@2024 Afarand., IRAN
ISSN: 2252-0805 The Horizon of Medical Sciences 2017;23(3):187-192
ISSN: 2252-0805 The Horizon of Medical Sciences 2017;23(3):187-192
Comparison of Body Dysmorphic Metacognition based on the Personality Dimensions between Two Behavioral Activation and -Inhibition Systems in Adolescents
ARTICLE INFO
Article Type
Descriptive & Survey StudyAuthors
Amiri S. (* )Rafiei Z. (1 )
Azad-Marzabadi E. (2)
(* ) Psychology Department, Literature & Human Sciences Faculty, Urmia University, Urmia, Iran
(1 ) Psychology Department, Literature & Human Sciences Faculty, Urmia University, Urmia, Iran
(2) Behavioral Sciences Research Canter, Baqiatollah University of Medical Sciences, Tehran , Iran
Correspondence
Address: Psychology Department, Literature & Human Sciences Faculty, Urmia University, Valfajr Street, Urmia, IranPhone: -
Fax: -
amirysohrab@yahoo.com
Article History
Received: December 20, 2016Accepted: April 8, 2017
ePublished: July 22, 2017
BRIEF TEXT
The teenage period has been identified as a critical period in the formation of psychological trauma, which involves many transitions including changes in the social environment and puberty. These rapid developmental changes, along with other common stresses trigger psychological injuries [1].
… [2-24]. In a study of patients with BDD, higher levels of injury avoidance, has been reported as a BIS related personality trait [25]. These findings indicate behavioral inhibition in people with BDD. However, studies in this area are often carried out on small clinical group with BDD disorder, and research on personality factors in BDD is low; personality factors in people with BDD as an example of total population have not been considered [26]. … [27].
The aim of this study was to investigate the body dysmorphic metacognition dimensions based on personality traits associated with Behavioral Activation System (BAS) and Behavioral Inhibition System (BIS) in adolescents.
The present study is post-traumatic (causal/comparison).
This study was conducted in 2015 among all male and female high school students in Arak City.
60 individuals from the first prototype based on the standard score (z) on the brain/behavioral scale were divided into four groups of 15 including individuals with a High-Level Behavioral Activator System (HBIS) and Low Behavioral Inhibition System (LBIS).
Behavioral Activation System and Behavioral Inhibition Scale (BAS/BIS): This scale has been prepared by Carvar and White [23] and consists of 24 items, seven of which are related to BIS and 13 of which are related to BAS. The other 4 items of this questionnaire are neutral. The items are ranked by the four grade Likert Scale from “totally disagree” (with score one) to “totally agree” (with score 4) by the subjects. Carver and White [23] have reported the internal consistency of BIS and the subscales of drive, joy seeking, and answering as 0.74, 0.73, 0.76 and 0.66 respectively. The internal consistency of the subscales of the inhibition of the behavior is 0.69 and the internal consistency of behavioral activation subscales are 0.87, 0.74, and 0.65 respectively; the internal consistency of the total subscale of behavioral activation is 0.78. Estimation of test-retest reliability over a two week interval for the subscale of behavioral inhibition and the subscales of behavioral activation including traumatizing, seeking entertainment, responding to rewards and the total subscale of behavioral activation are 0.68, 0.71, 0.73, 0.62 and 0.71 respectively [28]. Body Deformity Metacognition Scale: This questionnaire consists of 31 questions and four factors of metacognitive control strategies (in appearance), objectification of thoughts (mixture of thoughts), positive and negative metacognitive beliefs and secure behaviors about body deformity, which are ranked in the form of a four-level Likert Scale. Each of the factors of this scale consists of 14 items, 8 items, 5 items, and 4 items respectively [29]. Cronbach's alpha coefficients for each of the subscales and the whole scale was between 0.70 and 0.94 which indicates the desired inner stability of the scale [29]. The concurrent validity of the dysmorphic metacognition scale with the desired inner stability scale was obtained 0.74 (p<0.001). Also, the reliability coefficients of the Cronbach's alpha scales of metacognitive control strategies, objectivity of thoughts, metacognitive positive and negative beliefs, safety behaviors and total scale were 0.90, 0.91, 0.78, 0.70, and 0.94 respectively [29]. … [30-31]. Statistical analysis: At first, the normal distribution of the collected data and consistency of their variance were investigated by Kolmogorov-Smirnov test and Levene test. Then, in order to compare four personality groups in the dimensions of physical deformity, multivariate analysis of variance, univariate analysis of variance, and Schaffe post hoc test were used.
Of the participants, 20 (33.3), 22(36.7), and 18 (30.0%) were studying in the fields of mathematics and physics, science and humanities respectively. Of these, 22 (36.7%), 17(28.3%) and 21 (35.0%) were in the second and third grades of high school, and pre-university level respectively. The mean scores of the four groups in the body deformity metacognition dimensions showed a significant difference with each other (p<0.001), that the component of metacognitive control strategies of the LBIS group had a lower score compared to other personality groups and the HBIS group showed a higher score compared to LBAS group. In the component of objectifying thoughts, individuals in the LBIS group scored lower compared to LBAS and HBIS groups. In the components of metacognitive positive and negative beliefs and secure believes, the HBAS and in the component of secure behaviors, HBIS groups had the higher score respectively (p<0.05; Table 1).
… [32-33]. A review of the studies show that the high and low levels of BAS and BIS sensitivity tend to be signs of specific types of psychological injuries including obsession [34], depression [35], bipolar disorder [36], rumination and neurological symptoms of overeating [37]. Therefore, the findings of this study can be considered in line with related theories and previous findings that behavioral inhibition is a risk factor for psychiatric disorders [38] as it is also shown in this study that behavioral Inhibition System (BIS) is more relevant to metacognitive beliefs about body deformity disorder than behavioral activator system.
It is suggested that the explanation of the results of the interim analyzes of this study be followed by cause and effect method. In addition, intermediate models be tested using longitudinal or experimental studies. It is also recommended that similar studies be conducted on clinical populations and age groups. With regards to personality differences. BAS and BIS can be considered as an interpersonal variable, and similarly it is recommended to use other means of personality trait tools to increase the validity of the current study.
Some limitations of this study should be considered. The present study was a cross-sectional study that cannot be a causal relationship illustrator. Another limitation of the present study was that data was collected only through self-reported scale that could threaten internal validity. Applying multiple methods for evaluation can reduce the impact of the subject. Also, another limitation of the present study was that participants were among adolescent students and were therefore often in the same range, and on the other hand, non-clinical subjects were included. Therefore, the generalization of the results to the other age groups and clinical population should be cautious.
Body deformity metacognition is affected by personality traits based on the sensitivity of behavioral activator systems (BAS) and behavioral inhibition system (BIS).
Thanks to all the contributors who helped researchers to do the study.
Non-declared
At all stages of the research, ethical considerations in working with the participants were observed.
This article is the results of the authors' research and its financial sources are personal.
TABLES and CHARTS
Show attach fileCITIATION LINKS
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[20]Tapper K, Baker L, Jiga-Boy G, Haddock G, Maio GR. Sensitivity to reward and punishment: Associations with diet, alcohol consumption, and smoking. Personal Individ Dif. 2015;72:79-84.
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[22]Gray JA, Mcnaughton N. The neuropsychology of anxiety: An enquiry into the functions of the septo-hippocampal system. Oxford: Oxford University Press; 2000.
[23]Carver CS, White TL. Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: the BIS/BAS scales. J Personal Soc Psychol. 1994;67(2):319-33.
[24]Cohen LJ, Kingston P, Bell A, Kwon J, Aronowitz B, Hollander E. Comorbid personality impairment in body dysmorphic disorder. Compr Psychiatry. 2000;41(1):4-12.
[25]Mancuso SG, Knoesen NP, Chamberlain JA, Cloninger CR, Castle DJ. The temperament and character profile of a body dysmorphic disorder outpatient sample. Personal Ment Health. 2009;3(4):284-94.
[26]Buhlmann U, Etcoff NL, Wilhelm S. Facial attractiveness ratings and perfectionism in body dysmorphic disorder and obsessive-compulsive disorder. J Anxiety Disord. 2008;22(3):540-7.
[27]Phillips KA. Body dysmorphic disorder: Recognizing and treating imagined ugliness. World Psychiatry. 2004;3(1):12-7.
[28]Amiri S, Hassani J. Assessment of psychometric properties of behavioral activation and behavioral inhibition systems scale associated with impulsivity and anxiety. Razi J Med Sci. 2016;23(144):68-80. [Persian]
[29]Rabiei M, Salahian A, Bahrami F, Palahang H. Construction and standardization of the body dysmorphic metacognition questionnaire. J Mazandaran Univ Med Sci. 2011;21(83):43-52. [Persian]
[30]Wells A, Matthews G. Modeling cognition in emotional disorder: The S-REF model. Behav Res Ther. 1996;34(11-12):881-8.
[31]Rachman S, Shafran R. Cognitive distortions: Thought-action fusion. Clin Psychol Psychother. 1999;6(2):80-5.
[32]Meyer B, Johnson SL, Winters R. Responsiveness to threat and incentive in bipolar disorder: Relations of the BIS/BAS scales with symptoms. J Psychopathol Behav Assess. 2001;23(3):133-43.
[33]Kimbrel NA. A model of the development and maintenance of generalized social phobia. Clin Psychol Rev. 2008;28(4):592-612.
[34]Fullana M, Mataix-Cols D, Trujillo JL, Caseras X, Serrano F, Alonso P, et al. Personality characteristics in obsessive–compulsive disorder and individuals with subclinical obsessive–compulsive problems. Br J Clin Psychol. 2004;43(4):387-98.
[35]Pinto-Meza A, Caseras X, Soler J, Puigdemont D, Perez V, Torrubia R. Behavioral inhibition and behavioral activation systems in current and recovered major depression participants. Personal Individ Dif. 2006;40(2):215-26.
[36]Alloy LB, Abramson LY, Walshaw PD, Cogswell A, Grandin LD, Hughes ME, et al. Behavioral approach system and behavioral inhibition system sensitivities and bipolar spectrum disorders: Prospective prediction of bipolar mood episodes. Bipolar Disord. 2008;10(2):310-22.
[37]Tull MT, Gratz KL, Latzman RD, Kimbrel NA, Lejuez CW. Reinforcement sensitivity theory and emotion regulation difficulties: A multimodal investigation. Personal Individ Differ. 2010;49:989-94.
[38]Bijttebier P, Beck I, Claes L, Vandereycken W. Gray’s Reinforcement Sensitivity Theory as a framework for research on personality–psychopathology associations. Clin Psychol Rev. 2009;29(5):421-30.
[2]Rudiger JA, Cash TF, Roehrig M, Thompson JK. Day-to-day body-image states: Prospective predictors of intra-individual level and variability. Body Image. 2007;4(1):1-9.
[3]Cash TF, Smolak L. Body image: A handbook of science, practice, and prevention. 2nd edition. New York: Guilford Press; 2011.
[4]Greenberg JL, Markowitz S. Cognitive-behavioral therapy for adolescent body dysmorphic disorder. Cogn Behav Pract. 2010;17(3):248-58.
[5]American Psychiatric Association. Diagnostic & statistical manual of mental disorders. 5th edition. Washington, DC: American Psychiatric Association; 2013.
[6]Phillips KA, Menard W, Fay C, Weisberg R. Demographic characteristics, phenomenology, comorbidity, and family history in 200 individuals with body dysmorphic disorder. Psychosomatics. 2005;46(4):317-25.
[7]Phillips KA. The broken mirror: Understanding and treating body dysmorphic disorder (Revised & Expanded Edition). Oxford: Oxford University Press; 2005.
[8]Hadley SJ, Greenberg J, Hollander E. Diagnosing and treatment of body dysmorphic disorder in adolescents. Curr Psychiatry Rep. 2002;4(2):108-13.
[9]Wilhelm S. Feeling good about the way you look: A program for overcoming body image problems. 1st edition. New York: The Guildford Press; 2006.
[10]Schieber K, Kollei I, de Zwaan M, Müller A, Martin A. Personality traits as vulnerability factors in body dysmorphic disorder. Psychiatry Res. 2010;201(1):242-6.
[11]Philips KA. Understanding body dysmorphic disorder. Oxford: Oxford University Press 2009.
[12]Flavell JH. Metacognition and cognitive monitoring: A new area of cognitive developmental inquiry. Am Psychol. 1979;34(10):906-11.
[13]Wells A. Metacognitive therapy for anxiety and depression. New York: Guilford Press; 2009.
[14]Wells A. Emotional disorders and metacognition: Innovative cognitive therapy. New York: John Wiley & Sons; PP: 3-54; 2000.
[15]Cooper MJ, Osman S. Metacognition in body dysmorphic disorder- a preliminary exploration. J Cogn Psychother. 2007;21(3):148-55.
[16]Veale D. Advances in a cognitive behavioral model of body dysmorphic disorder. Body Image. 2004;1(1):113-25.
[17]Gander M, Sevecke K, Buchheim A. Eating disorders in adolescence: Attachment issues from a developmental perspective. Front Psychol. 2015;6:1136.
[18]Gray JA. Framework for a taxonomy of psychiatric disorder. In: van Gozen S, van de Poll N, Sergeant JA, editors. Emotions: Essays on emotion theory. Hillsdale, NJ, US: Lawrence Erlbaum Associates; 1993. pp. 29-59.
[19]Corr PJ. Reinforcement sensitivity theory (RST): Introduction. In: Corr PJ, editor. The reinforcement sensitivity theory of personality. Cambridge: Cambridge University Press; 2008. pp. 1-43.
[20]Tapper K, Baker L, Jiga-Boy G, Haddock G, Maio GR. Sensitivity to reward and punishment: Associations with diet, alcohol consumption, and smoking. Personal Individ Dif. 2015;72:79-84.
[21]Corr PJ. Gray’s reinforcement sensitivity theory: Tests of the joint subsystems hypothesis of anxiety and impulsivity. Personal Individ Dif. 2002;33:511-32.
[22]Gray JA, Mcnaughton N. The neuropsychology of anxiety: An enquiry into the functions of the septo-hippocampal system. Oxford: Oxford University Press; 2000.
[23]Carver CS, White TL. Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: the BIS/BAS scales. J Personal Soc Psychol. 1994;67(2):319-33.
[24]Cohen LJ, Kingston P, Bell A, Kwon J, Aronowitz B, Hollander E. Comorbid personality impairment in body dysmorphic disorder. Compr Psychiatry. 2000;41(1):4-12.
[25]Mancuso SG, Knoesen NP, Chamberlain JA, Cloninger CR, Castle DJ. The temperament and character profile of a body dysmorphic disorder outpatient sample. Personal Ment Health. 2009;3(4):284-94.
[26]Buhlmann U, Etcoff NL, Wilhelm S. Facial attractiveness ratings and perfectionism in body dysmorphic disorder and obsessive-compulsive disorder. J Anxiety Disord. 2008;22(3):540-7.
[27]Phillips KA. Body dysmorphic disorder: Recognizing and treating imagined ugliness. World Psychiatry. 2004;3(1):12-7.
[28]Amiri S, Hassani J. Assessment of psychometric properties of behavioral activation and behavioral inhibition systems scale associated with impulsivity and anxiety. Razi J Med Sci. 2016;23(144):68-80. [Persian]
[29]Rabiei M, Salahian A, Bahrami F, Palahang H. Construction and standardization of the body dysmorphic metacognition questionnaire. J Mazandaran Univ Med Sci. 2011;21(83):43-52. [Persian]
[30]Wells A, Matthews G. Modeling cognition in emotional disorder: The S-REF model. Behav Res Ther. 1996;34(11-12):881-8.
[31]Rachman S, Shafran R. Cognitive distortions: Thought-action fusion. Clin Psychol Psychother. 1999;6(2):80-5.
[32]Meyer B, Johnson SL, Winters R. Responsiveness to threat and incentive in bipolar disorder: Relations of the BIS/BAS scales with symptoms. J Psychopathol Behav Assess. 2001;23(3):133-43.
[33]Kimbrel NA. A model of the development and maintenance of generalized social phobia. Clin Psychol Rev. 2008;28(4):592-612.
[34]Fullana M, Mataix-Cols D, Trujillo JL, Caseras X, Serrano F, Alonso P, et al. Personality characteristics in obsessive–compulsive disorder and individuals with subclinical obsessive–compulsive problems. Br J Clin Psychol. 2004;43(4):387-98.
[35]Pinto-Meza A, Caseras X, Soler J, Puigdemont D, Perez V, Torrubia R. Behavioral inhibition and behavioral activation systems in current and recovered major depression participants. Personal Individ Dif. 2006;40(2):215-26.
[36]Alloy LB, Abramson LY, Walshaw PD, Cogswell A, Grandin LD, Hughes ME, et al. Behavioral approach system and behavioral inhibition system sensitivities and bipolar spectrum disorders: Prospective prediction of bipolar mood episodes. Bipolar Disord. 2008;10(2):310-22.
[37]Tull MT, Gratz KL, Latzman RD, Kimbrel NA, Lejuez CW. Reinforcement sensitivity theory and emotion regulation difficulties: A multimodal investigation. Personal Individ Differ. 2010;49:989-94.
[38]Bijttebier P, Beck I, Claes L, Vandereycken W. Gray’s Reinforcement Sensitivity Theory as a framework for research on personality–psychopathology associations. Clin Psychol Rev. 2009;29(5):421-30.