Investigating the Structural Relationships of Rumination with the Mediation of Body Image on the Anxiety of People with Bulimia Nervosa Disorder

Document Type : Original Article

Authors

1 PhD student, Department of General Psychology, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran

2 Associate Professor, Department of Psychology, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran

3 Associate Professor, Department of Psychology, University of Hormozgan, Bandar Abbas, Iran

4 Assistant Professor, Department of Psychology, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran

10.22034/pdmd.2024.444564.1050

Abstract

The present research was conducted with the aim of investigating the structural relationships of rumination with the mediation of body image on the anxiety of people with bulimia nervosa disorder. This study was a descriptive from type of correlation. The statistical population of this research was all women with bulimia nervosa disorder who referred to counseling and psychology centers of Tehran city in the spring of 2022 year. The sample of the present study was 260 people who were selected according to the inclusion criteria with using the purposeful sampling method. The research tools were included the rumination questionnaire of Nolen-Hoeksema and Morrow (1991), anxiety subscale of the stress, anxiety and depression scale of Lovibond and Lovibond (1995) and body image concern inventory of Littleton et al (2005). The data of this study were analyzed by Pearson correlation coefficient and path analysis methods in SPSS-21 and LISREL-8.8 software. The findings showed that there were a positive and significant relationship between rumination, anxiety and body image concern in people with bulimia nervosa disorder (P<0.01). In addition, rumination model with the mediation of body image concern on the anxiety of people with bulimia nervosa disorder had a good fit. Also, the effect of rumination on the anxiety was significant (P<0.001), but the effect of rumination on the body image concern and the effect of body image concern on the anxiety was not significant (P>0.05). In addition, the effect of rumination with the mediation of body image concern on the anxiety was not significant (P>0.05). According to the results of this study, in order to reduce the anxiety of people with bulimia nervosa disorder can be used by educational workshops prepare the ground for reducing rumination.

Keywords


Andrews PW, Altman M, Sevcikova M, Cacciatore J. (2021). An evolutionary approach to grief-related rumination: Construction and validation of the bereavement analytical rumination questionnaire. Evolution and Human Behavior, 42(5), 441-452.
Asfaw A. (2024). Paid sick leave and self-reported depression and anxiety: Evidence from a nationally representative longitudinal survey. American Journal of Preventive Medicine, 66(4), 627-634.
Aslmarz F, Aidi Sh. (2020). Investigating the factors affecting anxiety and ruling depression in between teachers and its effect on student’s mental health. Sociology of Education, 6(1), 1-12. (Persian)
Ataei R, Ghasemzadeh A, Haghi N. (2023). The effectiveness of metacognitive therapy on anxiety and communication skills of secondary school girls in Parsabad city. Psychological Dynamics in Mood Disorders, 2(1), 1-11. (Persian)
Azimi Khatibani SM, Amoopour M. (2018). Investigate the relationship between creativity with obsessive beliefs and rumination in high school students in the city of Rasht. Sociology of Education, 9, 157-171. (Persian)
Babakhanlou A, Babakhanlou Z. (2023). Presenting structural model of emotional eating in people with obesity based on self-regulation with the mediating role of emotional processing. Psychological Dynamics in Mood Disorders, 2(2), 30-40. (Persian)
Baharlou F, Mahdian H, Bakhshipour A. (2023). Comparison the effectiveness of dialectical behavior therapy and transactional behavior analysis on the interpersonal problems of students with social anxiety. Sociology of Education, 9(2), 345-355. (Persian)
Battaglini AM, Rnic K, Tracy A, Jopling E, LeMoult J. (2021). Co-rumination across in-person and digital communication: Associations with affect and relationship closeness in adolescents. Journal of Adolescence, 89, 161-169.
Besharat MA, Bagheri S, Rostami R, Tavalaeyan F. (2015). Meditating role of rumination and worry on the relationship between locus of control with depression and anxiety in a sample of depressed and anxious patients. Research Clinical Psychology and Counseling, 5(2), 16-31. (Persian)
Brichacek AL, Neill JT, Murray K, Rieger E, Warsford C. (2023). Ways of responding to body image threats: Development of the body image flexibility and inflexibility scale for youth. Journal of Contextual Behavioral Science, 30, 31-40.
Cardi V, Leppanen J, Leslie M, Esposito M, Treasure J. (2019). The use of a positive mood induction video-clip to target eating behaviour in people with bulimia nervosa or binge eating disorder: An experimental study. Appetite, 133, 400-404.
Cimke S, Gurkan DY. (2023). Factors affecting body image perception, social media addiction, and social media consciousness regarding physical appearance in adolescents. Journal of Pediatric Nursing, 73, 197-203.
Claytor JD, Kochar B, Kappelman MD, Long MD. (2020). Body image dissatisfaction among pediatric patients with inflammatory bowel disease. The Journal of Pediatrics, 223, 68-72.
Edgar EV, Richards A, Castagna PJ, Bloch MH, Crowley MJ. (2024). Post-event rumination and social anxiety: A systematic review and meta-analysis. Journal of Psychiatric Research, 173, 87-97.
Esmaeilpour K, Pak R, Joorbonyaan A. (2021). Investigating the relationship between self-focused attention and social anxiety mediated by rumination. Journal of Psychology New Ideas, 10(14), 1-10. (Persian)
Greenaway AM, Hwang F, Nasuto S, Ho AK. (2024). Rumination in dementia and its relationship with depression, anxiety, and attentional biases. Aging, Neuropsychology and Cognition, In Press.
Hartmann AS, Cordes M, Hirschfeld G, Vocks S. (2019). Affect and worry during a checking episode: A comparison of individuals with symptoms of obsessive-compulsive disorder, anorexia nervosa, bulimia nervosa, body dysmorphic disorder, illness anxiety disorder, and panic disorder. Psychiatry Research, 272, 349-358.
He ZH, Li MD, Liu CJ, Ma XY. (2021). Relationship between body image, anxiety, food-specific inhibitory control, and emotional eating in young women with abdominal obesity: a comparative cross-sectional study. Archives of Public Health, 79(11), 1-10.
Littleton HL, Axsom D, Pury CLS. (2005). Development of the body image concern inventory. Behaviour Research and Therapy, 43(2), 229-241.
Liu J, Tai Z, Hu F. (2024). Prevalence and coping of depression and anxiety among college students during COVID-19 lockdowns in China. Journal of Affective Disorders, 348, 305-313.
Liu Y, Jiang TT, Shi TY. (2020). The relationship among rumination, coping strategies, and subjective well-being in Chinese patients with breast cancer: A cross-sectional study. Asian Nursing Research, 14(4), 206-211.
Lovibond PF, Lovibond SH. (1995). The structure of negative emotional states: Comparison of the depression anxiety stress scales (DASS) with the Beck depression and anxiety inventories. Behaviour Research and Therapy, 33(3), 335-343.
Maldar S, Ahi Q, Gholamrezaei H. (2021). The effectiveness of compassion-based therapy on psychological helplessness of women affected by extramarital affairs. Journal of North Khorasan University of Medical Sciences, 13(2), 8-15. (Persian)
McComb SE, Mills JS. (2022). The effect of physical appearance perfectionism and social comparison to thin-, slim-thick-, and fit-ideal Instagram imagery on young women’s body image. Body Image, 40, 165-175.
Mercado AE, Donthula D, Thomas JE, Ring D, Trust M, Crijns TJ. (2022). Mediators and moderators of the relationship between body image and community integration among burn survivors. Burns, 48(4), 932-940.
Mojtahedzadeh F, Mashayekh A. (2022). Relationship between body image and physical fitness with depression, anxiety and stress in female students from Nour city. Quarterly Journal of Educational Psychology, 12(4), 52-66. (Persian)
Mousavi SM, Narimani M, Asgari SS. (2022). Modeling suicidal ideation based on body Image and rumination with the mediation of social phobia in individuals with gender dysphoria disorder. Journal of Clinical Psychology, 14(4), 39-51. (Persian)
Nematollahi Sh, AfshariNia K, Hosseini S, Kakabraei K, Parandin Sh. (2023). The effectiveness of metacognitive therapy and compassion-based therapy on reducing rumination, anxiety and worry in obsessive-compulsive patients. Psychological Dynamics in Mood Disorders, 2(3), 50-61. (Persian)
Nolen-Hoeksema S, Morrow J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61(1), 115-121.
Pandya SP. (2024). Women with disabilities, body image, and wellbeing: Assessing the effectiveness of dance sessions. Journal of Bodywork and Movement Therapies, 39, 142-155.
Pehlivan MJ, Sherman KA, Wuthrich V, Horn M, Basson M, Duckworth T. (2022). Body image and depression in endometriosis: Examining self-esteem and rumination as mediators. Body Image, 43, 463-473.
Poursaberi R, Yousefpour N, Derakhshan N. (2023). Prediction of school anxiety based on the academic self-efficacy, academic support and academic engagement of first secondary students of Tabriz city. Iranian Journal of Educational Sociology, 6(2), 131-139.
Qin Q, Yang G, Li Y, Wu W, Wang J, Chen Z, et al. (2024) The relationship between major life events and non-suicidal self-injury among college students: the effect of rumination and body image. Frontiers in Public Health, 11(1308186), 1-9.
Rasouli Mahin Z. (2020). The relationship between body image dissatisfaction and alexithymia with smartphone addiction in adolescents. Rooyesh-e-Ravanshenasi, 9(8), 63-70. (Persian)
Saghaei F, Parva M, Samani S. (2022). Effect of environmental psychology on reducing stress and
anxiety on the pediatric dialysis patients. Iranian Journal of Educational Sociology, 4(4), 41-49.
Samadian SH, Estaki M, Koochakentezar R, Baghdassarians A, Ghanbari Panah A. (2021). Explain the mediation role of rumination in the relationship between personality traits and perceived stress with body image concern. Medical Science Journal of Islamic Azad University, 31(2), 218-228. (Persian)
Squires SD, Hu M, Milev RV, Poppenk J. (2022). The impact of non-infection pandemic stress on depression and anxiety severity: Investigating mediation by intrusive and deliberate rumination. Journal of Affective Disorders, 310, 291-295.
Stice E, Rohde P, Shaw H, Desjardins C. (2020). Weight suppression increases odds for future onset of anorexia nervosa, bulimia nervosa, and purging disorder, but not binge eating disorder. The American Journal of Clinical Nutrition, 112(4), 941-947.
Sun X, So SHW, Chung LKH, Chiu CD, Chan RCK, Leung PWL. (2022). Longitudinal bifactor modeling of anxiety, depression and schizotypy - The role of rumination as a shared mechanism. Schizophrenia Research, 240, 153-161.
Treynor W, Gonzalez R, Nolen-Hoeksema S. (2003). Rumination re considered: A psychometric analysis. Cognitive Therapy and Research 27(3), 247-259.
Wang J, Tang L, Wang M, Wu G, Li W, Wang Y, et al. (2023). Fronto-temporal dysfunction in appetitive regulation of bulimia nervosa with affective disorders: A regional homogeneity and remote connectivity pattern analysis. Journal of Affective Disorders, 340, 280-289.
Waring SV, Sharpinskyi K, Kelly AC. (2022). Individual differences in relational body image: Within-person variability predicts maladaptive trait body image. Body Image, 43, 41-53.
Zali R, Esmaeili A, Saberi H. (2023). The mediating role of cognitive flexibility styles in the relationship between anxiety and body image in women with voluntary mastectomy breast cancer. Journal of Applied Family Therapy, 3(5), 567-580. (Persian)
Zarabi Sh, Tabatabaei Nejad F, Latifi Z. (2021). Comparison of the effectiveness of cognitive-behavioral therapy and self-healing therapy on the distress tolerance of women with bulimia nervosa. Journal of Research in Behavioral Sciences, 19(2), 369-380. (Persian)
Zheng Q, Liu F, Xu S, Hu J, Lu H, Liu T. (2023). Artificial intelligence empowering research on loneliness, depression and anxiety — Using Covid-19 as an opportunity. Journal of Safety Science and Resilience, 4(4), 396-409.