Jinan Jamil Jana *
Faten Mahmoud Al-Saleh**
نبذة عن البحث باللغة العربية:
مفارقة التحكّم في اضطرابات الأكل
الكماليّة في مواجهة الفاعلية الذاتية
تهدف هذه الدراسة إلى التحقق من الدور التفاعلي للكمالية والفاعلية الذاتية للعلاج في التنبؤ بشدة أعراض اضطرابات الأكل لدى عينة لبنانية من الإناث المصابات باضطرابات الأكل.
تتكوّن عينة الدراسة من 106 مشاركات تتراوح أعمارهن بين 14 و45 عامًا ممن تم تشخيصهن باضطرابات الأكل وفق معايير DSM-5. تستخدم الدراسة مقياس الكمالية المعدّل (APS-R) بأبعاده الثلاثة (المعايير، التناقض، النظام)، ومقياس الفاعلية الذاتية للعلاج من اضطرابات الأكل (EDRSQ)، واستبيان فحص اضطرابات الأكل (EDE-Q) لقياس شدة الأعراض. وقد أُجريت التحليلات الإحصائية باستخدام برنامجSPSS PROCESS Model 1 بعد التمركز حول المتوسط وتحليل التفاعل بين المتغيرات.
تظهر النتائج أن المعايير والتناقض (من أبعاد الكمالية) ارتبطا إيجابيًّا بشدة أعراض اضطرابات الأكل، إلا أن هذا الارتباط كان أضعف بوجود درجة عالية من الفاعلية الذاتية للعلاج. بينما لم يُظهر بعد النظام أي ارتباط يُذكر بالأعراض أو تفاعل مع الفاعلية الذاتية للعلاج.
تدعم النتائج نموذج مفارقة التحكم الذي يشير إلى أن السعي إلى السيطرة من خلال الكمالية يؤدي إلى تفاقم أعراض اضطرابات الأكل عند انخفاض الفاعلية الذاتية للعلاج، بينما تعمل الفاعلية الذاتية العالية للعلاج كآلية وقائية تُعيد الإحساس بالتحكم وتدعم التعافي. وتوصي الدراسة بدمج استراتيجيات تعزيز الفاعلية الذاتية للعلاج ضمن برامج العلاج النفسي لاضطرابات الأكل لتعزيز التحكم التكيفي، وتحقيق تعافٍ مستدام.
اضطرابات الأكل؛ مفارقة التحكم؛ الكمالية؛ الفاعلية الذاتية للعلاج
***
Abstract:
This study aimed to examine the interactive role of perfectionism and treatment self-efficacy in predicting eating-disorder symptom severity among a Lebanese female sample with eating disorders.
The sample consisted of 106 participants aged 14–45 years diagnosed with DSM-5 eating disorders. Instruments included the Almost Perfect Scale-Revised (APS-R; Standards, Discrepancy, Order), the Eating Disorder Recovery Self-Efficacy Questionnaire (EDRSQ; total score only), and the Eating Disorder Examination-Questionnaire (EDE-Q) to assess symptom severity. Data were analyzed using SPSS PROCESS Model 1, applying mean-centering and moderation analysis to test interaction effects.
The Standards and Discrepancy dimensions of perfectionism were positively associated with eating-disorder severity, but these associations were significantly weaker at higher levels of treatment self-efficacy. The Order dimension showed no association with pathology and no significant interaction.
Findings support the proposed Control Paradox Model, suggesting that perfectionistic striving for control exacerbates symptoms when self-efficacy is low, whereas high self-efficacy restores perceived control and supports recovery. The study recommends integrating self-efficacy-enhancing strategies within eating disorder treatment to foster adaptive control and sustainable improvement.
Keywords:
Perfectionism; Treatment self-efficacy; Eating disorder; Control Paradox
***
* د. جنان جميل جانا : باحثة لبنانية. اختصاصية ومعالجة نفسية، ومعالجة معتمدة بالعلاج المعرفي السلوكي المعزز لاضطرابات الأكل (CBT-E)، ومستشارة في علاج الصدمات النفسية. وتشغل منصب أستاذة محاضرة في علم النفس في الجامعة اللبنانية، والجامعة العالمية (Global University)، وجامعة بيروت العربية.
* Dr. Jinan Jamil Jana is a Clinical Psychologist, CBT-E Therapist, and Trauma Counselor. She is an Adjunct Professor of Psychology at Lebanese University, Global University, and Beirut Arab University.
** د. فاتن محمود الصالح : باحثة لبنانية. اختصاصية ومعالجة نفسية، ومعالجة معتمدة بالعلاج المعرفي السلوكي المعزز لاضطرابات الأكل (CBT-E)، ومستشارة في علاج الصدمات النفسية. وتشغل منصب مدرّسة في علم النفس في معهد الساحل للتمريض.
** Dr. Faten Mahmoud Al-Saleh is a Clinical Psychologist, CBT-E Therapist, and Trauma Counselor. She is a Psychology instructor at AL-Sahel Institute for Nursing.
References
- Bardone‐Cone, A. M., Sturm, K., Lawson, M. A., Robinson, D. P., & Smith, R. (2009). Perfectionism across stages of recovery from eating disorders. International Journal of Eating Disorders, 43(2), 139–148. https://doi.org/10.1002/eat.20674
- Bardone‐Cone, A. M., Thompson, K. A., & Miller, A. J. (2018). The self and eating disorders. Journal of Personality, 88(1), 59–75. https://doi.org/10.1111/jopy.12448
- Berman, E. S. (2006). The relationship between eating self-efficacy and eating disorder symptoms in a non-clinical sample. Eating Behaviors, 7(1), 79–90. https://doi.org/10.1016/j.eatbeh.2005.07.004
- Bills, E., Muir, S. R., Stackpole, R., & Egan, S. J. (2025). Perfectionism and compulsive exercise: a systematic review and preliminary meta-analysis. Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity, 30(1). https://doi.org/10.1007/s40519-024-01704-1
- Boone, L., Soenens, B., & Braet, C. (2011). Perfectionism, Body Dissatisfaction, and Bulimic Symptoms: The Intervening Role of Perceived Pressure to be Thin and Thin Ideal Internalization. Journal of Social and Clinical Psychology, 30(10), 1043–1068. https://doi.org/10.1521/jscp.2011.30.10.1043
- Boone, L., Soenens, B., & Luyten, P. (2014). When or why does perfectionism translate into eating disorder pathology? A longitudinal examination of the moderating and mediating role of body dissatisfaction. Journal of Abnormal Psychology, 123(2), 412–418. https://doi.org/10.1037/a0036254
- Fairburn, C. G. (2008). Cognitive behavior therapy and eating disorders. Guilford Press.
- Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41(5), 509–528. https://doi.org/10.1016/s0005-7967(02)00088-8
- Frost, R. O., Marten, P., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14(5), 449–468. https://doi.org/10.1007/bf01172967
- Gäde, J. C., Schermelleh-Engel, K., & Klein, A. G. (2017). Disentangling the common variance of perfectionistic strivings and perfectionistic concerns: a bifactor model of perfectionism. Frontiers in Psychology, 8. https://doi.org/10.3389/fpsyg.2017.00160
- Hage, R. (2021). The relationship of societal pressures and disordered eating among Lebanese women [PhD Dissertation, Antioch University New England]. In AURA - Antioch University Repository and Archive. https://aura.antioch.edu/etds/720
- Hayes, A. F. (2022). Introduction to mediation, moderation, and conditional process analysis: A Regression-Based Approach. Guilford Publications.
- Hill, R. W., Huelsman, T. J., & Araujo, G. (2010). Perfectionistic concerns suppress associations between perfectionistic strivings and positive life outcomes. Personality and Individual Differences, 48(5), 584–589. https://doi.org/10.1016/j.paid.2009.12.011
- Keshen, A., Helson, T., Town, J., & Warren, K. (2017). Self-efficacy as a predictor of treatment outcome in an outpatient eating disorder program. Eating Disorders, 25(5), 406–419. https://doi.org/10.1080/10640266.2017.1324073
- Krug, I., Liu, S., Portingale, J., Croce, S., Dar, B., Obleada, K., Satheesh, V., Wong, M., & Fuller-Tyszkiewicz, M. (2025). A meta-analysis of mortality rates in eating disorders: An update of the literature from 2010 to 2024. Clinical Psychology Review, 116, 102547. https://doi.org/10.1016/j.cpr.2025.102547
- Larionow, P. (2024). How are different perfectionism traits related to mental health in students? Behavioral Sciences, 14(3), 187. https://doi.org/10.3390/bs14030187
- Leppanen, J., Brown, D., McLinden, H., Williams, S., & Tchanturia, K. (2022). The Role of Emotion Regulation in Eating Disorders: A Network Meta-Analysis Approach. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.793094
- Limburg, K., Watson, H. J., Hagger, M. S., & Egan, S. J. (2016). The Relationship between Perfectionism and Psychopathology: A Meta‐Analysis. Journal of Clinical Psychology, 73(10), 1301–1326. https://doi.org/10.1002/jclp.22435
- Liu, X., Liu, L., Yu, H., Yang, X., Liu, Z., Yu, Z., Qin, X., & Liu, Y. (2025). Global, regional, and national burdens of eating disorders from 1990 to 2021 and projection to 2035. Frontiers in Nutrition, 12. https://doi.org/10.3389/fnut.2025.1595390
- Lloyd, S., Schmidt, U., Khondoker, M., & Tchanturia, K. (2014). Can Psychological interventions reduce perfectionism? A Systematic review and Meta-analysis. Behavioural and Cognitive Psychotherapy, 43(6), 705–731. https://doi.org/10.1017/s1352465814000162
- Mallaram, G. K., Sharma, P., Kattula, D., Singh, S., & Pavuluru, P. (2023). Body image perception, eating disorder behavior, self-esteem and quality of life: a cross-sectional study among female medical students. Journal of Eating Disorders, 11(1). https://doi.org/10.1186/s40337-023-00945-2
- Miles, S., Nedeljkovic, M., & Phillipou, A. (2023). Investigating differences in cognitive flexibility, clinical perfectionism, and eating disorder-specific rumination across anorexia nervosa illness states. Eating Disorders, 31(6), 610–631. https://doi.org/10.1080/10640266.2023.2206751
- Miskovic-Wheatley, J., Bryant, E., Ong, S. H., Vatter, S., Le, A., Aouad, P., Barakat, S., Boakes, R., Brennan, L., Bryant, E., Byrne, S., Caldwell, B., Calvert, S., Carroll, B., Castle, D., Caterson, I., Chelius, B., Chiem, L., Clarke, S., . . . Maguire, S. (2023). Eating disorder outcomes: findings from a rapid review of over a decade of research. Journal of Eating Disorders, 11(1). https://doi.org/10.1186/s40337-023-00801-3
- Pinto, A. M., Guarda, A. S., Heinberg, L. J., & DiClemente, C. C. (2006). Development of the eating disorder recovery self‐efficacy questionnaire. International Journal of Eating Disorders, 39(5), 376–384. https://doi.org/10.1002/eat.20256
- Raymond, B. O. (2022). Coping Self-Efficacy as a moderator in the relationship between trauma and disordered eating. Georgia Southern Commons. https://digitalcommons.georgiasouthern.edu/etd/2447
- Schmidt, R., Schewe, D., Herpertz, S., Zipfel, S., Tuschen‐Caffier, B., Friederich, H., Mayr, A., De Zwaan, M., & Hilbert, A. (2025). Mechanisms of Change in Cognitive‐Behavioral therapy for Adults with Binge‐Eating Disorder: A Dynamic Structural Equation Modeling approach. International Journal of Eating Disorders. https://doi.org/10.1002/eat.24469
- Shafran, R., Cooper, Z., & Fairburn, C. G. (2002). Clinical perfectionism: a cognitive–behavioural analysis. Behaviour Research and Therapy, 40(7), 773–791. https://doi.org/10.1016/s0005-7967(01)00059-6
- Slaney, R. B., Rice, K. G., & Ashby, J. S. (2002). A programmatic approach to measuring perfectionism: The Almost Perfect Scales. In American Psychological Association eBooks (pp. 63–88). https://doi.org/10.1037/10458-003
- Smith, M. M., Hewitt, P. L., Sherry, S. B., Flett, G. L., Kealy, D., Tasca, G. A., Ge, S., Ying, F., & Bakken, K. (2023). A meta-analytic test of the efficacy of cognitive behavioural therapy for perfectionism: A replication and extension. Canadian Psychology/Psychologie Canadienne, 64(4), 355–376. https://doi.org/10.1037/cap0000360
- Soltani, M., Salehi, B., & Kheirabadi, G. (2024). Explaining the relationship between perfectionism and binge eating disorder in female college students: The mediating role of cognitive emotion regulation. Practice in Clinical Psychology, 12(1), 67–80. https://doi.org/10.32598/jpcp.12.1.919.1
- Stackpole, R., Greene, D., Bills, E., & Egan, S. J. (2023). The association between eating disorders and perfectionism in adults: A systematic review and meta-analysis. Eating Behaviors, 50, 101769. https://doi.org/10.1016/j.eatbeh.2023.101769
- Suh, H., Liou, P., Jeong, J., & Kim, S. Y. (2022). Perfectionism, Prolonged stress reactivity, and Depression: A Two-Wave Cross-Lagged Analysis. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 42(1), 54–68. https://doi.org/10.1007/s10942-022-00483-x
- Vanzhula, I. A., Wang, E., Martinelli, M. K., Schreyer, C., & Guarda, A. S. (2023). Inpatient hospital course and self-reported symptomatology in underweight adults with ARFID compared to age- and sex-matched controls with anorexia nervosa. Journal of Eating Disorders, 11(1). https://doi.org/10.1186/s40337-023-00912-x
- Vicent, M., Gonzálvez, C., Quiles, M. J., & Sánchez-Meca, J. (2023). Perfectionism and binge eating association: a systematic review and meta-analysis. Journal of Eating Disorders, 11(1). https://doi.org/10.1186/s40337-023-00817-9
- Zeeni, N., Gharibeh, N., & Katsounari, I. (2013). The influence of sociocultural factors on the eating attitudes of Lebanese and Cypriot students: a cross‐cultural study. Journal of Human Nutrition and Dietetics, 26(s1), 45–52. https://doi.org/10.1111/jhn.12059
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