ارزیابی مدل فراتشخیصی لینچ برای اختلالات درونی‌سازی در رابطه با هراس اجتماعی: مدل‌یابی معادلات ساختاری

نوع مقاله : مقاله پژوهشی

نویسندگان

1 Ph.D. in clinical psychology, Assistant professor, University of Bojnord, Bojnord, Iran

2 Ph.D. in clinical psychology, Professor, Department of clinical psychology, Shahed University, Iran

3 Associate professor, Department of psychology, Tehran University, Tehran, Iran

4 Department of psychology, Tarbiat Modares University, Tehran, Iran

چکیده

مقدمه: مدل لینچ، یک مدل فراتشخیصی جدید است که به تبیین اختلالات درونی سازی می­پردازد. مطالعه حاضر، بخش­های مهم این مدل را  در رابطه با هراس اجتماعی، به عنوان یک اختلال درونی­سازی، مورد بررسی قرار می­دهد.
روش کار: در این مطالعه، 521 دانشجو از سه دانشگاه  (دانشگاه تهران، دانشگاه شاهد و دانشگاه آزاد- واحد علوم پزشکی تهران) در سال تحصیلی 95-1394 با استفاده از روش نمونه­گیری در دسترس انتخاب شدند و از طریق پرسش­نامه هراس اجتماعی، مقیاس کمال­گرایی چندبعدی فراست (خرده­مقیاس­های کمال­گرایی ناسازگارانه)، پرسش­نامه دوسوگرایی در ابراز هیجان، مقیاس امنیت و لذت اجتماعی و پرسش­نامه مشکلات بین­فردی مورد ارزیابی قرار گرفتند. داده­ها با استفاده از روش مدل­یابی معادلات ساختاری، نرم افزارهای SPSS نسخه 22 و AMOS نسخه 22 مورد تحلیل قرار گرفتند.
یافته­ها: مدل ذکر شده برازش خوبی را نشان داد (  :9/2؛ RMSEA: 06/0؛ CFI: 98/0؛ GFI: 98/0؛ AGFI: 96/0). مطابق با نتایج به دست آمده، سبک مقابله­ای بیش­کنترل­گرایانه (شامل بیش­کمال­گرایی، دوسوگرایی هیجانی، مشکلات بین­فردی و فقدان امنیت اجتماعی) میانجی رابطه بین کمال­گرایی والدینی و هراس اجتماعی هستند (اثر غیرمستقیم کمال­گرایی والدینی بر هراس اجتماعی از طریق بیش­کنترل­گری: 35/0، 001/0 p <).
نتیجه­گیری: به نظر می رسد که مدل فراتشخیصی لینچ برای اختلالات درونی­سازی در زمینه هراس اجتماعی مورد تایید باشد. بر این اساس، کمال­گرایی ناسازگارانه والدینی به سبک مقابله­ای بیش­کنترل­گرانه منجر می­شود؛ این سبک مقابله­ای نیز به نوبه خود به هراس اجتماعی منجر می­شود.

کلیدواژه‌ها


  1. Kessler RC, Chiu W, Demler O, Walters EE. Prevalence,  severity,  and  comorbidity  of  12-month  DSM-IV disorders  in  the  National  Comorbidity  Survey    Arch Gen Psychiatry 2005; 62: 617-27.
  2. Forman–Hoffman VL, Batts KR, Hedden SL, Spagnola K, Bose J. Comorbid mental disorders among adults in the mental health surveillance survey. Ann Epidemiol 2018; 28(7): 468-74.
  3. Alonso, J, Mortier, P, Auerbach, RP, Bruffaerts R, Vilagut G, Cuijpers P, et al. Severe role impairment associated with mental disorders: Results of the WHO World Mental Health Surveys International College Student Project. Depress Anxiety 2018; 35: 802-14.
  4. Hendriks SM, Spijker J, Licht CMM, Hardeveld F, de Graaf R, Batelaan NM, et al. Long-term disability in anxiety disorders. BMC Psychiatry 2016; 16(1): 248.
  5. Stein DJ, Lim CCW, Roest AM, de Jonge P, Aguilar-Gaxiola S, Al-Hamzawi A, et al. The cross-national epidemiology of social anxiety disorder: Data from the World Mental Health Survey Initiative. BMC Med 2017; 15(1): 143.
  6. Narusyte J, Amin MR, Svedberg P. Social phobia in adolescence, sickness absence and unemployment: a prospective twin study. Eur J Public Health 2017; 27(suppl 3): ckx189.130.
  7. Wittchen HU, Fehm L. Epidemiology, patterns of comorbidity, and associated disabilities of social phobia. Psychiatr Clin N Am 2001; 24(4): 617-41.
  8. Ruscio AM, Brown TA, Chiu WT, Sareen J, Stein MB, Kessler RC. Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication. Psychol Med 2008; 38(1): 15-28.
  9. Koyuncu A, İnce E, Ertekin E, Tükel R. Comorbidity in social anxiety disorder: diagnostic and therapeutic challenges. Drugs Context 2019; 8: 212573.
  10. De Graaf R,  Bijl RV, Spijker J,  Beekman ATF,  Vollebergh Temporal sequencing of lifetime mood disorders in relation to comorbid anxiety and substance use disorders. Findings from the Netherlands Mental Health Survey and Incidence Study. Soc Psychiatr Psychiatr Epidemiol 2003; 38: 1-11.
  11. Ohayon MM, Schatzberg AF. Social phobia and depression: Prevalence and comorbidity. J Psychosom Res 2010; 68(3): 235-43.
  12. Cummings CM, Caporino NE, Kendall PC. Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychol Bull 2014; 140(3): 816-45.
  13. Beesdo K, Bittner A, Pine DS, Stein MB, Hofler M, Lieb R, et al. Incidence of social anxiety disorder and the consistent risk for secondary depression in the first three decades of life. Arch Gen Psychiatry 2007; 64(8): 903-12.
  14. Kraines MA, White EJ, Grant DM, Wells TT. Social anxiety as a precursor for depression: Influence of interpersonal rejection and attention to emotional stimuli. Psychiatr Res 2019; 275: 296-303.
  15. Acarturk C, de Graaf R, van Straten A, Have M, Cuijpers P. Social phobia and number of social fears, and their association with comorbidity, health-related quality of life and help seeking: A population-based study. Soc Psychiatr Psychiatr Epidemiol 2008; 43: 273-9.
  16. Wenzel, A. Relation to clinical syndromes in adulthood. In: Hofmann SG, DiBartolo PM. (editors). Social anxiety: Clinical, developmental, and social perspectives. 2nd London: Academic Press; 2010: 183-205.
  17. Nagata T, Suzuki F, Teo AR. Generalized social anxiety disorder: a still-neglected anxiety disorder 3 decades since Liebowitz’s review. Psychiatry Clin Neurosci 2015; 69(12): 724-40.
  18. Wersebe H, Lieb R, Meyer AH, Miche M, Mikoteit T, Imboden C, et al. Well-being in major depression and social phobia with and without comorbidity. Int J Clin Health Psychol 2018 ; 18(3): 201-8.
  19. Blanco C, Heimberg RG, Schneier FR, Fresco DM, Chen H, Turk CL, et al. A placebo-controlled trial of phenelzine, cognitive behavioral group therapy, and their combination for social anxiety disorder. Arch Gen Psychiatry 2010; 67(3): 286-95.
  20. Menezes GB, Fontenelle LF, Mululo S, Versiani M. Treatment-resistant anxiety disorders: social phobia, generalized anxiety disorder and panic disorder. Revista Brasileira de Psiquiatria 2007; 2: S55-60. (Brazilian)
  21. Roy-Byrne P. Treatment in nonresponsive patients with social anxiety: Back to the future with benzodiazepines. Am J Psychiatry 2014; 171(1): 1-4.
  22. Arch JJ, Ayers CR. Which treatment worked better for whom? Moderators  of  group  cognitive  behavioral  therapy versus  adapted  mindfulness  based  stress  reduction  for  anxiety    Behav Res Ther 2013; 51: 434-42.
  23. Newby JM, McKinnon A, Kuyken W, Gilbody S, Dalgleish T. Systematic review and meta-analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood. Clin Psychol Rev 2015; 40: 91-110.
  24. Lynch TR, Gray KL, Hempel RJ, Titley M, Chen EY, O´Mahen HA. Radically open-dialectical behavior therapy for adult anorexia nervosa: Feasibility and outcomes from an inpatient program. BMC Psychiatry 2013; 13: 293.
  25. Lynch TR, Hempel RJ, Dunkley C. Radically open-dialectical behavior therapy for disorders of over-control: Signaling matters. Am J Psychother 2015; 69(2): 141-62.
  26. Lynch T, Seretis D, Hemple R. Radically open-dialectical behaviour therapy: Theory and practice for treating disorders of overcontrol. New York: Guilford; 2018.
  27. Achenbach TM, Edelbrock CS. The classification of child psychopathology: A review and analysis of empirical efforts. Psychol Bull 1978; 85(6): 1275-301.
  28. Krueger RF, Caspi A, Moffitt TE, Silva PA. The structure and stability of common mental disorders (DSM-III-R): a longitudinal-epidemiological study. J Abnorm Psychol 1998; 107(2): 216-27.
  29. Krueger RF, McGue M, Iacono WG. The higher-order structure of common DSM mental disorders: internalization, externalization, and their connections to personality. Pers Individ Diff 2001; 30(7): 1245-59.
  30. Alavi Kh, Asghari Moghadam MA, Rahiminazhad A, Farahani H. [The evaluation of transdiagnostic model based on Lynche’s theory in regard to depression in nonclinical population]. Journal of research in psychological health 2018; 12 (1): 37-53. (Persian)
  31. Loehlin JC. Latent variable models: An introduction to factor, path and structural analysis. 4th Hillsdale, NJ: Erlbaum; 2004.
  32. Norman GR, Streiner DL. PDQ Statistics (PDQ Series). 3rd Toronto: BC; 2003.
  33. Kline RX. Principles and practicen of structural equation modeling. 3rd New York: Guilford; 2011.
  34. Hooman HA. [Structural equation modeling with LISREL application]. Tehran: SAMT; 2008. (Persian)
  35. American Psychological Association. Publication manual of the American Psychological Association. 6th Washington, DC: American Psychological Association; 2009.
  36. Connor KM, Davidson JRT, Churchill LE, Sherwood A, Foa E, Weisler RH. Psychometric properties of the social phobia inventory (SPIN). Br J Psychiatry 2000; 176: 379-86.
  37. Antony MM, Coons MJ, McCabe RE, Ashbaugha A, Swinsona RP. Psychometric properties of the social phobia inventory: Further evaluation. Behav Res Ther 2006; 44: 1177-85.
  38. Atrifard M, Mokhberiannezhad R, Zarei A, Hoseini M. [Factor structure of the Persian form of social phobia inventory in an Iranian nonclinical sample]. Journal of research in psychological health 2015; 9(2): 40-53. (Persian)
  39. Amoozadeh MH, Bagheri A, Shairi MR. [Reliability and validity of SPIN in nonclinical students’ samples]. Proceeding of the 5th Seminar of students’ mental health; 2010: 75-6. (Persian)
  40. Frost RO, Marten P, Lahart C, Rosenblate R. The dimensions of perfectionism. Cogn Ther Res 1990; 14(5): 449-68.
  41. Bitaraf Sh, Shaeeri MR, Hakim Javadi M. [Social phobia, parenting styles, and perfectionism]. Developmental psychology: Iranian psychologists 2010; 7: 75-82. (Persian)
  42. King LA, Emmons RA. Conflict over emotional expression: psychological and physical correlates. J Pers Soc Psychol 1990; 58(5): 864-77.
  43. Alavi Kh, Asghari Moghadam A, Rahiminezhad A, Farahani H. [Psychometric properties of ambivalence over emotional expression questionnaire]. Research in psychological health 2017; 11 (1): 74-91. (Persian)
  44. Gilbert P, McEvan K, Mitra, R, Richter A, Franks L, Mills A, et al. An exploration of different types of positive affect in students and in patients with bipolar disorder. Clin Neuropsychiatry 2009; 6:135-43.
  45. Alavi Kh, Asghari Moghadam A, Rahiminezhad A, Farahani H, Modares M. Psychometric properties of Social Safeness and Pleasure Scale (SSPS). Journal of fundamentals of mental health 2017; 19(1): 5-13.
  46. Kelly AC, Carter JC. Eating disorder subtypes differ in their rates of psychosocial improvement over treatment. J Eat Disord2014; 2: 2.
  47. Barkham M, Hardy GE, Startup M. The IIP-32: A short version of the Inventory of Interpersonal Problems. Br J Clin Psychol 1996; 35(1): 21-35.
  48. Fath N, Azadfallah P, Tabatabayi K, Rahimi CH. [Validity and reliability of the inventory of interpersonal problems]. Clinical psychology 2013; 5(3): 69-80. (Persian)
  49. Wheaton B, Muthen B, Alwin DF, Summers G. Assessing reliability and stability in panel models. Soc Method 1977; 8(1): 84-136.
  50. Kline RX. Principles and practice of structural equation modeling. 4th New York: Taylor and Francis group; 2016.
  51. Diamantopoulos A, Siguaw JA. Introducing LISREL: A guide for the uninitiated. New York: Sage; 2009.
  52. Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural equation modeling 1992; 6(1): 1-55.
  53. Byrne BM. Structural equation modeling with AMOS: Basic concepts, applications and programming. 2nd New York: Taylor and Francis group; 2010.
  54. Vieira AL. Interactive LISREL in practice: Getting started with a SIMPLIS approach. New York: Springer; 2011
  55. Preacher KJ, Hayes AF. Asymptotic and resampling strategies for comparing indirect effects in multiple mediator models. Behav Res Methods 2008; 40: 879-91.
  56. Per Villiers D. Perfectionism and social anxiety among college students. D. Dissertation. Boston, Massachusetts: Northeastern University, 2009.
  57. Mohammadian Y, Mahaki B, Dehghani M, Vahid M, Lavasani F. Investigating the role of interpersonal sensitivity, anger, and perfectionism in social anxiety. Int J Prev Med 2018; 9(1): 2.
  58. Asendorppf JB, Borkenau P, Ostendorf F, Van Aken MAG. Carving personality description at its joints: Confirmation of three replicable personality prototypes for both children and adults. Eur J Pers 2001; 15: 169-98
  59. Robins RW, John OP, Caspi A, Moffitt TE, Stouthamer-Loeber M. Resilient, overcontrolled, and undercontrolled boys: three replicable personality types. J Pers Soc Psychol 1996; 70(1): 157-71.
  60. Turner BJ, Claes L, Wilderjans TF, Pauwels E, Dierckx E, Chapman AL, et al. Personality profiles in Eating Disorders: Further evidence of the clinical utility of examining subtypes based on temperament. Psychiatr Res 2014; 219(1): 157-65.
  61. Egan SJ, Wade TD, Shafran R. Perfectionism as a transdiagnostic process: A clinical review. Clin Psychol Rev 2011; 31(2): 203-12.
  62. Rice KG, Aldea MA. State dependence and trait stability of perfectionism: A short-term longitudinal study. J Couns Psychol 2006; 53(2): 205-13.
  63. Nikooi [Perfectionism and fear of others evaluation in explaining social phobia]. Journal of educational psychology studies 2010; 7(12): 93-112. (Persian)
  64. Levinson CA, Rodebaugh TL, Shumaker EA, Menatti AR, Weeks JW, White EK, et al. Perception matters for clinical perfectionism and social anxiety. J Anxiety Disord 2015; 29: 61-71.
  65. Yap K, Gibbs AL, Francis AJ, Schuster SE. Testing the bivalent fear of evaluation model of social anxiety: The relationship between fear of positive evaluation, social anxiety, and perfectionism. Cognit Behav Ther 2016; 45(2): 136-49.
  66. Newby J, Pitura VA, Penney AM, Klein RG, Flett GL, Hewitt PL. Neuroticism and perfectionism as predictors of social anxiety. Pers Individ Dif 2017; 106: 263-7.
  67. Antony MM, Purdon CL, Huta V, Swinson RP. Dimensions of perfectionism across the anxiety disorders. Behav Res Ther 1998; 36(12): 1143-54.
  68. Juster HR, Heimberg RG, Frost RO, Holt CS, Mattia JI, Faccenda K. Social phobia and perfectionism. Pers Individ Dif 1996; 21(3): 403-10.
  69. Klemanski DH, Curtiss J, McLaughlin KA, Nolen-Hoeksema S. Emotion regulation and the transdiagnostic role of repetitive negative thinking in adolescents with social anxiety and depression. Cogn Ther Res 2017; 41(2): 206-19.
  70. Spokas M, Luterek JA, Heimberg RG. Social anxiety and emotional suppression: the mediating role of beliefs. J Behav Ther Exp Psychiatry 2009; 40(2): 283-91.
  71. Dryman MT, Heimberg RG. Emotion regulation in social anxiety and depression: a systematic review of expressive suppression and cognitive reappraisal. Clin Psychol Rev 2018; 65: 17-42.
  72. Ranta K, La Greca AM, Kaltiala-Heino R, Marttunen M. Social phobia and educational and interpersonal impairments in adolescence: A prospective study. Child Psychiatr Hum Dev 2016; 47(4): 665-77.
  73. Stangier U, Esser F, Leber S, Risch AK, Heidenreich T. Interpersonal problems in social phobia versus unipolar depression. Depress Anxiety 2006; 23(7): 418-21.
  74. Romano M, Moscovitch DA, Ma R, Huppert JD. Social problem solving in social anxiety disorder. J Anxiety Disord 2019; 68: 102152.
  75. Cook LC. The infuence of parent factors on child perfectionism: A cross-sectional study. Ph.D. Dissertation. Las Vegas: University of Nevada, 2012.
  76. Lozano LM, Valor-Segura I, Lozano L. Could a perfectionism context produce unhappy children? Personality and Individual Differences 2015; 80: 12-17.
  77. Azizi K, Besharat MA. The relationship between parental perfectionism and parenting styles. Procedia Soc Behav Sci 2011; 15(Suppl C): 1484-7.
  78. Madjar N, Voltsis M, Weinstock MP. The roles of perceived parental expectation and criticism in adolescents’ multidimensional perfectionism and achievement goals. Educ Psychol 2013; 35(6): 765-78.
  79. Choi Ju Y, Suh Kyung H. [Ambivalence over emotional expressiveness and interpersonal anxiety]. Korean journal of health psychology 2015; 20(1): 175-91. (Korean)
  80. HopfingerL, Berking M, Bockting CL, Ebert DD. Emotion regulation mediates the effect of childhood trauma on depression. J Affect Disord 2016; 198: 189-97.
  81. Huh HJ, Kim SY, Yu JJ, Chae JH. Childhood trauma and adult interpersonal relationship problems in patients with depression and anxiety disorders. Ann Gen Psychiatry 2014; 13: 26.
  82. Thanh Dang CS. Endorsing the model minority myth: A fine line between social support, parental perfectionism and depression among Asian college students. Dissertation. Ohio: The Ohio State University, 2013.
  83. Kelly AC, Dupasquier J. Social safeness mediates the relationship between recalled parental warmth and the capacity for self-compassion and receiving compassion. Pers Individ Diff 2016; 89: 157-61.
  84. Craske MG. Transdiagnostic treatment for anxiety and depression. Depress Anxiety 2012; 29(9): 749-53.
  85. Farchione TJ, Fairholme CP, Ellard KK, Boisseau CL, Thompson-Hollands J, Carl JR, et al. Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behav Ther 2012; 43(3): 666-78.
  86. McEvoy PM, Nathan P, Norton PJ. Efficacy of transdiagnostic treatments: A review of published outcome studies and future research directions. J Cogn Psychother 2009; 23(1): 20-33.
  87. Lynch TR, Hempel RJ, Whalley B, Byford S, Chamba R, Clarke P, et al. Refractory depression - mechanisms and efficacy of radically open dialectical behaviour therapy (RefraMED): Findings of a randomised trial on benefits and harms. Br J Psychiatry 2020; 216(4): 204-12.