نقش میانجی ارزش های مذهبی و همجوشی شناختی در ارتباط بین طرحواره نقص/شرم و خودانتقادی در معلولین جسمی حرکتی

Extended Abstract
 
Introduction and Objectives: Physical-motor disability, as a major challenge to health and a factor in social isolation, not only creates functional limitations but is also accompanied by extensive psychological consequences such as feelings of shame, social rejection, and negative self-evaluations. These conditions can lead to the formation and exacerbation of maladaptive cognitive schemas, such as the defect/shame schema. According to Young’s theory (1999), the defect/shame schema is a stable cognitive-emotional pattern in which the individual perceives themselves as inherently defective, worthless, and shameful. This schema plays a fundamental role in the emergence and persistence of self-criticism (i.e., an internal, blaming, and hostile process towards oneself). Self-criticism, itself as a risk factor, can lead to cognitive fusion; a state in which the individual accepts their negative thoughts as accurate representations of reality and is unable to achieve cognitive distance from them. On the other hand, religious values, as a potential spiritual and supportive resource, can play a moderating or protective role in this vicious cycle. However, the intensity of self-criticism may lead to the weakening of these values. Previous research has separately addressed the relationships between these variables, but a lack of a comprehensive model examining the chain interaction of these constructs in the vulnerable population of individuals with physical-motor disabilities was felt. Therefore, the main objective of the present study was to investigate the chain-mediating role of cognitive fusion and religious values in the relationship between the defect/shame schema and self-criticism in individuals with physical-motor disabilities.
Method: This research was of an applied type with a descriptive-correlational design and was conducted using structural equation modeling (SEM). The statistical population of the study consisted of all individuals with physical-motor disabilities covered by the Welfare Organization of Mashhad city in the year 1402 (2023). Using convenience sampling, out of 350 invited individuals, finally 330 people who met the inclusion criteria (such as having a confirmed disability certificate, minimum elementary education, and informed consent) and had completed the questionnaire in full, were entered into the analysis. The average age of the participants was 32.09 years, with 67% male and 33% female. Data collection tools included: the Young Schema Questionnaire (YSQ) to measure the defect/shame schema, the Levels of Self-Criticism Scale (LOSC) to measure self-criticism, the Cognitive Fusion Questionnaire (CFQ) to measure cognitive fusion, and the Religious Values Scale (RVS) to measure religious values. The validity and reliability of each of these tools had been confirmed in domestic and international studies. After collecting data online and in compliance with ethical principles, the data were analyzed using SPSS and AMOS software version 23. First, descriptive statistics and the Pearson correlation matrix were calculated. Then, using structural equation modeling, the direct and indirect relationships between the variables were fitted, and the mediating role of the variables was tested using the Bootstrap method (with 5000 resamples). The fit of the final model was also evaluated using GFI, CFI, NFI, IFI, AGFI, and RMSEA indices.
Results: Correlation findings indicated that all research variables had a significant relationship with each other. Specifically, the defect/shame schema had a positive correlation with self-criticism (r = .62, p < .01) and cognitive fusion (r = .63, p < .01), and a negative correlation with religious values (r = -.52, p < .01). The results of the structural equation model indicated a favorable fit of the final model with the data (X²/df = 1.83, GFI = .97, CFI = .99, RMSEA = .05). Examination of direct paths showed that the defect/shame schema had a significant positive direct effect on self-criticism (β = .66, p = .001) and cognitive fusion (β = .25, p = .001). Self-criticism had a significant positive direct effect on cognitive fusion (β = .34, p = .001) and a significant negative direct effect on religious values (β = -.69, p = .001). Religious values also had a significant negative direct effect on cognitive fusion (β = -.30, p = .001). Examination of the mediating role using the Bootstrap method showed that self-criticism significantly mediated the relationship between the defect/shame schema and cognitive fusion (indirect effect: β = .36, p = .001). Religious values significantly mediated the relationship between self-criticism and cognitive fusion (indirect effect: β = .21, p = .001). These findings indicate a chain model: the defect/shame schema increases cognitive fusion by increasing self-criticism. On the other hand, high self-criticism indirectly leads to increased cognitive fusion by weakening religious values.
Discussion and Conclusion: The findings of this study confirm a complex conceptual model of the interaction of cognitive, emotional, and spiritual constructs in individuals with physical-motor disabilities. According to schema therapy theory, the defect/shame schema, as a central core, prepares the ground for the formation of intense self-critical patterns by creating persistent feelings of shame and worthlessness. Self-criticism is not only an outcome but also a reinforcing factor that intensifies the maladaptive cognitive-emotional cycle by reducing the individual’s ability to distance themselves from negative thoughts (increasing cognitive fusion). The strength and distinction of this research was the inclusion of religious values in this model. The findings showed that strong religious values can, as a spiritual resource, reduce the negative effects of self-criticism on cognitive fusion. However, severe self-criticism can itself lead to the weakening of this protective resource. This bidirectional relationship shows the importance of integrated interventions. The findings of this study emphasize the necessity of using integrated therapeutic approaches such as schema therapy (for targeting early maladaptive schemas), acceptance and commitment therapy (for reducing cognitive fusion and increasing psychological flexibility), and strengthening spirituality and religious values (as a resource for creating meaning, self-acceptance, and support) in working with individuals with disabilities. Limitations such as the cross-sectional nature of the design, the use of convenience sampling, and the online completion of questionnaires should be considered when generalizing the results. It is suggested that future studies investigate the role of other moderating variables such as social support and resilience in this model using longitudinal design and random sampling.
Acknowledgements: This article is derived from the master’s thesis of the first author. We sincerely thank all the esteemed participants in the research who assisted us in data collection by devoting their time and care. We also appreciate the cooperation of the Mashhad Welfare Organization.
Conflict of Interest: The authors declare that there is no conflict of interest (financial, scientific, or personal) in the conduct and publication of this research.