Master's Thesis in Psychology (M.A.)
Trend: Clinical
Abstract
The main goal of people with rhinoplasty is to achieve an imaginary shape of the nose that they think is more in harmony with their face in order to achieve a more favorable image of their body. Research has shown that there is a relationship between metacognitive components and cosmetic surgery. The present study was conducted with the aim of determining the effectiveness of metacognitive intervention on reducing the anxiety and depression of cosmetic surgery applicants. For this purpose, 30 applicants for rhinoplasty surgery were selected by available sampling method and then randomly assigned to two groups of 15 people, experimental and control, to conduct the experiment, both groups completed the Das anxiety and Beck depression questionnaires. People in the experimental group underwent group metacognitive therapy in 8 sessions of 60 minutes. Finally, the information collected by the questionnaire was analyzed by spss software and using ANCAVA statistical method. The result of the data analysis showed that reality therapy training has significantly improved the level of anxiety and depression of cosmetic surgery applicants.
Key words: metacognition, anxiety and depression, rhinoplasty
Introduction
Attention to appearance in the social framework is normal, pleasant and even in a balanced way it indicates mental health, but in today's society due to the excessive emphasis on beauty and images presented in fashion, cinema and media magazines. Ha, this attention has taken an extreme form, especially among women. In such a way that almost all women have felt shame and dissatisfaction with their appearance at least once in their life, and this is not limited to a certain stratum, social class, and level of education (Brown, 2001). Such mental preoccupations can lead to the development of a distorted image of the body and self, and even progress in such a way that it provides the basis for suffering from body deformity disorder (Stimmdel, 2002). Therefore, it is not surprising that millions of people volunteer for cosmetic surgery every year (Hawse, 2008). For example, in 1994, the American Society of Plastic and Reconstructive Surgery reported that its members had performed more than 390,000 cosmetic surgeries, including liposuction (removing fat from different areas of the body), breast augmentation, nose surgery, and facelift (Sarwer, 1998).
Along with this increase, it is important to find the motivation and why of the decision to undergo cosmetic surgery. Shakespeare and Kelly (1997) defined cosmetic surgery in this way, a type of surgery to change the appearance of the body, in the absence of disease, damage and injury or congenital and hereditary deformity can be a factor to improve the quality of life (Browning, 2010), social scientists have found that people associate physical beauty with desirable personality traits such as intelligence, competence, agreeableness and social acceptance, which causes increased anxiety and depression. It becomes them. These surgeries are mostly done to eliminate people's dissatisfaction with their appearance and sometimes to increase their self-esteem. Low self-esteem and negative body image usually lead to stress for a person, which a person uses specific coping strategies to overcome. Ziger (2008) considers the use of defense mechanisms as one of the strategies for maintaining self-esteem. Hence, it is important to understand and recognize personality traits. Therefore, cosmetic surgery can be seen as the result of a certain psychological pattern. In other words, it is possible to use neurotic defense mechanisms unconsciously (Kaplan, 2010). It can also be said that for people who volunteer for cosmetic surgery, pursuing beauty through surgery is a psychological withdrawal from reality (defense mechanism), so that a person believes that he is able to rebuild himself, withdraws from reality with the illusion of self-improvement (lima, 2010). In favorable conditions, these patients seek psychotherapy to find out the true nature of their neurotic feelings of inadequacy, otherwise, with the continuation of this problem, the patient may suffer from depression. In addition, studies have shown that some mental states such as depression and anxiety and psychosis and people with schizoid and paranoid personality disorder, dramaturgy and depression are considered inappropriate options for cosmetic surgery (Totunchi et al., 2016)..
To achieve a healthy and satisfying life and create compatibility with others, it is necessary to have a realistic and decent mental image, and if a person feels good about himself physically, he has more chances to have a positive body image. But sometimes stress and anxiety, self-critical views or a person's low self-esteem affect how they feel about their own body, which makes many people change the appearance of their body and undergo plastic surgery (Stuart, 2006). The results of research in America showed that people who had significant symptoms of body image disorder showed high levels of depression, stress, anxiety and suicide. Based on the research, it was determined that body image disturbance leads to the creation of dimensions of cognitive, behavioral and health problems (Jennifer, 2006), which can be treated with several treatment methods, one of these treatment methods is metacognitive therapy.
In the past 40 years, the metacognitive-behavioral model has provided a rich understanding of the impact of cognition on psychological well-being, and techniques for treating anxiety, depression and other disorders have been derived from it. Metacognitive therapy, like the cognitive-behavioral model, sees psychological disorders as the result of distorted thinking. Metacognitions direct attention, determine the thinking style and also lead to the calling of opposite responses that repeatedly lead to the production of ineffective information (Wells, 1994). Therefore, according to what has been said, since people applying for cosmetic surgery due to an ineffective thinking style and high anxiety that manifests due to various reasons, including low self-esteem and negative body image, the researcher seeks to practically demonstrate the metacognitive treatment method on The level of depression of nose surgery applicants has an effect.
1-2- Statement of the problem
Today, cosmetic surgery has become one of human concerns. According to the American Society of Plastic Surgery, more than 13 million plastic surgeries were performed in 2010. In a national survey in Norway, it has been determined that 3% of men and 7% of women aged 18-65 have had some type of plastic surgery (Rahimi, 2013).
Official statistics about cosmetic surgery in Iran are not available. According to an unofficial statistic, more than 36 thousand Iranians undergo cosmetic surgery every year. Among the cosmetic surgeries performed in Iran, nose surgery ranks first. According to unofficial statistics, Iran ranks first in the world in terms of the number of rhinoplasty surgeries. After Iran, the countries of America, England and to some extent France are in the next ranks. These statistics and approximate figures were the only unofficial cases of cosmetic surgery. To these statistics and figures, people who have a desire for it but do not try it because of the fear of consequences should also be added (Bilali and Afsharkhan, 2013).
Humans increasingly feel the inner need to replicate their appearance, certain beauty models as a social norm, however, understanding the boundary between the common desire to improve a person's appearance and neurosis is very important. Extreme dissatisfaction with appearance may hide morbid mental states, and neglecting it may have serious medical consequences (Mozaheri, 2008).
Harris and Moss (2009) showed that the level of anxiety and depression of cosmetic surgery applicants is higher than that of non-applicants. Marsh in the year (2000), in a research, also looked at the relationship of body dissatisfaction in cosmetic surgery applicants with anxiety, depression, social isolation, psychotic disorders, obsession and weakening of self-concept. Therefore, the presence of anxiety and depression in cosmetic surgery applicants, as well as the creation of several treatment methods for the treatment of anxiety disorders in psychological science, metacognition therapy has been introduced as one of the effective treatments for this disorder. Metacognition refers to psychological structures, knowledge and processes, which deals with controlling, changing thoughts and cognitions. According to recent theorists, metacognition is one of the important factors in the development and continuation of psychological disorders. Metacognition affects emotional processing and reactions related to injury, through the effect of metacognitive knowledge and strategies on changing beliefs, as well as the interpretation of specific symptoms such as disturbing thoughts, and metacognitive beliefs play an effective role in the etiology and stability of anxiety and depression disorders (Mohammed Khani, 1379).