ObjectiveThe aim of this research was to examine the effectiveness of the acceptance and commitment therapy (ACT) for body image flexibility and body awareness in these patients.MethodsA randomized clinical trial was conducted at Kashan University of Medical Sciences clinics in Kashan, Iran, from December 1, 2017 to March 30, 2018. A sample of 75 patients with psychosomatic disorders was selected by convenience sampling. The selected patients were randomly divided into three 25-member groups. The experimental group received medicinal treatment combined with the (ACT). The active control group received the usual treatment plus psycho education in general psychology, and the treatment group solely received the medicinal treatment usually used in the treatment centers. The results were obtained using the following scales in the pretest and posttest phases and the two-month follow-up: the demographic questionnaire; Shields’ body awareness questionnaire; and Sandoz’s body image flexibility questionnaire. The data were analyzed using the descriptive statistics tests (mean and standard deviation) and the repeated measures analysis of variance and chi-square tests in IBM-SPSS version 21.ResultsThere was no significant difference among the three groups in terms of body image flexibility, body awareness, somatic symptoms, and demographic variables. The results of the posttest and follow-up examinations suggested that the ACT group more effectively and significantly improved body image flexibility and body awareness as compared to both of the control groups (p=0.02).ConclusionsThe ACT successfully improves body image flexibility and body awareness in patients with psychosomatic disorders.Clinical trial registrationThis research was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT ID: IRCT2017092532057N2.FundingResearch and Technology Department of Kashan University of Medical Sciences funded the study (Ref: 96053).

Background: The Body Image Acceptance and Action Questionnaire (BI-AAQ) assesses cognitive flexibility and acceptance of body image. Objectives: This study was done to assess the validity and reliability of the Persian version of BI-AAQ, as an instrument to measure body image flexibility, in patients with somatic symptom and related disorders. Methods: This descriptive psychometric study was done in 2017 on 357 patients with somatic symptom and related disorders selected through a convenient sampling method from Kashan University of Medical Sciences clinics. They responded to the BI-AAQ, Depression, Anxiety, and Stress Scale (DASS), Acceptance and Action Questionnaire-II (AAQ-II), and Freiburg Mindfulness Inventory (FMI). The reliability of the BI-AAQ was calculated using Cronbach’s alpha coefficient. To assess its validity, the exploratory and confirmatory factor analyses were used. The gathered data were analyzed via SPSS-22 and Amos-22 software. Results: This version retained a one-factor structure, similar to the original version of the questionnaire, which explained 42.55% of the variance. It had high internal consistency (0.84), split-half method (0.77), and correlates with AAQ (0.45), mindfulness (0.39) and correlates contrastingly with stress (0.11), anxiety (0.36) and depression (0.43). Conclusions: According to the results of the current research, the BI-AAQ is a reliable instrument with valid psychometric properties to measure the body image acceptance of individuals in Iranian patients with somatic symptom and related disorders.

The current research investigated the effectiveness of Acceptance and Commitment Therapy (ACT) on psychosomatic symptoms and mindfulness in patients with psychosomatic disorders.