CC BY
11PSYCHOLOGICAL SCIENCES
PROGRAM FAMILY PSYCHO CORRECTION OF TEENAGE GIRLS WITH ALIMENTARY
OBESITY
Polumeeva D.
assistant of the Department ofpsychosomatics and psychotherapy, St. Petersburg State Pediatric Medical
University, St. Petersburg
Abstract
The article presents the results of the development and testing of the program of family psychocorrection of adolescent girls with alimentary obesity. The following targets were identified: pathologizing type of family education, a high level of general family anxiety and maladaptive family strategies for coping with psyhotraumatic situations. The psychocorrection program consists of three blocks and includes work both with families in general and with family subsystems. Psychodiagnostic and follow-up methods revealed a harmonization of the style of family education, a decrease in the level of anxiety at the systemic family and at the personal level, a decrease in dysfunctional strategies for coping with stress 1 month and 3 months after the psychocorrectional program. The obtained data necessitate the introduction of a family psychocorrection program into the system of complex treatment of adolescent girls with alimentary obesity.
Keywords: program family psycho correction, alimentary obesity.
Introduction
According to the WHO, there are more than 1.7 billion people in the world who are overweight or obese. Alimentary obesity - (Latin alimentum - food) -an eating disorder caused by overeating. [1, 2, 7].
Currently, various types of eating disorders (restrictive, emotiogenic, external) have been described [10, 16, 17, 19, 20]. In 60% of obese patients, an emoti-ogenic type of eating behavior is noted. A high level of anxiety and difficulty in expressing emotions cause a maladaptive reaction of the "seizing" type of a traumatic situation and confirm the psychosomatic nature of the disease [3, 5, 6, 8, 9, 18, 10, 11, 21]. Child-parent relationships are the basis for the formation of a child's personality and child's system of relationships. Dysfunctional patterns of intrafamily interaction can lead to chronic psychoemotional stress at the systemic family level and the formation of a psychosomatic illness in the "weakest family member", which is more often a child [6, 12, 13, 14, 15].
Previous studies [4,3] made it necessary to develop and test a program of family psychocorrection.
In order to approbate the program of family psychocorrection, a study was conducted in which 30 people took part: adolescent girls aged 15-16 years, suffering from alimentary obesity of the II degree and their parents. The composition of the nuclear family is 3 people.
The targets of family psychocorrection were identified: 1. Pathologizing type of family education (hy-perprotection and unstable style of family education). 2. High level of general family anxiety. 3. Maladaptive family strategies for coping with traumatic situations.
Based on the identified targets, we developed and approbated a program for family psychocorrection of adolescent girls suffering from alimentary obesity. This program is based on the model of "diamond-shaped" vector family psychotherapy for children and adolescents with psychosomatic disorders, developed by M.P. Biletskaya [6].
The psychocorrection program is designed for 24 academic hours and is implemented within a month.
The structure of the psychocorrection program:
1. Organizational stage. Working with the family as a system. Purpose: Primary psychodiagnostics, psychological consultation.
II. The main stage.
Block 1: Group work with teenagers. Purpose: Psychocorrection of emotional and behavioral patterns in girls with alimentary obesity.
2 block. Psychocorrection in the parental subsystem. Purpose: Increasing parental competence and psycho-correction of parenting style.
3 block. Family psychocorrection. Purpose: Reconstruction of family relationships. Working with the family as a system.
III. Final. Working with the family as a system. Purpose: Summing Up and Disconnecting.
To determine the effectiveness of the psychocor-rectional program, the following methods were used:
1) Psychodiagnostic method: 1. Questionnaire "Analysis of family relationships" (Eidemiller EG, Yustitskis VV).
2. Questionnaire "Analysis of family anxiety" (Eidemiller EG, Yustitskis VV).
3. Questionnaire "Scale of family adaptation and cohesion" (FACES-3; Olson D. X., Portner J., Lavi I., adaptation by M. Perret).
2) Statistical method is a nonparametric method for comparing Mann-Whitney means.
3) Follow-up method.
In the course of the program, the dysfunctional characteristics of family upbringing were worked out, both for mothers and fathers: the level of protection, indulgence, expansion of parental feelings, preference for children's qualities and the phobia of loss of a child significantly decreased. Decreased indicators on the scale "underdeveloped parental feelings", which indicates an increase in parental competence.
The psychodiagnostic method revealed a decrease in the level of general family anxiety and the level of family anxiety in all family members, 1 month and 3 months after the psychocorrectional program. In mothers, there was a decrease in the level of general family anxiety (9.9 ± 2.6; 7.3 ± 2.2; 4.7 ± 1.6; p <0.05), the level of family anxiety (5 ± 1.3; 3.5 ± 1.1; 2.1 ± 0.8; p <0.01). The fathers showed a decrease in the level of general family anxiety (7.75 ± 2.3; 5.5 ± 1.7; 4.8 ± 1.2; p <0.05) and the level of family anxiety (3.5 ± 1, 4; 2.5 ± 1.08; 2.25 ± 0.9; p <0.001). In adolescent girls, there was a decrease in the level of general family anxiety (8.5 ± 2.1; 6.2 ± 1.9; 4.9 ± 2.1; p <0.05) and the level of family anxiety (3.8 ± 1.19; 2.8 ± 1.1; 2.5 ± 1.6; p <0.01).
An increase in family cohesion and family adaptation is also noted, which may indicate the balance of the family system and the adaptability of coping as a whole after the psychocorrectional program. The mothers have high scores on the scale of family adaptation (18.25 ± 2.06; 29.1 ± 2.8; 29.1 ± 2.5; p <0.005). The fathers show improvements in indicators on the scales of family cohesion (19.4 ± 2.8; 22.4 ± 2.9; 30.6 ± 2.6 p <0.005) family adaptation (14.25 ± 2.7; 21, 8 ± 3.6;
24.5 ± 3.8; p <0.005). In adolescent girls, indicators on the scales of family cohesion (19.5 ± 2.6; 21.5 ± 1.04; 31.7 ± 2.4; p <0.005) and family adaptation (14.8 ± 2.6;
23.6 ± 2.8; 25.6 ± 2.3; p <0.001) 3 months later, higher than a month after the program and higher than before the start of the psychocorrectional program.
The follow-up method showed that after 3 months, 58.3% of the girls noted an improvement in their physical condition and weight loss. Also, 75% of girls claim that they use the techniques that they have mastered in the process of conducting the program. In 83.3%, all family members note positive improvements, which they characterize as improving "mutual understanding".
Conclusion
Families with adolescent obese girls are dysfunctional. The targets of family psychocorrection were identified. A psychocorrectional program based on the "diamond-shaped" vector family psychotherapy of children and adolescents with psychosomatic disorders has been developed and tested. Psychodiagnostic and follow-up methods made it possible to reveal a decrease in the level of anxiety in the family, to work out dysfunctional patterns of parent-child relations and help to reduce "seizing" as a way of coping with psycho-traumatic situations. Thus, the obtained data necessitate the inclusion of family psychotherapy in the complex treatment of obesity in adolescents.
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