Research code: IR.IAU.ILAM.REC.1402.041
Ethics code: IR.IAU.ILAM.REC.1402.041
Clinical trials code: IR.IAU.ILAM.REC.1402.041
1- Department of Psychology, Faculty of Humanities, Ilam Branch, Islamic Azad University, Ilam, Iran
Abstract: (1 Views)
Background & Aim: Body dysmorphic disorder (BDD) is a complex psychological condition characterized by excessive preoccupation with perceived or actual defects in physical appearance, which significantly impairs individuals’ quality of life and mental health. One of the central challenges in BDD is difficulties in emotion regulation, which can exacerbate symptom severity and disorder progression. Given the critical role of emotion regulation in therapeutic outcomes, the primary aim of this study was to compare the effectiveness of two prominent therapeutic approaches Acceptance and Commitment Therapy (ACT) and Cognitive-Behavioral Therapy (CBT) in enhancing emotion regulation skills among individuals exhibiting symptoms of body dysmorphic disorder.
Methods: The present study employed a quasi-experimental design with a pretest-posttest and two-month follow-up, including a control group. The statistical population comprised all individuals who visited beauty clinics in Kermanshah city during the year 1402 (2023-2024). From this population, 54 eligible volunteers were recruited via convenience sampling and randomly assigned into three groups: Acceptance and Commitment Therapy (ACT), Cognitive-Behavioral Therapy (CBT), and a control group, with 18 participants in each group. Inclusion criteria were: willingness to participate and signed informed consent, presence of body dysmorphic disorder symptoms based on clinical interview and a cutoff score of 20 on the Modified Body Dysmorphic Disorder Questionnaire (30), age between 20 and 50 years, minimum education level of high school diploma, and ability to attend therapy sessions regularly. Exclusion criteria included severe psychiatric disorders such as schizophrenia or bipolar disorder, unstable concurrent psychiatric medication use, history of similar psychotherapy within the last six months, and absence from more than two intervention sessions. Data were collected using the Difficulties in Emotion Regulation Scale (DERS) developed by Gratz and Roemer (2004). The first experimental group received Acceptance and Commitment Therapy over 4 weeks (8 sessions of 90 minutes each) following the protocol by Hayes et al. (2013). The second experimental group underwent Cognitive-Behavioral Therapy for 5 weeks (10 sessions of 90 minutes each) based on the Beck and Beck manual (2011). Meanwhile, the control group did not receive any intervention. Following administration of pretest, posttest, and follow-up assessments, data were analyzed using repeated measures ANOVA and Bonferroni post-hoc tests in SPSS version 26, with a significance level set at P<0.05.
Results: The results indicated that the mean scores of difficulties in emotion regulation and its subcomponents in the experimental groups significantly decreased in the posttest and follow-up phases compared to the pretest. In contrast, no significant differences were observed in the control group between the posttest and follow-up compared to the pretest. The within-group effects showed that over time (from pretest to follow-up), there were significant improvements in the overall emotion regulation score and its subcomponents, including non-acceptance of emotional responses, difficulties engaging in goal-directed behavior, impulse control difficulties, lack of emotional awareness, limited access to emotion regulation strategies, and lack of emotional clarity (P<0.001). Between-group analysis revealed significant differences in the overall emotion regulation score and all its subcomponents (P<0.001). Moreover, the interaction effect of time and group was significant for the total score and all subcomponents of emotion regulation difficulties (P<0.001). The results also demonstrated a significant difference between pretest and posttest/follow-up scores in the experimental groups (P<0.001), while there was no significant difference between posttest and follow-up scores (P>0.001), indicating the durability of the effects of both Acceptance and Commitment Therapy and Cognitive-Behavioral Therapy on emotion regulation. Furthermore, a statistically significant difference was found between the effectiveness of the two treatments (P<0.001), with Cognitive-Behavioral Therapy showing greater efficacy than Acceptance and Commitment Therapy in improving emotion regulation among individuals with body dysmorphic disorder symptoms.
Conclusion: The findings of the present study demonstrated that cognitive-behavioral therapy (CBT) can be considered a more effective approach for improving emotion regulation in individuals with body dysmorphic disorder symptoms compared to acceptance and commitment therapy (ACT). Based on these results, it is recommended that CBT be given greater attention by therapists and mental health professionals when working with individuals exhibiting body dysmorphic disorder symptoms. Additionally, necessary training should be provided to enhance the awareness and competency of psychologists and therapists in this area.
Keywords: Acceptance and Commitment Therapy, Cognitive-Behavioral Therapy, Emotion Regulation, Individuals with Body Dysmorphic Disorder Symptoms.
Type of Study: Original Research Article |
Subject:
Psychology
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