding, and M. Panagioti, Suicidality in body dysmorphic disorder (BDD): A systematic review with meta-analysis. Clinical psychology review, 2016. 49: p. 55-66.Epub 2016 Aug 28. PMID: 27607741.
https://doi.org/10.1016/j.cpr.2016.08.002
PMid:27607741  
 
10. McGrath, L.R., et al., Prevalence of body dysmorphic disorder: A systematic review and meta-analysis. Body image, 2023. 46: p. 202-211. Epub 2023 Jun 21. PMID: 37352787.
https://doi.org/10.1016/j.bodyim.2023.06.008
PMid:37352787  
 
11. Sherman, A.D., et al., Approach and avoidant coping among black transgender women who have experienced violence: A qualitative analysis. Psychological services, 2022. 19(S1): p. 45. Epub 2021 Aug 30. PMID: 34460276; PMCID: PMC9891319.
https://doi.org/10.1037/ser0000581
PMid:34460276 PMCid:PMC9891319  
 
12. Kuck, N., et al., Body dysmorphic disorder and self-esteem: a meta-analysis. BMC psychiatry, 2021. 21(1): p. 310. PMID: 34130638; PMCID: PMC8207567.
https://doi.org/10.1186/s12888-021-03185-3
PMid:34130638 PMCid:PMC8207567  
 
13. Ramos-Luna, M.E. and J. Oliver, Relationship between differentiation of self, emotional intelligence and self-esteem in a Spanish sample. Current Psychology, 2024. 43(8): p. 6797-6806.
https://doi.org/10.1007/s12144-023-04822-8  
 
14. Doba, K., et al., Self-differentiation and eating disorders in early and middle adolescence: A cross-sectional path analysis. Eating behaviors, 2018. 29: p. 75-82. Epub 2018 Mar 7. PMID: 29547826.
https://doi.org/10.1016/j.eatbeh.2018.03.003
PMid:29547826  
 
15. Süloğlu, D. and Ç. Güler, Predicting perceived stress and resilience: the role of differentiation of self. Current Issues in Personality Psychology, 2021. 9(4): p. 289-298. PMID: 38014407; PMCID: PMC10655777.
https://doi.org/10.5114/cipp.2021.106140
PMid:38014407 PMCid:PMC10655777  
 
16. Saab, A., et al., Prevalence of Body Dysmorphic Disorder (BDD) among the Lebanese University students: associated risk factors and repercussion on mental health. Journal of Preventive Medicine and Hygiene, 2023. 64(4): p. E481. PMID: 38379749; PMCID: PMC10876033.  
 
17. Peleg, O., M. Boniel-Nissim, and O. Tzischinsky, Adolescents at risk of eating disorders: The mediating role of emotional distress in the relationship between differentiation of self and eating disorders. Frontiers in Psychology, 2023. 13: p. 1015405. PMID: 36710825; PMCID: PMC9874111
https://doi.org/10.3389/fpsyg.2022.1015405
PMid:36710825 PMCid:PMC9874111  
 
18. Sexton, K.A. and M.J. Dugas, The cognitive avoidance questionnaire: validation of the English translation. Journal of anxiety disorders, 2008. 22(3): p. 355-370. Epub 2007 Apr 25. PMID: 17544253.
https://doi.org/10.1016/j.janxdis.2007.04.005
PMid:17544253  
 
19. Aghajani, S., H. SAMADIFARD, and M. Narimani, The Role of Cognitive Avoidance Components and Metacognitive Belief in the Prediction of Quality of Life in Diabetic Patients. Health Psychology, 2017. 6(21): p. 142-156.  
 
20. Drake, J.R., et al., Differentiation of self inventory-Short form: Development and preliminary validation. Contemporary Family Therapy, 2015. 37: p. 101-112.
https://doi.org/10.1007/s10591-015-9329-7  
 
21. Rasoli, M., et al., Factor structure and validation of self-differentiation inventory short form (SDI-SF). Psychometry, 2016. 4(16): p. 1-10.  
 
22. Phillips, K.A., et al., A severity rating scale for body dysmorphic disorder: development, reliability, and validity of a modified version of the Yale-Brown Obsessive Compulsive Scale. Psychopharmacology bulletin, 1997. 33(1): p. 17.  
 
23. Rabiei, M., et al., The investigation of correlation between metacognitive subscales, meta worry, and thoughts-fusion with body dysmorphic disorder. NPWJM 2015; 2 (4) :162-167.  
 
24. Shah Mohamadi, J., et al., The relationship between experimental avoidance with body image concern in predicting positive tendency to cosmetic surgery. Shenakht Journal of Psychology and Psychiatry, 2023. 10(1): p. 19-30.
https://doi.org/10.32598/shenakht.10.1.19  
 
25. Gillen, M.M. and C.H. Markey, Body image, weight management behavior, and women's interest in cosmetic surgery. Psychology, Health & Medicine, 2021. 26(5): p. 621-630. Epub 2020 Jun 4. PMID: 32496824.
https://doi.org/10.1080/13548506.2020.1776890
PMid:32496824  
 
26. Phillips, K.A. and M.M. Kelly, Body dysmorphic disorder: clinical overview and relationship to obsessive-compulsive disorder. Focus, 2020. 19(4): p. 413-419. Epub 2021 Nov 5. PMID: 35747292.
https://doi.org/10.1176/appi.focus.20210012
PMid:35747292 PMCid:PMC9063569  
 
27. Blakey, S.M., et al., Experiential avoidance and dysfunctional beliefs in the prediction of body image disturbance in a nonclinical sample of women. Body image, 2017. 22: p. 72-77. Epub 2017 Jun 29. PMID: 28667898.
https://doi.org/10.1016/j.bodyim.2017.06.003
PMid:28667898  
 
28. Lewis-Smith, H., P.C. Diedrichs, and E. Halliwell, Cognitive-behavioral roots of body image therapy and prevention. Body image, 2019. 31: p. 309-320. Epub 2019 Sep 11. PMID: 31519523.
https://doi.org/10.1016/j.bodyim.2019.08.009
PMid:31519523  
 
29. Songco, A., J.L. Hudson, and E. Fox, A cognitive model of pathological worry in children and adolescents: A systematic review. Clinical Child and Family Psychology Review, 2020. 23(2): p. 229-249. PMID: 31989444.
https://doi.org/10.1007/s10567-020-00311-7
PMid:31989444 PMCid:PMC7192867  
 
30. Sagui-Henson, S.J., Cognitive avoidance. Encyclopedia of personality and individual differences, 2017: p. 1-3.
https://doi.org/10.1007/978-3-319-28099-8_964-1  
 
31. Onken R, C.D., Dietel FA, Kneipp C, Hoppen L, Schulz C, Dirksen D, Buhlmann U, Facial symmetry perception and attractiveness ratings in body dysmorphic disorder. Journal of Obsessive-Compulsive and Related Disorders, 2024
https://doi.org/10.1016/j.jocrd.2024.100859  
 
32. Vahidi, S., A. Aghausefi, and H. Namvar, Prediction of Happiness upon Neuroticism, Self-descrimination with Mediating Body Image, and Optimism in obese women and men. Applied Family Therapy Journal (AFTJ), 2022. 3(3): p. 237-262.
https://doi.org/10.61838/kman.aftj.3.3.14