Determining the Effectiveness of Positive Psychotherapy on Behavioral Self-regulation and Self-esteem of Female Students with Bulimia Nervosa

Habibzade Miandoab, Pardis; Kazemi , Reza; Kiamarsi , Azar

Volume 15 - Articles-1404 MEJDS (2025) 15: 51 | Back to browse issues page

Mendeley

Zotero

RefWorks

Habibzade Miandoab P, Kazemi R, Kiamarsi A. Determining the Effectiveness of Positive Psychotherapy on Behavioral Self-regulation and Self-esteem of Female Students with Bulimia Nervosa. MEJDS 2025; 15 (0) :51-51
URL: http://jdisabilstud.org/article-1-3624-en.html

Determining the Effectiveness of Positive Psychotherapy on Behavioral Self-regulation and Self-esteem of Female Students with Bulimia Nervosa

Pardis Habibzade Miandoab¹

, Reza Kazemi ^*²

, Azar Kiamarsi³

1- PhD Student, Department of Psychology, Ardabil Branch, Islamic Azad University, Ardabil, Iran
2- Assistant Professor, Department of Psychology, Ardabil Branch, Islamic Azad University, Ardabil, Iran
3- Assistant Professor, Department of Psychology, Rasht Branch, Islamic Azad University, Rasht, Iran

Abstract: (490 Views)

Abstract
Background & Objectives: Today, eating disorders are considered one of the most challenging disorders in psychiatry to treat, of which the most notable is bulimia nervosa. Bulimia nervosa is a type of eating disorder that is defined as periodic binge eating accompanied by inappropriate methods of preventing weight gain. People who suffer from bulimia nervosa also experience problems in various psychological aspects. In this regard, the results of studies have pointed to the self-regulatory behaviors and low self-esteem of these people. Despite the necessity felt in the field of self-regulatory behaviors and self-esteem in female university students with bulimia nervosa as the main pillars of building the future of the country, there is a fundamental research gap in this field. Additionally, given the importance of this group's health and the need for effective psychological interventions within this statistical population, further research in this field is necessary. Finally, this study aimed to determine the effectiveness of positive psychotherapy on behavioral self-regulation and self-esteem of female students with bulimia nervosa.
Methods: The quasi-experimental research employed a pretest-posttest and a three-month follow-up period design with a control group. The statistical population of this study included all female students with bulimia nervosa at universities in Miandoab City, Iran, in the academic year 2024-2025. From this population, 40 eligible individuals were enrolled in the study using the convenience sampling method and randomly assigned to the experimental and control groups (20 individuals in each group). The inclusion criteria for the subjects in the study were as follows: female gender; diagnosis of bulimia nervosa based on the Eating Disorders Diagnostic Scale (Stice et al., 2004) with a cut-off score of 24 or higher; age range of 18 to 40 years; participation in positive therapy training sessions; willingness of participants and written consent; completion of the consent form for participation in the study; not taking medications related to bulimia nervosa; and not taking neuropsychiatric medicines based on a self-declaration form. The exclusion criteria for the subjects from the study were absent from more than two sessions of positive therapy training sessions and failure to complete the assignments included in the positive therapy sessions. Ethical considerations, including the principle of scientific confidentiality and respect for the authors' rights to choose, freedom, and intellectual property, were observed. The subjects were included in the study following these ethical considerations and the stated objectives. They were assured that all information would be confidential and would be used for research purposes. To respect privacy, the names and surnames of the participants were not recorded. The measurement tools were the Behavioral Self-regulation Questionnaire (Carey et al., 2004) and the Self-esteem Scale (Rosenberg, 1965). The experimental group underwent 8 sessions of 70-minute positive psychotherapy, and the control group did not receive any intervention. Data analysis was performed using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics, including independent t test, Chi-square test, analysis of variance with repeated measures, and Bonferroni post hoc test at a significance level of 0.05 in SPSS version 23.
Results: The results showed that the group, the time, and the group × time interaction effects on the variables of self-awareness, goal setting, action planning, self-monitoring, and self-esteem were significant (p<0.05). Also, in the experimental group, the difference between the mean scores of self-awareness, goal setting, action planning, self-monitoring, and self-esteem variables between the pretest and the posttest and follow-up was significant (p<0.05). However, in the experimental group, the difference between the mean scores of the aforementioned variables between the posttest and follow-up was not significant (p>0.05), indicating the stability of the effect of the positive psychotherapy intervention over time.
Conclusion: According to the findings, positive psychotherapy is effective in increasing behavioral self-regulation and self-esteem of female students with bulimia nervosa. So, it is suggested that positive psychotherapy, along with other psychological interventions, be used as one of the effective methods in improving behavioral self-regulation and self-esteem of female students with bulimia nervosa.

Keywords: Positive therapy, Behavioral self-regulation, Self-esteem, Female students

Full-Text [PDF 408 kb] (63 Downloads)

Type of Study: Original Research Article | Subject: Psychology

References

1. Tabuenca K, Crowe DE, Gillis AJ, Kabiling C, Saccacio B, Velkova AV, et al. Updates in the treatment of eating disorders in 2024: a year in review in Eating Disorders: The Journal of Treatment & Prevention. Eat Disord. 2025;33(4):434–50. [DOI]

2. Himmerich H, Keeler JL, Davies HL, Tessema SA, Treasure J. The evolving profile of eating disorders and their treatment in a changing and globalised world. Lancet. 2024;403(10445):2671–5. [DOI]

3. Şaban H, Baki E. Anorexia nervosa and bulimia nervosa. International Scientific Journal Vision. 2024;1:27–46. [DOI]

4. Wu S, Hao X, Qu D, Zhao X, Zhao X, Xu J, et al. Association of temporal self–regulation theory and its constructs with eating behavior: A systematic review and meta-analysis. Appetite. 2025;208:107937. [DOI]

5. Annesi JJ, Powell SM. Carry–over of exercise–related self–regulation to eating–related self–regulation in women participating in behavioral obesity treatments. Res Q Exerc Sport. 2024;95(3):789–94. [DOI]

6. Moilanen KL. The adolescent self–regulatory inventory: the development and validation of a questionnaire of short–term and long–term self–regulation. Journal of Youth and Adolescence. 2007;36(6):835–48. [DOI]

7. Hamzehnejadi F, Bagheri F, Hatami M, Dortaj F. Comparison of the effectiveness of attentive behavior self–regulation interventions with motivational behavior self–regulation training on attention deficit / hyperactivity disorder (ADHD). Journal of Exceptional Children. 2021;21(4):21–32. [Persian] [Article]

8. Slaten CD, Rose CA, Elison ZM, Chui MM. Understanding the connection between youths' belonging, resilience and self–regulatory learning. Educational and Child Psychology. 2019;36(2):91–105.

9. Monnery–Patris S, Rigal N, Peteuil A, Chabanet C, Issanchou S. Development of a new questionnaire to assess the links between children's self–regulation of eating and related parental feeding practices. Appetite. 2019;138:174–83. [DOI]

10. Yöyen E, Dereli Ş, Barış TG. Predictors of orthorexia nervosa in women: eating attitudes, emotional regulation difficulties, anxiety, depression and self–esteem. BMC Psychol. 2025;13(1):554. [DOI]

11. Zacharias BS, Upendra S, Waghmare S, Mistry M, Dumbre D. The psychological tapestry of orthorexia nervosa: unpacking its intricate relationship with self–esteem, anxiety, and eating attitude. American Journal of Health Education. 2025;56(4):356–65. [DOI]

12. Martínez I, Murgui S, Garcia OF, Garcia F. Parenting and adolescent adjustment: the mediational role of family self–esteem. Journal of Child and Family Studies. 2021;30(5):1184–97. [DOI]

13. Kim A, Jeon S, Song J. Self–stigma and mental health in divorced single–parent women: mediating effect of self–esteem. Behav Sci (Basel). 2023;13(9):744. [DOI]

14. Mostaghimi MR, Shahriari Ahmadi M, Amiri Majd M. The relationship between authoritarian parenting and conduct disorder mediated by self–esteem in adolescent boys living in correction and rehabilitation centers. Rooyesh–e–Ravanshenasi Journal. 2022;11(4):133–44. [Persian] [Article]

15. Muris P, Otgaar H. Self–esteem and self–compassion: a narrative review and meta–analysis on their links to psychological problems and well–being. Psychol Res Behav Manag. 2023;16:2961–75. [DOI]

16. MacIntyre PD, Gregersen T, Mercer S. Setting an agenda for positive psychology in SLA: theory, practice, and research. Modern Language Journal. 2019;103(1):262–74. [DOI]

17. Jankowski PJ, Sandage SJ, Bell CA, Davis DE, Porter E, Jessen M, et al. Virtue, flourishing, and positive psychology in psychotherapy: an overview and research prospectus. Psychotherapy. 2020;57(3):291–309. [DOI]

18. Lakani N, Akbari B. The effectiveness of positive psychotherapy on emotional regulation, cognitive flexibility and mental happiness of internet addicted students. Medical Journal of Mashhad university of Medical Sciences. 2021;64(3):3421–38. [Persian] [DOI]

19. Ghorbani M, Alipour A, Aliakbaridehkordi M. The effectiveness of interventions of positive approach on depression, self–esteem, life expectancy and body image of mastectomized women. Health Psychology. 2017;6(23):151–67.[Persian] [Article]

20. Stice E, Fisher M, Martinez E. Eating Disorder Diagnostic Scale: additional evidence of reliability and validity. Psychol Assess. 2004;16(1):60–71. [DOI]

21. Carey KB, Neal DJ, Collins SE. A psychometric analysis of the Self–Regulation Questionnaire. Addict Behav. 2004;29(2):253–60. [DOI]

22. Motamed–Jahromi M, Kaveh MH, Mohammadpour A, Asadollahi A. Psychometric validation of the Persian version of Short Form Self–Regulation Questionnaire in community–dwelling older adults. Front Psychol. 2022;13:844871. [DOI]

23. Rosenberg M. Rosenberg Self–Esteem Scale [Internet]. 2011 [cited 2025 Jul 4]. Available from: [DOI]

24. Greenberger E, Chen C, Dmitrieva J, Farruggia SP. Item–wording and the dimensionality of the Rosenberg Self–Esteem Scale: do they matter? Personality and Individual Differences. 2003;35(6):1241–54. [DOI]

25. Rajabi G, Bohlel N. The reliability and validity of Rosenberg Self–Esteem Scale in freshman students of Shahid Chamran University of Ahvaz. Journal of Educational and Psychological Research. 2008;3(2):33–48. [Persian]

26. Quilliam S. Positive thinking. Barati Sadeh F, Sadeghi A. (Persian translator). Tehran: Roshd Pub; 2003.

27. Mitsea E, Drigas A, Skianis C. Well–being technologies and positive psychology strategies for training metacognition, emotional intelligence and motivation meta–skills in clinical populations: a systematic review. Psych. 2024;6(1):305–44. [DOI]

28. Marmarosh CL, Sandage S, Wade N, Captari LE, Crabtree S. New horizons in group psychotherapy research and practice from third wave positive psychology: a practice–friendly review. Res Psychother. 2022;25(3): 642–3. [DOI]