رابطه بین کارکرد خانواده و تحمل پریشانی مراجعان غیربستری: نقش واسطه‌ای انعطاف‌پذیری روان‌شناختی و خودشفقت‌ورزی

Introdaction: Distress tolerance is a central construct in clinical psychology, referring to individuals’ perceived capacity to endure negative emotions and stressful internal or external experiences. Low distress tolerance has been linked to various forms of psychopathology and maladaptive behaviors, including depression, anxiety, obsessive-compulsive symptoms, and substance use. Family functioning, as a fundamental system shaping psychological development and emotional adjustment, plays a crucial role in fostering or impairing distress tolerance. Families characterized by effective communication, emotional cohesion, and appropriate behavioral regulation tend to cultivate greater distress tolerance among their members. Two key psychological factors- psychological flexibility and self-compassion- are proposed to mediate this relationship. Psychological flexibility denotes the ability to adapt to difficult circumstances while engaging in value-consistent behavior, whereas self-compassion involves being kind to oneself, recognizing shared humanity, and maintaining mindful awareness during suffering. Previous studies have identified positive associations among family functioning, psychological flexibility, self-compassion, and distress tolerance. However, few studies have simultaneously examined the mediating roles of psychological flexibility and self-compassion in the association between family functioning and distress tolerance, particularly among non-clinical outpatient populations. The present study seeks to address this gap and provide a more comprehensive understanding of these underlying psychological mechanisms.

Methodology: This study employed a quantitative, fundamental, cross-sectional, and correlational design to investigate psychological variables among clients of Aramesh Mandegar Counseling Centers in Mashhad during the first half of 2024. The statistical population included all individuals who sought psychological or counseling services at these centers, and a total of 318 participants were selected using convenience sampling. Although 320 questionnaires were distributed, two were excluded due to incomplete responses, resulting in a final sample of 318 participants. Inclusion criteria comprised an age range of 20–50 years, literacy in reading and writing, absence of chronic physical illnesses, and voluntary consent to participate in the research. Exclusion criteria included incomplete questionnaire responses and withdrawal of consent. All ethical standards were strictly observed, including confidentiality, respect for participants’ privacy, avoidance of harm, and obtaining written informed consent. The study received ethical approval from the Biomedical Research Ethics Committee of Islamic Azad University, Neyshabur Branch (Code: IR.IAU.NEYSHABUR.REC.1403.017). Research instruments included the short form of the Family Assessment Device (Turliuc et al., 2016), the Psychological Flexibility Questionnaire (Ben-Itzhak et al., 2014), the Self-Compassion Scale (Neff, 2003), and the Distress Tolerance Scale (Simons & Gaher, 2005). Data analysis was performed using Structural Equation Modeling (SEM) with SPSS version 26 and AMOS version 24 to test the hypothesized relationships among the study variables.

Findings: After excluding two incomplete responses, data analysis was conducted on 318 participants, including 100 men (31.4%) and 218 women (68.6%). Among them, 42.5% were single, 49.1% married, 5.7% divorced, and 2.5% separated. Regarding education, 23.6% held a high school diploma, 13.5% an associate degree, 47.2% a bachelor’s, 14.8% a master’s, and 0.9% a PhD. Additionally, 36.5% were referred by others, while 63.5% were self-referred. Seventeen-point-nine percent had a history of suicide attempts, whereas 82.1% did not. All study variables were measured on interval scales. Correlational analyses indicated that family functioning had a significant negative relationship with self-warmth and psychological flexibility (p < .05), but a positive relationship with self-coldness and distress tolerance (p < .05). Self-warmth and psychological flexibility were negatively correlated with distress tolerance, while self-coldness was positively correlated (p < .05). Structural equation modeling results showed that family functioning had significant direct effects on psychological flexibility (β = –0.16, p < .05), self-coldness (β = 0.30, p < .05), and distress tolerance (β = 0.16, p < .05). Indirect effects were observed through psychological flexibility (β = 0.036) and self-coldness (β = 0.265), with a total effect of β = 0.35. Model fit indices (CFI = .93, TLI = .92, IFI = .93, GFI = .91, RMSEA = .067) indicated an acceptable overall model fit.

Conclusion: The present study aimed to examine the mediating role of psychological flexibility and self-compassion in the relationship between family functioning and distress tolerance among outpatient clients. Findings indicated that family functioning influences distress tolerance both directly and indirectly through psychological flexibility and self-coldness. Optimal family functioning was associated with higher distress tolerance, whereas dysfunctional family patterns corresponded to lower tolerance. Families with poor functioning often lack problem-solving abilities, clear behavioral patterns, effective communication, and emotional support, which reduces members’ capacity to cope with distress. Dysfunctional family environments also undermine psychological flexibility, limiting individuals’ capacity to adapt behaviors to situational demands, regulate emotions, and employ coping strategies, thereby decreasing distress tolerance. Similarly, self-compassion, particularly high self-coldness, mediates the impact of family functioning on distress tolerance. Self-coldness, originates in early family relationships and is shaped by family support, cohesion, and secure attachment. Dysfunctional families increase self-judgment, isolation, and over-identification, reducing individuals’ ability to use self-compassion when facing stress and emotional distress. Interventions that improve family functioning, enhance psychological flexibility, and self-compassion may strengthen individuals’ ability to manage and tolerate distress more effectively.