Showing 64 results for ahi
Elham Ghasemi, Mohsen Amiri, Tahereh Elahi,
Volume 14, Issue 3 (12-2020)
Abstract
The present study aimed to investigate the effect of Parent-Child Interaction (PCIT) Therapy of mothers on children with separation anxiety disorder, on reducing over protection, parenting anxiety and anxiety symptoms of their 3-6 years old children. The research design was quasi-experimental with pre-test and post-test and control groups. To do so, 30 mothers of children with SAD (separation anxiety disorder) were selected using at-hand sampling and, then, they were replaced into two experimental and control groups after being matched. The research tools were included CSI-4 questionnaire (Sprafikin & Gadow, 1994), MCRE questionnaire (ROBERT, 1961), and State-trait Anxiety Inventory (STAI) (Spielberger, 1960). The parental behavior training was performed in ten 90-minute sessions in experimental group. Data were analyzed using analysis of covariance, gain score, and T-test. The results show the effectiveness of experimental treatment on reduced scores of anxiety in children of mothers in the experimental group compared with the control group. The results also showed decrease in over protection and anxiety in mothers in the experimental group. Generally speaking, the findings demonstrated that parent-child interaction education causes to reduce the separation anxiety disorder signs, parental anxiety symptoms, and over protection. Moreover, it constructs secure attachment between child and parents.
Arezo Zarebi, Fateme Jafari, Simin Hosseinian, Abaas Abdollahi,
Volume 14, Issue 4 (2-2021)
Abstract
The aim of the present study was to prepare a Persian version of the Dias, Compos, Almeida and Palha (2018) Mental Health Literacy Questionnaire (MHLQ) and to examine its psychometric properties. For this purpose, 346 undergraduate, graduate and doctoral students of Shahroud University were selected in the academic year of 1398-99 through the available sampling. They completed the Persian version of the MHLQ (2018), Attitude Scale - Fischer and Farina (1995) - Short Form, questionnaire, and Health Anxiety inventory - Salkovskis & Warwick - Short Form (2002), and Beck Depression Questionnaire. The results of compound reliability for all subscales were more than 0.5, which indicates the desired reliability of the scale. CVR was more than 0.62 percent and the CVI was more than 0.75 percent, indicating the appropriate content validity of the scale. The results of the confirmatory factor analysis showed that the factor load of the items is more than 0.15 and all the routes from the items to the variable hidden at the level. 0.5 were significant and the scale had a good construct validity. An examination of the validity of the structure using CFA showed that the scale has a factor structure consisting of 4 subscales. The study of validity at the same time as calculating the correlation of this scale with the scale of attitude with the help of psychological psychologists - Fisher and Farina (1995) short form, Health Anxiety Questionnaire - Salkoskis and Varvik short form (2002), indicates a positive relationship between scale scores. The results indicate that the mental health literacy questionnaire is a valid and appropriate tool for use in Iranian society.
Yasaman Shahriari, Sogand Ghasemzadeh, Leila Kashani Vahid, Samira Vakili,
Volume 15, Issue 1 (5-2021)
Abstract
The aim of this study was to investigate the effectiveness of group Transdiagnostic Treatment on anxiety in adolescents with type 1 diabetes and their parenting stress. The present study was a quasiexperimental with a pretest and posttest design with a control group. The statistical population of the present study was all adolescents aged 1215 years with type 1 diabetes referred to the Iranian Diabetes Association and their parents in 2020. Using available and targeted sampling method, fortyfour people were selected and randomly divided into two groups of twentytwo. In order to assess parental stress, parental stress index (Abidin, 1990) and Child / adolescent Behavior Checklist (Achenbach, 1991) were used before and after the Protocol. The Protocol was performed for the experimental group during 17 sessions. Data analysis was performed using covariance analysis. The results showed that there was a significant difference between the groups in terms of parental stress (P<0.005) and anxiety in adolescents (P<0.001). The analysis of the results showed the effect of the group Transdiagnostic Treatment on reducing anxiety in adolescents with type 1 diabetes and reducing their parenting stress.This Protocol can be used to provide education to adolescents with diabetes and their families and to provide preventive interventions.
Dr. Mahdieh Rahmanian, Dr. Mohammad Oraki, Mrs. Fahimeh Mirzadeh Ahari,
Volume 15, Issue 2 (9-2021)
Abstract
The purpose of this study was to investigate the effectiveness of mindfulness based cognitive therapy anxiety and cigarette craving. The present research is a quasi-experimental, pre-test and post-test with the experimental and control group. The statistical population consisted of all smokers who were referred to health centers in 22nd district of Tehran in the spring of 1396. 30 Individuals were selected by available sampling method. The subjects were randomly assigned into experimental and control groups. To measure anxiety, the Spielberger questionnaire and cigarette craving, Fagerstrom questionnaire were used. After selecting the experimental and control group, interventional training on mindfulness based cognitive therapy on the experimental group was performed for 8 sessions of 90 minutes and one session per week. One-way covariance analysis was used to analyze the data. Data analysis showed that there was a significant difference between the mean of post test scores of the experimental and control groups in anxiety and cigarette craving (p<0.01); as mindfulness based cognitive therapy reduced anxiety and cigarette craving in experimental group. Generally, could be showed that mindfulness based cognitive therapy could improve the psychological components of smoking cessation.
Phd Student Maryam Akbarzadeh, Dr. Parviz Sabahi, Dr. Parvin Rafienia, Dr. Afsaneh Moradi,
Volume 15, Issue 2 (9-2021)
Abstract
The aim of this research was comparison of the effectiveness of Mindfulness Based Cognitive Therapy(MBCT) and Transcranial direct-current Stimulation(tDCS) in pain intensity and quality of life and their subcomponents on fibromyalgia patients. The study was semi-experimental pre-post treatment design. 36 fibromyalgia patients were selected and randomly classified into three MBCT, tDCS and sham group. The members of these groups were asked to complete short form of McGill Pain questionnaire and SF-36 Quality of life questionnaire before and after the intervention. Multivariate Covariance analysis showed that in terms of the pain intense variable, while both treatments were effective, but no significant differences between MBCT and tDCS treatment was seen(P<0.05) In terms of quality of life, the MBCT method was significantly more effective than both sham and tDCS groups(P<0.05) this paper showed significant results in effectiveness of MBCT and tDCS on fibromyalgia patients that could help the therapists to treat them and decrease their treatment costs.
Najmeh Tavakoli, Masoud Taherinia, Dariush Jalali, Ebrahim Givaki,
Volume 15, Issue 3 (12-2021)
Abstract
The purpose of this research is sustainable investigating the effectiveness of group financial therapy based on acceptance and commitment (ACT) approach on financial stress in Shahrekord marketers was implemented. This research is practical and semi-experimental in terms of research methods which have pre-test, post-test designs with a one-year follow-up with the control group. The statistical population of the study was forty people of Shahrekord marketers in 2019. They were assigned randomly to two experimental and control groups and completed research questionnaires that related to financial stress.Then the experimental group received financial therapy interventions based on acceptance and commitment in 10 sessions of 120 minutes in person and online and the control group did not receive any intervention. Data were tested using repeated measures analysis of variance.
The results showed that financial therapy based on acceptance and commitment (ACT) has led to a reduction in financial stress (P <0.001), due to the sustainable effectiveness of financial therapy based on acceptance and commitment (ACT). It can be said that in order to improve the health of people and reduce their financial stress during the Covid 19 pandemic, which leads to financial and psychological problems, such interventions and training seem necessary and important
Azadeh Saffarzadeh, Abbas Rahiminezhad, Hadi Bahrami Ehsan, Azam Noferesti, Nazila Shahmansouri,
Volume 15, Issue 3 (12-2021)
Abstract
Fear of death is a global and cultural issue. The aim of the present study was to develop and validate a scale for afterlife fears in the Iranian sample. This study was an exploratory sequential mixed method design. The Qualitative phase included semi-structured interviews with 12 acute cardiac patients. The content of patients answers about afterlife fears rearranged as 14 items for quantitative phase. At the quantitative phase, 313 subjects (230 women and 83 men) were selected from Tehran city and carried out the questionnaires online. For studying construct validity of Afterlife Fear Scale, the responses of normal sample analyzed by exploratory factor analysis method. For assessing the concurrent validity of new Afterlife Fears Scale, its correlation with the Beck Depression Inventory (BDI-II, 1996) and the Rosenberg Self-Esteem Scale (SES, 1965) were calculated. Data analysis was performed using Pearson correlation coefficient, exploratory factor analysis, principal component extraction method and parallel analysis. Three factors were extracted which were named as "fear of punishment and grave torment", "loneliness and abandonment" and "longing and confidence in God", respectively. The internal consistency method was used to determine the reliability of the scale. Cronbach's alpha coefficient of the subscales ranged from .63 to .88, which indicated the appropriate internal consistency of the scale and its components. The Afterlife Fears Scale has good reliability and validity in the Iranian Muslim sample and can be used to identify the underpinning fears of cardiovascular patients and anxiety reduction interventions, as well as cross-cultural comparisons. |
Marzieh Asghari, Mojtaba Dehghan, Sima Shahinfar, Elaheh Azad Manjiri,
Volume 15, Issue 4 (2-2022)
Abstract
The aim of this study was to investigate the role of self-concept, emotion regulation, and coronavirus anxiety in predicting self-care behaviors related with covid-19 disease. Design of this study was correlation (prediction-based). The statistical population of the study included people aged 18 to 45 years, 355 people participated in the study by available sampling method and voluntarily through online calling. Data were collected using self-care behaviors questionnaire, emotion regulation questionnaire, integrative self-knowledge scale, self‐compassion scale–short form, self-concept clarity scale and corona disease anxiety scale. Data were analyzed using correlation tests and hierarchical multiple regression analysis. The results showed a correlation test that self-concept clarity, cognitive reappraisal and coronavirus anxiety were positively and significantly correlated with self-care behaviors, but suppression was negatively and significantly correlated with it. Regression results showed that self-concept clarity, cognitive reappraisal and coronavirus anxiety were predictors of increased self-care behaviors, but suppression was negatively and significantly its predictor. According to the findings of this study, it can be used to determine educational priorities and psychological interventions to increase self-care behaviors and reduce the risk of Covid-19 disease.
Hannaneh Panahipour, Nahid Hoseininezhad, Mahsima Pourshahriari,
Volume 16, Issue 1 (6-2022)
Abstract
One of the most common childhood disorders is attention deficit hyperactivity disorder (ADHD) and its interaction with parental behaviors. This study aimed to determine the effectiveness of parent-child interaction therapy (PCIT) on reducing verbal and non-verbal violence of mothers and symptoms of ADHD in preschool children. The method of the study was a quasi-experimental pretest-posttest with a control group. The statistical population included preschool children with ADHD symptoms and their mothers in Tehran. Twenty of these children and their mothers were selected using convenience sampling method and were matched and randomly assigned in experimental (n = 10) and control (n = 10) groups. The experimental group participated in 8 sessions of 90 minutes in PCIT sessions. The instruments included the Connors’ Parent Rating Scale and the Parent Behavior Screening. Data analysis using MANCOVA in SPSS version 22 showed that the scores of verbal and non-verbal violence of mothers, also the symptoms of ADHD decreased in the post-test compared to the pre-test (p <0.001) and treatment has a significant effect on reducing mothers’ verbal and non-verbal violence and symptoms of ADHD. It can be concluded PCIT could decrease the severity of ADHD symptoms in children and mothers' verbal and non-verbal violence.
Dr. Ebrahim Ahmadi,
Volume 16, Issue 1 (6-2022)
Abstract
Research has shown a negative correlation between mindfulness and defensive reactions to the reminder/thought of death, and the purpose of the present study was to illuminate the effect of meditation and mindfulness on these reactions using an experimental method. The call for participation in the study was sent to 30,000 subscribers of Hamrahe Aval and Irancell in Tehran and using the convenience sampling, 127 of them (53 males) with a mean age of 37 years were selected to participate in this study and were randomly assign to four groups of Meditation-Death Thought, Meditation-Without Death Thought, Without Meditation-Death Thought, and Without Meditation-Without Death Thought. After teaching Buddhist mindful breathing meditation and measuring mindfulness using Toronto Mindfulness Scale (TMS), death thought was created in participants using the method of Burke et al. (2010) and then death thought Suppression, as an immediate defense, was measured using the method of Arndt et al. (1997) once after creating death thought and once after a delay, and worldview defense, as a delayed defense, was measured using the method of Greenberg et al. (1990) after a delay. ANOVAs showed that meditation increased mindfulness and was able to prevent the effect of death thought on death thought suppression
Doctor Tahere Elahi, Afagh Zolfaghari,
Volume 16, Issue 2 (9-2022)
Abstract
The presentstudy was conducted with the aim of investigating the role of interpersonal communication skills, personalitytraits and family cohesion with the mediating role of loneliness in the psychological problems of the physical disabled during social distancing. This correlational study byconvenience sampling method was done on 133of Physical disabled in Tehran in2020. For collecting data, the Anxiety, Stress, and Depression Scale(DASS-21), theMatson InterpersonalCommunication Skills Scale, the Samani Family Cohesion Scale (2002), the Neo Personality Traits, and the Russell Loneliness Scale were used. Pearson correlation coefficients betweenfamily cohesion and interpersonal communication skills with anxiety, stress and depression and between neuroticism with anxiety,Loneliness with stress, interpersonal communication skills and family cohesion were significant. The results of Multivariate regression analysis in hierarchical method showed that all of variablesinterpersonal communication skills, family cohesion,Personality Traits and loneliness accounted for61% of the variance in the psychological problems of the physically disabled. The mediating role of loneliness with R3% was significant. interpersonal communication skills and neuroticism with beta coefficient -0.69and0.113 acordingly were significsnt predictors of psychologicsl problems, too. According to these results, Lack of interpersonal communication skills and tendency to experience negative emotions mediated by loneliness has been an important factor in aggravating the psychological problems of physicaldisabled.
Mrs Leila Soleimanian, Mrs Fatemeh Mohammadi Shirmahaleh, Mr Javid Peymani, Mrs Marzieh Gholami Tooranposhti, Mrs Nahid Havasi Soomar,
Volume 16, Issue 4 (Volume18, Issue 4 2023)
Abstract
The purpose of this study was to cmpare the effectiveness of Cognitive behavioral therapy and compassion-based therapy on glycosylated hemoglobin and coronaanxiety diabetic patients. This research was semi-experimental with a pre-test-post-test design and with a control group. The research population of patients with diabetes were members of the Hamedan Diabetes Association in 2020. Among them, 48 people were selected using available sampling method and they were divided into two experimental groups and one control group with the help of lottery. In one group, cognitive-behavioral therapy intervention program and in the other group, compassion-based interventions were trained for 8 sessions of 90 minutes each, and the control group was placed on the waiting list for training.Blood tests of patients were used to measure glycosylated hemoglobin, and the Corona Virus Anxiety Scale (2018) was used to measure the anxiety of Corona virus. The research data were analyzed using the Mancova statistical method and appropriate post hoc tests. The results indicate that compassion-based therapy on glycosylated hemoglobin was more effective than cognitive-behavioral therapy.No significant difference was observed between the compassion-based therapy and the cognitive-behavioral therapy regarding the corona anxiety In ordertoincrese thephsical andpsychological improvement.using of these treatmentin indiviual or group coursesseemes be effective
Yaser Bodaghi, Eshag Rahimian Boogar,
Volume 17, Issue 2 (Volume17 Issue 2 2023)
Abstract
The present study was conducted with the aim of comparing metacognitive beliefs and pain catastrophizing between women with fibromyalgia syndrome, women with chronic pain and normal women. In this research, 40 people with fibromyalgia syndrome, 40 people with chronic pain and 40 normal people were selected from the women of Tehran. The participants completed two scales, the short form of the Wells Metacognition Questionnaire and the standard pain catastrophizing questionnaire. The obtained data were analyzed using descriptive statistics, analysis of variance and post hoc tests in SPSS 26 software. The results of the one-way analysis of variance test show that the mean scores of the pain catastrophizing variable are higher in the fibromyalgia group than in the chronic pain group and are higher in the chronic pain group than in the normal group. The results of multivariate variance analysis of metacognitive beliefs show that, except for the variable of positive belief about worry, the average of metacognitive beliefs in fibromyalgia and chronic pain groups is higher than the normal group. According to the findings of this research, dealing with metacognitive beliefs and pain catastrophizing in the treatment of patients with fibromyalgia and chronic pain should be taken into account.
Sara Jafari, Zahra Roshandel, Amin Shaneii, Dr Parisa Kolahi, Zohreh Ganbari,
Volume 17, Issue 2 (Volume17 Issue 2 2023)
Abstract
The purpose of this research is to investigate the effectiveness of emotion-oriented couple therapy on marital commitment and marital exhaustion of couples with marital conflict. The research design of this study is quasi-experimental with pre-test-post-test and control sample. For this purpose, a number of (30) couples with marital conflict were identified and selected by available sampling method. Of these, 15 people were randomly assigned to the experimental group and 15 to the control group. In order to collect data, Adamer and Jones Marital Commitment Questionnaire and Pines Marital Exhaustion Questionnaire were used. Also, the training package of emotion-oriented couple therapy was applied to the experimental group during 8 two-hour therapy sessions. The results of covariance analysis showed that there is a significant difference between the couples of the experimental group and the experimental group. Based on the findings of this research, it can be concluded that emotion-oriented couple therapy interventions have increased marital commitment and reduced marital exhaustion of couples. In fact, the correct communication based on love and interest between couples has increased marital commitment and couples showed different reactions to marital conflicts.
Maryam Zareei, Dr Abdolmajid Bahrainian, Dr Qasem Ahi, Dr Ahmad Mansouri,
Volume 17, Issue 3 (Volume17 Issue 3 2023)
Abstract
The present study was conducted with the aim of comparing the effectiveness of cognitive therapy based on mindfulness and schema therapy on mental rumination and social anxiety of women with practical obsessive-compulsive symptoms. The current research method was semi-experimental with pre-test, post-test and follow-up. The statistical population of the research included all women with obsessive-compulsive disorder who referred to the counseling centers of Mashhad in 1402, based on the entry and exit criteria, 48 people were selected as a sample using the purposeful-available sampling method and randomly divided into two experimental groups. and a control group were assigned. Subjects were evaluated using Hoeksma and Maro (1991) rumination questionnaires and Wells' (1994) social anxiety questionnaires in the pre-test, post-test and follow-up stages. The results of mixed analysis of variance showed that the difference Significance between intervention groups with control in mental rumination and social anxiety of women with obsessive compulsive symptoms, the presence of medication, cognitive therapy based on mindfulness and schema therapy has led to the reduction of mental rumination and social anxiety. Also, schema therapy is more effective than cognitive therapy based on mindfulness in mental rumination.
Maryam Zareii, Dr Abdolmajid Bahreinian, Dr Qasem Ahi, Dr Ahmad Mansouri,
Volume 17, Issue 4 (Volume17 Issue 4 2024)
Abstract
The present study aimed to comparison the effectiveness of cognitive therapy based on mindfulness and schema therapy on emotional regulation and distress tolerance of women with obsessive-compulsive symptoms. The present research method was semi-experimental with pretest, posttest and follow-up. The statistical population of the study included all women with obsessive-compulsive disorder who referred to the counseling centers of Mashhad in 2023-2024. Based on the inclusion and exclusion criteria, 48 people were selected by convenience sampling and randomly assigned to two experimental groups and one control group. The participants were evaluated using the emotion regulation questionnaire (Gross & John, 2003) and distress tolerance scale in the pretest, posttest and follow-up. Data were analyzed using SPSS 26 software and using descriptive and inferential statistics. The results of and analysis of variance with repeated measures showed that there is a significant difference between the experimental and control groups in emotion regulation and distress tolerance (P<0.05). Cognitive therapy based on mindfulness and schema therapy has led to improved emotion regulation and increased distress tolerance. Cognitive therapy based on mindfulness is more effective than schema therapy in improving emotion regulation.
Mr Masoud Afshani, Dr Abdolrahim Kasaee Esfahani, Dr Kianoush Zahrakar,
Volume 18, Issue 1 (Volume18, Issue 1 2024)
Abstract
The purpose of this study was to investigate the mediating role of using social networks in the relationship between authoritarian and permissive parenting styles and academic procrastination in first secondary school students. The research was of the correlation type, and the statistical population included all the students of the first secondary level of Ashnoye city in 1401. In this study, 339 people (170 girls and 169 boys) were selected as a statistical sample using the multi-stage cluster random sampling method. In order to collect information, Bamrind's 1967 parenting styles (PSI), Solomon and Rothblum's academic procrastination (PASS) 1984, and Jahan Bani's social networks (2017) were used. The data were analyzed by covariance analysis and structural equation modeling. The results of the current research regarding the mediation of the use of social networks in the relationship between authoritarian parenting style and academic procrastination showed that authoritarian parenting style not only directly but also indirectly and with the mediation of the use of social networks on students' academic procrastination. It has an effect.
Masoome Barzegari, Dr Simin Hooseinian, Dr Abbas Abdollahi,
Volume 18, Issue 2 (Volume18, Issue 2 2024)
Abstract
Abstract:
The purpose of the present study was to determine the moderating role of self-compassion in relation between couple’s romantic perfectionism (self-centered and other-centered) with quality of marital life in the women. This study was of a descriptive-correlation type and the statistical population included married women of Tabriz city. 321 samples were selected using a convenience sampling method and the link of the questionnaires was provided to them. The tools of this research included: Rees et al.'s self-compassion scale (2011), Abdollahi and Allen's (2022) romantic perfectionism scale (self-centered and other-centered), and Busby et al.'s (1995) marital quality measurement scale. . After entering the data into the computer, the data were analyzed using SPSS26 and PLS3 software using the structural equation modeling method. The results showed that self-compassion has a significant relationship with the quality of married life (P<0.001,β=0.384),on the other hand self-centered romantic perfectionism has a significant relationship with the quality of married life (P<0.001,β=0.361),also other-centered romantic perfectionism has a significant relationship with the quality of married life (P<0.001,β=-0.713). Self-compassion played a moderating role between self-oriented perfectionism and marital life quality, but it did not play a moderating role in relation to other-oriented perfectionism and marital life. According to these findings, the importance of getting to know the dimensions of romantic perfectionism and teaching the skills of self-compassion in pre-marriage and post-marriage counseling, both in preventing the decrease in the quality of marital life and in increasing the quality of marital life, doubles.
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Ebrahim Baradari, Ali Sheykholeslami, Esmaiel Sadri Damirchi, Hossein Ghamarigivi,
Volume 18, Issue 3 (Volume18, Issue 3 2024)
Abstract
The present study aimed to determine the effectiveness of narrative therapy on family resilience and marital happiness of Conflicted couple. The research method was semi-experimental with pre-test-post-test and three-month follow-up. The statistical population of this research included including all Conflicted couples of Tabriz in 1402, who had referred to Happy Life and Mobin Counseling Centers of Tabriz. According to the research design, a sample of 32 people was selected by purposive sampling and randomly replaced in the experimental group (16 people) and the control group (16 people). Data were collected using the family resilience Scale (Sikbi, 2005), and marital happiness Questionnaire (Azrin et all., 1973). The experimental group received 10 sessions of 60 minutes of narrative therapy, and the control group, which was on the waiting list, did not receive any training. The data were analyzed using analysis of variance with repeated measurements and Bonferroni's post hoc test. The results showed that after controlling the effects of the pre-test, there was a significant difference between the post-test average of the two groups in family resilience (F=104/873, Eta= 0/778) and marital happiness(F=38/529, Eta= 0/562) (P<0.05), which can indicate the effectiveness of the mentioned intervention on the mentioned variables and Also, the stability of the effectiveness is in the follow-up phase. The results of this research showed that narrative therapy can be used as effective approach in increase family resilience and marital happiness.
Milad Rahimi, Vahid Sadeghi-Firoozabadi,
Volume 18, Issue 4 (Volume18, Issue 4 2025)
Abstract
The aim of this study was to investigate the mediating roles of anxiety sensitivity and body dissatisfaction in the relationship between childhood trauma and eating attitudes in college students. This correlational and path analysis research included students aged 18 to 25 years from Kharazmi University of Tehran, studying in the second semester of the 1402 academic year. A total of 422 students were selected by convenience sampling. The research instruments included the 26-item version of Garner et al.'s eating attitude test (1982), the revised anxiety sensitivity index of Taylor and Cox (1998), the body shape questionnaire of Cooper et al. (1987), and the childhood trauma questionnaire of Bernstein et al. (2003). The findings indicated a good fit between the data and the model. The results showed that there is a direct and significant relationship between childhood trauma, anxiety sensitivity and body dissatisfaction with eating attitudes. Also, childhood trauma have a direct and significant relationship with anxiety sensitivity and body dissatisfaction. In addition, anxiety sensitivity has a direct and significant relationship with body dissatisfaction. Also, body dissatisfaction and anxiety sensitivity play a mediating role in the relationship between childhood trauma and eating attitudes.