Document Type : Research Article


1 Department of Psychology, University of Hormozgan, Bandar Abbas, Iran

2 Department of Educational Sciences, Faculty of Humanities, University of Hormozgan, Bandar Abbas, Iran


Background: Self-criticism is one of the psychological impairments with inappropriate consequences for all members of a family, especially women. It is affected by various factors. The present study aimed to assess the mediating role of cognitive fusion and experiential avoidance in the correlation between self-criticism and external shame.
Methods: The present research utilized the structural equation modeling. The statistical population included all the married women aged 20 to 60 years in Bandar Abbas, Iran in 2022, out of whom 293 were selected via available sampling. For data collection, self-critical questionnaires (Louise, 2004), external shame questionnaire (Gross et al., 1994), cognitive fusion questionnaire (Gilanders et al., 2014), and experiential avoidance questionnaire (Bund et al., 2011) were used. The data were analyzed using correlation and path analysis methods via SPSS Version 26 and AMOS Version 24.
Results: The results indicated that external shame (P<0.001), cognitive fusion (P<0.001), and experiential avoidance (P<0.001) had a direct, significant, and positive effect on self-criticism. The results of a path analysis revealed that external shame through cognitive fusion (P<0.001) had a significant indirect effect on self-criticism. Furthermore, external shame had a significant indirect effect on self-criticism through experiential avoidance (P<0.001).
Conclusions: The results suggested that psychologists and counselors reduce the psychological impairment threatening the family system by holding educational workshops and performing individual and group therapies.


1. Mirzaei H, Aghayari T, Katebi M. A Study on Life Quality among Married Women in Family Institution. Journal of Sociology of Social Institutions. 2014;1(3):71-93.Persian. ## 2. Weiner-Davis M. Healing from infidelity. Michele Weiner-Davis Training Corp, Woodstock; 2017. ## 3. Ghanbari Baghestan A, Farahmand E, MD Nor M. The Impact of "Intimacy", "Belonging" and "Forgiveness" on Marital Satisfaction: A Case Study of Married Women in Mashhad, Iran. Cultural Studies & Communication. 2021;17(64):163-183. doi: 10.22034/JCSC.2022.546518.2520. Persian. ## 4. Sakallı Uğurlu N, Türkoğlu B, Kuzlak A, Gupta A. Stereotypes of single and married women and men in Turkish culture. Current Psychology. 2021;40(8):213-25. doi: 10.1007/s12144-018-9920-9. ## 5. Mikaeili Manee F, Shirzadeh M, Ab Khiz S. The Relationship between Marital Satisfaction and Perceived Social Support with life Satisfaction in Married Women: Investigating the Moderating Role of Occupation and Perceived Socioeconomic Status. Women's Studies Sociological and Psychological. 2022;19(4):129-169. doi: 10.22051/JWSPS.2022.37623.2499. Persian. ## 6. Gilbert P. Compassion focused therapy: Distinctive features: Routledge; 2010. ## 7. Austin J, Drossaert CHC, Sanderman R, Schroevers MJ, Bohlmeijer ET. Experiences of Self-Criticism and Self-Compassion in People Diagnosed With Cancer: A Multimethod Qualitative Study. Front Psychol. 2021;12:737725. doi: 10.3389/fpsyg.2021.737725. PubMed PMID: 34721209; PubMed Central PMCID: PMC8549076. ## 8. Gilbert P, Procter S. Compassionate mind training for people with high shame and self‐criticism: Overview and pilot study of a group therapy approach. Clinical Psychology & Psychotherapy. 2006;13(6):353-379. doi: 10.1002/cpp.507. ## 9. Evans-Lacko S, Courtin E, Fiorillo A, Knapp M, Luciano M, Park A-L, et al. The state of the art in European research on reducing social exclusion and stigma related to mental health: a systematic mapping of the literature. Eur Psychiatry. 2014;29(6):381-9. doi: 10.1016/j.eurpsy.2014.02.007. ## 10. Hayes SC. Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behav Ther. 2016;47(6):869-885. doi: 10.1016/j.beth.2016.11.006. PubMed PMID: 27993338. ## 11. Barati A, Ebrahimi ME, Firoozeh Z. Comparison of the effectiveness of gestalt coaching training and acceptance and commitment-based therapy on emotional intelligence and self-efficacy. Journal of RBS. 2021;18(4):470-480. doi: 20.1001.1.17352029.1399. ## 12. Xiong A, Lai X, Wu S, Yuan X, Tang J, Chen J, et al. Relationship Between Cognitive Fusion, Experiential Avoidance, and Obsessive–Compulsive Symptoms in Patients With Obsessive–Compulsive Disorder. Front Psychol. 2021;12:655154. doi: 10.3389/fpsyg.2021.655154. PubMed PMID: 33912117; PubMed Central PMCID: PMC8072044. ## 13. Gillanders DT, Sinclair AK, MacLean M, Jardine K. Illness cognitions, cognitive fusion, avoidance and self-compassion as predictors of distress and quality of life in a heterogeneous sample of adults, after cancer. Journal of Contextual Behavioral Science. 2015;4(4):300-311. doi: 10.1016/j.jcbs.2015.07.003. ## 14. Hayes SC, Hofmann SG. Process-based CBT: The science and core clinical competencies of cognitive behavioral therapy: New Harbinger Publications; 2018. ## 15. Hayes SC, Luoma J, Bond F, Masuda A, Lillis J. Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther. 2006;44(1):1-25. doi: 10.1016/j.brat.2005.06.006. PubMed PMID: 16300724. ## 16. Bohlmeijer ET, Fledderus M, Rokx T, Pieterse ME. Efficacy of an early intervention based on acceptance and commitment therapy for adults with depressive symptomatology: Evaluation in a randomized controlled trial. Behav Res Ther. 2011;49(1):62-7. doi: 10.1016/j.brat.2010.10.003. PubMed PMID: 21074752. ## 17. Woolf-King SE, Sheinfil AZ, Babowich JD, Siedle-Khan B, Loitsch A, Maisto SA. Acceptance and commitment therapy (ACT) for HIV-infected hazardous drinkers: a qualitative study of acceptability. Alcohol Treat Q. 2019;37(3):342-358. doi: 10.1080/07347324.2018.1539630. PubMed PMID: 31564766; PubMed Central PMCID: PMC6764523. ## 18. Afari N, Herbert M, Godfrey K, Cuneo J, Salamat J, Mostoufi S, et al. Acceptance and commitment therapy as an adjunct to the MOVE! programme: a randomized controlled trial. Obes Sci Pract. 2019;5(5):397-407. doi: 10.1002/osp4.356. PubMed PMID: 31687165; PubMed Central PMCID: PMC6819973. ## 19. Asgariyan Z, Rezaei Kheirabadi M. Predicting adolescent’s internalized shame based on social anxiety, relationship with parent, self-esteem and self-efficacy. Rooyesh. 2021;10(2):103-112. doi: 20.1001.1.2383353.1400. Persian. ## 20. Abdollahzadeh H, Kabirinasab Y. The Effectiveness of acceptance and Commitment Therapy on internalized Shame and Sexual self-esteem of Women with Breast Cancer after Mastectomy Surgery. Health Psychology. 2019;7(28):184-99. doi: 10.30473/HPJ.2019.43575.4221. Persian. ## 21. Mete P, Subasi M. The relationship between academic coping, approach achievement goals and the fear of shame and embarrassment in science class. Journal of Education in Science, Environment and Health. 2021;7(1):15-25. doi: 10.21891/jeseh.806463. ## 22. Kline RB. Structural equation modeling. New York: Guilford; 1998. doi: 1049731509336986. ## 23. Thompson R, Zuroff DC. The Levels of Self-Criticism Scale: comparative self-criticism and internalized self-criticism. Personality and Individual Differences. 2004;36(2):419-430. doi: 10.1016/S0191-8869(03)00106-5. ## 24. Yousefi Moridani M, Fallahian H, Mikaeili N. The Role of Self-criticism and Shyness in Predicting Social Appearance Anxiety of Female Students. Pajouhan Sci J. 2020;18(4):54-60. doi: 10.52547/psj.18.4.54. Persian. ## 25. Yamaguchi A, Kim M-S. Effects of self-criticism and its relationship with depression across cultures. International Journal of Psychological Studies. 2013;5(1):1-1. doi: 10.5539/ijps.v5n1p1. ## 26. Rezaei AM, Jahan F. Predicting Depression Based on the Components of Perfectionism: The Mediating Role of Self-Criticism. Clinical Psychology Studies. 2015;5(19):1-17. Persian. ## 27. Moosavi AS, Ghorbani N. Self-awareness, self-criticism, and mental health. Journal of Psychological Studies. 2006;2(3):75-91. Persian. ## 28. Saadati A, Mazboohi S, Marzi S. A confirmatory factor analysis and validation of the forms of self-criticism/reassurance scale among teachers. Quarterly of Educational Measurement. 2019;9(34):133-147. doi: 10.22054/JEM.2019.20805.1520. Persian. ## 29. Goss K, Gilbert P, Allan S. An exploration of shame measures—I: The other as Shamer scale. Personality and Individual differences. 1994;17(5):713-717. doi: 10.1016/0191-8869(94)90149-X. ## 30. Pinto‐Gouveia J, Matos M, Castilho P, Xavier A. Differences between depression and paranoia: The role of emotional memories, shame and subordination. Clin Psychol Psychother. 2014;21(1):49-61. doi: 10.1002/cpp.1818. PubMed PMID: 22996754. ## 31. Troop NA, Allan S, Serpell L, Treasure JL. Shame in women with a history of eating disorders. Eur Eat Disord Rev. 2008;16(6):480-8. doi: 10.1002/erv.858. PubMed PMID: 18240123. ## 32. Foroughi A, Khanjani S, Kazemini M, Tayeri F. Factor structure and psychometric properties of Iranian version of External Shame Scale. Shenakht Journal of Psychology and Psychiatry. 2015;2(2):50-57. Persian. ## 33. Donati MA, Berrocal C, Bernini O, Gori C, Primi C. Measuring cognitive fusion through the Cognitive Fusion Questionnaire-7: Measurement invariance across non-clinical and clinical psychological samples. PloS One. 2021;16(2):e0246434. doi: 10.1371/journal.pone.0246434. ## 34. Gillanders DT, Bolderston H, Bond FW, Dempster M, Flaxman PE, Campbell L, et al. The development and initial validation of the cognitive fusion questionnaire. Behav Ther. 2014;45(1):83-101. doi: 10.1016/j.beth.2013.09.001. PubMed PMID: 24411117. ## 35. Ruiz FJ, Suárez-Falcón JC, Riano-Hernández D, Gillanders D. Psychometric properties of the cognitive fusion questionnaire in colombia. Revista Latinoamericana de Psicología. 2017;49(1):80-7. doi: 10.1016/j.rlp.2016.09.006. ## 36. Trindade IA, Ferreira C, Pinto-Gouveia J. Assessment of chronic illness-related cognitive fusion: Preliminary development and validation of a new scale with an IBD sample. J Clin Psychol Med Settings. 2018;25(4):356-366. doi: 10.1007/s10880-017-9536-5. PubMed PMID: 29460106. ## 37. Fooladvand K. The Role of Cognitive Fusion and Mindfulness Components in Prediction of Student’s Depression. Journal of Psychological Studies. 2020;16(3):89-104. doi: 10.22051/PSY.2020.30114.2153. ## 38. Soltani E, Izadi S, Sharifi P, Poursadeghfard M. Psychometric Properties of the Persian Version of Cognitive Fusion Questionnaire-Chronic Illness in Multiple Sclerosis. Iran J Psychiatry Behav Sci. 2022;16(1):e113524. doi: 10.5812/ijpbs.113524. ## 39. Akbari M, Mohamadkhani S, Zarghami F. The Mediating Role of Cognitive Fusion in Explaining the Relationship between Emotional Dysregulation with Anxiety and Depression: A Transdiagnostic Factor. Iranian Journal of Psychiatry and Clinical Psychology. 2016;22(1):17-29. Persian. ## 40. Tyndall I, Waldeck D, Pancani L, Whelan R, Roche B, Dawson DL. The Acceptance and Action Questionnaire-II (AAQ-II) as a measure of experiential avoidance: Concerns over discriminant validity. Journal of Contextual Behavioral Science. 2019;12:278-284. doi: 10.1016/j.jcbs.2018.09.005. ## 41. Pennato T, Berrocal C, Bernini O, Moya TR. Italian version of the acceptance and action questionnaire-II (AAQ-II): Dimensionality, reliability, convergent and criterion validity. Journal of Psychopathology and Behavioral Assessment. 2013;35(4):552-63. doi: 10.1007/s10862-013-9355-4. ## 42. Yarollahi NA, Shairi MR. Investigation the role of experiential avoidance on anticipation general health in non-clinical samples. Shenakht Journal of Psychology and Psychiatry. 2018;5(3):1-11. doi: 10.29252/shenakht.5.3.1. Persian. ## 43. Guerrini Usubini A, Cattivelli R, Giusti EM, Riboni FV, Varallo G, Pietrabissa G, et al. The ACTyourCHANGE study protocol: promoting a healthy lifestyle in patients with obesity with Acceptance and Commitment Therapy—a randomized controlled trial. Trials. 2021;22(1):290. doi: 10.1186/s13063-021-05191-y. PubMed PMID: 33879183; PubMed Central PMCID: PMC8056547. ## 44. Reshadat S, Morovati F, Zakiei A, Rajabi Gilan N. Predicting Social Anxiety based on Mindfulness, Experiential Avoidance, and Metacognitive Beliefs in Adolescents. J Mazandaran Univ Med Sci. 2019;29(176):92-104. Persian. ## 45. Dinis A, Carvalho S, Gouveia JP, Estanqueiro C. Shame memories and depression symptoms: The role of cognitive fusion and experiential avoidance. International Journal of Psychology and Psychological Therapy. 2015;15(1):63-86. ##