Middle Eastern Journal of Disability Studies

Abstract
Background & Objective: One of the main needs of women in the modern era is to look beautiful, and in this regard, societies have set highly competitive standards; therefore, cosmetic surgeries are among the most common surgeries in the world today. However, not all of these surgeries are necessary and are mostly due to psychological aspects. One of these aspects is body dysmorphic disorder. This disorder is known as a mental preoccupation with an imaginary defect in a person's appearance, which causes significant problems in functioning, and for this reason, these people are the main applicants for these surgeries. Also, due to the psychological origin of this disorder, after cosmetic surgeries, the symptoms intensify and can lead to depression and suicide. Therefore, reducing effective psychological problems in this field is an important issue. One of the common problems of women with body dysmorphic disorder is lack of self-esteem. In other words, women are seeking cosmetic surgeries to conform to the standards set by the global community for beauty and to increase their self-esteem. Therefore, efforts were made to improve self-esteem in this group. In this context, two interventions, mentalization therapy and acceptance and commitment therapy, seem to be applicable. In this context, it can be expected that mentalization therapy, by correcting thoughts and restoring emotions, can help women with stereotypes in correcting their attitude towards themselves, deciding on cosmetic surgery, and rebuilding self-esteem, and acceptance and commitment therapy, by strengthening the individual's ability to remain active and act in accordance with personal values, increasing mindfulness, cognitive distancing, and creating a commitment to active engagement in the outside world and striving to achieve a meaningful life, can help women cope with stressful situations and social pressures in an efficient manner. Therefore, in order to determine the most appropriate treatment in this field and save people's time and money, the purpose of this study was to compare the effectiveness of mentalization therapy and acceptance and commitment therapy on the self-esteem of women with body dysmorphic disorder who are candidates for cosmetic surgery.
Methods: The research method was a quasi-experimental design with a pre-test-post-test design with a control group and a three-month follow-up period. The research population was women with dysmorphic disorder who were applying for cosmetic surgery and referred to specialized centers in Isfahan in 2023. From the aforementioned population, 54 people were selected purposively and randomly divided into two experimental groups and a control group, and a pre-test was administered. The research instruments were the Rosenberg Self-Esteem Scale (1965) and the modified Yale-Brown Scale for Body Dysmorphic Disorder by Phillips et al. (1997). The first experimental group underwent mentalization therapy and the second experimental group underwent acceptance and commitment therapy in the form of 20 45-minute sessions twice a week. The control group did not receive any intervention during this period. After completing the sessions and also three months after implementing the interventions, the research groups were re-evaluated. The results were analyzed using repeated measures analysis of variance and SPSS₂₆ software.
Results: In the self-esteem variable, the time factor (F=196.41), the group factor (F=748.9), and the interaction of time and group (F=358.14) are significant. The significance of the interaction of the time factor and group membership, along with the significance of the group factor, indicates that there is a significant difference between the three research groups in the self-esteem variable. The results of the Bonferroni test also showed that in the post-test and follow-up stages, there is no difference between the two treatment groups in the mean of the self-esteem variable (P<0.05), but there is a difference between the mentalization treatment and acceptance and commitment treatment groups and the control group (P<0.01).
Conclusion: Mentalization based therapy and acceptance and commitment therapy are effective interventions in increasing the self-esteem of women with body dysmorphic disorder who are seeking cosmetic surgery.
Keywords: Body dysmorphic disorder, mentalization based therapy, acceptance and commitment therapy, self-esteem.