مدل¬یابی رابطه تروما و اختلال خوردن با میانجیگری معنای زندگی و اجتناب تجربه¬ای در دانشجویان
محورهای موضوعی : روانشناسی
هادی خیرآبادی
1
,
محمود جاجرمی
2
,
ابوالفضل بخشی پور
3
1 - دانشجوی دکتری، گروه مشاوره، واحد بجنورد، دانشگاه آزاد اسلامی، بجنورد، ایران
2 - استادیار، گروه مشاوره، واحد بجنورد، دانشگاه آزاد اسلامی، بجنورد، ایران
3 - استادیار، گروه مشاوره، واحد بجنورد، دانشگاه آزاد اسلامی، بجنورد، ایران
کلید واژه: دانشجویان, تروما, اجتناب تجربه¬ای, معنای زندگی, اختلال خوردن.,
چکیده مقاله :
هدف این پژوهش، مدل¬یابی رابطه تروما و اختلال خوردن با میانجی¬گری معنای زندگی و اجتناب تجربه¬ای در دانشجویان بود. روش تحقیق توصیفی از نوع مدل¬های ساختاری همبستگی بود. جامعه آماری این پژوهش کلیه دانشجویان در حال تحصیل دانشگاه فردوسی مشهد بود. برای انجام این پژوهش از بین شاغلین به تحصیل در سال 2020-2019 دانشگاه فردوسی مشهد با روش نمونه گیری خوشه¬ای چند مرحله¬ای، 387 نفر انتخاب شدند. آزمودنی¬ها پرسشنامه¬های استاندارد نگرش به خوردن (Garner & Garfinkel, 1979)، اجتناب تجربه¬ای چندبعدی (Gamez et al., 2011)، پرسش نامه معناي زندگي (Steger & Shin, 2010) و رویدادهای زندگی تروماتیک (Kubany et al., 2000) را تکمیل نمودند. داده¬ها با نرم افزار آماری SPSS-23 و AMOS-23 تجزیه و تحلیل شد. سطح معنی¬داری در تحلیل مدل اثر کامل و مدل اثر میانجی معنی¬دار بود (کوچکتر از 01/0). نتایج تحلیل مدل اثر کامل نشان داد که متغیر تروما به صورت مستقیم و در جهت مثبت با متغیر اختلال خوردن رابطه دارد. همچنین نتایج تحلیل مدل اثر میانجی نشان داد که در رابطه تروما با اختلال خوردن، اجتناب تجربه¬ای در جهت مثبت و به صورت جزئی و معنای زندگی در جهت منفی و به صورت جزئی میانجی¬گری می¬کنند.
The purpose of this study was to model the relationship of trauma and eating disorder by mediating meaning in life and experiential avoidance in students. The research method was descriptive and type of Structural Correlation Modeling. The statistical population of this study was all studying students at Mashhad Ferdowsi University. For this study, 387 people were selected from the studying students of Mashhad Ferdowsi University that were studying in academic Year 2019-2020. The participants answered to Eating Attitudes Test (Garner & Garfinkel, 1979), Multidimensional Experiential Avoidance Questionnaire (Gamez et al., 2011), Meaning in Life Questionnaire (Steger & Shin, 2010) and Traumatic Life Events Questionnaire (Kubany et al., 2000). Data were analyzed by SPSS-23 and AMOS-23 statistical software. P-value in the Total Effect Model analysis and Mediation Effect Model analysis was meaningful (smaller than 0.01). The results of Total Effect Model analysis showed that the Trauma was directly and positively related to Eating Disorder. Also, the results of the Mediation Effect Model analysis showed that the Experiential Avoidance mediates positively and partially between Trauma and Eating Disorder. The Meaning in Life mediates negatively and partially between Trauma and Eating Disorder.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th Ed.). Arlington, VA: American Psychiatric Publishing.
American Psychological Association. (2014). Trauma. Retrieved from: http://www.apa.org/topics/ trauma/index.aspx.Archives of Suicide Research, 9, 147-151.
Aoun, A., Garcia, F. D., Mounzer, C., Hlais, S., Grigioni, S., Honein, K., & Dechelotte, P. (2013). War stress may be another risk factor for eating disorders in civilians: A study in Lebanese University Students. General Hospital Psychiatry, 35(4), 393-397.
Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: a meta-analysis of 36 studies. Archives of general psychiatry, 68(7), 724-731.
Bramford, B., & Sly, Richard. (2009). Exploring quality of life in the eating disorders. Advance online publication. Wiley InterScience
Breen, W. E., & Kashdan, T. B. (2011). Anger suppression after imagined rejection among individuals with social anxiety. Journal of anxiety disorders, 25(7), 879-887.
Brewerton, T. D., Rance, S. J., Dansky, B. S., O'Neil, P. M., & Kilpatrick, D. G. (2014). A comparison of women with child.adolescent versus adult onset binge eating: Results from the national women's study. International Journal of Eating Disorders, 47(7), 836-843.
Calhoun, L. G., Cann, A., Tedeschi, R. G., & McMillan, J. (2000). A correlational test of the relationship between posttraumatic growth, religion, and cognitive processing. Journal of Traumatic Stress, 13(3), 521-527.
Collins, B., Fischer, S., Stojek, M., & Becker, K. (2014). The relationship of thought suppression and recent rape to disordered eating in emerging adulthood. Journal of Adolescence, 37(2), 113-121.
Cowdrey, F. A., & Park, R. J. (2012). The role of experiential avoidance, rumination and mindfulness in eating disorders. Eating behaviors, 13(2), 100-105.
Creamer, M., Burgess, P.M., & McFarlane, A.C. 2001. Post-traumatic stress disorder: findings from the Australian national survey of mental health and wellbeing. Psychological Medicine, 31(7): 1237–1247.
Cusack, A. (2014). The relationship between acceptance, thought suppression, and eating disordered behavior in an adult eating disorders population. Dissertation Abstracts International, 74, 8-B (E).
Fontana, A., & Rosenheck, R. (2005). The role of loss of meaning in the pursuit of treatment for posttraumatic stress disorder. Journal of Traumatic Stress, 18(2), 133-136.
Fox, A. P., & Leung, N. (2009). Existential well-being in younger and older people with anorexia nervosa – A preliminary investigation. European Eating Disorders Review, 17, 24-30.
Frazier, P., Conlon, A., Steger, M., Tashiro, T., & Glaser, T. (2006). Positive life changes following sexual assault: A replication and extension. In G. D. Kume (Ed.), Posttraumatic stress: New research (pp. 1-22).
Gamez, W., Chmielewski, M., Kotov, R., Ruggero, C., & Watson, D. (2011). Development of a measure of experiential avoidance: The Multidimensional Experiential Avoidance.
Garfinkel P. E., & Newman, A. (2001). The Eating Attitudes Test: Twenty-five years later. Eating and Weight Disorders, 6, 1–24.
Garner, D. M., & Garfinkel, P. E. (1979). The Eating Attitudes Test: An index of the symptoms of anorexia nervosa. Psychological medicine, 9(2), 273-279.
Garner, D. M., Rosen, L. W., & Barry, D. (1998). Eating disorders among athletes: Research and recommendations. Child and adolescent psychiatric clinics of North America, 7(4), 839-857.
Hayes, S. C. (2004). Acceptance and Commitment Therapy, Relational Frame Theory, and the Third Wave of Behavioral and Cognitive Therapies. Behavior Therapy, 35(4), 639-665.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The process and practice of mindful change (2nd ed.) New York, NY: Guilford Press.
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6), 1152-1168.
Ho, M. Y., Cheung, F. M., & Cheung, S. F. (2010). The role of meaning in life and Optimism in promoting well-being. Personality and Individual Differences, 48(1), 658-663.
Juarascio, A., Shaw, J., Forman, E., Timko, C. A., Herbert, J., Butryn, M., & Lowe, M. (2014). Acceptance and commitment therapy as a novel treatment for eating disorders: An initial test of efficacy and mediation. Behavior Modification, 37(4), 459-489.
Kashdan, T. B., & Breen, W. E. (2008). Social anxiety and positive emotions: A prospective examination of a self-regulatory model with tendencies to suppress or express emotions as a moderating variable. Behavior Therapy, 39(1), 1-12.
Kashdan, T. B., & Kane, J. Q. (2011). Post-traumatic distress and the presence of post-traumatic growth and meaning in life: Experiential avoidance as a moderator. Personality and Individual Differences, 50(1), 84-89.
Kashdan, T. B., Barrios, V., Forsyth, J. P., & Steger, M. F. (2006). Experiential avoidance as a generalized psychological vulnerability: Comparisons with coping and emotion regulation strategies. Behavior Research and Therapy, 44(9), 1301-1320.
Kilpatrick, D. G., Resnick, H. S., Milanak, M. E., Miller, M. W., Keyes, K. M., & Friedman, M. J. (2013). National estimates of exposure to traumatic events and PTSD prevalence using DSM‐IV and DSM‐5 criteria. Journal of traumatic stress, 26(5), 537-547.
Krause, N. (2005). Traumatic events and meaning in life: Exploring variations in three age cohorts. Ageing & Society, 25(4), 501-524.
Kubany, e. (1995). The traumatic life events questionnaire (TLEQ): a brief measure of prior trauma exposure. Unpublished scale.
Kubany, E. S., Leisen, M. B., Kaplan, A. S., Watson, S. B., Haynes, S. N., Owens, J. A., & Burns, K. (2000). Development and preliminary validation of a brief broad-spectrum measure of trauma exposure: the Traumatic Life Events Questionnaire. Psychological assessment, 12(2), 210.
Lejonclou, A., Nilsson, D., & Holmqvist, R. (2014). Variants of potentially traumatizing life events in eating disorder patients. Psychological Trauma: Theory, Research, Practice, and Policy, 6(6), 661-667.
Lewis, M., & Naugle, A. (2017). Measuring experiential avoidance: Evidence toward multidimensional predictors of trauma sequelae. Behavioral Sciences, 7(1), 9.
Marx, B., & Sloan, D. (2005). Peritraumatic dissociation and experiential avoidance as predictors of posttraumatic stress symptomatology. Behaviour Research and Therapy, 43, 569-583.
McVandy, M ., McVandy, b. (2016). The Relationship between Experimental Avoidance and Symptoms of Eating Disorders in Students of Ahwaz Jundishapur University of Medical Sciences. Jundishapur Scientific Medical Journal, 14 (6), 681-689. [Persian].
Mesrabadi, J., Jafariyan, S., & Ostovar, N. (2013). Discriminative and construct validity of meaning in life questionnaire for Iranian students. International Journal of Behavioral Sciences, 7(1), 83-90.
Mitchell, K. S., Mazzeo, S. E., Schlesinger, M. R., Brewerton, T. D., & Smith, B. N. (2012). Comorbidity of partial and subthreshold PTSD among men and women with eating disorders in the national comorbidity survey-replication study. The International Journal of Eating Disorders, 45(3), 307-315. doi: 10.1002/eat.20965
Mollazadeh Esfanjani R, Arazi H, Rohi S, Mohammadi M. (2012). Effects of Aerobic Training on Eating Disorders in Non-athlete Female Students. JSSU, 20 (3), 322-31. [Persian].
Moradi, A., Barghi Irani, Z., Begian Koule Marz, M., Kariminejad, K. & Zabet M. (2017). Determining the Factor Structure and Psychometric Properties of a Multidimensional experiential Avoidance Questionnaire. Journal of Social Cognition, 6(2). [Persian].
National Institute of Mental Health (NIMH) Eating disorders: About more than food (No. 11-4901) (2014) Available at: www.nimh.nih.gov/ health/publications/eating-disorders/eating-disorders.pdf
Norris, F. H. (1992). Epidemiology of trauma: frequency and impact of different potentially traumatic events on different demographic groups. Journal of consulting and clinical psychology, 60(3), 409.
Owens, G. P., Steger, M. F., Whitesell, A. A., & Herrera, C. J. (2009). Posttraumatic stress disorder, guilt, depression, and meaning in life among military veterans. Journal of Traumatic Stress: Official Publication of the International Society for Traumatic Stress Studies, 22(6), 654-657.
Pahlevan Sharif, S., Mahdavian, V. (2018). Modeling structural equations with AMOS. Tehran: Bisheh Publications. [Persian].
Plumb, J. C., Orsillo, S. M., & Luterek, J. A. (2004). A preliminary test of the role of experiential avoidance in post-event functioning. Journal of behavior therapy and experimental psychiatry, 35(3), 245-257.
Rawal, A., Park, R. J., & Williams, J. G. (2010). Rumination, experiential avoidance, and dysfunctional thinking in eating disorders. Behavior Research and Therapy, 48(9), 851-859.
Reddy, M., Pickett, S., & Orcutt, H. (2006). Experiential avoidance as a mediator in the relationship between childhood psychological abuse and current mental health symptoms in college students. Journal of Emotional Abuse, 6, 67-85.
Resnick, H.S, Kilpatrick, D.G, Dansky, B.S, Saunders, B.E, & Best, C.L. 1993. Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women. Journal of Consulting and Clinical Psychology, 61: 984–991.
Rosario, W. B. (2009). Estimating the development of risk factors associated with the co-occurrence of eating disorders and substance abuse in military personnel. Dissertation Abstracts International Section A, 70, 486.
Rosenthal, M., Hall, M., Palm, K., Batten, S., & Follette, V. (2005). Chronic avoidance helps explain the relationship between severity of childhood sexual abuse and psychological distress in adulthood. Journal of Child Sexual Abuse, 14, 25-41.
Smith, J. M. (2019). Depressive rumination as experiential avoidance (Doctoral dissertation, Temple University Libraries).
Steger, M.F., Frazier, P.A., & Zacchanini, J.L. (2008). Terrorism in two cultures: Stress and growth following September 11 and the Madrid train bombings. Journal of Loss and Trauma, 13, 511–527.
Tagay, S., Schlegl, S., & Senf, W. (2010). Traumatic events, posttraumatic stress symptomatology and somatoform symptoms in eating disorder patients. European Eating Disorders Review: the Journal of the Eating Disorders Association, 18(2), 124-132. doi: 10.1002/erv.972.
Tagay, S., Schlottbohm, E., Reyes-Rodriguez, M. L., Repic, N., & Senf, W. (2014). Eating disorders, trauma, PTSD, and psychosocial resources. Eating Disorders: The Journal of Treatment & Prevention, 22(1), 33-49.
Tedeschi, R. G., Park, C. L., & Calhoun, L. G. (Eds.). (1998). Posttraumatic growth: Positive changes in the aftermath of crisis. Routledge.
Yalom ID. (1980). Existential Psychotherapy. New York: Basic books.