The Effectiveness of Acceptance and Commitment Based Therapy on Psychological Well-Being in Men with Bulimia Nervosa

Introduction & Objective: Eating disorders are one of the most common mental/psychological disorders that cause many problems in physical health and mental function and also impair the quality of life of the sufferer and cause death. Eating disorders can cause nutrition-related disorders and threaten a person's health by changing their eating patterns and undesirable intake of nutrients. Eating disorders are characterized by behaviors such as reduced eating, fasting, overeating, and eating with vomiting and the use of anti-constipation and diuretic drugs. These disorders can also lead to malnutrition, osteoporosis, amenorrhea, cardiovascular disease, and depression. The clinical manifestations of these disorders are anorexia nervosa and binge eating disorder. Bulimia nervosa is a form of eating disorder in which a person eats too much. In this condition, patients often maintain their normal weight or become overweight. Body image distortion in these patients is less than in patients with anorexia nervosa. Complications of overeating are often electrolyte disturbances, heartburn, gastric bleeding, intestinal disorders, enamel erosion, decreased heart rate, hypotension, and decreased metabolic rate. There are several treatments for binge eating disorder: Cognitive-Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), Dialectical Behavioral Therapy (DBT), Interpersonal Therapy (ITP), and Awareness Training. Appetite (AAT) and all have shown success in reducing the frequency of overeating periods. Explaining models of overeating in nervous disorders and eating disorders have stated that painful emotions are the most important accelerator and maintainer and overeating itself plays an important role in regulating emotion for the patient (5). Acceptance and Commitment Therapy emphasizes accepting as much awareness and connection as possible and participating in activities that are in line with personal values. Research (Limani, Khodavirdi, and Ghasemzadeh (2014), Safarzadeh and Mahmoudi Khorandi (2015), Kaviani, Javaheri, Bahiraei (2005) and Mohammadi et al. (2015) shows the importance of psychological acceptance, especially in psychological functions. Clients who report a greater tendency to experience negative psychological experiences, emotional experiences, unpleasant thoughts and memories, show better social, physical, and emotional functioning. Research has shown that avoiding experiences with There is a wide range of behavioral and psychological problems involved: People who are more inclined to suppress such experiences when they experience stress and anxiety at school, at work, in a relationship with their spouse, and so on. Control intensifies their disturbances. Therapists increase the quality of life of the community and people with bulimia nervosa suffer a lot from these components, so according to the lip of the present study seeks to answer the question of whether the therapy is based on acceptance and commitment to the dimensions of psychological well-being is effective in men with bulimia nervosa? Method: The present study is a semi-experimental implementation in the form of pre-test and post-test designs with a control group, which was approved with the code of ethics IR.IAU.BA.REC.1400.010. The statistical population in this study includes all men with bulimia nervosa referred to the Iranian Overeating Association who have received a diagnosis of bulimia nervosa by a psychiatrist. The sample size of the present study according to the test power (0.80), effect size (0.50), and confidence level (0.05) was considered for each sample group of 15 people who were randomly selected. After reviewing and conducting the clinical interview, the clients with the criteria for entering the study were identified and selected by screening, which was randomly divided into two groups of 15 experimental and 15 control, then the experimental group for 8 weeks. 1 session was trained for 70 to 90 minutes and the control group did not receive any intervention and then post-test was performed for both experimental and control groups. The research instrument was Reef Psychological Welfare Questionnaire (2002). Data analysis was performed after examining statistical assumptions by comparing differential scores with t-test. Results: The results of the analysis showed that in the experimental group there was a significant change in improving the components of autonomy, positive relationships, purpose in life, and acceptance in the post-test compared to the control group under the influence of the intervention. Conclusion: The results of the analysis showed that there is a significant difference between the experimental and control groups in terms of at least one of the dependent variables (dimensions of psychological well-being). According to the results, it can be said that in the experimental group there was a significant change in improving the components of autonomy, positive relationships, purpose in life, and post-test acceptance compared to the control group under the influence of intervention. In acceptance and commitment therapy, the goal was to help patients experience the annoying thoughts and feelings as just a thought and become aware of the ineffective nature of their current plans and instead respond to what is in their lives. It is important and in line with their values, pay. In this treatment, by substituting themselves as a background, patients can easily experience unpleasant internal events in the present and are able to separate themselves from unpleasant reactions, dangers, and thoughts. In fact, in this treatment, patients are taught how to accept internal events instead of controlling them; Get rid of annoying thoughts, strengthen self-observation instead of being conceptualized; Specify and address values; In other words, in this treatment, patients learn to accept their emotions instead of distancing themselves from them. And through mindfulness skills to pay more attention to their thoughts and thought processes and link them to purposeful activities. Also, in this treatment, people are asked to work towards their values ​​and experience their thoughts and feelings. It can be said that thoughts, feelings, and desires that were strengthened by avoidance and inhibition will be less called upon after they are accepted. But what needs to be said is that this process takes place over time. This study, as noted, with limitations such as available sampling and failure to examine some of the intervening variables, so caution should be exercised in generalizing the results. The samples of this study included men with overeating in Bushehr. Therefore, caution should be exercised in generalizing the findings to other age groups (children and adolescents) and women. It is suggested that in future research, research be conducted with male and female subjects and compare the effectiveness of acceptance and commitment therapy in both gender groups.